In my last article, I wrote about emotional triggers, providing definitions and giving some examples.
Not all emotional triggers are the same. In fact, some actually are positive and make us feel happy or proud. However, in this article, I will describe some coping tools that were used to help three of my clients deal with negative trigger situations in their lives.
Fear of being humiliated in front of groups
Yossi, 29, is a single man who is in a long-term relationship with his girlfriend. He works as a member of a marketing team in a hi-tech company.
One of the issues that Yossi spoke about was his anxiety at work, especially when asked to make a presentation to his team.
Yossi was able to recall the initial experience when this fear began. When he was in seventh grade, he was making a presentation, and his teacher made fun of him in front of the class. He never got over that experience and remained very scared to do presentations.
Now, he was asked to give his first presentation to this team. Yossi knew the material well, but this did not seem to help. He was scared.
To help Yossi, I taught him two relaxation techniques.
I told Yossi that he could use some interesting mind games to help him relax. I explained that people can “psych” themselves through a scary experience by envisioning themselves in a way that helps them feel less stressed. He asked me to explain.
I told Yossi to imagine that he was the CEO of his company, and that the team members were extremely anxious about his authority. In other words, this mental image gave Yossi a way to turn the tables in his mind. Yossi liked the idea and decided to give it a try.
In addition, I told Yossi that before the presentation, he should try a breathing technique that could also help to lower his anxiety and stress. Yossi was on board.
The 4-7-8 breathing technique was developed by Dr. Andrew Weil (https://www.drweil.com). We practiced the technique in the office. “Get into a comfortable position sitting on a chair. Holding your back up straight with shoulders back, close your lips. Start by exhaling all air audibly out of your mouth. Next inhale through your nose for a count of four. Putting your hand on your stomach, you should feel your diaphragm raising as you inhale. Next, hold your breath for a count of seven. Lastly, exhale completely through your mouth audibly and forcefully, making a whoosh sound for a count of eight. This completes one cycle.” Weil recommends four cycles to get the best benefit.
Yossi came to therapy the following week and reported that the presentation was a success. Not only did Yossi have a positive feeling of accomplishment, but he also learned some important tools to help face similar tasks in the future.
Smoke cessation
Steve, 29, came to therapy to get help quit smoking cigarettes.
Some years ago, I created a smoke cessation program called SmokeQuitters. The program aims to teach people the cognitive and behavioral skills to successfully quit smoking and maintain the change.
After a relatively short time, Steve was helped to quit smoking with a combination of psychoeducation about his addiction and the use of nicotine replacement patches.
Once the client quits smoking, the focus of the program shifts to the most important phase of treatment – helping the client identify and cope with the triggers that can precipitate a relapse.
For example, one trigger is being around other people who smoke. Steve had to learn how to be assertive and ask his smoking friends not to smoke around him.
Another trigger is nicotine craving. It can be triggered by any of the people, places and things associated with cigarette usage. Scientific studies have in fact shown that if you don’t give in to the urge to smoke when the craving is strong, these cravings only last about five minutes. Clients are always surprised to discover that waiting out the urge to smoke for five minutes actually works, and that the craving dissipates.
Quite a few years have passed, and Steve has not returned to smoking.
Car accident and trigger avoidance
Josh, 25, was driving his car when the driver in front of him slammed on his brakes. Josh tried to brake his car, but he was not able to, and slammed into the back of the other car. Neither driver was seriously hurt, but the emotional trauma from the car accident began to take a toll on Josh.
A few interventions were used to help Josh deal with his anxiety from the incident. Therapeutic empathetic listening, combined with cognitive-behavioral therapy, has been shown to help many victims of trauma as well as those who develop post-traumatic stress disorder.
Besides instructing Josh to use the breathing technique described above, I taught Josh two additional relaxation exercises that I felt would help his tensed-up body unwind.
Progressive muscle relaxation is a grounding technique in which you intentionally focus on tensing and then relaxing each muscle in your body from head to toe. When doing this exercise, you need to tense each muscle for five seconds and then let go. Josh was instructed to notice the tension and then notice the difference when relaxing the muscle.
Five senses mindfulness exercise: Josh was encouraged to use all five senses to divert his thoughts away from thinking repeatedly about the car accident.
- Name 5 things you can see.
- Name 4 things you can hear.
- Name 3 things you can touch within your immediate reach.
- Name 2 things you can smell.
- Name 1 thing you can taste.
This mindfulness exercise was very effective in helping Josh diffuse his fear and get more grounded.
The treatment literature on coping with emotional triggers is vast. The above cases provide a few examples of how powerful and effective treatment techniques can be used in countering negative emotional triggers.
The writer is a marital, child and adult cognitive-behavioral psychotherapist and consultant with offices in Ra’anana and Jerusalem. drmikegropper@gmail.com