Triggers, Flashbacks and Grounding Techniques

CONTENT WARNING: This episode contains implied childhood sexual assault as well as mentions of sexual assault.

This episode discusses different types of trauma triggers and their effects. It also discusses different types of flashbacks and how they can affect people. It finishes with a discussion of grounding techniques and how they can be helpful.

Transcript

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Triggers, Flashbacks & Grounding Techniques

Sean: Before we get started, I would like to forewarn you that this episode contains implied Childhood Sexual Abuse as well as mentions of sexual assault. 

April: Hello! Welcome to “Trauma: Let’s Talk About It.” I’m April! 

Sean: And I’m Sean. Today we are going to be discussing triggers, flashbacks and grounding techniques. While there are many other types of triggers, like for other disorders or situations, today we will be focusing on trauma triggers. 

April: A trauma trigger is caused by the previous experience of a traumatic event. A trigger can be just about anything. One of the types of triggers people most commonly understand is how fireworks and other loud noises may trigger people who have been in combat to remember combat situations, and react as if they were happening in that moment. Triggers may also be other sounds, sights, smells, tastes or textures that are connected with a traumatic event – some examples are a song that was playing when the event happened, or a scent worn by an attacker. Other possibilities are a location where an event happened, or a date or time of day when it happened. Any or all of these types of triggers are valid and reasonable.

Sean: All of those are external triggers, but there are internal triggers as well.

April: That’s true. While we mostly think about triggers as something outside us that trigger us, such as a sound or a smell, a person can also be triggered by internal causes related to trauma. For instance, feeling lonely or abandoned could trigger someone. Pain which is similar to the pain a person went through during trauma could also easily trigger them. Anger, sadness, anxiety, or a feeling of vulnerability are also all valid internal trauma triggers.

Sean: You are so right about all triggers being valid. The stereotypical portrayal of a trigger is that it causes a flashback, where a person thinks they are back in the moment where the traumatic event happened. This is one possible outcome, but there are other trigger responses which, while seen by many as “less extreme,” can still be extremely difficult and distressing. 

April: Some triggers might cause anxiety or panic attacks. Others might cause emotional responses, such as sadness or anger, which might come for no apparent reason or might be a valid response to present events but at a much stronger level than would be expected. Some might cause a person to act in ways they did at a younger age. Triggers may also bring on feelings of dissociation and numbness. Any or all of these responses to being triggered are valid and reasonable.

Sean: If you have been through trauma, you may have triggers. Sometimes it may be easy for you to tell what triggered you and how it affected you, but at other times it may be more difficult – for instance, sometimes you only realize you’ve been triggered when you become aware that your emotional responses don’t seem to make sense to you. Once you realize you are being triggered and are able to figure out what is triggering you, you can consider how you might want to handle it.

April: It’s very helpful when you can figure out what’s triggering you, because that can make it possible to avoid it or prepare for it. While that’s not always possible, some triggers are predictable. One type of trigger that is easier to see coming before it hits you, that many people have, is a traumaversary.

Sean: Oh yes, that’s a pretty common one, but I don’t hear them talked about much. The only frequently discussed example I can think of is death. People often talk about feeling sad on the day a loved one died. I know for myself, my father died over twenty years ago, and I still find I think about him more and more easily feel sad on the day he died.

April: That’s a good example. A traumaversary can be any day a trauma happened, or sometimes a few days around the past event, or even longer. Sometimes holidays can be triggering in the same way, and this can be made more difficult if it’s a holiday which gets a lot of media attention, such as Christmas. Sometimes a day can become triggering for reasons that are unclear, as you can’t recall anything happening then. What’s important is to recognize if a certain day or time, such as a traumaversary, is a trigger for you.

Sean: That makes sense. And traumaversaries can be really tough. They can cause depression or sadness, like I mentioned for me. They can make you more irritable or make your emotions seem more overwhelming. They can also cause an increase in the frequency of flashbacks and nightmares. They can make you more easily triggered, too. Once you understand it’s an issue, you have the advantage that you know when a traumaversary is coming up and can prepare for it.

April: Yes, and that’s a really good idea to do. This could be preparation like making plans to do things that will distract you, like going out with friends or resisting watching the new season of a show you enjoy, with the plan of binge watching it on the difficult day.

Sean: That’s a good idea. Another thing you can do is plan for support, like making sure any friends who can do it are with you or ready for you to call. You also might want to see if your therapist can make themselves more available to you or plan for extra sessions. If you are not part of a support group, you can look into one in advance and plan for them to be there for you, too.

April: Those ideas could really help. Another thing I find really helpful is to create a self-care box. This is a box containing things that help comfort you, such as bath bombs, fidget toys, face masks, a journal and pen, letters from loved ones, or any other favourite item. There are no rules or limits to what can be in the box, it’s purely about what can help you.

