hi everyone Emma McAdam here I'm a licensed Marriage and Family Therapist
and in this video I'm going to teach you what a trigger is how they get formed
the one thing you do that makes them worse and the basic principle behind how
to overcome them
real quick just want to remind you I've got some courses on
udemy.com check out the link in the description for a coupon code they'll
teach you things about basic mental health coping skills and self-care how
to change your brain chemistry some alternatives to medication so check
those courses out hopefully I'm gonna have a PTSD and a rewiring your anxious
brain course up soon they are not completed yet but they're in progress
and I'm hoping to have them done by the end of this year okay so let's jump into
triggers so a few months ago I took my daughters to free day at the Museum and
we rode the elevator up to the fifth floor and of course the emergency call
button is right at the eye level of my two-year-old daughter so she pushes it
and I'm trying to explain to security that we're fine and we don't have an
emergency and the door is open and I'm struggling to get my stroller and the
two-year-old out the door of the elevator and my four-year-old was
distracted with this conversation with the like emergency personnel on the
other end of the phone and the door is shut like super fast with her in the
elevator and so suddenly my four-year-old is going down to one of
the four floors below and I'm stuck like hitting the call button on the elevator
as fast as I can and now we actually like needed the security people to help
us and my daughter was I don't know I don't know what happened so then I ride
the elevator down and then she rides the elevator back up with the security
person and I'm like talking to the security desk people in anyway long
story short we were reunited pretty quickly but after that my four-year-old
was understandably anxious around elevators she came to the belief that
elevators are dangerous and she didn't want to ride them but elevators aren't
actually dangerous being separated from your mom in a museum with 5,000 other
people may be dangerous but it's not the elevator but basically
her brain had made this connection like elevator equals danger like lookout and
this is called a paired association or a trigger so a trigger is the common term
for a psychological principle called paired association so this simply means
anything that reminds someone of previous trauma or danger to be
triggered is to have an intense emotional or physical reaction like a
panic attack after encountering a stimulus triggers have gotten a lot of
attention recently with the word being overused to mean like someone who takes
offense or even like using it as an excuse so someone might say oh I was so
triggered by your actions so I had to leave or I yelled or I had to get high
but today we're not going to be talking about that kind of trigger we're gonna
be talking about triggers as they relate to anxiety and PTSD as far as triggers
go there's an interesting new trend trigger warnings so this is like you
might see it on social media or I've even heard of universities doing this
where someone's basically like hey guys I'm gonna be talking about some intense
topic so look out like you might want to leave but these warnings may be actually
making things worse because most people have no idea what to do with real
triggers other than avoid them so to understand triggers let's talk about
Pavlov's dogs for a minute in a famous experiment a scientist named Yvan Pavlov
was studying digestion and wanted to see what triggered the production of saliva
you know what makes your mouth water when you think about food so he hooked
some dogs up to a device that measured their saliva output and when they
brought the dog food they observed the the presence of food made the dog drool
now he was curious about this physical reaction so it makes sense that we make
saliva when we eat it helps us digest but what triggers that physical response
so he took a neutral object a bell and he rang it and the bell did not cause
the dog to salivate then he started to ring the bell when he brought the food
to the dog and every time he rang the bell he'd then
bring food pretty soon he noticed that before the food was even brought out the
dogs started salivating he then started to just ring the bell but no food was
involved and the dog started to drool without any food being there the bell
had become a trigger it triggered the dog's physiological
reflex to salivate with no real food involved he had paired a neutral object
of bell to a physiological response drooling so this is called pairing a
neutral object a safe object gets linked to a subconscious physiological reaction
triggers could be something like associating a loved one with the smell
their perfume or a happy memory with a type of food and these trigger a
pleasing and calming reaction but most often when we talk about triggers we're
talking about the context of anxiety or anger so a soldier who has seen a
backpack used as an IED a bomb he might feel anxious when he's back home and he
sees a backpack sitting on the sidewalk or someone who was in an abusive
relationship with someone who smokes might get stomachaches when they smell
cigarette smoke even when it has nothing to do with their abusive partner
so that stimulus the backpack or the smoke is paired with that physical
reaction the anxiety or the stomachache so these these objects or these
experiences are triggering a physiological response that's not really
in our control now the big picture is our brain is supposed to be making the
links between things that are actually dangerous and the anxiety and avoidance
response we are supposed to have a fear and avoidance reaction to rattlesnakes
or we're supposed to have a physical aversion to food that made us throw up
so like if you ever like one time I ate chili and it made me throw up and for a
long time I couldn't eat chili anymore because it made me sick to my stomach
just to think about it like I wasn't appetized by chili and that's a paired
association they're supposed to protect us from danger like food poisoning but
sometimes the brains natural response gets hijacked by trauma and associates
something that is safe with that danger response so a trigger is not
