Identifying your triggers with a… | Counseling | Therapy

Identifying your triggers with a PTSD trigger table

Alex Robboy , CAS, MSW, ACSW, LCSW — Founder & executive director


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Identifying your triggers with a PTSD trigger table image

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What is a PTSD Trigger Table? A PTSD Trigger Table is a simple method of tracking your triggers and reactions to these triggers. While it may not be possible to have this table on you at all times, it is helpful to have the table with you as much as possible. This will enable you to immediately record your trigger and your response to the trigger which will likely lead to more a more accurate account of your triggers and your responses. You may be able to carry your table discreetly in a calendar or planner. If you have a “smart phone” you may be able to use a program like Microsoft Word or Notes to record your table. You will likely need to record your responses for at least two weeks to notice important patterns in your PTSD triggers and your responses.

What should I record on the table? There are five important categories that make up the table. First is the “date and time” of the trigger. This will help track the frequency of triggers and may reveal a pattern related to the time of day or month. The next category is “trigger” which is where you record the exact stimulus that caused your PTSD like symptoms. Be as specific as possible and make sure to note which senses where involved (sight, sound, touch, taste and smell). You might not always know the exact trigger. If that is the case make sure to record as much detail as you can about the general situation and surroundings when you began to experience PTSD like symptoms.

The third category is physical responses; Note any physical response to the trigger even if you think it is unrelated. You may experience: headache, migraine, racing heart, chest pain, numbness in a specific body part, pain in a specific body part, ringing in the ears, tightness in your chest, shaking, nausea, stomach ache, diarrhea, dizziness, etc. Physical symptoms may initially appear unrelated until you track your triggers and realize you have a pattern of a specific physical response. Also note any existing physical conditions you may already have that seem to be impacted by the triggers. For instance, if you have IBS, your IBS symptoms may become worse after having experienced a PTSD trigger.

The fourth category is “emotional responses.” Record the emotions you felt during or shortly after experiencing the trigger. You may feel: guilt, shame, anger, disappointment, annoyance, frustration, loneliness, anxiety, sadness, hostility, hopelessness, humiliation, confusion, numbness, etc. Record whatever emotions come up even if you are puzzled by your emotional reaction to the trigger. The final category is the “thoughts” category. In this section of the table make sure to record your exact thoughts either during the reaction to the trigger or shortly after. Do not be critical of your thoughts! Recording your thoughts honestly will increase the chances that you will uncover a pattern.

Below are two examples of PTSD Trigger Tables. The first example is a day from Bob’s PTSD Trigger Table. Bob is a police officer who has been experiencing PTSD like symptoms since being shot at during a domestic violence call. The second example is a day from Anna’s PTSD Trigger Table. Anna is an ER nurse who has been experiencing PTSD like symptoms since being attacked and raped while she was walking from the subway to her apartment after work.

Bob’s PTSD Trigger Table

Date & Time Trigger Physical Responses Emotional Responses Thoughts
December 7th, 2010 @ 6AM Was getting dressed for work and had the news on, a story about a woman found murdered in the park came on Tightness in chest Agitated Angry I thought of the girlfriend who had been murdered at the scene, saw her face in my mind
Makes me angry that things like this happen a lot
December 7th, 2010 @ 10:20AM Got called to a domestic violence incident Sweating Tightness in chest Nervous Ashamed Dread Why do I have to feel this way ... I need to be able to do my job! Even though I know most likely nothing horrible will happen, I just feel like it will
December 7th, 2010 @ 10:45AM At house of domestic violence incident, house smelled like cat pee, house where the murder took place and that guy was shooting at me also smelled like cat piss Nausea Whole body felt keyed up, adrenaline rush Disgust Irritable How can people live like that? This guy better not start with me…
December 7th, 2010 @ 1:15PM Was eating lunch with co-workers, they were talking laughing and joking about a call they had Just tense, kind of all over Unease I would normally be able to laugh with them, but I just couldn’t
December 7th, 2010 @ 3:45PM Had to fill out additional paperwork about the murder for the prosecutor Low energy Tightness in chest Drained Irritable I am tired of having to think about this incident, worried about the trial because that will force me to think about it much more
December 7th, 2010 @ 5:00PM When I was parking in front of my house, my neighbors car backfired, it sounded like a gun shot to me, memories about the guy trying to shoot at me kept popping into my head for the next hour or so Revved up; like an adrenaline rush Embarrassed Irritable Thought about punching my neighbor (not seriously, just fantasy) Wished I would stop reacting to so many things
December 7th, 2010 @ 7:45PM Jack (son) wanted me to a play video game, said no because it was a shooting game, just thinking about the game made me think of the shooting again, memories from the incident kept popping into my head for ~ 20 minutes Low energy Back feels tight Drained Guilty Just want to go to bed I’m being a bad Dad for not wanting to play the game with my son

