Posts Tagged ‘triggers’


Timelines and Trigger Mapping in Healing PTSD

Posted on:

In the “old” days of psychotherapy, when I began in the 80s, abreaction or emotional release of traumatic memories was considered a goal of therapy. This idea of therapy was also made popular in powerful movies such as Goodwill Hunting.

Abreaction will happen when it happens, and it will facilitate healing. But it is not enough.

We have to live with the day-to-day realities of our history as they manifest in the present moment. With that in mind, I wanted to share two of the most helpful activities in or out of therapy for people who suffer PTSD.

The first activity is to create a timeline of events. When our PTSD results in dissociation our sense of time can get distorted. In fact, many would say that PTSD itself distorts the part of the brain responsible for the sense of time passing.

In any case, most people I see have a very poor sense of the timeline of what happened to them. Also most people I see have had more than one type of trauma. Some peoples’ lives have been one traumatic event after another. Creating a visual timeline can help us understand and digest what we have actually been through.

 Chances are, when you begin, you will not put down every event. Our brains are associative, so if you are looking at, say, accidents, you will put down accidents. But, you may forget about abuse, or you may remember one type of abuse but not another. I consider the timeline a working document in therapy, whether on paper, or just as an understanding between my client and myself.

When you record an event, you have an opportunity to look at your age at the time. A good timeline should include: event, type of event, age and any other relevant details (such as physical injury).   The timeline provides a chance to re-associate the aspects of yourself connected to your own history and is a valuable tool for your therapist. (P.S. therapists can and do become dissociative too, so this tool can help ground both of you.)

The second important activity that will really start to empower you is trigger mapping. Everyone with PTSD has triggers! They may or may not be known to you. Knowing triggers can help you and your loved ones anticipate PTSD storms and head them off.

Here is how I describe trigger mapping in my book The Trauma Tool Kit:

I recommend writing down or drawing your triggers, getting them down on paper in some form or fashion. Some triggers you will know right away; some you will have to ferret out. Triggers fall into six categories: the five senses of taste, touch, smell, sight, and hearing, plus feeling states. Let’s start with the senses, because they are the easiest. You can divide your paper into different sections reflecting each of these senses. It will help jog your memory to go through each sense modality individually. Let’s say you are working in the smell category. Ask yourself what smells really bother you. All of us have smells we do and don’t like. Generally we all like floral scents and dislike the smell of feces, but I am not talking about ordinary aversions here; I am talking about radical reactions. Nobody likes the smell of poop, but if that smell sends you into a panic or frozen numbness and dissociation, it’s a trigger. Or maybe the scent of lavender makes you want to rip someone’s head off. That’s a little unusual; write it down. Take your time working through each category. Do not attempt to do all of this work in one day! If you are in therapy, it can feel safe and reassuring to do it with your therapist. Or it may not depending again on your triggers, but find some way to do it anyway. p. 184-185

The great thing about timelines and trigger mapping is that they create a bridge of healing between the present and the past. They empower and they inform, and they are tangible.  You can also add to them and edit them as you go. It is a great joy to be able to remove a trigger off the list!

One last thing, when you do them, do them with care and beauty. Take your time. Use beautiful colors and paper. Or if you just do them in your own head give yourself the benefit of a peaceful space and time to contemplate your own history and healing.

Blessings on your journey, Sue PB




PTSD and the Holiday Season

Posted on:

Here’s the sad truth. PTSD often worsens during the holiday season. One would hope it was different, that holiday cheer, food, friends and good spirit would pop up like champagne on one of those commercials we see on TV where people are toasting each other, smiling and all looking fit, young and strong. But alas, it is not and here are some reasons why:

1) Holidays come with lots of triggers. We can be around too many people or too few. Even if we want to be with people, loneliness can be enhanced by the inability to connect in the midst of deep emotions such as fear, grief, or rage. There is no lonely like the lonely that comes in the midst of a group of friends or family.

2) We tend to eat foods that aggravate our nervous system. PTSD causes an inflammatory reaction in the body (see my HPA Axis posts). When we pile on the sugar, alcohol, fatty foods and just plain junk that pervades holiday fare our delicate and taxed nervous system can come under a lot of strain. Eating aggravates our anxiety, and anxiety aggravates our eating, repeating until New Year’s Resolutions come.

3) Feelings of self-loathing tend to emerge more strongly in holiday season. Perhaps we are trying to live up to an unattainable ideal of our religious faith or maybe proximity to family reminds us of our (and their) shortcomings. Whatever the reason, the phenomenon is real.

4) There is a lot of stimuli in the environment! Bright lights, flashing lights, loud music, smells, endless holiday music, crowded shopping environments all add to the load on the nervous system. Not to mention traveling on overcrowded airplanes and roads in dangerous weather. Not exactly a good environment for the hypervigilant and stressed.

If you think avoiding the holidays is easy, just watch the hilarious movie, Christmas with the Kranks. A lucky few might escape to Hawaii or a cruise but even then the holidays follow and are on our mind (if not our neighbors).

So, what to do? If you see a therapist and can afford it, scheduling extra sessions can be helpful. For those of us not lucky enough to have that resource, protection from the holiday barrage starts with our own awareness.

Pace yourself. Take some time every day to see what it is you do and don’t want to do. Say ‘no’ as often as you must. Stop worrying about hurting other people’s feelings, and focus on healing your own. Remind yourself that this, too, shall pass. For it will.

Better yet, dig down in yourself to find your own meaning of the holiday – whether it is about religion, vacation, or promoting your business, find the meaning that will be best for you.

Move into alignment with the season. In Chinese philosophy, winter is a time to move inside, to become dormant like the plants outside, resting so that our roots will be nourished and the plant flourish in the Spring. This is my favorite meaning of the winter holidays: renewal, self-nourishment, quiet companionship with those you love, sleep. Lots of sleep. 

So here is my wish for you in the holiday and end of year time: Know when you are triggered and move to take care of yourself as needed. Cultivate compassion in your heart for yourself and others. Rest. Eat well. (And read The Trauma Tool Kit as needed.)

Happy Holidays. 




© Lotus Heart Counseling, LLC • 530 NW 23rd Avenue, Suite 109 • Portland, OR  97210 • (503) 869-0314 • moc.t1544465203tinab1544465203esaep1544465203eus@o1544465203fni1544465203

To Top