Dr. Ramani Durvasula is a clinical psychologist who writes extensively about mental health topics, so when she uses the term "triggered," it is not done flippantly — such as to complain that one was "triggered" by a woman's ugly dress. She said that people who misuse the term "trigger" are "doing a disservice to people who are navigating life while managing recollections and reminders of prior traumas. I work with clients with trauma histories, and to be 'triggered' is a very real and disruptive experience."
In the same vein, Dr. Jessica January Behr told Salon by email that "triggers are not just things you don't like or that offend you," adding, "the word trauma and trigger are thrown around very easily these days and while exposure and destigmatization are important, it is also important not to co-opt trauma into the generic colloquial lexicon. It is crucial that words retain their meaning in order to properly identify what it is we experience and what we can do about it."
Indeed, people who are triggered by traumatic memories experience genuine distress and even danger, and as such conversations around being "triggered" are most productive when they focus on actual mental health patients. "Trauma is a neuropsychiatric condition resulting from the experience of distressing or life threatening events," Behr told Salon. "Triggers are the environmental catalysts that set off psychophysiological memory of the trauma and initiate a set of symptoms."
Dr. Benjamin W. Bellet, a clinical psychology postdoctoral fellow at Massachusetts Mental Health Center, broke down exactly what happens in the brain of a trauma patient when they experience being triggered, emphasizing that post-traumatic stress disorder (PTSD) is at its core a "disorder of memory."
"Those suffering from PTSD have a memory of a traumatic event that is highly accessible (frequently recalled) and emotionally intense when recalled long after the traumatic event has occurred," Bellet explained to Salon by email. "This means that (relative to individuals who have experienced trauma but do not have PTSD, who form the majority of trauma survivors), those with the syndrome experience frequent unbidden intrusive memories of the traumatic event, flashbacks (feeling as if the traumatic event is happening again in the present moment), and psychological and physiological reactivity to reminders of trauma."
People will feel intensely afraid or anxious, their heart rate will shoot up, their body will tremble and they may suffer panic attacks.
"Traumatic stress creates an increase in the firing and presence of neurotransmitters cortisol (a stress hormone) and norepinephrine (adrenaline)," Behr explained. "MRI studies have shown that those experiencing symptoms of PTSD or traumatic stress exhibit structural brain changes including smaller and less active hippocampus (memory center of the brain) and increased amygdala function (emotion center). Therefore, when a traumatic experience occurs the cortisol and norepinephrine receptors in your brain and body increase and this can create structural brain changes that can increase emotional response and decrease the proper encoding and storage of memory."
Durvasula, who echoed Behr's explanation of the neurochemistry behind being triggered, helped clarify matters by detailing exactly what happens to a triggered person as they endure they ordeal. It is not merely that they are remembering something unpleasant — there are a whole panoply of emotions and emotional responses that factor into being triggered.
"When a person is triggered they are responding as though there is a clear and present threat – though to an external observer there is not – these threats can either be experienced internally (e.g internal sensations) or due to external stimuli (e.g. smelling something associated with a past traumatic event)," Durvasula observed. People who are triggered respond in part through their sympathetic nervous systems, involving what is traditionally known as the fight/flight/freeze response. People may also hyperventilate, sweat, experience chest tightness or sweat profusely. All of this culminates in the patient feeling panicked.
"Accompanying these physical sensations can be a whole set of emotional reactions including fear, terror, anger, sadness, exhaustion, guilt/shame," Durvasula told Salon. "In some cases, when a person is triggered they will dissociate – which may manifest as an alteration of consciousness and numbing of emotion. These won’t be the same for every person – and will vary based on numerous factors including history of adverse childhood experiences, other co-occurring mental health issues, issues specific to the trauma."
It's important to note, people who are triggered do not have to suffer alone. In addition to having a strong support network of family and friends, there are ways that people who suffer from these reactions to cope. Durvasula said that there is no substitute for getting professional treatment, urging people who have experienced treatment to work with licensed mental health providers. In addition to that, though, Durvasula said there are also techniques a person can use at home and in the moment. This includes breathing exercises.
"Breathing grounds us, and dysregulated breathing is one of the many of the sympathetic nervous system responses at the time of being triggered," Durvasula observed. "By working on breathing at times a person is not triggered, it can become a practice a person can turn to as a tool to center and ground when they do feel triggered."
She also recommended placing a hand on one's chest, finding one's pulse, feeling one's hand go up and down — anything that can ground an individual when the negative physical responses associated with being triggered seem overwhelming. Taking an inventory of one's environment through one's physical senses is a mental trick both Durvasula and Behr suggested.
"Returning to your body through grounding practices can be beneficial for combating your response to a trigger," Behr pointed out. "One way of going about this is to activate the Five Senses. Name 5 things I can see, 4 things I can hear, 3 things I can touch, 2 things I can smell and 1 thing I can taste. This exercise returns us to our bodies and allows us to activate our senses in a way that can decenter the trigger."
Bellet offered other suggestions for how people can escape from feeling triggered when that happens, such as leaving the classroom when a difficult topic is brought up. Of course this is only a temporary coping strategy — ultimately, patients are encouraged to expose themselves to reminders in a supportive environment so they can learn healthy ways of managing adverse stimuli.
"Indeed, most evidence-based therapies for PTSD entail the opposite behavior, i.e., exposure to the trauma memory and reminders in a supportive therapeutic environment in order to help survivors to deal with difficult emotions without forming their lives around the basis that such emotions are dangerous," Bellet told Salon. "Therefore, the best way to feel safe around triggers is to seek evidence-based therapy for PTSD."
