Complex PTSD Triggers In Relationships (And How To Manage Them)

Written By Canh Tran

What is Complex Trauma/CPTSD?

Complex trauma is a term used to describe repeated or prolonged exposure to traumatic events, often during childhood or within close relationships.

Individuals who have experienced complex trauma may encounter triggers that can evoke distressing emotions and memories associated with their past traumatic experiences.

What Are Triggers?

Complex trauma triggers are stimuli that remind individuals of their past traumatic experiences and activate distressing emotions and memories.

These triggers can vary from person to person, depending on their unique traumatic experiences and the associations they have formed.

They can be external, such as specific situations or environments, or internal, such as thoughts and emotions.

Examples of PTSD Triggers (Also Known As Re-Experiencing)

  • Overwhelming emotions

    • Feeling misunderstood

    • Feeling invalidated

    • Feeling helpless

    • Feeling confused

    • Guilt

  • Shame spiral

    • Feeling like you are inadequate, bad, unworthy

    • Feeling like this for hours and days at a time

    • Difficulty separating feelings from thoughts

    • Feeling disconnected from your true Self, emotions, and body

  • Lack of boundaries

    • Someone touching you without permission

    • Someone yelling at you for something that isn’t your fault

    • Someone blaming you for their emotions

    • Someone putting their responsibility on you

  • Too much stimuli

    • Loud sounds

    • Bright lights

    • Crowds of people

  • Anniversaries and memories

    • Nightmares

    • Death anniversaries

    • Birthdays

    • Holidays

  • Feeling unsafe

    • No clear directions

    • No options or choices given

    • Lack of safety in your body

  • Intimacy

    • When things get too deep and intimate

Common Thoughts When Triggered

  • This person is out to get me

  • I can’t trust this person

  • Why are you attacking me?

  • Why are you asking me so many questions?

  • I can’t do anything right

  • What’s wrong with me?

  • I’m such a loser

  • I’m pathetic

  • Why do I always do this?

  • I don’t understand why everyone treats me this way.

  • I can’t stop ruminating/thinking over and over again

  • It doesn’t matter. What’s the point?

Common Feelings When Triggered

  • Helpless

  • Confused

  • Irritable

  • Angry

  • Frustrated

  • Rage

  • Sadness

  • Grief

  • Scared/Fear

  • Numb

Common Behaviors When Triggered

  • Slouching posture

  • No/poor eye contact

  • Feeling tense and restless

  • Needing space, to go away, and for one to touch me or be near me

  • Feeling numb, disassociated, and/or disconnected

  • Feeling angry like I’m about to burst and yell

  • Moving fast and having an excess of energy

  • Wanting to break things, self harm, and/or self destruct

  • Suicidal ideation

Emotional Dysregulation

When someone is unable to manage their emotions and it overwhelms their nervous system, they are dysregulated.

All of us can be dysregulated, even without a history of trauma.

Emotional Regulation

Emotional regulation is when someone is able to:

  • Name their feelings

  • Identify their feelings

  • Understand what triggers them

  • Understand and reduce their emotional vulnerability (increase your ability to cope with difficult emotions)

To learn and read more about emotion regulation from a DBT lens, click here.

What Makes It Hard To Regulate Our Emotions?

  • Lack of skills and tools

  • Biology

  • Emotional overload/feeling overwhelmed

  • Myths/false stories around emotions

  • Reinforcements around emotional behavior

  • Moodiness and irritability

The Good News Is That We Can All Learn To Regulate Our Emotions

Therapy is not the only way to heal, learn to assert our boundaries without guilt, ask for help, and manage life stressors and transitions more healthily. There are so many ways to grow, heal, and change.

With therapy, an effective therapist can offer you hope, space, patience, validation, and the ability to practice skills and tools without judgement.

What is the Window of Tolerance?

The window of tolerance was developed by Dr. Dan Siegel to describe the optimal zone of “arousal” for a person to function in everyday life.

When a person is operating within this zone or window, they can effectively manage and cope with their emotions.

For clients who have experienced trauma, it is often difficult to regulate emotions and the zone of arousal where they can function effectively becomes quite narrow.

How Do I Get Back In My Window of Tolerance AKA Manage My Triggers?

  1. Grounding Techniques

    Grounding is the direct contact of the body or a part of the body with something that provides support to the body. You can ground by sitting in a chair, standing against a wall, walking and paying attention to how your feet make contact to the ground, lying down on the floor or on a bed.

    When you are grounded, you are aware of your body the present moment. When you are in the present moment, you are not worried about the past or the future.

    The grounding skill known as "54321" was not created by a specific individual or organization. It is a technique commonly used in cognitive-behavioral therapy (CBT) and other therapeutic approaches to help individuals manage anxiety, stress, or overwhelming emotions.

    The 54321 technique involves focusing on your senses and surroundings to bring your attention to the present moment.

