Tuesday, January 12, 2016

Triggers

Recently a very wise friend asked me about triggers and how I cope with them. She said she feels like she should always keep me entertained and busy so that I don't get bored.  I laughed. But the truth is, she's right. For me, a major trigger is boredom.

What is a trigger you ask?
 "A trigger can be thought of as anything that brings back thoughts, feelings, and memories that have to do with addiction. As if matters needed to be made worse, triggers not only bring about responses that make you think about the drug. In fact, over and over in learning and addiction research, it's been shown that triggers actually bring back drug seeking, and drug wanting, behavior. As soon as a cue (or trigger) is presented, both animals and humans who have been exposed to drugs for an extended period of time, will go right back to the activity that used to bring them drugs even after months of being without it. In fact, their levels of drug seeking will bounce back as if no time has passed" (Jaffe).

One of the reasons my second rehab (The McClean Center see The Pathways Home) was so successful for me was because we spent a great deal of time learning about and discussing triggers.  If you have read my book, you might be thinking, but it wasn't successful, you relapsed! And yet, sadly relapse is in fact PART OF RECOVERY and should be expected in ALL cases of addicts recovering from drug abuse AT LEAST once.  So as an addict, or as an addict's loved one, triggers are pretty darn important.  This is why spending so much time learning about them was crucial to my eventual success at maintaining sobriety. In group therapy we would talk about the physical response to triggers, then we would discuss the emotional response, and finally we would contemplate and hypothesize how to react to those responses. We often discussed cues, or triggers that we would likely experience in the coming week. For example, I was working at a restaurant at the time, and I would volunteer something like, "After work all of my co-workers head to the bar together to unwind and to hang out.  That is a huge temptation for me and a TRIGGER to feel like I'm missing out on something." The group would offer suggestions and support about how to respond when I was in that situation.

Triggers are as unique as the people who experience them.  But generally speaking, they tend to center around emotions and stress.  Each member of my group had added associations based on their own experiences. For me, when I quit smoking cigarettes, driving in a car or after a meal were really hard times. My body was so programmed to smoke every time I set foot in a vehicle and after every meal for so long that it was physically hard to get through those times.  I started keeping a bag of dum dum lollipops in my car so that at least my fingers and mouth could be kept busy.  Eventually, the cravings and triggers dulled and now I can't remember the last time I felt the urge to smoke a cigarette.

Some triggers are far more subconscious than others.  For example, after each rehab, and then for the first seven years of sobriety this final time, every season change made me feel so uncomfortable. Season changes are triggers for me.  I'm not entirely sure why.  And the past few years I have not had the same experience because, like the cravings for nicotine, these associations have been replaced with others.  Still, for decades, something about the weather changing, particularly from cold to warm, made my skin crawl and brought feelings of discontentment and anxiety.  In time, I grew to expect them and to force myself to evaluate all of the wonderful things in my life.  When summer came along, I might not be heading to the nearest bar, but I was bringing my children to my most favorite place, Lake Tahoe.  So I would try to ease those strange feelings by reminding my brain how much more beautiful my life was sober.  For the last few years, I've braced myself with a new feeling in the air, but the triggers have not come; the anxiety has not been present; the desire to use has not risen up.  This is incredibly motivating for me. Now, I can't speak for everyone, but I certainly hope that this is a common phenomenon because to me it means that so long as you withstand the temptations for long enough, eventually they will go away.

This is not to say that triggers don't exist in my life.  Sometimes a trigger will hit me out of nowhere sharp enough to take my breath away. Driving at night time by myself (something that doesn't happen often anyway with four kids) can evoke cravings or feelings of dissatisfaction.  But even those are more and more fleeting every single year.

So back to boredom.  I never made the connection before this week, but this is likely the reason that I am almost never bored. I am scheduled and planned two weeks out constantly adjusting to fit everything in and always with a lengthy to-do list.  This particular trigger can be problematic to my well-being because a little boredom goes a long way in introspection. As a result, I often have to schedule time to THINK about me, my goals, my accomplishments, the things I need to work on.  That's a little backwards to most people who think about those things more organically than I do.  But I'm grateful that I almost naturally overcame this trigger without putting much thought into it. I innately crave activity and action, so it has not been a challenge for me to fill my life with both.  I am a complete extrovert, and I'm grateful always to husband and friends for being my companion and network.  All along the way I've relied on friends and family to help me feel happy and alive.

Probably my most pervasive trigger is weight gain. This is my trickiest because my weight fluctuates a lot. This is also problematic because weight gain triggers a desire to do drugs and to starve or throw up or take laxatives.  This is one that I continuously have to work on and have spent the most of my recovery overcoming. Another thing that's tricky about this particular trigger is that it encompasses so much more than just weight.  Why did I overeat? Why did I gain weight? What emotional challenges or stresses have I encountered? What is leading me to binge? These are the questions I have to ask and sincerely analyze in order to combat this particular trigger.  I'm not perfect at it, but like the cravings, It seems to get easier with practice and time.
(During this phase of my life was when I felt the fattest, ugliest and was filled with the most self-doubt.)
(20 years and close to 100 pounds later, I am way better at seeing myself, my worth, and my ability through a clearer lens.)

Through therapy, I learned coping mechanisms to combat my triggers. This might not be true of all of your loved ones who suffer from drug or alcohol addictions. So one thing you can do to help is get to the bottom of it in a kind and loving way.  This can be difficult because many addicts don't know what their triggers are themselves and are therefore ill-equipped to articulate them to others.  During or after recovery, spend time with your loved ones talking with them about what types of experiences are particularly hard for them. That will be a great place to look for their triggers.

Also, I relapsed even after learning all of this about my recovery. So if your loved one relapses (and most of them will), try to love them anyway. When they are ready for change, be prepared to completely replace their social network. People who stay in their same environment with their same friends are almost never successful at sobriety. If you can figure out what their triggers are, you can help support them in their quest for sobriety.  Don't beat them up about relapse as that will lead to more intense feelings of guilt (believe me they already feel like a failure, and they already feel like all is lost).  You can support them by showing them that they can start again. It's never too late to have your first day, or hour, or minute of sobriety. It's never too late.

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