This post is an excerpt from the study guide which accompanies the “Post-Traumatic Stress” seminar. This portion is one element from “STEP 7: IDENTIFY GOALS that allow me to combat the impact of my suffering.”
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An important part of “reclaiming” your own mind is enhancing your ability to offset the intrusive symptoms of trauma. We want to get to the place where we can pick up and put down our thoughts at our own volition. We want our relationship to be like one we might share with a pesky house cat (written by a “dog person”); the cat may jump in our lap throughout the day, but if it is a time that we do not wish to entertain the cat, we want to be able to put it down and continue our day.
Decreasing the Power of Triggers
The big idea of countering intrusive symptoms is the ability to accurately gauge and respond to a troubling event. Intrusive symptoms gain their force by exaggerating (trigger events and panic attacks) or falsely generating (flash backs) the degree of threat in an unpleasant circumstance. In this section, we will look at preventing the “amping up” of intrusive symptoms. In the next section, we will consider how to “amp down” intrusive symptoms once they have surged.
“Not all danger is overwhelming; not all fear is terror (p. 199).” Judith Hermann in Trauma and Recovery
Initial measures on decreasing the influence of triggers require placing intentional thought between the disturbance and our reaction. Admittedly, this is easier said than done, but it is both possible and worth the effort.
The first two major elements you should have already established in the earlier parts of this study: (1) establishing a sense of safety so that the triggering event is not magnified by a pervasive sense of danger, and (2) disempower the memory of the trauma through stripping of its false messages and grieving losses related to it so that each triggering event does not feel like the crescendo of a fatalistic story.
These areas of growth should greatly help you put intentional thought between the disturbance and your reaction. Now we want to add a four step process you can use when you encounter a triggering event. There is no magic in the steps; they are much more fire drill than incantation. They give you steps to follow towards safety when fear might seem paralyzing.
1. Stop
Stopping is different from “freezing.” Stopping is a choice to make life slow down when it wants to move fast. Stopping is an act of defiance against the effects of trauma. Stopping is the equivalent of stomping your foot, looking trauma in the eye, and saying, “Not this time. I’m in charge now and you don’t get to call the shots.”
On a side note, personifying your post-traumatic experience can be a way to make the experience seem less ghostly. If this type of imagery is helpful for you, be sure you’re the adult in the imagined dialogue; you are the one with the “final say” about how things will proceed.
2. Breathe
In this case breathing is more than a relaxation exercise; it is an indication of safety and peace. There is time to breathe. You are refusing to react on trauma’s false-rushed time table. But don’t let this defiance feed a reaction in anger. Anger is too closely associated with feeling threatened.
Imagine your trauma like an impatient child demanding to go to the park, “Right NOW!” What is the best response? Calmness. Anger gives the impression something is going to happen immediately; it is an indication the child is gaining control. Calmness says you are in control.
Taking the child tantrum imagery further, you can understand why the child wants to go to the park so badly and this gives compassion towards their immature demands. Similarly, you can understand why a trigger event wants a “code red response” and this allows you to be compassionate without acquiescing to your natural response.
This final point is more important than many people realize. If you are harsh with yourself for being stirred by triggering events, this will impede your efforts. You will feel condemned by your own conscience even when you respond wisely to triggers. Being patient with yourself is part of maintaining a sense of safety during and after the effects of a triggering event.
3. Think
The newly established pace of response should give you an asset you’ve not had to battle a triggering event: time to think. Your goal with this time is to assess how big of a gap exists between your real and perceived threat. Use these questions to help you make this assessment.
- How many options do I have in responding to this situation?
- Is my fear or anger rooted more in this moment or its similarity to my past trauma?
- What will my life look like in an hour if I respond well to this moment?
Our natural reaction during a traumatic trigger is to assume, “I have no options. This moment is as threatening as it feels. My foreseeable future is ruined.” When we respond based on these assumptions we compound the traumatic moment with foolish choices and the consequences seem to confirm what our initial fear foretold. It is by stopping to think and assess a situation that we can prove our fears to be the false prophets they are. The more times we can pair wise choices with triggering events the less believable our fears will become. Our trauma-hyped fears become like the bad friend who we learn not to trust because they break their promises and following their counsel gets us in trouble.
4. Choose
Choice is how you express power and voice. Whether or not your choice is “the best choice,” let it be your choice and not one forced upon you by fear. Don’t hold yourself to a standard of perfection in these choices; that would be unrealistic even if you weren’t battling the effects of a trigger event.
Your standard should simply be: did I make a choice that I deemed to be wise and reasonable based on the information that was available to me in that moment? If the answer is yes, then you’re making progress. With time, once you are consistently making choices in pursuit of wisdom rather than in reaction to fear, the quality of your decision making will improve. But regaining your sense of autonomy and voice to choose is the first step.
Read II Corinthians 10:3-6. What we have discussed above is an exercise in “taking every thought captive” (v. 5), which does not just apply to theological arguments or moral dilemmas. Verse 3 describes our human tendency to react as if immaterial threats were physical threats. Satan loves to use hypothetical or traumatically-inflated threats to disrupt our lives. This is one of our enemy’s strategies for establishing a stronghold in our life. This does not mean that a trigger response is wrong. Remember, Satan would as gladly use suffering to disrupt our lives as sin, but God gives us the strength to take every thought captive both when the temptation is not to sin but also when Satan would use suffering as his means to disorder our lives.
