I wondered if anyone has any suggestions for dealing with triggers at work. I am a teacher by profession and having a really difficult time during our staff training sessions. Triggers seem to have become far worse since trying to address them with my employers. There are so many that I am afraid to tell them about them all, and try to avoid discussing them anyway because this also triggers the condition. Non of the "grounding" techniques seem to help, but I am open to hearing anything that has helped anyone else. The triggers used to be specific activities that were part of the training, though they have now escalated to being the whole of the training - The fact that I am expecting triggers makes the whole experience unsafe. I am often sick on the day, will have had unbroken sleep and nightmares the days leading up to and after training, and usually resort to unhelpful ways to distract myself from the pain and flashbacks such as alcohol and self harm. My employers have no idea how severe the condidtion can be, though they are trying to support me with the limited information I have shared. They think that leaving the sessions for 10mins when they become difficult is an answer. How do I explain the sheer terror, panic, guilt, shame and exhaustion that does not conveniently disappear after 10 mins? Any help, advice from those who have experienced similar conflicts much appreciated. It was at my employers suggestion that I am posting to a forum, and therefore it is of paramount importance that I have at least some suggestions to take back to them - I have none, accept a request to avoid all training activities.
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Work Related Triggers
- Post starter Rach0113
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Hi Rach0113,
I too experienced (past tense) workplace triggers that impacted me attending meetings (some of my duties involved staff training). My apologies if this is information you already have. Your post does not indicate if you are currently working with a Psychologist. When I returned to work I met with a Psychologist weekly for that first year with a focus on workplace employee/employer issues.
Are you familiar with SUDS; subjective units of distress scale? This scale is a way of communicating to other people how much distress you are experiencing at any given time. Picture a thermometer with the higher numbers indicating you are on bust and the lower numbers indicating less distress.
With my input, the Psychologist listed all the triggers that caused me distress. We rated these triggers using the thermometer. Things at the lower end of the scale were the items we chose to tackle first. We chose things initially that had a better chance of success / did not need to set myself up for failure.
If you work on too many triggers at one time, you risk flooding yourself with too many negative emotions. You can taint the process by moving too fast, picking too many triggers to work on at the same time, or trying too many techniques at the same time.
If it seems that what you are doing is not working, it might mean you are doing too many things. There can also be a sense that things are getting worse rather than better. This is a natural phenomenon of therapy. However, if there is no relief, you need to re-evaluate with your therapist what you are doing.
I could not tolerate staff meetings or training and I was initially exempt from these events. These were my "on bust" triggers. We didn't touch these at all, not initially. I could tolerate a grocery store for 10 minutes so we started here. So this was my homework. I remember going into a grocery store with a timer in my bag and when it went off after 10 minutes, I left the store. I left feeling a low level of distress vs. a high level of distress had I stayed longer. When I was ready, I increased the time to 12 minutes, 14 minutes, and so on.
What we did was create a positive memory, thus I left before my distress became uncomfortable. Had I stayed beyond the initial 10 minutes, I would have experienced a negative association with being in the store thus reinforcing my distress. Does this make sense?
I could not tolerate going to the gym. We used another technique called task analysis. I listed all the steps involved in going to the gym. This list looked like this; drive past the gym, drive on to the parking lot (don't stay), drive on to the parking lot and park, sit in the car and look at the entrance (drank a coffee whist I did this), get out of the car and walk to the door, go inside for one minute and leave, etc. I trust you get the gist here. Eight days of this homework and I was back at the gym and on the treadmill for 30 minutes. Awesome.
You can move through a hierarchy like this fairy quickly. There were times I did get stuck and this was generally because I moved too quickly. I experienced a ripple effect with this approach. Suddenly something that had been a high distress activity for me took on a lower rating, and we hadn't even worked on it.
When I was ready to tackle staff meetings and training I used the same strategy as the grocery store (minus the timer). I had a friend call me on my cell and used this as my cue to leave the meeting. Sometimes I came to the meeting when the group was breaking for coffee. I had many "pee" breaks. I was lucky to have a Psychologist who was clever and thought outside the box.
