Understanding Trauma Triggers: You Are Not What Happened to You.
Introduction
In this blog I’ll discuss the difference between trauma triggers in PTSD and CPTSD. More often than not, the people I work with have heard of PTSD (Post-Traumatic Stress Disorder), but many have not heard of CPTSD (Complex Post-Traumatic Stress Disorder). The former is an official diagnosis that is recognized across health fields and insurance companies. CPTSD is not yet an official diagnosis, but our understanding is growing. For many clients, learning about the differences between these two related, but different, experiences can be deeply healing and can help them understand, accept, and manage their reactions to stressful situations.
Trauma and the Brain
Understanding trauma and learning skills for managing the body’s responses to trauma is exciting to me because of the difference in can make in my client’s lives and the lives of their families. My doctoral dissertation is about understanding the cultural competence of counselors who work with veteran populations which including researching PTSD resulting from the operations in Iraq and Afghanistan. Many people think of trauma as a rare occurrence, but it isn’t. It’s an integral part of the human experience and is partly a result of our big brains trying to make sense of experiences that probably don’t make much sense.
Humans have understood trauma can change people and have lasting effects for millennia, especially for the survivors of armed conflicts. Since the 1970s, our understanding has deepened because Vietnam veterans and sexual assault survivors started to bravely share their stories. At the same time, the past 30 years of research into how trauma can affect brain and nervous system development has changed the way we understand the lasting effects of trauma on mental, emotional, and physical health, especially in kids. This research has had far reaching effect on education, parenting, and in medicine. When kids go through unstable and abusive situations or have unreliable caregivers, it changes their nervous systems and their brains and can lead to life-long vulnerabilities and risks (more about this in a future blog on Adverse Childhood Events, ACEs). The good news is that, with learning to observe your responses and calming skills, people can recover and reduce the long-term effects. It’s a process I see every day and is humbling to witness.
Understanding Trauma Triggers
Trauma triggers can be tricky little buggers to identify. Triggers can be sights, sounds, smells, sensations, tastes, even thoughts and emotions. In the middle part of our brains, behind our ears, are the amygdala. These two small structures are like a combination watch tower and database that are always on the lookout for danger. If the amygdala sees patterns that you have seen before, they send an alert that can trigger the emergency responses of fight, flight, freeze, faint, or feign/fawn (saying or doing whatever is possible to appease the threat) reactions. For instance, a person may have seen a cell phone flying through the air when they were in a car accident. The phone didn’t cause the accident or hurt anyone in the accident. It was just in the wrong place at the wrong time. Immediately after the accident someone tossing their phone to a friend or onto the bed at the end of the day might trigger memories or a trauma response from the accident. But, here’s why trauma triggers are tricky. They generalize over time. That means that at first the phone needs to be flying through the air to be a trigger, but over time, it generalizes to just be the sight of a phone, or even a ringtone, that can trigger distressing memories, emotions, thoughts, or sensations. (Don’t despair, healing is possible!). Triggers play a role in both PTSD and CPTSD, but how people experience triggers can differ between these two conditions.
PTSD: Reliving the Past
People with PTSD usually experience one, or sometimes several, events that are a threat to their lives, their bodily integrity, or their sanity; events like a natural disaster, car crash, or assault. Typically, they can remember a time before these events and want to get back to who they were before their life went sideways. Individuals with PTSD often experience intense and intrusive memories of the traumatic event, as well as flashbacks, nightmares, and vivid sensory recollections. For those with PTSD, trauma triggers can activate these distressing experiences, causing a range of physical, emotional, and belief/cognitive responses.
Trauma triggers in PTSD often resemble or directly relate to the original traumatic event. For example, a combat veteran may be triggered by loud noises or crowded places that remind them of the battlefield. The triggers can overwhelm the person, leading to hypervigilance, heightened anxiety, and a desire to avoid situations that might cause similar responses.
Childhood CPTSD: Complex Layers of Triggers
People with CPTSD experienced repeated and prolonged traumatic experiences during childhood and adolescence such as neglect, abuse, or witnessing domestic violence. The events they experienced may have been repeated across different developmental stages and may have started before they had any verbal or conscious memories. Unlike PTSD, here is no ‘before’ in CPTSD. Family dysfunction, or a relationship with their abuser, is often the person’s normal experience. Additionally, unlike PTSD, CPTSD is characterized by a broader range of symptoms that include emotional, relationship difficulties, and sometimes even difficulty knowing who they are. In CPTSD, people may have emotional, scent, or even touch memories and non-visual flashbacks, but not always be able to connect those specific memories of the experiences that caused them. They can have strong emotions triggered, seemingly mysteriously, by sounds, sensations, emotions, locations, or stressful situations in relationships. Often my clients have memories of specific instances of abuse or neglect, but non-specific trauma triggers that cause feelings of abandonment, betrayal, or powerlessness can be really confusing. They can feel checked out, dissociated, or hijacked by familiar feelings of “it’s happening again,” even though they aren’t sure what “it’ is. The people I work with often struggle with feeling safe, emotional regulation, self-esteem, trust, and forming secure relationships.
How Counseling Can Help
These challenges can make parenting hard, especially when you are working to break generational and family patterns. Until my clients enter therapy, they may not even know what has been happening. But, they do know they don’t want to be emotionally reactive, anxious, or angry anymore. The moms I work with want to make sure that they parent by example and that their kids grow up in a safe, loving, and calm environment; an environment where their kids learn the values of respect for everyone, open mindedness to new ideas, and how to take care of our planet. The good news is that you can learn tools and skills to help reduce these reactions, calm your nervous system, re-wire your neural network, and have a healthier, happier, life for yourself and your kids. Working with a counselor that provides a safe and empathetic environment, you can learn to identify when you are feeling triggered and simple effective techniques to help manage triggers. No counselor can promise complete recovery, but I’ve seen many people get better and feel more in control of their emotions and their lives.