Monday, December 8, 2008


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.

Just as gravity has a motivating effect on a roller coaster, brain chemistry has a similar effect motivating triggers. When people use substances or engage in escape behaviors the brain releases neurotransmitters such as adrenaline and dopamine that trigger the brain’s pleasure/reward center; or it may release serotonin which lessens anxiety and depression. With repetition of the drugs alcohol, or other addictive behavior, the brain’s reward center overrides the cognitive, rational thinking part of itself. Brain scans show that when using or engaged, there are reduced levels of activity in what is called the prefrontal cortex. This is the part of the brain where rational thought could override impulsive behavior. But addiction hijacks the brain. The reward, pleasure center holds captive the thinking center. Science also indicates that stress alters the way we think. Parts of the brain that help us problem solve shut down at times of stress fueling impulsive behavior.

It is very likely you have heard your husband, wife, partner, mother, father, your boss, a friend, your attorney or even a judge say, “What were you thinking?” The answer is − you weren’t thinking.
The science of addiction indicates that 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 appears to be connected to brain chemistry.

The good news is to know that the brain has plasticity to it. That means in treatment and recovery practices you can learn skills to calm the emotional responses and reactivity area of the brain. You can learn to avoid triggers that activate the emotional area of the brain, and you can learn to enhance the decision making area of the brain 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 practicing new skills and new ways of thinking, hence the reason we so strongly urge ongoing involvement in aftercare and other support systems.

Will power alone is not a defense against a relapse. Recovery is achieved, maintained and enjoyed through a series of actions. Learn to identify your triggers and with each one identify a plan that anticipates and deescalates 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 only on the positive feelings you associate with the behavior, it is glamorizing using behaviors and in the moment totally forgetting about the negative consequences.
When I get overwhelmed about my life today, I find myself calling a few old buddies and reminiscing about the 'good old times.' Well let me tell you about those times - I was young, married with two kids, and my wife was unhappy with me because I wasn’t keeping a job while she was working two. I was doped up a lot and would get on my motorcycle and take off for days at a time, lost in my drugs. I wasn’t responsible or accountable to anyone. I was just into me. So now, in recovery, it is scary to realize I am accountable to my two kids and to my girlfriend today. It’s depressing to look at the financial mess I made as a result of my drinking and using, so I go back into moments of glorifying the old times to forget about the fears I have about how to handle my responsibilities.

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 and at that moment you enter a slippery zone, touching the trigger. While romanticizing is in and of itself a trigger, it is often 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 off into 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 as you watch you 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?

2. Feelings
Addicts have used their behaviors and substances for years to separate from their emotional states. And there is so much to feel about—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.

Any person or situation can trigger threatening feelings. You are upset when you realize your friends are reluctant to include you on a weekend outing because you created a scene last time. You want the people you work with to like you but you are anxious that you will be rejected, or not welcomed. Your sister won’t let you baby sit her kids anymore and you feel guilty, sad and angry. You just met with your ex-wife and you walk away angry, like always when you see her. You are working hard in your recovery and you know you are doing pretty good but it still isn’t easy to have these feelings and not be reactive. 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, so the goal is to learn how to tolerate the feelings. Recovery is the ability to tolerate your feelings without the need to medicate, 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 conscious, offering direction for amends. It is critical for you to have this insight, and more importantly to start to take ownership of recognizing the feelings when you have them. It is vital to learn how to be with the feeling and how to appropriately express it. It is also necessary to find safe people in which to share your emotional experiences.

So when you recognize your feelings ask yourself -
What do you need? What feelings are ones you go to any length to avoid? What is the price you pay for hiding, masking those feelings?

3. Loss
Coupled with the trigger of feelings is the fact those feelings are often associated with loss. By the time you get to recovery you have had multiple losses in your life, often losses 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; or the death of friends, family; or abortions, career or work opportunities missed. As an addict you are likely to have losses related to health issues. Perhaps you have Hepatitis C, or HIV, or injuries due to accidents.

It is not that you are suddenly thinking about these losses, but one more time there may be a physical trigger − 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, but to not live in the pain and anguish of them which is what happens when you don’t acknowledge them and what they mean, triggering you back to your using behavior. With some loss 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.

4. Resentments
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, 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. They are also built on entitlement, which is a form of unrealistic expectations and impatience.
I have been in recovery six weeks now. I resent the fact that my wife still doesn’t trust me.
Now that I am clean and sober my boss should give me that promotion I deserve.

The attitude in both examples is not just that you should be rewarded for doing well, but that you should be rewarded for the sacrifices made, after all you have given up your alcohol, your drugs, and/or the addictive behavior and therefore deserve to be rewarded. The problem here is that you are still more connected to the loss than to the gifts of sobriety.

Unrealistic expectations + impatience = resentments.

Ways to move from resentments are – 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 live.

Some questions to consider are - What does it mean for you to hang onto resentments?
What would it mean to accept that you have been hurt or wronged and that you can no longer change that? What does it mean to take responsibility for your own feelings? Ultimately who pays the price for hanging onto resentments? Today are you willing to let go of resentments?

5. Slippery people, places or situations
You need to identify specific triggers that are people, places, and situations that are high risk. Slippery people could be your ex-lover, certain family members, 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, a family event, or vacation setting.

Medication may be a trigger for which you need to be accountable. While there are situations where 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 your brain is going to remember a good feeling, saying more is better. There is also a tendency to look for outside fixes too readily. Just because you are agitated, doesn’t mean you need a prescription pill. Just because your knee hurts you don’t need to take your sister’s pain meds. Or if you have difficulty sleeping it doesn’t automatically mean a sleeping pill is indicated. Again, there are situations where 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 creates the greatest safety for you to not get triggered? What triggers can you avoid? For example, do you really need to be at this family event? Is it worth the risk? That is what you always need to ask yourself, is it worth the risk? You don’t need to test yourself, you don’t have to prove anything; this isn’t a contest. If you can’t avoid a certain place, can you lessen the contact or time? Meaning, you go to the wedding, but you know you will leave prior to the reception.

While some decisions around triggers are absolute, others are not necessary for your entire life. Know your triggers and make a plan accordingly. In the face of a trigger, what do you need to do? What do you need to tell yourself? Who can you reach out to for support and or problem solving?

Today in recovery you have options:
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 has proven time and time again, that recovery is not a solitary process, and cannot be sustained in isolation.
4) trust your Higher Power is on your side

This article is excerpted from Claudia's new audio CD Triggers and new DVD The Triggering effect.

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