Sean: I really like that idea. I might have to think of one for myself. There are a lot of different things that could trigger someone, but from what I’ve heard, there aren’t really rules about that either.

April: That’s right. There are no “silly” or “stupid” triggers. Some people may think if a trigger doesn’t fit with common clichés of triggers, it’s not really valid. Some people may think if the response to a trigger isn’t a complete disconnect from reality, it isn’t a big deal. Both of these things are not true. Triggers can be anything. And they also bring forth a variety of reactions. 

Sean: I’ve definitely seen some triggers be made fun of or not understood because they come off as “weird”. I remember not too long ago that I saw someone on your blog, who was skeptical about the idea of a colour being a trigger. 

April: To someone that doesn’t have a colour as a trigger, it might be hard to understand. While I don’t believe anyone owes anyone an explanation, I would like to share a brief explanation because I think it may help someone to understand how a colour could be a trigger (please note this is only my personal experience, and is not necessarily why someone else may have a colour trigger.) For me, the walls in the room where I was sexually abused as a child were pink.

Those walls were what I focused on when I was enduring something horrific. For the longest time, seeing that shade of pink would make me feel panicked, like I couldn’t breathe and like I could feel his hands on me. Seeing that colour brought my brain back to a time when I was surrounded by that colour during a traumatic experience. 

Sean: That sounds really terrible. 

April: I do also want to point out that pink is now one of my two favourite colours - so you should know that there is hope that triggers can be overcome. They might not necessarily become your favourite thing, but they can become manageable.

Sean: That does sound promising. What are some ways to deal with triggers?

April: When it comes to handling triggers, there are different ways to work on them. These include exposure therapy, or relaxation techniques to calm yourself when triggers happen, that allow you to cope more effectively. While exposure therapy can be beneficial, it can be a lot of work and can take an emotional toll. In some cases, it might be worth considering whether avoiding the trigger is a better response for you. While avoiding a trigger will not get rid of it, it might make more sense depending on the trigger. 

For example, if something is a trigger you're going to see frequently (possibly even daily), it might be worth considering something like exposure therapy (with a trained and trusted professional) because avoiding that trigger in such a circumstance seems near impossible and likely to cause you significant distress. On the other hand, if a trigger is something you are unlikely to see often, or perhaps which only comes up once a year, avoiding the trigger might be the way to go. 

In this case, it is still recommended to work on relaxation and grounding techniques to cope more effectively when triggers do arise. At the end of the day, you are the one who should decide how to handle your healing and triggers and only you can determine what's best for you. 

Sean: That’s true. While other people might have helpful advice, only you can really judge what’s best to do about a trigger. There is a lot you can do on your own to try to stop or lessen the impact of your triggers. 

April: You’re right. One possibility is filling out worksheets or a journal, trying to pinpoint the way a trigger affects you and better understand where it comes from and why it triggers you. There are plenty of other strategies as well. With that being said, it can be a good idea to get professional advice before you start trying to work through and lessen the impact of a trigger. A therapist or other mental health professional may be able to guide you more carefully through work on your trigger.

Sean: That makes sense. Journaling and worksheets can also help you to recognize if there are any mood changes, or changes in how you think, that happen as you start to be triggered. If you understand your own early signs of triggering, it might be easier to deal with things or avoid getting triggered more strongly. 

I do think something important to remember is that if you try to work through a trigger on your own, you may have a greater risk of retraumatizing yourself or otherwise making things harder for yourself than you would if a professional helped you with this process. 

April: We mentioned briefly how triggers can cause flashbacks. I’d like to spend some time talking about flashbacks. 

Sean: That makes sense. I’ve heard about flashbacks, and I think a lot of other people have as well, but I don’t really know much about them. We’re talking about flashbacks of memories, right? So to start with, what are flashbacks?

April: That’s right. Flashbacks are when a person has a sudden and involuntary re-experiencing of a memory, as if the event were happening right at that moment. This experience can be so powerful that the person cannot tell it is not actually happening. The most common ideas of flashbacks I hear about are seeing what you saw at the time the memory was formed, but there are other types of flashbacks as well.

Sean: I’ve heard about that type.

April: That type is generally called a visual flashback. They come in a lot of different varieties - some happen as the replaying of an entire event, while others are disjointed and jump from one point in time to another. Some people may see a mix of the sights from the memory and the sights that are actually around them, and have some awareness of what’s going on, while others may completely lose connection with the place and time they are actually in.

Sean: That sounds really confusing.

