Trauma triggers vs. conditioned responses

[Kas_Can_Fly]

I'm sure there must be some overlap between the two, either that or the same thing? I've always had a tough time understanding what is and isn't a trigger. I think if something triggers a flashback/hyper-vigilance/intense dissociation, or in some other way reminds you of your trauma hence worsening your PTSD it is trauma trigger. For a conditioned response, I think is a learned action/emotion (or series of) in response to a trigger - that it's a survival response rather than a cognitive one.

A purely hypothetical example:

• A person who was drugged at a party with red beer cups and then raped, now associates red beer cups as being dangerous and potentially drugged, s/he won't drink from them and feels intense discomfort and fear surrounding red beer cups. Their response is a cognitive recognition that the beer mug was what delivered the drug that led to their trauma and naturally they want to avoid it.
• An abusive spouse only beats their partner after extensive alcohol consumption and does so repeatedly over the span of their long marriage. The beaten partner also had an abusively alcoholic parent(s). Their response to the smell, sight or sound of anything relating to alcohol results in intense fear, shaking and the physical need to curl up into a ball. They have been shown repeatedly through out their life that alcohol = severe bruising, their response to a defensive position and in anticipation of fear is protective of their vital organs.

Are these actually any different, or are they extensions of the same thing. Am I missing the point completely? I'm just trying to understand, I'm looking for any input, advice, correction on definition etc, etc.

Also if this needs moving feel free, I had no idea where to put this to be honest!

Thanks in advance :)

 

[anthony]

I've always had a tough time understanding what is and isn't a trigger.

https://www.myptsd.com/threads/stressor-vs-trigger-what-is-a-trigger.13912/

 

[Kas_Can_Fly]

Thanks Anthony, I've re-read that now but I have read that in the past. I think it's just an issue relating to me as I can recognise what distresses others immediately. I tend to minimize my responses a lot and the few times I have a nasty habit of chastising myself for trying to get attention - despite the fact that I keep all of this hidden. When it comes to triggers I can see that I either have a huge number, or I have virtually none, lumping everything together rather than being able to filter somethings out into various levels of triggers and stressors, some of which are worse that others.

There are things that are still confusing for me with it and I think the reason I have this issue is in part due to the complex natures of my traumas . What's written in that article makes a lot of sense but where I'm having difficulty isn't the few things I KNOW are triggers (the smell of stale sweat, smoke and cooking oil; being aware of immediate drug use around me in particular the smell of cannabis are two of my most easily identified triggers). I also recognise that conflict is a stressor but add in raised voices, outward anger/aggressive frustration and I can't cope - so this is probably a spectrum of stressor into trigger.

Similar to my example however, there has been a long standing issue with me smelling the smell of cannabis and immediately curling up into a ball and shaking - I am aware that it's not rational but my body is locked in this position, if I attempt to pull myself out of it I feel intense pain and nausea. Is this a trigger, or is it a conditioned response or is it both? My earliest recognition of my father's pot supply (which he set me up to find to punish me) was followed by being screamed at for several hours. Shortly after that the abuse started in full swing and without fail every trauma, including every time I was raped was immediately after heavy use of cannabis. Not only was my father a drug user, my main abuser was his dealer and it I was payment for my father's constant and heavy supply.

Another example is certain sounds, cause me to raise my hands defensively and slam my eyes shut and immediately hide/curl and lock up as well as intense fear and dread even if I know the cause of the sounds source.

Also on a curious note, if these aren't isn't a conditioned response what is? I know my T has bandied around the term at points but not everything she says I remember and what I do is rarely accurate in part bad memory, in part dissociation. I'm just trying to understand what is meant. Thanks!

 

[Kas_Can_Fly]

I spoke to my T about my reactions before I was going to go on to ask about conditioned response, but she literally said it before I did. That it was natural to feel such an intense reaction after some of what I've been through and that conditioned responses are difficult to break, especially when it's about something like cannabis which is illegal. Then I went on to explain how I wouldn't want to break my fear of it, only perhaps the power that the fear held over me as it wouldn't feel safe and then we got on to survival mode and the types of responses that is normal in that.

I wonder if others here have conditioned responses and how they've managed to deal with them, is this something that exposure is really the only way to overcome them?

 

[anthony]

Is this a trigger, or is it a conditioned response or is it both?

Smelling the cannabis is the trigger. The trigger stops there. The response is conditioned, yes... basically because that is what you've done, your brain acknowledges safety and or security being in that position when associated with that trigger. Two different things... keep them isolated. You can't control smelling cannabis, but you can work on your conditioned response through behavioural therapy change. Do it enough, your changes become the new normal for your brain... thus you could eventually be triggered by cannabis smell, no issue there, but your new normal response is to acknowledge the smell, rationalise it and do nothing further than forget about it or say "someone's smoking pot," or such.

Keep them separate though... don't combine them under trigger.

Sound issue is the same. Sound is the trigger, stops there. The rest is conditioned response. Change the response to change how you react to the trigger, as you can't change the trigger.

The only part I would disagree with is the part about being hard to break conditioned responses. It actually isn't that hard, you simply have to focus on one at a time, change its response, then work on another. Yes, you will do the response, but you force yourself to instead opt for your slightly revised response, then do that even though you did what comes natural. Repeat and rinse. You intentionally trigger yourself into the response and invoking change to what you want, not what your body just does.

