Real World Clinical Blog: What Really Triggers Us

by Dr. Danna Bodenheimer, LCSW, author of Real World Clinical Social Work: Find Your Voice and Find Your Way

     The use or overuse of the word trigger has become so prevalent that the significance of the word has diminished greatly. You might read a blog post that offers a trigger warning, a professor might offer a trigger warning at the beginning of a class, or you might hear people using the word triggered to describe how they are feeling in response to the election. These trigger warnings and utterances are being used to describe a wide array of psychological states, often leaving us confused about what the word actually means. The fact is that being triggered is a very specific psychological state, and understanding its precise presentation is quite valuable.

     First, it is important to know that being triggered is about having first been traumatized. The word triggered signifies that a trauma has occurred and that specific stimuli can bring us back to this traumatized state.  It is understood that the impact of trauma is stored in both the brain and the body. In the brain, it can be stored in the form of flashbacks, reluctance around attachment, and a confused sense of self-worth. In the body, it can be stored as cortisol, a stress hormone that coarses through the body and can feel like poison as it runs through us. It can also be stored as a heightened sense of vigilance, as we move rapidly between flight or fight states.

     Trauma is based on our inability to make sense of what is happening to us. The process of metabolizing trauma takes an incredible amount of time and is often unending. As we try and sort through it, or to deny it, pieces of our traumatic experience break off and rest in us both physically and psychologically. But because we are driven to make sense of our lives and our worlds, the traumatic material cannot remain in an interminably resting state.

     Triggers, external stimuli in our environment, awaken our more traumatized states and leave us feeling both fragile and raw. However, there are a few serious misconceptions about triggers. First, triggers don’t exist as literally as we think they do. For example, if there is a student in a class who has faced a horrible history of racial oppression, a professor might offer a trigger warning to help that student prepare for viewing a movie about slavery. There is an assumption that material that feels close to the originally traumatizing material will be experienced as triggering. Although this is somewhat true, it doesn’t actually capture the way the whole process goes down. We are, instead, actually traumatized by more subtle cues and unconscious communications.

     So, the movie about slavery would likely be experienced as traumatizing if everyone watching it disavowed the tragedy of it, expressed denial about it, watched it without affect, or was able to move onto another topic seamlessly. See, we are actually most triggered by being exposed to the defenses used to negotiate our original trauma rather than by the actual material that we are watching or hearing about. We are also triggered by witnessing or experiencing affective states that bring us back to our original trauma. Because trauma is not something that we can really make sense of cognitively, it lives in us in a more primitive way than that. We almost sense the danger of it with instincts, not thoughts. These instincts are evoked by seeing the same signs of danger that we have originally been unable to manage. But the signs of danger are usually forms of communication and interaction, not literal words or images.

     I was recently in a session when I closed my eyes to picture what a client was describing. It was for a mere second or two. We were not talking about anything particularly charged. However, in this moment, my client described an immediate feeling of being triggered. Her abuser often closed his eyes when yelling at her. His closed eyes were a sign of danger to her. My closed eyes were a sign of danger to her, leaving her feeling as if she was in an aroused and heightened state.

     This heightened state is one that can last anywhere from a few minutes to a few weeks. People usually don’t stay triggered for more than two weeks, because the mind starts to re-regulate and store the trauma in more distant recesses of the mind. However, there are some settings that make the ceasing of the triggered state more unlikely. If external stimuli constantly signify danger, the feeling of being triggered will sustain. If family members constantly remain in a state of denial or disavowal, this will allow being triggered to remain. Further, our clients typically feel the most ashamed, which is a feeling that accompanies any trauma, if they feel triggered by events that happened a long time ago. It is important, in these instances, to remind our clients that the unconscious – where trauma is most powerfully stored – has no sense of time, and the passage of more or less time really doesn’t change much at all.

     Being triggered is very real, but it also actually means something specific and powerful. The overuse of the term cheapens the gravity of the triggered state. It also keeps us from studying the ways in which a triggered state can be properly nurtured. The main intervention for feeling triggered is the reduction of external stimuli. This means less noise, less screens, less talking in large groups, and less offering up of ourselves to help others understand our internal world. The more that we are able to find peace, quiet, trusting relationships, and the presence of others who understand us, the less metastatic the trigger. The more we are able to recognize the need to tend to our own rawness, living in us like a sunburn, the less likely we are to leave ourselves out and unprotected for more searing.

Dr. Danna R. Bodenheimer, LCSW, is in private practice at Walnut Psychotherapy Center in Philadelphia, PA, and teaches at Bryn Mawr College Graduate School of Social Work and Social Research. Read more of her clinical perspective and tips on the most burning questions of developing clinicians in her book, Real World Clinical Social Work: Find Your Voice and Find Your Way.