I know too that I offered no explanation to anyone about my comings and goings. I dealt with my HR (Human Resources) department regarding what I needed to return to work. My Psychiatrist and Psychologist provided the documentation. Managers were on a need to know basis. They struggled to understand. It was none of their business. I did not try and explain the situation to them. I let the documentation from my medical team do the talking through HR. When I was questioned by an immediate manager, I referred him/her to HR.
When I did go to training events, I arrived early. I identified what I call the PTSD chair. This is generally by an exit so my comings and goings could remain relatively unnoticed.
I could not have returned to work without the support of counselling. I was accommodated in some aspects of my job. I worked with small achievable goals.
A plan was devised so that what I did miss at meetings was shared with me by my manager in a 1-1 meeting or by a colleague I could trust. It’s bad enough that you feel you don’t fit in. It doesn’t help when you don’t know what is going on. So for sure communication needs to be built into any plan.
I hope this is helpful to you. Feel free to ask me more direct questions about the process I went through. I am thinking of the time line. It did take time. For sure all of 2007 with the Psychologist regarding workplace issues and since then on going psychological support regarding other issues. But realistically, it took almost two years to get me back where I was at work, with most of the hard work in year one and tweaking in year two. Take care.
CM
I too experienced (past tense) workplace triggers that impacted me attending meetings (some of my duties involved staff training). My apologies if this is information you already have. Your post does not indicate if you are currently working with a Psychologist. When I returned to work I met with a Psychologist weekly for that first year with a focus on workplace employee/employer issues.
Are you familiar with SUDS; subjective units of distress scale? This scale is a way of communicating to other people how much distress you are experiencing at any given time. Picture a thermometer with the higher numbers indicating you are on bust and the lower numbers indicating less distress.
With my input, the Psychologist listed all the triggers that caused me distress. We rated these triggers using the thermometer. Things at the lower end of the scale were the items we chose to tackle first. We chose things initially that had a better chance of success / did not need to set myself up for failure.
If you work on too many triggers at one time, you risk flooding yourself with too many negative emotions. You can taint the process by moving too fast, picking too many triggers to work on at the same time, or trying too many techniques at the same time.
If it seems that what you are doing is not working, it might mean you are doing too many things. There can also be a sense that things are getting worse rather than better. This is a natural phenomenon of therapy. However, if there is no relief, you need to re-evaluate with your therapist what you are doing.
I could not tolerate staff meetings or training and I was initially exempt from these events. These were my "on bust" triggers. We didn't touch these at all, not initially. I could tolerate a grocery store for 10 minutes so we started here. So this was my homework. I remember going into a grocery store with a timer in my bag and when it went off after 10 minutes, I left the store. I left feeling a low level of distress vs. a high level of distress had I stayed longer. When I was ready, I increased the time to 12 minutes, 14 minutes, and so on.
What we did was create a positive memory, thus I left before my distress became uncomfortable. Had I stayed beyond the initial 10 minutes, I would have experienced a negative association with being in the store thus reinforcing my distress. Does this make sense?
I could not tolerate going to the gym. We used another technique called task analysis. I listed all the steps involved in going to the gym. This list looked like this; drive past the gym, drive on to the parking lot (don't stay), drive on to the parking lot and park, sit in the car and look at the entrance (drank a coffee whist I did this), get out of the car and walk to the door, go inside for one minute and leave, etc. I trust you get the gist here. Eight days of this homework and I was back at the gym and on the treadmill for 30 minutes. Awesome.
You can move through a hierarchy like this fairy quickly. There were times I did get stuck and this was generally because I moved too quickly. I experienced a ripple effect with this approach. Suddenly something that had been a high distress activity for me took on a lower rating, and we hadn't even worked on it.
When I was ready to tackle staff meetings and training I used the same strategy as the grocery store (minus the timer). I had a friend call me on my cell and used this as my cue to leave the meeting. Sometimes I came to the meeting when the group was breaking for coffee. I had many "pee" breaks. I was lucky to have a Psychologist who was clever and thought outside the box.
