5 ways to help yourself manage trauma triggers
Hands clammy, heart pumping, Susan froze; the familiar nausea and bile rose in her throat as the blond man’s blue eyes stared at her. She slapped at a hand that had touched her arm. “Susan, are you OK?” The hand stayed – it felt different, comforting, rather than moving to restrain her or cover her mouth. “It’s OK Susan, you’re here with me,” said the voice of her dear friend Ira, bringing her back to standing in a line of people at the newsagent, being served by a blond man. Susan took a deep breath, held Ira’s hand, and said to herself, “This is not my father. I am safe”.
Susan’s experience is a typical example of post-traumatic stress disorder (PTSD). Aged 45, she had endured nine years of sexual abuse between the ages of four and 13. For years, she didn’t remember it, and then – as occurs with many PTSD survivors – an event later on in life triggered similar feelings to the original trauma; in Susan’s case, her pelvis was broken in a car accident, and the feelings of powerlessness caused the memories to re-emerge, along with panic attacks. Other traumas that can result in PTSD include natural disasters, accidents and war; many survivors endure symptoms for years. It’s essential to get the right help, with a clinical psychologist with specific training and experience to go through these steps to healing.
1. Switch to ‘rest and digest’
People who have been traumatized have an overactive ‘fight or flight’ nervous system, making them anxious, angry, jumpy, and prone to flashbacks and panic attacks. Their breathing rate is also often very high, which further activates the nervous system. Slowing down the breath, via deep, diaphragmatic breathing, switches on the ‘rest and digest’ system instead, helping them to become less reactive. I ask clients to practise diaphragmatic breathing for one minute at night, in the morning, and at the first signs of anxiety. Using audio relaxation and meditation programs four to five times a week also reduces overall anxiety.
2. Establish safety
Imagine there is only one place in the world you feel safe, perhaps your bedroom. Now, imagine someone taking that place and destroying it. This is what it’s like for someone with PTSD: there is no safe place. The therapist’s job, therefore, is to show feel and touch there – where they can go to when they feel overwhelmed.
3. Get grounded
Traumatized people can feel numb and spaced out – what is known as ‘dissociative’ – which is the psyche’s way of avoiding the pain of the trauma. However, feeling numb and spaced out means the person can’t effectively process the trauma; it also means they can’t experience positive feelings. Getting present, and fully experiencing our feelings is essential to healing. This simple exercise helps to ground the person and distracts them from their memories: Name five things you can see right now. Now, name five things you can hear, and five things you can touch. Continue, naming first four more things you can see, hear, and touch, then three, two, and one.
4. Manage memories
The two most effective evidence-based therapies used to treat PTSD are: Exposure or Desensitisation, and Eye Movement Desensitisation and Reprocessing (EMDR). These therapies should only be undertaken with a trained therapist. Desensitising a single memory usually takes one to three sessions. People with multiple memories, such as years of abuse, don’t need to desensitise every one, as working on several has a generalising effect. The end result is that the memories don’t disappear, but they no longer hurt you; anxiety and avoidance will also reduce or disappear, so that ultimately, you are free of the past and living in the present.
5. Diaphragmatic breathing
• Place your hands on your belly, just above your navel, with your two middle fingers touching. Very gently take a deep slow breath and, as you do so, allow your belly to rise. Your two middle fingers should come slightly apart. As you breathe out, allow your belly to drop.
• Continue breathing in this way, allowing your belly to rise on the in-breath and drop on the out-breath. Let your in-breath and out-breath get longer and allow yourself to relax more and more with every breath you let go.
• If you are a visual person, imagine breathing in a calming colour like pink through your heart and allowing it to spread through your whole body – any part of your body this colour touches makes it instantly twice as relaxed.
Sonia Zadro is a clinical psychologist with 17 years experience as a therapist. She has worked in private psychiatric hospitals, for TAFE NSW an runs a private practice at the Lotus Centre.