Trigger

“Trigger” comes from English and means “trigger.” It refers to a stimulus that sets off a strong, often excessive reaction in a child: panic, anger, disgust, the urge to starve oneself, to self-harm, or to withdraw. To outsiders, the stimulus itself often seems harmless—a song, a smell, a glance in the mirror, a casual remark about food. For the child, however, this stimulus is linked to something distressing and immediately triggers the same old reaction.

The term appears in connection with various issues: eating disorders, anxiety, self-harm, and post-traumatic stress disorder. In every case, it refers to the same basic pattern. A specific internal or external trigger becomes linked to a distressing experience and later triggers an almost automatic reaction that is very difficult to stop through willpower alone.

Triggers usually manifest in the gap between the event and the reaction. The reaction is much more intense than the situation would warrant. One child abruptly leaves the table; another experiences a racing heart upon entering a certain room.

Typical triggers described by parents:

• social media featuring photoshopped bodies and diet-related content (see “Eating Disorders and Social Media”)
• weight, mirrors, tight clothing, changing rooms
• Conflicts, criticism, pressure to perform before exams
• Anniversaries of a traumatic event
• In cases of trauma: smells, sounds, places, or people that remind the person of the experience

In post-traumatic stress disorder, memories return involuntarily, as images during the day or as nightmares at night (technical term: intrusions). Some children may appear to zone out for a few seconds. Simply observing is helpful. Note what happened just before the episode, without assuming the child did it on purpose.

Triggers and causes are not the same thing. The Center for Eating Disorders (BIÖG) makes a clear distinction between the two: Causes contribute to a predisposition to the disorder, while a trigger brings about its onset. A trigger, therefore, rarely creates a problem on its own. It encounters a situation that is already fraught with stress.

In eating disorders, biological, familial, and sociocultural factors interact. Comparisons on social media, beauty ideals, and comments about body shape can set off a downward spiral in a vulnerable child.

In post-traumatic stress disorder, the intensity of the response is explained by memory. The brain has linked the stimulus to danger. If a child later encounters a similar stimulus, the alarm system kicks in before the mind can process that there is no real threat. This results in hyperarousal, jumpiness, and the urge to avoid anything that brings back memories. How a child learns to cope with these emotional surges is part of the topic of emotion regulation.

Many parents’ instinct is understandable: to keep every trigger at bay. In the short term, this provides relief. Over time, however, it leads to a problem that experts call avoidance behavior. The more consistently a child avoids certain places, topics, or situations, the more powerful the trigger becomes. The child’s range of safety narrows, and the fear remains.

In trauma therapy, therefore, therapists use a gradual, guided approach so that the child learns that the stimulus is tolerable and poses no real danger (see exposure therapy). For everyday life at home, this means:

• calmly naming the trigger without embarrassing the child
• allowing small steps instead of complete avoidance
• agreeing on a plan for the moment in advance—such as taking deep breaths, stepping outside briefly, or talking to someone
• staying calm yourself, because children take their cue from their parents’ reactions

Setbacks are part of the process. An old trigger can resurface after months (see relapse). This does not negate any progress made. Keep track of what has helped in the past, and build on that.

Parents can help their children identify and cope with triggers, but they should not try to treat them on their own. Seek professional help if these reactions are disrupting daily life, if your child is harming themselves, refusing to eat, or talking about suicidal thoughts. The first point of contact is a child and adolescent psychiatric practice or a psychotherapy specialist.

Rückenwind Parents, I’ll guide you through this time as a coach, help you make sense of your observations, and empower you in your interactions with your child. Janike is a social worker and parent coach currently training to become a child and adolescent psychotherapist; she does not make diagnoses. Determining whether an eating disorder, an anxiety disorder, or post-traumatic stress disorder (PTSD) is underlying these triggers—as well as the treatment itself—is the exclusive responsibility of a child and adolescent psychiatry (KJP) practice or a medical or psychotherapeutic specialist.