Note: This article originally appeared in the Spring/Summer 2009 edition of MeadowLark, the magazine for alumni of The Meadows.
The Triggering Effect
By Claudia Black, PhD, MSW
Article excerpted from newly released CD Triggers and DVD The Triggering Effect.
Triggers are specific memories, behaviors, thoughts and situations that jeopardize recovery - signals you are entering a stage that brings you closer to a relapse. The process is much like riding a roller coaster that loops over itself. Once the roller coaster car gets to a certain spot in the track, a threshold is met, there is no turning back, and it starts the downward loop.
It is very likely you have heard your husband, wife, partner, mother, father, boss, a friend, attorney or even a judge say, "What were you thinking?" The answer is: you weren't thinking.
The inability to recognize the impact of your behavior, the willingness to risk what is significant in your life, and in this case, the quick lapse into old behaviors in spite of good intentions appear to be connected to brain chemistry. Addiction hijacks the brain. The reward/pleasure center holds captive the thinking center.
The good news is that the brain has plasticity. That means, in treatment and recovery practices, you can learn skills to calm the brain's emotional responses and reactivity area. You can learn to avoid triggers that activate the emotional area, and you can learn to enhance the decision-making area so you can rationally think through decisions, rather than respond impulsively and from such a strong emotional basis. But it takes time for the brain to be rewired, and it gets rewired with the repetition of new skills and new ways of thinking; hence, we strongly urge ongoing involvement in aftercare and other support systems.
Willpower alone is not a defense against relapse. Recovery is achieved, maintained and enjoyed through a series of actions. Learn to identify your triggers and, with each, identify a plan that anticipates and de-escalates the power of the trigger. With that, your reward is another day of sobriety with endless possibilities.
Five common triggers are:
1. Romanticizing the Behaviors
Romanticizing involves a tunnel focus on the positive feelings you associate with the behavior; it involves glamorizing using behaviors and, in the moment, totally forgetting about the negative consequences.
Getting overwhelmed at times is to be expected, but it's very easy to slip into romanticizing without any insight as to how you got there. At that moment, you enter a slippery zone, touching the trigger. While romanticizing is itself a trigger, it often occurs in tandem with an external trigger such as noises, sights, sounds or even tastes. You could be watching a movie and the next thing you know it is depicting the power of alcohol, drugs and sex in a positive way, and you are romanticizing. Or you're listening to the radio and an advertisement for a drug comes on, and you think about your pain pills as the commercial goes on to tell you how much better you'll feel, and off you go. Or you're watching a ball game on TV and can almost smell the popcorn and peanuts, and you see the spectators drinking large cups of beer and everyone is smiling like it's only a good time.
Take a few moments to think about how you romanticize your addictive behavior. What do you find yourself thinking about? What is the romanticizing covering up? What are you forgetting to take into account?
Addicts have used their behaviors and substances for years to separate from their emotional states. And there is so much to feel - guilt for how your behavior has hurt others, sadness for your losses, anger with yourself, fear of what is in front of you, shame for thinking you are inadequate, not worthy. You can act out in response to every feeling imaginable.
You lessen or get rid of feelings when you own them, talk about them or, in some cases, engage in problem solving. It is when you try to divert, ignore, and numb that you get into trouble. Feelings are a part of the human condition and you can't escape them. Recovery is the ability to tolerate your feelings without the need to medicate or engage in self-destructive or self-defeating behaviors and thoughts.
Recognize the gifts that come with feelings. Feelings are cues and indicators telling you what you need. Loneliness tells you, in your humanness, you need connection; fear can offer you protection, sadness offers growth, guilt is your conscience, offering direction for amends. It is critical for you to have this insight and, more importantly, to start to take ownership of the feelings when you have them.
Coupled with the trigger of feelings is the fact that those feelings are often associated with loss. By the time you get to recovery, you have had multiple losses in your life, often related to childhood, many times due to being raised with abuse, addiction, mental illness, etc. While you may have experienced trauma within your original family, pain of loss may be from a specific situation.
You may have experienced the loss of relationship with your parents or children, the death of friends or family, abortions, or career or work opportunities missed. As an addict, you are likely to have experienced losses related to health issues. Perhaps you have Hepatitis C, HIV, or injuries due to accidents.
It is not that you are suddenly thinking about these losses, but there may be a trigger. Perhaps you are in treatment and you see other people's children come to visit, and you have three kids and you don't even know where they live. Your daughter tells you that your ex-husband has just moved in with someone else. The goal is not to dwell on your losses, to not live in the pain and anguish. This is what happens when you don't acknowledge them and what they mean, triggering you back to your using behavior. With some losses, you can only grieve and ultimately come to find some meaning from your experience; with others, in time, you can attempt to repair damaged relationships.
Resentment is also a feeling, but I think it warrants its own place as a significant trigger. Resentments are like burrs in a saddle blanket; if you do not get rid of them, they fester into an infection. Resentments are often built on assumptions, i.e., "When you don't look at me, I assume you think you are better than me." "When you don't include me in a social gathering, I am assuming you think I am not good enough to be with you and your friends." Resentments are also built on entitlement, which is a form of unrealistic expectations and impatience.
Unrealistic expectations + impatience = resentments.
Move from resentments. When assuming, check it out. Put yourself in someone else's shoes (it may allow expectations to be more realistic). Identify and own the feelings the resentment is covering (often it's a cover for feelings of inadequacy and/or fear). Be willing to live and let live.
5. Slippery people, places or situations
You need to identify specific triggers - the people, places, and situations that are high-risk. Slippery people could be your ex-lover, certain family members, or past using/party buddies. A slippery place might be a bar you used to frequent, a casino, or an area in your community where you cruised - in essence, any place that triggers a positive association about the use of your drug of choice. Slippery situations could be an emotionally charged social gathering, such as a wedding, family event, or vacation.
Medication may be a trigger for which you need to be accountable. While there are situations when medication is needed, you are at high risk to abuse. You need to be proactive in how you are going to cope with this situation, because it is likely that your brain is going to remember a good feeling, saying more is better. Again, there are situations when medications are necessary, but self-diagnosis and/or self-prescribing only create a recipe for disaster.
What are the people, places or situations that are potential triggers? What provides safety for you to not be triggered? What triggers can you avoid? While some decisions around triggers are absolute, others are not necessarily in place for the rest of your life. Know your triggers and plan accordingly. In the face of a trigger, what do you need to do? What do you need to tell yourself? To whom can you reach out for support and/or problem solving?
Today in recovery:
1. Practice staying in the present; don't sit in the past or project into the future.
2. Validate the gifts of recovery for the day - practice gratitude daily.
3. Identify, build and use a support system - you need to stay connected. History and experience have proven time and time again that recovery is not a solitary process and cannot be sustained in isolation.
4. Trust that your Higher Power is on your side.