I know too that I offered no explanation to anyone about my comings and goings. I dealt with my HR (Human Resources) department regarding what I needed to return to work. My Psychiatrist and Psychologist provided the documentation. Managers were on a need to know basis. They struggled to understand. It was none of their business. I did not try and explain the situation to them. I let the documentation from my medical team do the talking through HR. When I was questioned by an immediate manager, I referred him/her to HR.
When I did go to training events, I arrived early. I identified what I call the PTSD chair. This is generally by an exit so my comings and goings could remain relatively unnoticed.
I could not have returned to work without the support of counselling. I was accommodated in some aspects of my job. I worked with small achievable goals.
A plan was devised so that what I did miss at meetings was shared with me by my manager in a 1-1 meeting or by a colleague I could trust. It’s bad enough that you feel you don’t fit in. It doesn’t help when you don’t know what is going on. So for sure communication needs to be built into any plan.
I hope this is helpful to you. Feel free to ask me more direct questions about the process I went through. I am thinking of the time line. It did take time. For sure all of 2007 with the Psychologist regarding workplace issues and since then on going psychological support regarding other issues. But realistically, it took almost two years to get me back where I was at work, with most of the hard work in year one and tweaking in year two. Take care.
CM
I want to add Rach0113 that I had a fair bit of distorted thinking in the early days of my diagnosis. Most of the time I felt afraid. I came across this definition on another site recently and it really hit home. I have it laminated and velcroed in my day planner. For me it speaks volumes.
What is "Fear" FALSE, EVIDENCE, APPEARING, REAL!! So if you are anxious or afraid of something there is a good chance that it is not real.
Cheers.
CM
What is "Fear" FALSE, EVIDENCE, APPEARING, REAL!! So if you are anxious or afraid of something there is a good chance that it is not real.
Cheers.
CM
- Post starter
- #5
Thank you for your reply. I can relate very closely to much that you have said. Especially the need to sit by a door. Anxiety becomes unbearable when either doowways are blocked or I am not in a position with easy access to escape unnoticed. I am not currently seeking professional help as the whole process of discussing the condition triggers symptoms and sends me into a deep depression with feelings of frustration and being a failure. I am very afraid of sinking back into a state of helplessness and suicidal thinking, so have chosen to try to address the conflicts alone. When I did seek professional help, it was not through my own choice, and the person I saw described me as guarded and difficult to treat - this was not really true, more that I am so afraid and untrusting of others that I cannot talk openly to anyone.
Can I ask, how did quickly did you recover from triggers? Personally, the anxiety takes over my life for what I consider a longer period than it should. Sometimes it can be days, other times weeks before I stop having nightmares, or feeling sick everyday. I know I make it worse by usng alcohol as an escape mechanism, though I still fall into that trap and struggle to find another way to cope.
Can I ask, how did quickly did you recover from triggers? Personally, the anxiety takes over my life for what I consider a longer period than it should. Sometimes it can be days, other times weeks before I stop having nightmares, or feeling sick everyday. I know I make it worse by usng alcohol as an escape mechanism, though I still fall into that trap and struggle to find another way to cope.
Hi Rach0113,
It is not easy to benefit from professional help when it is mandated. The relationship between yourself and your therapist is based on trust. Therapy will not work if you are not ready for it. I am so sorry that the therapist you saw described you as difficult to treat. I remember being told I was non-compliant. Labels are not what you need when you are desperately seeking relief.
I admire your courage in going it alone. I am thinking though that this might not be the time for such bravery. It is true that things will appear to get worse as you begin to process your trauma. This is a natural by product of therapy. There is an increase in symptoms. As you learn to ground yourself and self regulate, a de-escalation occurs.
A skilled trauma therapist will work with you in processing your issues, allowing you breaks during the process for this grounding and self regulation. I encourage you to search for the support you need. Keep in mind you met one therapist. There are many more out there. A knowledgeable therapist will not start processing your trauma until you know how to keep yourself safe.
