485 – Triggers Out With the Bad and In With the Good
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Objectives
– Identify PACER triggers for stress and relapse, ways to prevent and mitigate them and steps to remind yourself to do the prevention activities.
– Switch focus from eliminating triggers for your addiction or mental health issues to ADDING triggers for health and recovery.
Triggers
– Triggers are sights (including people, places and things), sounds, smells, situations that make you think about doing something or bring up particular memories or emotions.
– Triggers can be positive. They remind you to do things that are good for you or make you happy.
– Puppies
– Push notification to remind you to do to a meeting or do a mindfulness check.
– Triggers can also be negative. They make you think about or want to do things that are not helpful for your recovery, cause cravings or bring up memories or feelings that are unpleasant.
– Alcohol in the house
– “Stress”
Triggers During a Crisis
– During a crisis people are at risk for the development or resurgence of mental health issues because there are so many things that trigger anxiety, anger, hopelessness and helplessness
– Emotional valence can refer to the strength of a trigger.
– Research has shown that negative triggers and events are about 5 times stronger than positive ones.
– We will go through PACER triggers for distress that can be mitigated and for happiness that can be enhanced.
Triggers Gamification
– ABCs
– Pictionary
– Taboo
– Acronym maker
– Trivial Pursuit (Physical, Affective, Cognitive, Environmental, Relationships, Spirituality)
– Flip chart (causes, interventions)
– Beach ball
– Small group activity
– Family Feud—top 5 physical triggers for depression…
– Jeopardy—A good pillow can help with this…
Physical Triggers
– How can each of the following be a trigger for depression, anxiety or addiction during a crisis- What might cause it and how can you prevent or minimize each one-
– Pain
– Fatigue
– Hunger
– Sickness (gastric upset, allergies, a cold)
– Substance use
– Sleeping too much/altered circadian rhythms
– What things can you do to remind yourself to do the prevention activities (i.e. a push notification to get ready for bed)-
Affective Triggers
– During a crisis what might cause each emotion and how can you prevent or minimize each one-
– Anger
– Loneliness
– Hopelessness/Helplessness
– Depression
– Envy/Jealousy
– Guilt
– Grief
– What can you do to remind yourself to do the prevention activities- (i.e. Turn off the television. Call a friend. 5:1 control activity)
Cognitive Triggers
– How can each of the following thought patterns be a trigger for addiction, depression or anxiety during a crisis- How can you prevent or minimize each one-
– Thinking you can control nothing (What can you control)
– All or nothing thinking (Find exceptions)
– Personalization (What are other explanations-)
– Emotional reasoning (Find the facts)
– Negative perceptions (Find the positive)
– What can you do to remind yourself to do the prevention activities-
Challenging Questions: REAP REWARD
– Reasoning: Facts vs. Emotions
– Extremes
– All Aspects
– Probabilities: High vs. Low
– Recognize your reactions (How and why)
– Examine your options and resources to improve the next moment
– Welcome the challenge
– Accept the things you cannot change
– Reach out for support and to help others
– Determine the best use of your energy (purposeful action)
Environmental Triggers
– How can each of the following be a trigger for stress during a crisis- How can you prevent or minimize each one-
• Places (cabin fever)
• People (coughing, sneezing)
• Sights (masks, media, billboards, commercials, hearse)
• Smells
• Sounds (sirens, ominous music)
– What can you do to remind yourself to do the prevention activities-
Relationship Triggers
– How can each of the following be a trigger for stress during a crisis- What might cause it and how can you prevent or minimize each one-
– Low Self-Esteem
– Rejection/Abandonment
– Isolation
– Friends and family that are not with you
– Friends and family that ARE with you
– What things can you do to remind yourself to do the prevention activities-
Triggers for Happiness and Recovery
Physical Protective Factors
– Physical things that you can do to improve your health and happiness.
– Nutrition: Hydration, reduce stimulants, eat
– Sunlight
– Sleep
– Exercise
– Pain Management
– Health
Affective Protective Factors
– Positive emotions help balance out distress.
– Happiness
– Curiosity
– Determination
– Competence
– Ability to self-regulate when you get upset
Cognitive Protective Factors
– Cognitive factors that enhance recovery include:
• Optimism
• Knowledge of how to stay healthy and the impact of physical health on recovery
• Confidence in your competence to handle the situation
• Creativity & effective problem solving skills
• Distress tolerance skills
• Clear future goals and plans to achieve them
• Determination and perseverence
Environmental Protective Factors
– When you are in a safe and comfortable environment you are less vulnerable to distress and you can relax and let your brain and body regroup after a stressful day.
– Create emotional and physical safety (Sights, sounds, smells)
– Ensure access to basic needs: Health/mental health care, housing, food
– Identify sources of employment and financial support
Relationship Protective Factors
– Social support is essential for health and wellbeing.
– Social Support (even online)
– Secure attachment (CRAVES: Consistency, Responsiveness, Attention, Validation, Empathy, Solution Generation)
– Family connectedness
– Effective communication skills
– Emotional Intelligence
Final Thoughts
– Recovery and Resilience are about beginning new behaviors, encouraging positive feelings and embracing new ways of thinking, not just eliminating old behaviors, people, places and things.