Chapter Four - Triggers Triggers are events or circumstances that will produce some of the flashback reactions; therefore, your triggers need to be identified. It is important to understand what triggers you and make plans on how you will react. How Do Triggers Work? To understand triggers, we need to work backward. A trigger can be a sound, a smell, something we see, or something we feel that causes an internal reaction related to a previous stressful experience. A firecracker may send someone diving under a table. This is a common reaction and is a good example of a trigger. If this ever happens to you, you will feel embarrassed for a minute. You just need to get up and say that the sound just threw you back to the sounds of the war. Other common examples are smells. Think of the many smells you experienced while you were deployed. You may experience some of these smells again, and you may find yourself reliving an experience. Take some time to identify your triggers that can cause intense emotions. Think about the times over the last few weeks when your anger came on quickly and was most intense. Now, consider what was going on at the time.

* Where were you? * What were you doing? * Who were you with? * What were you thinking about just before you became angry?

* Did your reaction seem to fit the situation, or was it more of an over-reaction? *What seemed to trigger your anger?

Evaluate whether your reactions are associated with your war experiences. You may be surprised at how many are connected. Check any of the items on the list below that are triggers for you. What other triggers would be on your list?

___ Anniversary of a loss or trauma ___ Traumatic news event (e.g., pictures or videos of war) ___ Being overtired ___ Work stress ___ Family friction ___ A relationship ending ___ Spending too much time alone ___ Being judged or criticized ___ Financial problems ___ Hearing sudden noises (e.g., door slamming, car backfiring) ___ Feeling left out ___ Things that remind you of abandonment ___ Intimacy/touch ___ Excessive stress ___ Someone telling you how to run your life ___ Extreme guilt ___ Smells ___ Physical illness ___ Sexual harassment ___ Encounters with law enforcement (uniforms, being questioned, sirens, flashing lights)

Write down your own real life examples of things that triggered you. Now, develop a plan that you feel will help if a triggering event occurs, for example:

* Call and ask a support person to listen while you begin talking through the situation. * Do some deep breathing exercises. * Get validation from someone close. * Do a relaxation exercise. * Remember that if you don’t know why you’re having a strong reaction, there is still a reason for it (and it’s not that you’re "crazy"). You can talk about it to help figure it out. * Talk to your doctor about a screening for stress if you experience the following reactions for more than a week:

a) You find yourself getting triggered with similar or worsening intensity. b) The stress is creating difficulty in your work or relationships in other ways (for example, sleeplessness, nightmares, jumpiness, difficulty remembering or concentrating, irritability). Stress-related memory blackouts that are not caused by head injury or alcohol/drug abuse warrant a screening for stress as soon as possible.

Nipping the stress in the bud can cut down on complications later on. You can benefit from counseling to develop effective strategies for stress management so your reactions to triggers won’t continue untreated. Sometimes these reactions will keep happening unless they are treated with specific, effective methods. Action Plan on Triggers Underline the ones you would like on your own triggers response list. What else should be on your list?