I’ve begun to understand better how often I am “triggered” by a variety of things and how that relates back to traumas I’ve undergone in my life, especially living with Stage IV Metastatic Breast Cancer (MBC) since my de novo diagnosis in 2017. Identifying and defining a trigger is often helpful for me to understand why I have an extreme or long lasting response to something that doesn’t appear to affect me directly in any discernible way. These moments of “freaking out” or feeling out of control are often scary for me inside even as I’m attempting to calm myself or compartmentalize since my normal coping mechanisms are not successful.
But first, as I often do, let’s look at a generally accepted definition of the concept of a trigger:
something that causes someone to feel upset and frightened because they are made to remember something bad that has happened in the past: A trigger is something that sets off a flashback, transporting the person back to the traumatic event.https://dictionary.cambridge.org/us/dictionary/english/trigger
I’ve written about Betrayal Trauma previously and I think that concept could also be viewed through the lens of triggers in that when one has been traumatized by a betrayal, one is then on guard and affected differently by ongoing or further betrayals.
Regardless of the label, it all starts with trauma.
I think it is good to remember when thinking about triggers or when someone is triggered, that underneath whatever is happening is trauma, sometimes the worst trauma that a person has ever experienced. Similar to the concept of how a person who needs the most love and care often asks for it in the most unlovable ways, a person who is triggered from a trauma often behaves badly in trying to protect themselves from a future trauma in an unlovable way. Further, the reaction is typically directed towards people who had nothing to do with original trauma, which often ensures a re-traumatization since the people receiving the reaction have no idea what occurred and cannot address the underlying issue and are left with a bad impression of the person freaking out.
Some examples of triggers for me having to do with MBC:
- Someone with a new similar diagnosis;
- Someone with a similar diagnosis doing well;
- Someone with a similar diagnosis doing badly;
- A widow/widower finding love again after their loved one has died from a similar diagnosis at any time after the loved one’s demise;
- Doctors or medical professionals discounting symptoms or concerns;
- Doctors or medical professionals so rushed during appointments that there is no time to raise concerns;
- Insurance companies;
- Scheduling people who make appointments without talking to you or other ways our autonomy is infringed upon by the medical system;
- Doctors or medical professionals attempting to impose their perspective rather than listening;
- Scheduling a Scan;
- Going to get a Scan;
- Waiting for the results of a Scan;
- A phone call from a doctor’s office or medical group — just the call showing up on the screen of one’s phone;
- Paperwork at a new doctor’s office;
- Correspondence from doctor or medical system;
- Insurance companies — anything that an insurance company does or doesn’t do;
This isn’t an exhaustive list and I’m sure there are many other triggers that I’ve missed, but I think you get the gist. Once a trauma has occurred or is ongoing, the reminder of that trauma or the ongoing parts of that trauma pull the person who has experienced that trauma right back into the feelings or reactions of the original trauma. The trigger or trauma is then compounded when something like when the results of scans are always bad and there is literally nothing positive to hold onto. One friend described it this way — a trigger is not always “just” about re-living a trauma, but also losing the expectation of good news. How does one live when there is no expectation that anything good will occur ever again? I don’t have a good answer for my friend or anyone else.
So what to do about triggers?
One option is to avoid triggers, like how smokers avoid the places or people or experiences that would cause them to want to smoke. I think about stories of how those in AA or NA (Alcoholics or Narcotics Anonymous) are encouraged to avoid the triggers that would cause them to drink or to call their sponsor when encountering said triggers. Perhaps if we learn from the 12 steppers in this, we could learn to avoid or handle the triggers with the help of a sponsor or mentor.
I find that processing the emotions behind the trauma, the triggers, the responses, the aftermath, etc., with people who get it, like those of us with MBC has been a helpful antidote. We talk a lot in our support groups about how when an emotion matches the experience, that equals emotional health. Thus, when we are responding to a trigger by feeling the emotion it causes and not stuffing or avoiding that emotion, it is a product of emotional health. To be emotionally healthy means to be living in reality and being truly alive.
Emotionally healthy or not, dealing with triggers is not easy. It drains me of energy and taxes my coping mechanisms, both medical and otherwise such that I spend every spoon available and have nothing left. I try to explain to my team how this happens, how the way they do business is a trigger in and of itself. I try to provide other ideas and feedback and suggestions, but sometimes that’s too much of a trigger in and of itself.
And that’s the struggle. To solve a trigger is often to enter into the mechanics of the trigger itself, to look at each part, to name and identify the parts, and work towards solutions. At least on the intellectual/cognitive side. It’s much easier to live there, to keep the discussion as intellectual as possible, to try to keep one’s emotions under control or at least locked down in the process.
And yet, as I’ve been musing over, is the cost worth it?
What do you think?