To change a response you may opt to do it in one huge step, or you may opt to try for curling to sitting, sitting to standing silent against a wall, standing silent to continuing doing what you're doing, laughing that someone is smoking pot.

 

[joeylittle]

I wonder if others here have conditioned responses and how they've managed to deal with them, is this something that exposure is really the only way to overcome them?

I don't think I'd say exposure is required so much as practice. Practice will end up invoking a certain amount of exposure, but not all the time.

I have many of these. I go at them religiously, and it does take time - but re-training your body to stay relaxed with certain stimuli is something you can practice simply by training yourself to stay relaxed at all times. Conditioned response is neither positive or negative in and of itself. So, you have a response you want to change, you replace it with a different response.

I think the big fallacy is that there's such a thing as neutral, or non-responsiveness. Instead of thinking of "getting rid of" my startle response, I think about strengthening my ability to regulate my breathing, and (for me) that will improve my startle response (without me needing to be startled a bazillion times).

I also think it's easier to work on these things when you can identify the physical response that goes along with the cognitive/emotional response. It's more tangible to work on your body and what it does.

 

[anthony]

exposure

That is exposure therapy... practiced and change learned responses. Exposure therapy, one type, literally means "doing" and not talking about.

You also have prolonged exposure, which is piecing together fragmented memories through writing exercises, which also desensitises the person at the same time to talk about the trauma further.

 

[Kas_Can_Fly]

Keep them separate though... don't combine them under trigger.

Thanks for the responses! It took me a couple of reads of your post Anthony (don't know why it didn't sink in immediately - it's not so hard of an idea!) but I think see where I'm getting confused in all of this. I just presumed that a trigger included the response but now I understand differently. The reason I'd gotten it all so muddled in my head is because the cannabis smell response in particular is immediate - like putting your hand over a flame and immediately withdrawing it due to a nerve response. That and my apparent unwillingness to accept things as triggers.

In which case I think this helps me a lot more as it helps me further understand what triggers are. Many more things may be genuine triggers for me - just because they don't have an immediate, obvious reaction or I manage to control my responses to them, it doesn't mean they aren't still a trigger - which in some ways is a relief. I think I've somehow been invalidating myself a lot with my previous way of understanding/thinking.

I think the main reason my T said it would be difficult is because it would be unethical to recommend me any number of means of exposure to it. Which I still would rather not do, I would far rather change the way I think and react to it, but would still rather avoid contact wherever possible. I will talk to my T about other forms of behavioral therapies including prolonged exposure and what she thinks would work best for me in my current situation

but re-training your body to stay relaxed with certain stimuli is something you can practice simply by training yourself to stay relaxed at all times.

My problem with this is sometimes I think I am relaxed but it turns out that I'm just dissociated. :rolleyes: I obviously have a lot to learn! One keen step at a time. I'm beginning to see why some people need therapy for years and years - it's not related to the severity of their trauma, or even the severity of their illness but because of their ability to apply what they learn in therapy to practice. Examples like this one have two main elements to start tackling - but tackling dissociation is not necessarily an easy thing and I bet has other layers to it. Wow, like shrek, I think I'm an onion... A very complicated onion! :D

 

[anthony]

I would far rather change the way I think and react to it

The problem with this logic, is that it's only part of the solution. You can't change the way you think and react to a trigger, without exposing yourself over and over to that trigger in order to practice the theory. That is how you change a trigger to a non-issue, thus removing the response altogether. There is no theoretical way to change a trigger without exposure to it, in order to test the theory and logic.

The whole process is a combined package. The difference is that you do it within a controlled environment and force yourself to change the reaction.

 

[Kas_Can_Fly]

But being surrounded by illegal drugs and/or people under the influence of drugs seems like a pretty healthy thing to avoid. I can see why it would be helpful. [Deletes a lot of back and forth rambling] I am highly conflicted about this due to moral and legal issues as well as issues of my current instincts which are based on survival and irrational fears. I find that even if I were to not be so scared of the drugs, morally I don't want to be around people who do them anyway. Society as a whole frowns upon drug use, it seems odd to want to be more comfortable. I don't know. I'm confused! :dead:

 

[anthony]

You're thinking too hard about it, and interpreting narrowly. Who said you have to be around anyone when it is the smell of marijuana that triggers you? You could simply get hold of a small amount, stick it in a bowl at home, light it, then practice... repeat, rinse, until you no longer are triggered by the smell.

Think outside the box. Exposure therapy IS NOT about exposing you to rationally harmful things, its about looking outside the box and helping you to safely remove triggers, thus symptomatic responses, from your life within a controlled environment. Going out to a drug neighbourhood is not how you would do it. With this particular trigger, there are actual legal chinese herbs that smell exactly like marijuana, but are legal, and would do the same thing. Now you've removed even the illegal part of having a drug around to help remove a trigger.

People need to stop being so closed minded about exposure to elements in order to remove triggers. Exposure therapy is only about rational exposure, not irrational.

 

[Kas_Can_Fly]

Thanks Anthony, its not intentional narrow mindedness, it's literally my understanding of what exposure is and in this case lack of knowledge about alternatives. You've helpfully provided me with solutions to both so thanks. :)