    • 54321

      • 5 things you can see

      • 4 things you can touch

      • 3 things you can hear

      • 2 things you can smell

      • 1 thing you can taste

        Learn more about the 54321 method here

  2. Breath Work

    Breathwork is a practice that involves consciously controlling and regulating our breath patterns to bring about a sense of calm and balance.

    It's an ancient technique used in many cultures worldwide, and its benefits extend far beyond simple relaxation.

    First, breathwork activates the parasympathetic nervous system, also known as the 'rest and digest' mode. When we experience trauma or stress, our sympathetic nervous system, responsible for the 'fight or flight' response, goes into overdrive. This can leave us feeling on edge, hypervigilant, and trapped in a state of constant anxiety.

    By consciously engaging in deep, slow breaths, we signal to our body that it's safe to relax. This activates the parasympathetic nervous system, bringing a sense of calm and reducing the intensity of trauma-related symptoms. It helps us find stability in the present moment.

    Breathwork also provides a safe and empowering tool for self-regulation. Trauma can make us feel helpless and out of control. By incorporating intentional breathwork into our daily routine, we regain a sense of agency over our own well-being.

    • Examples of breath work

      • Deep breathing

      • Belly breathing

      • Box breathing

      Learn more about different types of breath work here and here

  3. Dialectical Behavior Therapy (DBT) TIPP

    Dialectical Behavior Therapy (DBT) was developed by Marsha Linehan, DBT combines elements of cognitive-behavioral therapy with mindfulness practices.

    One of the core components of DBT is the TIPP skills, a set of techniques designed to help individuals regulate intense emotions.

    • Temperature

      • This technique involves using temperature to help regulate intense emotions.

      • By applying cold or warm sensations to the body, you can create a shift in your emotional state.

      • For example, placing your face in cold water or holding an ice pack on your eyes can activate the body's dive reflex and help calm down strong emotions.

      • Conversely, taking a warm bath or wrapping yourself in a cozy blanket can provide comfort and soothe distress.

    • Intense Exercise

      • The "Intense Exercise" skill involves engaging in physical activity to regulate emotions.

      • Exercise has long been known to release endorphins, which are natural mood-boosting chemicals in the brain.

      • When faced with overwhelming emotions, participating in intense exercise such as running, jumping jacks, or engaging in a high-energy sport can help channel that emotional energy into a more positive outlet.

    • Progressive Muscle Relaxation

      • The "Paired Muscle Relaxation" skill involves tensing and then releasing different muscle groups to promote relaxation.

      • By consciously tensing a specific muscle group, such as clenching your fists or scrunching your facial muscles, and then releasing the tension, you can induce a sense of physical and mental calmness.

      • This technique helps individuals become more aware of bodily sensations and learn to release muscle tension associated with stress or intense emotions.

    • Paced Breathing

      • “Paced Breathing" is a technique that focuses on controlling your breath to calm down the body and mind.

      • By intentionally slowing down your breathing and making it more regular, you can activate the body's relaxation response.

      • Practice taking slow, deep breaths in through your nose and exhaling gently through your mouth. This skill helps regulate the body's autonomic nervous system, reducing the physiological symptoms of stress and anxiety.

    Learn more about DBT’s TIPP skill here

  4. Resourcing

    • Resourcing is the process of identifying and cultivating inner and outer resources that can provide a sense of safety, stability, and comfort.

    • These resources can include personal qualities, memories, relationships, activities, and environments that promote a feeling of well-being and connection.

    • Resourcing acts as a buffer against the distressing effects of trauma, helping individuals regulate emotions and create a foundation for healing.

      • Examples of Resourcing from EMDR (Eye Movement Desensitization Reprocessing) Therapy

        • Calm Space

          • The calm space technique is aimed at helping individuals establish a mental refuge—a place of safety, serenity, and peace within their minds by creating a vivid mental image of a calming and secure space.

          • This space can be a real or imagined location that brings a sense of tranquility, such as a beach, a garden, or a cozy room. Use your imagination to create a space that is calm and safe to you. If you want to be all alone, imagine a space where you are alone. If you want to be in a contained space with locks and 4 four walls, create such a space.

          • By actively engaging with this imagery, individuals can access a refuge within themselves whenever they feel overwhelmed by distressing emotions.

          • The calm space technique serves as a grounding resource, allowing individuals to experience moments of respite and restoration during their healing process.

        • Containment

          • Containment is involves creating a mental container or box to hold and manage overwhelming emotions or distressing memories. This can be a shoebox, a drawer, a chest, a garage, a storage unit, or any type of container.

          • This technique enables individuals to regulate their emotions and prevent them from overwhelming their present experience by visualizing a safe, protective container where they can mentally store distressing feelings or memories.

          • This container serves as a reminder that they have control over when and how to engage with these challenging experiences, promoting a sense of safety and self-efficacy.

        • Imaginal Nurturing/Protective Figure

          • Imaginal nurturing is a technique that focuses on cultivating a nurturing and supportive inner resource where you feel cared for, protected, safe, and loved.

