Managing Triggers

(C) GOT PARTS? BY ATW

Triggers are something that remind you of, or bring you back to, an emotional or psychic place of remembering something about the traumatic event(s) in your past.

Triggers vary greatly from person to person, and from alter to alter. A person (or part) may or may not be aware of what their triggers are, or why they are triggers. Triggers are specific to that person's/alter's experience. Something which is very triggering to one person or alter may not be a trigger to anyone else, perhaps not even to anyone else in one's own system. Triggers usually involve one or more of the five senses: sight, sound, taste, touch or smell.

One basic way to begin learning to manage triggers is to have each part make a list of what their triggers are, understanding this list may grow longer as the therapeutic process progresses. This is not because you're 'getting worse', but is because your bank of self-knowledge and self-awareness is growing. This is a good thing, because the more you know, the less chance you have of being blindsided by something on the future.

Each alter can share their list with others inside, and as co-consciousness and the level of trust between parts increases, you all can find ways of helping each other when one or more parts get triggered.

It will be important to share your lists of triggers with your therapist, who will have additional ideas on how to work to get them to a manageable level. However, please remember there is no magic answer, no quick fix to any of this. It comes down to doing hard and challenging work, seeing what works for others, and sometimes, plain old trial and error.

We are not isolated in the effects our triggers have. People around us, and those we are in some type of relationship with are also affected when we are triggered, or when we learn to deal with our triggers.

One system had this to say about triggers...

"People have different triggers. It would be helpful to discuss these things. Allow yourself some room to avoid certain triggers while working on becoming comfortable with a physical environment that has been involved in previous hurts. It's very possible to overcome these triggers with work and support. Believe in yourself!"

While some triggers may never totally go away, over time you can figure out what works, and so to get to a place where the effects of triggers don't have to be as devastating or disabling.

Sectioned in Hospital - 5 months 15 days

Written by Fox.

DAY 169 - 23rd January, Thursday

Well, today wasn't really any different from yesterday. Keri's been up and down and sideways and front ways and back ways... I can't keep up with her mood!

She caught up with Becki today who visited today. She's coming every Thursday now. Keri let her know about the stuff that's happened since she visited last week. She told Keri to email her with anything Keri wants from the storage unit in social services. Keri's wondering whether there's much point. She's been told to live a day at a time, not to plan anything so she's under no pressure and try to get her basic needs met. She can't really do that until someone gets through to Sally, which at the moment is hard as Keri and Sally are both agreeing secretly on suicide plans. It sucks when that happens. I don't want to die, but when Sally's at the forefront, there's not much we can do.

Keri's mum and her partner came to visit today. They spent time chatting, drinking coffee, all that kind of stuff. They didn't bring Amos today as Keri doesn't have any unescorted leave so it wouldn't have been fair for him to be sat in the boot of the car for hours. Keri was fairly okay besides the fact she was in tears before they arrived, pulled herself together and then burst into tears again once they'd left. Something is seriously triggering off Keri's depression and I can't think what it is. Keri had a think with Matt when he read the blog but she couldn't think of anything either. It's getting really hard for all of us! The problem is Keri's been pretending to be okay for the last couple of days so she can try and get out with Sally to commit suicide. And I think she's actually being successful in fooling the staff. 

Sectioned in Hospital - 5 months 4 days

Written by Fox.

DAY 158 - 12th January, Sunday

Keri was actually up before midday! She wanted to go back to sleep but her headache had gotten pretty bad. Her depression was telling her not to get up. She's still suicidal but doesn't want to do anything while she's on one to one observation. Sally hasn't come out today but Keri's head has just been getting worse and worse. If she doesn't come out this evening then it's got to be tomorrow or something. There's only so long Sally can control herself before she explodes.

Because of her headache and feeling tense, Keri's started rocking quite a lot and pacing around quite quickly. There's a lot of nervous energy that she needs to let out but she still feels tired. She doesn't went to pace yet does anyway because she can't help it. She'd prefer to be sat in her room watching movies, huddled in bed rather than feeling compelled to sit there rocking back and forwards.

Keri's illness that she had yesterday has triggered off her disordered eating again. She had a nice hot meal last night when her stomach stopped rejecting all food but then woke up this morning and decided this was the time she was going to get back down to her 'target weight'. She's even gotten to the point where she's going on a forum promoting disordered eating behaviours. She's been a member since last year but forgot about it when her eating wasn't so bad. Now she's back on it and has already joined a group of people who are going to start a fast tomorrow. Keri's already fasted today so she's getting in a head start there. I don't want her becoming really underweight again. She's already been on the brink of fainting today! Luckily she's stuck to Guitar Hero and hasn't started all her exercise yet.

Keri had a one to one with Matt and they went through my blog. Then Matt decided to have a go on Keri's Guitar Hero! He's never played it before and didn't get through a single song without getting booed off stage which I found quite funny. Giving him credit though, he did pretty well considering he's never played it before! But still terrible. That's the basis of Keri's exercise at the moment, standing up for so long though makes her dizzy. If the physiotherapist turns up tomorrow there's no way she's going to be able to take Keri to the gym to do her exercises, that's if she can get Keri to say yes anyway! Does the almost-fainting urge Keri to eat something? No. She sees it as a sign that she's doing well and losing weight. WHY CAN'T SHE UNDERSTAND SHE IS NOT FAT. She's either starving herself or deliberately making herself sick. Can't we find a happy medium? Apparently not. 

Hopefully we'll have good news tomorrow whatever comes out of this review thing. Everyone's still unclear about what on earth is going on with Keri, her placement and her obs levels. That'll be interesting tomorrow if she gets her leave all given back. May as well give Sally a free ticket to do what she wants and give Keri a suicide ticket. They can't keep her on this level of obs permanently though. It totally defeats the object of a rehabilitation unit. If the worst comes to the worst she'll be sent back to either the acute ward or the secure ward. 

