Friday, May 25, 2012

Triggers - Avoid or Expose?

I was just thinking about the practice of identifying and avoiding triggers in therapy. Sure, inherently harmful triggers are best avoided... but what about triggers that are what we call "conditioned stimuli?"

[For the non-psychologists out there: some of us are triggered by certain things that are actually harmless, but during the course of our lives, we somehow came to associate them with feeling like crap. For instance, walking by a restaurant you used to frequent with an ex could trigger negative emotions. The restaurant itself is harmless, but you've been conditioned to feel sad when walking by it. As such, the restaurant is now a trigger.]

Some therapists may urge their patients to simply avoid all triggers. Sure, this sounds like a good idea, but is it truly helpful? If the patient is in acute / reactive pain, then throwing some more negative experiences their way probably isn't a good idea. But typically, I think that systematically exposing people to triggers, just like you would to anxiety provoking stimuli, would lead to habituation.

While this may be common practice for treating some disorders, it doesn't seem to be the case for all of them (i.e. eating disorders). For instance, when a particular food may trigger a binge, the general advice simply seems to be to avoid that food. Well, I'm just not so sure.

1 comment:

Rev. Katie Norris said...

I have had different therapists give me advice both ways on this, avoid the trigger or try to desensitize it. From my personal experience, desensitization does not work for me.

I constantly expose myself (since high school and I am now 34) to the trigger of a panic attack from performing or speaking in front of other people, and the panic has never gone away. As a minister I preach all the time and speak in many places, but the panic never goes away. I also panic in hospitals but have worked as a hospital chaplain and that never got rid of the panic either. And it is interesting that you write about binge eating because I have a binge eating disorder and we can't keep any trigger foods in the house. People keep telling me to eat binge foods "in moderation" but one bite leads to months of binging.

Clearly every person is different but this approach has not worked for me.