Tuesday, July 7, 2009

Trigger: It's Not Just for Roy Rogers Anymore

The Quarterback has a friend who has Post Traumatic Stress Disorder.  The details aren't important, she just does.  Recently, she told me that while she enjoyed reading this blog, she thought she might have to stop, because it triggers her.  If you've never been triggered you may not have the first clue what it means.  Once you have been, you don't have any doubt that that's what it was.

Simply put, when someone is triggered, they suddenly feel the emotions and physical sensations of something really awful -- often something really awful from their past, but not always -- because of some association with the present.  People with PTSD of course are more easily triggered and their reactions when they are triggered can be much more severe.  But really, anyone can be triggered, and sometimes the connections can be quite tenuous.

I will use myself by way of illustration -- I don't know of anyone else who has volunteered to have their personal trauma reactions exposed to public scrutiny.  One of the standard things that instructors warn you about when you take classes in Critical Incident Stress Management is that some scenario or other that is being used in a practice exercise may trigger you.  So I'm going to warn you that I'm about to share a scenario that triggered me, and encourage you to take a deep breath, maybe have some tea, because it might well trigger you.

Last summer I took the Strategic Response to Crisis class at an ICISF regional conference.  The practice scenarios in this class all build on one another.  First there's a car accident in a small town.  Then there's a leak at the chemical plant, causing the town to be evacuated.  Then a school administrator completes a suicide, and it turns out he was responsible for part of the evacuation in which someone died.  Then some kids on a hiking trip get lost in the mountains, and a rescuer falls over a cliff.  In our class, we joked that this town was about as safe to live in as the fictional town of Cabot Cove, Maine was in the old TV series Murder She Wrote.

About the third or fourth scenario involved a panicked mother coming up to a roadblock during the evacuation and saying she couldn't reach her babysitter.   Sure enough, the sitter had missed the evacuation notice, and both she and the baby were dead.  When we reached that part of the script, there was a collective gasp and sort of a thud feeling in the group.  And there was that same thud in my gut.  Something must have shown in my face, because my instructor, the incomparable Doug Mitchell, asked if I was OK.  I said, "This is a hard one for me" and he told me to take a walk.  (As an aside, I went to the ladies room and Doug came to find me and sent someone in to drag me out.  I enjoy telling people that Doug Mitchell once followed me into the ladies room.)

It wasn't that anything like this had ever happened to me or anyone I knew.  It just represented the worst fear I had ever had as a parent.  The fact that it had happened, even fictionally, represented on some level that it actually could happen, and my panic and all the associated emotions just flooded me.  Doug did that which we do -- he walked and talked with me for a bit and told me I was normal, these things happen, and then I went back to class.

The thing I want to highlight here is that he told me I was normal.  There are different ways people like to phrase this message, and different phrasings that different people like to hear:
  • What you're going through is pretty typical for people in your situation
  • You're having the normal reactions of a normal person under abnormal circumstances
  • I'd be worried about you if you weren't feeling a little off
  • I often hear that from people who have gone through something like this
There is some controversy about this, because some people who are feeling extremely stressed really don't want to be told they're "normal," because they certainly don't feel "normal."  Sometimes the word "typical" works better to distinguish between "normal" meaning "reacting in a way one would expect" and "normal" meaning "feeling like you usually do."

Personally, I prefer the very professional wording, "You're not crazy."  And I figure that between 80 and 90% of what I do in crisis intervention is deliver that message.  People under stress feel like they are losing their mind.  Reassurance that they're not goes a long way.

Which brings me back to my friend, and her triggering.  Triggering is a real phenomenon.  It happens to most people at some point in their lives, whether they have PTSD or not.  So, if you ever read anything in this blog that triggers you, or causes secondary trauma even to the slightest degree, let the Quarterback preemptively tell you that you're not crazy (well, you might be, but this isn't evidence of it).  Give yourself a break, do what you need to do to feel better, and don't feel like you have to read the rest of the post.  I'll live.


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Naomi Zikmund-Fisher
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