Sectioned in Hospital - 5 months 3 days

Written by Fox.

DAY 157 - 11th January, Saturday

Keri didn't even get out of bed until nearly 4pm. Unfortunately her stomach wasn't good and she was spending most of her time throwing up in her toilet. She felt better by the evening but she had to get some fluids inside her due to all the vomiting. 

When she finally went downstairs she found out from the staff that the manager (one higher up than the manager of Alder Unit) had been in touch. The police don't want yet another missing person report and to prevent this happening, Keri has to be kept on one to one observation whenever she's downstairs. This may be invading Keri's privacy but the choice is partly being taken out of the staff's hands at the moment. Sally's quite annoyed with the obs level. It won't necessarily stop her disappearing but it makes it slightly less likely. According to staff, if Keri left the unit (technically Sally would've left) then they'd set of their alarms and arrange for a PMVA team to take Sally to one of the seclusion units. For those that don't know, PMVA means the Prevention and Management of Violence and Aggression. Hopefully it doesn't get to that point but Sally might test her luck on that one. I feel so sorry for Keri if that happened. She would find herself in a strange secluded room, locked in, not knowing how or why she was there. It would be made worse if the nurses dealing with her were completely DID ignorant!

All her leave has been cancelled too. No unescorted leave, not even any escorted leave with staff. She's confined to the unit. Looks like their 'positive risk taking' idea doesn't seem to be being used at the moment!

Keri had a DVD evening with the staff today. They finished watching Yes Man and then watched the first Hangover movie. It was just her and the three staff. The other patients all seem to have disappeared. They're probably tired from their trip that they had to Weymouth yesterday. It's been very quiet. Although there's only 6 patients here at the moment; 4 on leave, 2 technically discharged.

With a headache starting up, it's probably good that her obs level is the way it is. It's now after 1am and I wouldn't usually write so late but I like doing my blog posts. It's weird as there's 3 members of staff working tonight. That hasn't happened since Keri arrived! Must be another management thing. Even when Keri's been brought back by police, even if still dissociated as Sally, there was still only ever two staff working. It's odd. Nothing has really been explained very well but as long as the weekend goes by without any incident, maybe we'll find out what's happening when they have another review meeting about Keri on Monday; whether we are invited to that meeting or not is still unclear.

Well, better let Keri back out. She's keeping herself well distracted but her headache keeps reminding her of things that could potentially happen and she's worrying about it. So far she hasn't told the staff. I hope she does by the time she goes to bed. There's some things that are fine being kept secret but when a trigger warning like her headaches start up then she needs to tell people about it.

Sectioned in Hospital - Day 111

Written by Fox.

DAY 111 - 26th November, Tuesday

Keri refused to get out of bed until the afternoon again even with the staff coming in repeatedly trying to encourage her to get up. By the time she got up she hadn't been up for even an hour before she was called in to have her ward round.

Her ward round consisted of Keri, her psychiatrist, and Blondie, plus Sye from Alder Unit in the beginning. Basically to put a long story short, Sye said that he would be happy to have Keri transferred to his unit on Monday, which is six days time, however she'd still have to remain sectioned. Keri was shocked at how quickly they were hoping to get her there but also glad that she would finally be leaving the acute ward. It's been nearly 4 months! To be able to move, Keri has to go out on unescorted ground leave every day starting tomorrow, even if it's just ten minutes. Her psychiatrist also turned around and said that she had been thinking about Keri's medication situation and wanted to add a mood stabiliser. She's already on antipsychotics, antidepressants, sleeping medication, benzodiazepines... and now she wants to add a mood stabiliser? Ridiculous! She's hoping it'll help Keri stay stable when it gets to the point they start weaning her off the high dose of Diazepam when she moves to Alder. They're going to have to wean her off very slowly over several months. So that was basically her ward round.

Since then Sally has been going nuts. She's been shouting and screaming which has meant Keri's ended up spending all day with her headphones on and sat in an almost catatonic stupor. She even tried talking to patients this evening but was hearing things they weren't actually saying, so they were getting confused and so was Keri. Jen gave her Lorazepam along with her sleeping meds at 1am and Keri's currently temporarily back onto ten minute observation as she was talking to Jen about how much Sally's behaviour was effecting her. I wouldn't be surprised if she comes out and slashes Keri's arm in a "Fuck you" kind of way. The problem is Keri's getting sleep deprived because of all this and it was even stated in ward round about how tired and haunted she looked. It's amazing how a couple of days can make such a difference to your appearance.

One achievement (well, Keri's in limbo about it even though she's tried hard to achieve it she's thinking of dieting again..) Keri is at a 'healthy' weight! 

Keri's CPN visited and she had physio but nothing exciting happened. Her CPN mentioned something about Keri being sectioned for 10 months?! I wasn't really listening so I'm really hoping I heard it out of context.The physio decided to electrocute her with a tens machine. I've never seen one of these before but she brought it up to try on Keri so see if it would help Keri if she consciously wanted to self harm. A tens machine basically sends out an electric shock repetitively and is used for pain relief, but if you turn it up high enough then it causes quite a lot of discomfort. Keri was really nervous when the physio first put it on. Her first thought was that it was going to be like being tazered; which Keri experienced once before when she was psychotic. Not a pleasant experience! But a tens machine is nothing like that. They tried it on Keri's arm but because of her injuries the physio couldn't turn it up too high. She's coming back tomorrow and try on the back of her neck. How exciting...

She did have some leave with Cat but got panicky. It was dark and she was seeing young children. By the time she got back she needed Lorazepam and ended up having a panic attack. Darkness and young children are two of Keri's massive triggers at the moment so it's a bloody good job she went out escorted!