April: It can be so confusing. But there are other types, which can be harder to recognize. For instance, someone might have an auditory flashback, where they only hear sounds from a memory. This might be hearing someone speaking, or hearing other sounds like a siren or loud banging. These sounds might seem extremely real, and can be very distressing. This can also happen with other senses, such as smelling a scent which is not actually present, or having a certain taste in your mouth. Flashbacks can be very powerful, but they can also be very subtle.

Sean: That doesn’t fit with the stereotype I’ve generally heard, but it does make sense when I think of the ones I’ve heard about where your emotions are the only thing affected.

April: Oh yes, emotional flashbacks can be very hard to recognize. Often someone having an emotional flashback does not even realize it is happening, unless they happen to look back and see that their emotional response does not fit with the situation they are in. 

This might mean they feel an emotion that does not make sense, such as anger after an event which generally would make them happy. On the other hand, it could mean they have a much more intense reaction than is fitting, such as overwhelming sadness in response to something that they might dislike but which would not usually strongly affect them. The emotional response is not coming from current events, but from the reactions the person had to the event which is flashing back.

Sean: That sounds difficult. I’ve heard there are flashbacks that people call “body flashbacks,” too?

April: Those can be hard to deal with. Body flashbacks come when you have physical sensations which are from a traumatic event which is flashing back. Sometimes these can be such faint sensations that you don’t realize they’re a flashback, at first. For instance, you might have a dull aching pain in your side for a while and be able to forget it’s there when you’re busy doing other things. Hours later, when you’re less occupied, you might feel the same aching pain and realize it’s what you felt when your ribs were bruised during a trauma. Your ribs might be perfectly fine now, but you are flashing back to how they felt then. 

Sean: That sounds like a very slight sensation. So body flashbacks are less noticeable than other types?

April: Not necessarily. Sometimes, body flashbacks are extremely obvious and can be very disturbing. I personally have had some body flashbacks which were seriously distressing. One that I still get frequently is the feeling of hands touching my legs in the exact same way as happened to me during an assault. It can be very confusing, because while I can see that no one is with me, the sensation seems extremely real. Body flashbacks can be hard to ignore and every bit as powerful as other types.

Sean: It makes me shiver to think about that. But at least they’re done quickly, right?

April: That is one of the major myths about flashbacks. People imagine, based on how flashbacks appear in the media, that they’re quick events. They can be. Sometimes flashbacks only last seconds. But flashbacks can last hours, or even days. 

And while I have described a number of different types of flashbacks, many can be a combination of what I have described - including sights, sounds, smells, emotions and physical sensations. It can be very difficult if not impossible to keep from getting lost in such flashbacks. Everyone experiences flashbacks in different ways, but these are some of the possibilities.

Sean: Are there any ways to deal with flashbacks?

April: Outside of the long term coping mechanisms, like working through the trauma itself, there are some short term coping skills as well. One of the most useful ones in my opinion are grounding exercises. There are mental grounding exercises and sensory grounding exercises. 

Sean: What are examples of mental grounding exercises?

April: One example is having an anchoring phrase. One that I’ve used is: “My name is April. I am 27 years old. It is November 8th, and it is 8:00 at night. I am currently sitting in the dining room of my home with my partner.” This helps me ground myself into the present date and time because for me, sometimes I feel a bit lost and it’s hard to even figure out how old I am or where I am. You would customize that with your own information. 

Sean: That sounds useful. 

April: It can be. Some other grounding things I do are thinking in categories. For example, I might pick a topic like dog breeds and then name every dog breed I can think of. I’ve also done different birds, bands, books and other various categories to occupy myself. 

Sean: That makes a lot of sense. I can see how that would be distracting. What are some sensory ideas?

April: Sensory ideas can be about any of the senses. For example, I might touch something like an ice cube and focus on the feeling of it melting or I might turn on some music I like and focus on that. Biting into something really sour can be jarring and helpful. Focusing on the items around me or even spraying different scents. 

Sean: That makes me think of a method I’ve heard which has someone go through the different senses starting with the number five. 

April: That’s right. It’s the 54321 method. How it works is you find five things you can see, four things you can touch, three things you can hear, two things you can smell and one thing you can taste. 

Sean: That sounds like it could be really useful for flashbacks. 

April: It can be. It can also really be useful for anxiety attacks, panic attacks and other overwhelming feelings. 

Sean: That makes sense, and is definitely something to keep in mind. If you check out our website in the episode description, I know that we have a list of grounding techniques in the coping skills section. This is probably a good stopping point for this episode. 

April: I think you’re right. Thank you for listening to us on “Trauma: Let’s Talk About It.”  Please remember that your triggers are nothing to be ashamed of, even if they aren’t things that are commonly understood. 

Sean: You can find more information about trauma and the social media that we are on through our website, www. for (that’s f o r) traumasurvivors.com.  As I said earlier, the link is also in our podcast description. Thanks for listening. Until next time.