          • This involves visualizing a caring and compassionate figure or presence, such as a wise guide, a loving parent, or a spiritual figure and connecting with this nurturing presence. This can be a role model, an archetype, a superhero, a spiritual figure, characters from books or movies, or a real person.

          • They can receive comfort, reassurance, and encouragement from this inner resource, offering a counterbalance to the distress associated with trauma.

          • Imaginal nurturing fosters a sense of self-compassion, validation, and emotional support, promoting healing and resilience.

          Read more about EMDR’s resourcing skills here

  5. Somatic Work

    Trauma often disrupts the connection between the mind and body, leaving survivors feeling disconnected and disassociated from their physical sensations.

    Somatic practices operate from a "bottom-up" approach, focusing on regulating the nervous system and rewiring neural pathways through body-centered interventions. This is different than a top-down approach where only talking is done where the goal is to facilitate awareness, education, and insight.

    Somatic practices focus on interoception, which is the ability to perceive and understand internal bodily sensations. By honing interoceptive skills through techniques such as mindful breathing, body scans, and gentle movement, trauma survivors can rebuild a sense of embodiment.

    Interoception fosters self-awareness, enabling survivors to identify and process emotional and physical sensations, ultimately empowering them to regulate their responses to triggers.

    One somatic therapeutic framework for trauma is called Somatic Experiencing (SE). SE is a therapeutic modality specifically designed to address trauma and its effects on the nervous system. It focuses on tracking bodily sensations and engaging the body's innate ability to self-regulate. SE practitioners guide individuals through titrated experiences, allowing them to gradually process and discharge stored trauma energy, promoting healing and resilience.

    • Examples of somatic skills for trauma

      • Yoga

        • Yoga combines movement, breathwork, and mindfulness to promote self-awareness and relaxation.

        • Trauma-informed yoga classes focus on creating a safe and non-judgmental environment, allowing individuals to explore their bodily sensations, release tension, and build resilience.

      • Tracking Sensations

        • Body tracking involves bringing conscious attention to the physical sensations present in the body.

        • It encourages individuals to notice and track subtle changes, tensions, or discomfort in different body regions.

        • By developing a greater awareness of bodily sensations, trauma survivors can begin to identify areas of trauma-related tension and work towards releasing and healing them.

      • Mindfulness

        • Mindfulness practices involve cultivating non-judgmental awareness of the present moment.

      • Body Scans

        • Body scans, a specific mindfulness technique, involve systematically bringing attention to different parts of the body, noticing physical sensations and any areas of tension or discomfort.

        • This practice helps trauma survivors develop a greater sense of embodiment and deepen their understanding of the body-mind connection.

      • Push both feet on the ground as hard as you can

      • Stretch

      • Stand up and jump

      • Put both hands on your chest and apply pressure

      • Put your hands together and clench them

      • Cross your arms and apply pressure on your shoulders (weighted hug)

      • Get a weighted blanket and put it on top of yourself

      • Clench and raise both feet off the ground and hold/tense it for 10 seconds

        Read more about SE here

  6. Compartmentalize

    Compartmentalization is a psychological defense mechanism that trauma survivors may employ as a means of coping with overwhelming experiences.

    It involves mentally separating or isolating certain thoughts, memories, or emotions from conscious awareness.

    While compartmentalization can be a temporary coping strategy, it is essential to eventually address and process the underlying trauma for long-term healing. However, when it comes to grounding techniques for trauma, the focus is on creating a sense of safety and stability in the present moment.

    Affirmations/Cognitive Reminders

    Repeat grounding affirmations to yourself. Affirmations can help counter negative or overwhelming thoughts and provide reassurance and stability.

    • It’s the year 2022

    • I’m in my apartment right now and the door is closed and locked

    • My name is (blank) and I am (blank) years old

    • This feeling will pass and is temporary

    • I am here in the present moment

    Questions to Ask and Answer

    • What day of the week is it?

    • What time is it?

    • How old am I?

    • What’s my first name?

    • What’s my favorite color?

    • What city am I living in right now?

    • What’s one thing I can see? What are the shades of color?

    • What’s one thing I can touch or feel right now? What does it feel like?

    • What’s one thing I ate earlier? What did it taste like?

These are simply skills and tools to get you back into the here-and-now/present moment. They are not magical cures or antidotes. However, skills are the starting point in therapy.

Trauma healing is a deeply personal journey, and different practices resonate differently with each individual. Working with a trauma therapist can provide guidance and support in choosing the most appropriate practices for individual needs and preferences.

Trauma Resources

  • Looking for more trauma resources? Click here for a list of evidenced based trauma therapies, books, and workbooks.

Further References & Reading

Read My Blog Post On How to Support Someone with CPTSD here.

Canh Tran
Previous

10 Things To Say To Someone With CPTSD (And Not Say)
Next

6 Signs You May Notice As You’re Healing From Trauma