inherently dangerous it's neutral it just is coupled with the feeling of
danger in your head so I've had clients whose fear reaction
was triggered by grasshoppers radiators rumble strips and loud chewing noises
each of these stimuluses these objects or these experiences these are neutral
they aren't inherently dangerous but they were paired to that anxiety
reaction in my daughter's case she developed a fear reaction to elevators
so her natural reaction was to avoid elevators before we went on an outing
she would ask are there elevators there if there are I don't want to go so she
had this trigger response now in order to best understand triggers we need to
talk about perceived danger so as I talked about in my other video on the
anxiety cycle when we avoid perceived danger that feeling of fear only grows
so now let's review perceived danger versus actual danger for a second a bomb
is actually dangerous a backpack is not an abusive spouse is actually dangerous
cigarette smoke is not okay I know cigarette smoke causes like cancer but
that's that's not what the fear is about that's not what that paired association
was about cigarette smoke is not going to beat you up and that's what that
anxiety response is associated with so the anxiety response in reaction to the
cigarette smoke had nothing to do with cancer it had to do with that paired
association of being beat up by a cigarette smoking spouse so when we talk
about triggers that we're trying to overcome it's almost always a fear
response to something safe but our typical response to triggers is
avoidance and if it's a bomb that you're avoiding that's actually a really
appropriate reaction right if you see a bomb in the street you shouldn't run the
other direction but if it's a backpack in the street and we avoid going out in
the street because there might be backpacks there this typical response
this avoidance actually makes things worse the next time it's going to make
your anxiety worse next time so when you avoid
something that feels dangerous your brain basically says phew the only
reason I survived was because I avoided that backpack and your brain is like I
better make my human more anxious so they do that again
pretty soon anxiety itself becomes a trigger so people get anxious about
being anxious they're like oh my gosh if I go out in the street there might be a
backpack I might get anxious so I'm worried about
going out in the street and then they avoid leaving the house so pretty
soon anxiety itself becomes a trigger right people get trapped in these cycles
of avoidance and they miss out on life so a soldier won't leave the house because
he's afraid of getting anxious if he sees a backpack and suddenly in addition
to having PTSD he now has depression too because his
life sucks these symptoms like anxiety and panic attacks they feel
uncomfortable but they're not actually dangerous when we try to avoid them it's
easy to see how our anxiety spirals out of control because we're creating
anxiety about anxiety so one of the most common triggers that bother people is
thinking about or hearing about people talk about distressing events so if
someone had experienced a sexual assault and then had to attend a college class
where that was the subject she might feel a strong physiological reaction feeling
anxious sweaty or frozen during that class she's having a danger reaction
when she's actually safe sitting in a chair in a college class this is one of
the essential characteristics of PTSD which is feeling in danger when you are
actually safe now just to be clear the moment of sexual assault was actually
dangerous but remembering that assault while sitting in class feels dangerous
and it triggers that physiological danger reaction that heart rate and the sweaty
hands and everything but it's actually safe so understanding that difference
between perceived danger and actual danger is one of the keys to learning
how to overcome triggers so are we stuck that way are you doomed to feel anxious
about triggers for the rest of your life is my daughter doomed to take the stairs
for the rest of her life no your brain is made to adapt to change and to grow
and to rewire itself over and over this is called neuroplasticity triggers can be
reassociated so let's go back to Pavlov's dogs for a minute when he would
ring the bell the dogs would salivate even when there
was no food they had this really strong paired response but when Pavlov kept
ringing the bell for a couple of days but he didn't bring food out pretty soon
the dog stopped salivating for the bell the bell became neutral again and that
physiological response went away so this experiment demonstrates something that
later psychological research has affirmed that when we face our triggers
in a safe place when we're exposed to them and nothing bad happens our brain
unpairs that physiological response so just like the dogs no longer salivated
when the bell was rung the soldier who had anxiety reactions to backpacks when
he first got home from Afghanistan if he's frequently around backpacks and he
keeps facing that fear eventually his brain relearns that backpacks are safe
and he no longer has that anxiety reaction so if it's that easy why does
it seem so hard it's because we humans are so good at avoidance avoidance of a
fear makes the fear stronger so going back to the anxiety cycle every time we
avoid a trigger and survive our brain is like phew let's do that again
so it takes our anxiety up the next time there are so many ways to avoid like
obviously there's the physical way like not going to class or not leaving the
house but there's also things like substances or emotional avoidance trying
not to care trying not to think about it endless distraction and even coping
skills blame and anger can all be types of avoidance so pause this video for a
moment and consider what are your go-to ways to avoid feeling anxious write it
down or leave it in the comments below if you want and if you want to rewire
your brain to overcome triggers then you need to let go of avoidance when we
understand that avoidance reinforces anxiety and PTSD symptoms then we're
given the key to freedom from those symptoms gradual exposure to
triggers in a safe way is the most effective and long-lasting approach to
resolving them instead of feeling helpless anxious and depressed when you
