Brain Health: Psychological triggers: Why they happen and what to do about them 

by Karen D. Sullivan, PhD, ABPP

Any stimulus such as a smell, sound, or image that consciously or unconsciously reminds you of a traumatic event from your past can “trigger” feelings of severe anxiety and protective behaviors like anger and emotional numbness. The stimulus itself doesn’t need to be inherently menacing or disturbing and may only indirectly remind you of an earlier traumatic event. Triggers can be subtle and difficult to anticipate. You may not even realize you’ve been triggered. For some of us, the way the light hits the wall during certain times of year, a melody, or even a particular sensation on the skin can kick off the body’s stress response. Smells tend to be the most intense triggers as the molecules go directly to the limbic system (i.e. the emotional brain), and, unlike all of the other senses, are not first processed by the cortex where they can be muted by rational thought.

According to the American Psychological Association, triggers are typically more distressing when they come as a surprise. This is commonly seen in car accidents with those getting hit from behind, with no warning. These people will usually experience more psychological distress. If we can anticipate a stressor, our brains can prepare and we can tell ourselves a rational story about what is happening and why.

When we experience a trigger, our hypothalamic-pituitary-adrenal axis (HPA axis) kicks off a complex process of self-protection that readies us for three possible actions: fight, flight or freeze. Our adrenaline spikes and stress hormones like cortisol course throughout our bodies and brain. Once these stress hormones are released, anxiety soars and we often lose touch with our healthy coping skills and succumb to reactions like lashing out or running away.

What to do when triggered?

1) Learn your stress signature. The first step is to recognize that you are being triggered as soon as the signs start in your body. Each one of us has a unique “stress signature” in which one of three things jolts us into the fight, flight or freeze response: increased heart rate, sweating or muscle tension. Pay close attention the next time you feel triggered and see which of these is most prominent for you. Biofeedback can be very helpful if you can’t figure it out on your own.

2) Calm the body. Once you understand your personal stress response, you can nip the cascade of anxiety in the bud by doing the opposite action. Deep breathing exercises can calm a racing heart, holding onto ice can literally chill you out, and progressive muscle relaxation will not allow bodily tension to build up. Calming the body is an essential grounding step. Anxiety causes a frenzied and disorganized mindset, making it very difficult to use healthy coping skills. We interpret reality according to our mood, so when we are anxious, our perception of threat is higher and we cannot objectively problem-solve. We are literally not thinking straight.

3) Label your emotions without judgment. Once your body and thoughts are calm, get clear on what exactly triggered you and what emotions you felt before, during and after the event. For most of us, it is usually a reaction related to the themes of safety and security and tied to another time in our lives when we felt similarly threatened and powerless.

4) Do not give in to avoidance. Trying to not think about our traumatic life events is very common but actually sets the stage for being triggered. A big part of us would love to put our head in the sand and pretend like that terrible thing never happened. Remember, what you resist, persists. The more we push something down, the more force it has when it inevitably pops back up. Long-term avoidance increases the likelihood we will develop a disabling level of posttraumatic stress disorder (PTSD), a treatable condition in which people experience overwhelming emotional or physical symptoms when triggered and get stuck in a cycle of hypervigilance where they are always being on the lookout for what can go wrong. After you label the emotions you had in response to the trigger, process and feel the feelings with a trusted person in a safe and supportive environment; a mental health professional specializing in trauma is ideal.

5) Correct your thinking about the trauma. The long-term psychological impact of trauma lies in how it shapes our beliefs about other people, the world and our self. Our brain has a strong need to understand threat and often provides us with emotional “short-cut” explanations that allow us to push the pain way down and out of awareness. Common explanations include, “No one can be trusted” or “I make bad decisions.” A consequence of these trauma-related beliefs is that we become untrusting of others or ourselves. We can start to suspect that everyone has an agenda with thoughts like, “If the person I used to trust could hurt me so badly, why not this person?” We often blame ourselves when bad things happen, ruminating about all the ways we “could or should have” done things differently to change an outcome we really had no or little control over. When we hold on to these beliefs without processing the emotions underneath, our nervous system can get stuck on high alert and lead to an inability to relax, social isolation, fitful sleep and strained relationships.

Learning to calm yourself and exploring your trauma-related beliefs, processing them with a trusted person, and balancing these thoughts against other possible explanations will help and the next time you experience a trigger the anxiety you feel will not be as overwhelming.

Dr. Karen Sullivan, a board-certified clinical neuropsychologist, owner of Pinehurst Neuropsychology Brain & Memory Clinic and creator of the I CARE FOR YOUR BRAIN program, can be reached at 910-420-8041 or by visiting www.pinehurstneuropsychology.com or www.icfyb.com.