Responding to a Flashback or Panic Attack
Flashbacks and panic attacks are more than sticky memories that are unsettling and hard to put down. They are experiences where the memory or fears associated with the memory of our trauma become more real to us than our actual surroundings. Instead of our present reality being in our cognitive-emotional foreground and the memory-emotions being in the background, this relationship is reversed.
The goal in battling a flash back or panic attack is to have our actual surroundings return to the foreground of our experience of life. Instead of being swept away in memory or emotions to such an extent that our present situation becomes inconsequential, we want to keep our roots in the here-and-now enough to withstand the memory or emotion.
Hopefully, this seems more doable than merely thinking you have to “stop the flash back or panic attack.” A strategy that only tells you what not to do is useless. One of the most effective ways to ground yourself in the here-and-now is through your five senses. Below we will talk about how to use each sense to return your present reality to the foreground of your experience when you are facing a flashback or panic attack. These strategies can also be effective if you feel yourself beginning to dissociate.
- Sight – Go to a mirror and make eye contact with yourself. Allowing your eyes to dart around the room seeking a threat loosens your visual anchor to the present. “Own” what you do with your eyes. As you look at yourself, see a competent adult; this is particularly helpful for those who experienced trauma as a child and return to feeling child-like during their experience of a flashback or panic attack.Keep your eyes open. The darkness of having your eyes closed creates a blank canvass upon which your imagination can depict your memories or fears. Keeping your eyes open is a choice you can make that is a sign of courage and autonomy. It represents a new attitude which recognizes you are larger than your memories.
- Smell – Keep your favorite scent handy; a potpourri sack or scented candy in your pocket. Pull it out when you feel a flashback or panic attack beginning. The deep breath you take activates both the calming influence of a pleasant smell and the calming effects of cooling the nasal cavity.Memory is more closely associated with the olfactory sense than any of the other five senses because the olfactory sense registers in the brain’s limbic system where emotion is also housed. Enhance the impact of your calming smell by having it present during activities you enjoy (i.e., favorite hobby, a warm bath, listening to calming music).
- Touch – What are your favorite sensations? Smooth velvet. A leathery baseball. A cool ice pack. A warm cup of coffee (probably decaf at a time like this). Keep these things readily available. But as you access them, don’t view them as an escape valve. That only exacerbates the sense of danger. Choose them as an exercise of your will about what you will give your attention to.Another means of using touch is soothing self-touches. What do you do with your hands when you’re stressed? Wrench your neck. Ruffle-pull your hair. Scratch your skin. What if you chose soothing touches instead? Massaging your temples. Relaxing your hands and shoulders. These are ways to communicate to yourself that you are safe and are made more effective if you repeat the gospel themes from chapter six to yourself as you do them.Pets also make for excellent soothing touch encounters. If you’re at home when you begin to experience a flashback or panic attack and have a pet, call them to you. Stroke their fur. Pay attention to how they lean into your hand or the affirming purr they give. Allow this to help keep “your safe here-and-now” in the forefront of your experience.
- Sound – Calming music, nature sounds, or even a white noise machine can help anchor you in your present surroundings. If you are sound sensitive, be aware of when you place yourself in high stimulation or high volume environments. These can increase your baseline stress levels without you being aware of it and leave you more susceptible to a post-traumatic reaction.Calling a friend is an excellent use of sound as a calming mechanism. Whether you choose to talk about the pending sense of a panic attack or flashback or not, the interactive quality of a conversation is an excellent means of grounding yourself in the present. If you are willing to talk about the experience, this can be a good way to counter its messages of doom; rarely does any fear seem as great or close once we speak it out loud with a trusted friend.
- Taste – Whether it’s a soothing piece of sweet candy or a shockingly sour candy, you can always have a taste anchor in your pocket and there is no social awkwardness about accessing it. Panic attacks and flashbacks are foul experiences; having something pleasant tasting in your mouth can help counter the experience.There is also something casual about having a snack. While this is not directly linked to the sense of taste, it can be part of the experience of eating which is calming. The experience of fear is also physically draining, and the boost of energy from a healthy snack helps counter this.
What do you do with these? Don’t expect to sensory bomb your next post-traumatic experience into oblivion. Recognizing these are tools and how to best use them will take some time. Be versatile in your options. Think through the various setting in which you’ve experienced panic attacks or flashbacks and select counter-triggers that fit well in each setting.
Also, become aware of the early experiences that are indicative of a pending flashback or panic attack. These anchors are most effective if you begin to use them before the intrusive symptoms have their full momentum.
Don’t expect yourself to interrupt every panic attack or flashback. If you do, then you will feel like you’ve failed when you have one of these intense experiences. A sense of failure makes us prone to give up and stop battling. Use these approaches with the mentality of war; you don’t have to win every battle to be victorious in the war. Make sure you do not surrender the momentum of the larger journey just because a single encounter with trauma went poorly.
Read passages referencing the five senses. Use an on-line Bible concordance to find passages that reference “look,” “taste,” “hear,” “feel,” “aroma,” and other sensory-related words. Sometimes we reduce the experience of our faith to a purely cognitive exercise, as if God were a set of beliefs. As you review these passages, you won’t “taste and smell God,” but you can gain an appreciation for how God intends for us to use all five senses in our knowledge and enjoyment of him. After all, it was God who chose the number of our senses and he delights when we use them to experience more of the life he intended for us.
If this post was beneficial for you, then considering reading other blogs from my “Favorite Posts on PTSD” post which address other facets of this subject.