face your triggers little by little you start to see yourself as resilient and
capable so here's the basic approach to resolving triggers and this is the
process you would work on with a therapist so number one notice and name
your triggers make a list of them and then check the list to see if any of
these are actually immediately life-threatening if they aren't there a
perceived threat so going back to my daughter's example our elevators
actually dangerous no they're very safe as long as you hold your mom's hand
number two write down what your physical and emotional reactions are to your
triggers what goes on in your body increase that awareness of things like
changes in your breathing or clenching your hands and meditation and
mindfulness can really help with this step so for example my daughter may have
felt a racing heart tight stomach or sweaty hands now you take this list of
triggers and the third step is writing this feels dangerous but actually safe
next to each of these or for my young daughter we may just sing it or we I was
reminding her elevators are actually safe okay and then out of your list of
triggers you want to choose one that you're ready to actively face and you do
this in the growth zone you don't throw yourself into the panic zone and you
don't keep yourself in the comfort or avoidance zone it may help to ask for
support from a friend or a therapist while you do it
and it may be helpful to break it down into small steps starting with the
easiest so check out my video on an exposure hierarchy to learn some ways to
break down these really seemingly overwhelming tasks into small pieces
number five is face that trigger in a safe place or with a safe person and you
practice relaxing into it sit with it until you feel a tiny bit calmer this is
really important you you can do this so with triggering memories sitting with it
might look like writing them down telling your therapist about them or
doing an art project about them with the fear of backpacks you might spend time
in a room with a backpack and then when you feel
safe with that you might head over to the local school so with my daughter we
practiced riding elevators together holding hands letting her push the
buttons until eventually she got comfortable with them again if I had
enabled her by helping her avoid elevators then most likely her fear and
anxiety around elevators would have grown now because we went back to
elevators and we consistently and gently faced them she's not scared of them
anymore she actually likes elevators now number six remind yourself that anxiety
feels uncomfortable but it isn't actually bad or dangerous tell yourself
I am safe I feel some anxiety but that's okay I am safe number seven breathe
practice self-regulation techniques so these are things that sooth your body
things like progressive muscle relaxation
deep breathing safe thinking so that's like reminding yourself I am safe right
now or envisioning your safe place but just because these things calm you down
it doesn't mean you need to wait until you believe it or until you're calm to
act so this whole process only works if you face the trigger and nothing bad
happens so with little kids this soothing process looks more like
co-regulation they need someone to help them so with my daughter it's me hugging
her and me modeling for her that we're safe but for adults this might look like
just facing a fear and softening your stomach muscles if you want to learn
more about some of these self-regulation techniques check out my anxiety skills
playlist but basically two things happen here the anxiety response goes down but
at the same time your emotional muscles get stronger so your ability to feel
strong emotions and be okay increases and both of these processes help people
feel more resilient and more peaceful so again as always I recommend working with
a licensed therapist that can help you do this in the safest most efficient way
but understanding the process can help you get the work done with them now I
want to throw out one last idea really briefly so what do you
about triggers that are actually potentially dangerous so for example
what about driving so there's a lot of people who had a car accident and then
after that they have this really strong anxiety response around driving so
driving is something that does actually involve danger you can't really tell
your mind nothing bad will ever happen this is 100% safe because the reality of
life is that driving a car comes with a very small risk out of the thousands and
thousands of times you get into a car every once in a while you may get into
an accident so what are we supposed to do with that anxiety response especially
if it gets heightened by some traumatic accident well here's where the whole
anxiety acceptance comes in so this is a skill from acceptance and commitment
therapy and I'm only gonna mention it briefly here today because it's
something we could spend a lot of time on but the basic idea is that life comes
with risk and risk comes with uncomfortable emotions like anxiety but
we can actively train ourselves to get better at feeling allowing ourselves to
make an intentional choice about our values and how much risk we're willing to
accept so we might say something like being able to drive is uncomfortable for
me but that's okay it's worth it because driving gets me to work and that's more
important than avoiding anxiety to do this we have to change our rules so
instead of saying anxiety is awful or I can't handle it or I won't do anything
that makes me anxious we take a more flexible approach like I
don't like feeling anxious but I can handle it and be okay or getting to work
or driving my kids to school is more important to me than avoiding discomfort
now there is so much more to learn about acceptance but I've got to save that for
some future videos the takeaway from this video is triggers are when a
neutral event or object gets paired with an anxiety response in our body and when
we avoid that stimulus our anxiety grows but when we gradually face that stimulus
and practice grounding our brain will eventually rewire itself to let go of
that paired anxiety response and of course working with a
therapist can help that process go more smoothly for you thank you for watching
please share this video you never know who might benefit from it and take care