Time lines are tricky. There are so many factors to consider when you have been injured. What you bring to recovery depends on everything from genetics, social supports, to resilience. PTSD plays out so differently from any other diagnosis that I am aware of. The diagnosis is often not made ‘til a significant time after the injury/trauma. By the time you have the diagnosis and start treatment, months/years might have passed. There is no quick fix.
The injury which led to my PTSD diagnosis occurred in 2003. I received my PTSD diagnosis in 2005. I was sidelined by a fall and surgery on 2006 and it took a year to recover from this. Therapy directed at my PTSD did not start ‘til 2007. I continue with therapy today. PTSD is a chronic condition. There are days I do not meet the criteria and days I do.
I have not recovered from my triggers. I do have periods of remission. I accept that I will always have triggers. What is different for me now is that I respond versus react. I learned to do this in therapy.
I do know that alcohol exasperated my symptoms. Self medicating with alcohol was for me a maladaptive way to make myself feel better. The risk of addiction is quite high amongst sufferers. It is for this reason that I don’t drink. I do not need to further complicate things with other issues.
I hope this is answering your question. Feel free to follow up if you have other thoughts. Take care.
CM
It is not easy to benefit from professional help when it is mandated. The relationship between yourself and your therapist is based on trust. Therapy will not work if you are not ready for it. I am so sorry that the therapist you saw described you as difficult to treat. I remember being told I was non-compliant. Labels are not what you need when you are desperately seeking relief.
I admire your courage in going it alone. I am thinking though that this might not be the time for such bravery. It is true that things will appear to get worse as you begin to process your trauma. This is a natural by product of therapy. There is an increase in symptoms. As you learn to ground yourself and self regulate, a de-escalation occurs.
A skilled trauma therapist will work with you in processing your issues, allowing you breaks during the process for this grounding and self regulation. I encourage you to search for the support you need. Keep in mind you met one therapist. There are many more out there. A knowledgeable therapist will not start processing your trauma until you know how to keep yourself safe.
Time lines are tricky. There are so many factors to consider when you have been injured. What you bring to recovery depends on everything from genetics, social supports, to resilience. PTSD plays out so differently from any other diagnosis that I am aware of. The diagnosis is often not made ‘til a significant time after the injury/trauma. By the time you have the diagnosis and start treatment, months/years might have passed. There is no quick fix.
The injury which led to my PTSD diagnosis occurred in 2003. I received my PTSD diagnosis in 2005. I was sidelined by a fall and surgery on 2006 and it took a year to recover from this. Therapy directed at my PTSD did not start ‘til 2007. I continue with therapy today. PTSD is a chronic condition. There are days I do not meet the criteria and days I do.
I have not recovered from my triggers. I do have periods of remission. I accept that I will always have triggers. What is different for me now is that I respond versus react. I learned to do this in therapy.
I do know that alcohol exasperated my symptoms. Self medicating with alcohol was for me a maladaptive way to make myself feel better. The risk of addiction is quite high amongst sufferers. It is for this reason that I don’t drink. I do not need to further complicate things with other issues.
I hope this is answering your question. Feel free to follow up if you have other thoughts. Take care.
CM
BloomInWinter
VIP Member
I wanted to add that PTSD is, I believe, a serious, progressive disease. It rarely goes into remission without adequate treatment. Not that it doesn't happen, but after finally finding the relief of a knowledgable, trusted therapist, I wish I had mustered up the courage to keep seeking one out much sooner. The positive changes in my life have been wonderful. I'm still having a lot of symptoms, but I don't feel alone or without resources.
I'd be wary of oversharing with employers and especially co-workers. If you had to leave these trainings to check your blood sugar, or take your heart meds, it would still amount to the same thing. You are taking care of your health and the real specifics are nobody's business but your's.
I'd be wary of oversharing with employers and especially co-workers. If you had to leave these trainings to check your blood sugar, or take your heart meds, it would still amount to the same thing. You are taking care of your health and the real specifics are nobody's business but your's.
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