Timelines and Trigger Mapping in Healing PTSD

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In the “old” days of psychotherapy, when I began in the 80s, abreaction or emotional release of traumatic memories was considered a goal of therapy. This idea of therapy was also made popular in powerful movies such as Goodwill Hunting.

Abreaction will happen when it happens, and it will facilitate healing. But it is not enough.

We have to live with the day-to-day realities of our history as they manifest in the present moment. With that in mind, I wanted to share two of the most helpful activities in or out of therapy for people who suffer PTSD.

The first activity is to create a timeline of events. When our PTSD results in dissociation our sense of time can get distorted. In fact, many would say that PTSD itself distorts the part of the brain responsible for the sense of time passing.

In any case, most people I see have a very poor sense of the timeline of what happened to them. Also most people I see have had more than one type of trauma. Some peoples’ lives have been one traumatic event after another. Creating a visual timeline can help us understand and digest what we have actually been through.

 Chances are, when you begin, you will not put down every event. Our brains are associative, so if you are looking at, say, accidents, you will put down accidents. But, you may forget about abuse, or you may remember one type of abuse but not another. I consider the timeline a working document in therapy, whether on paper, or just as an understanding between my client and myself.

When you record an event, you have an opportunity to look at your age at the time. A good timeline should include: event, type of event, age and any other relevant details (such as physical injury).   The timeline provides a chance to re-associate the aspects of yourself connected to your own history and is a valuable tool for your therapist. (P.S. therapists can and do become dissociative too, so this tool can help ground both of you.)

The second important activity that will really start to empower you is trigger mapping. Everyone with PTSD has triggers! They may or may not be known to you. Knowing triggers can help you and your loved ones anticipate PTSD storms and head them off.

Here is how I describe trigger mapping in my book The Trauma Tool Kit:

I recommend writing down or drawing your triggers, getting them down on paper in some form or fashion. Some triggers you will know right away; some you will have to ferret out. Triggers fall into six categories: the five senses of taste, touch, smell, sight, and hearing, plus feeling states. Let’s start with the senses, because they are the easiest. You can divide your paper into different sections reflecting each of these senses. It will help jog your memory to go through each sense modality individually. Let’s say you are working in the smell category. Ask yourself what smells really bother you. All of us have smells we do and don’t like. Generally we all like floral scents and dislike the smell of feces, but I am not talking about ordinary aversions here; I am talking about radical reactions. Nobody likes the smell of poop, but if that smell sends you into a panic or frozen numbness and dissociation, it’s a trigger. Or maybe the scent of lavender makes you want to rip someone’s head off. That’s a little unusual; write it down. Take your time working through each category. Do not attempt to do all of this work in one day! If you are in therapy, it can feel safe and reassuring to do it with your therapist. Or it may not depending again on your triggers, but find some way to do it anyway. p. 184-185

The great thing about timelines and trigger mapping is that they create a bridge of healing between the present and the past. They empower and they inform, and they are tangible.  You can also add to them and edit them as you go. It is a great joy to be able to remove a trigger off the list!

One last thing, when you do them, do them with care and beauty. Take your time. Use beautiful colors and paper. Or if you just do them in your own head give yourself the benefit of a peaceful space and time to contemplate your own history and healing.

Blessings on your journey, Sue PB

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