Anna’s PTSD Trigger Table

Date Time Trigger Physical Responses Emotional Responses Thoughts
December 7th, 2010 @ 10:30AM Got back from a great run, then Leo (friend) called to make plans about going out to a bar Saturday night for Michelle’s birthday, explained that I didn’t know if I felt like going out to a bar, Leo got mad and said I’ve been really unsocial and a bad friend recently Started getting a headache Irritated Annoyed Why don’t they get it that I just don’t want to go out right now? They’re being bad friends by not respecting the boundaries I need right now
December 7th, 2010 @ 12PM Headed out to work, construction guys started catcalling me, their comments reminded me of what the rapist was saying to me when following me just before attacking me Heart beating fast Adrenaline Rush Shaky Scared Mad I wish they knew how scary and hurtful their antics are to me! Wish I could have lashed out, punched them even Must find new way to subway
December 7th, 2010 @ 8PM Rape victim was in ER, even though supervisor agreed to temporarily have me not treat these cases, I still saw the woman and overheard what had happened to her, experienced intrusive images for over a hour Nausea Shaky Head hurting Sad Overwhelmed Why did this happen to me? To her? Wish I could forget it all
December 7th, 2010 @ 11:30PM As per my routine since the rape, took a cab home, drove past street where the guy attacked me Jittery Nausea Panic then numbness Can’t even recall, was just trying to think about nothing even though the rape kept replaying in my head
December 8th, 2010 @ 12AM Got home, listened to answering machine…Aunt Kate called to say she wants to set me up with her co-worker Noticed how tight my neck was Annoyed Irritated I’ve already said no twice! I just wish my family would respect my wish to not deal with dating right now
December 8th, 2010 @ 12:15AM Eating dinner, flipping through the TV channels, just happened to flip by Thelma & Louise on AMC Neck hurts A bit shaky Bitter Sad At least they got revenge (sort of), they’ll never even catch my rapist
December 8th, 2010 @ 1:30 AM Laid in bed for 45 minutes, could not sleep, crying, don’t know exactly what the trigger is? Alone? Dark? Tired at the end of the day? Left to my own intrusive thoughts? Neck hurts drained Sad Overwhelmed Tired Just want to sleep and not stay up wish I would not and worry about everything

Hopefully Bob and Anna’s PTSD Trigger Tables were helpful examples in what a PTSD trigger looks like and how to use it. Try this table for yourself. Track your triggers and your responses to these triggers for two weeks. At first, recording this information may feel like a daunting task. Remember to be honest in your recordings and simply try to do your best. After two weeks of recording your triggers and symptoms, set aside time to look over your table. Look for any patterns. What is surprising to you? What questions do you have? If you are struggling with finding patterns in your table, revisit the table after not having looked at it for one week. If you still cannot find patterns about your triggers or responses you may want to consult with a therapist who is familiar with trauma. Even if you have gained a great deal of insight from doing the table, you may still want to seek therapy to help you with how to best use the insight to manage your PTSD symptoms.

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