If you have a PTSD diagnosis as I have- one thing you’ll be intimately familiar with is the whole concept of triggers. Triggers are what turn you in an instant from ‘ok’, to PTSD’ed up to the max.
PTSD is not a constant illness. I have phases of normality and phases of PTSD flare ups. I very much feel I have PTSD and am ill at times when I’m triggered, but the rest of the time my PTSD remains neatly tucked away and boxed up in pretty ribbons- ready to become active again when reminders of my traumatic history punctuate my consciousness and transport me straight from the here-and-now, reminding me of way back when.
I suppose a great metaphor for PTSD would be that the illness of PTSD is a volcano. PTSD sufferers essentially live with a metaphorical volcano within us, but it is only active and spewing out explosions of lava when we become faced with a trigger that takes us slam back to a time when life was traumatic. BOOM.
A second ago we were ok. Now we’re not. Under-statement.
We’re erupting with full natural force, and nothing much can stop us.
You can’t politely tell a volcano to stop erupting can you? telling it that it is bad timing and a little inconvenient, and would you mind awfully ceasing to erupt right now (!)
A volcano does what it’s meant to do- periodically ERUPT. A volcano has ideas independent of what the humans caught up in the devastation really want. Volcanos have minds of their own.
It is not that often that I will be faced with one of my overt PTSD triggers during a therapy appointment itself, but yesterday’s sesh was a clear example of this….and it all centred on oranges. Yes you read that right…oranges (well a satsuma to be precise.)
To imagine a tiny satsuma has the power to make a volcano erupt is, on the surface, ridiculous, but I guess if the flap of a butterflies wings can cause a hurricane, then satsumas must be able to cause a volcano to erupt? Yeah?
Let me explain……
I go in in the therapy room as usual. We do the introductory patient -client small talk chat. I stare into space for a bit, interrupt her and say, “I smell oranges”
Therapist says “yes, I’ve just had one before I came in as my mouth was dry”
I say in a less friendly and more urgent tone “oranges are a PTSD trigger. You need to open the window…… NOW.“
awkward silence while she processes that it’s going to be a challenging apt, and I process the frustration that this unexpected and shitty trigger has intruded on my therapy sesh, which is meant to be therapeutic and not traumatising and a welcome relief after a difficult week
I already want to cry there and then, and therapy hasn’t even started.
Jeez, just remembering how upset I was in that moment makes me just as upset now :(
Cue panic, swirling spirals of darkening mood, frustration, annoyance and much sadness, tinged with a fair bit of embarrassment on my part.
I twist my body away from the person (who helps me more than anyone) to block her out. I’m annoyed with her because she has reminded me of trauma.
My eyes turn downward and remain there.
My arms block my body in defence.
I reach for my cardigan for protection from this orange scented sensory onslaught.
She talks to me about how she didn’t know the smell of oranges was a trigger for me and I reassure her she wasn’t to know, and eating an orange is a perfectly acceptable thing to do, but it’s my issues/my past/my history that make the smell of oranges unbearable and very upsetting to tolerate.
All the time I’m acutely aware of the ridiculousness of the situation, quietly beating myself up in my head with self-attacking statements and self-directed annoyance that oranges remain such a triggering issue for me.
‘Of all the things to find triggering, why on earth does it have to an everyday citrus fruit?!’ I silently ponder. This isn’t in the standard lists of PTSD triggers in the textbooks. What the hell is wrong with me?! sigh
I have literally banned oranges from my house. My husband and kids aren’t allowed them because they make me feel sick, uneasy, dizzy, totally disconnected from the world and mentally reliving traumatic childhood events that no child should ever go through.
Anyone eating an orange, or having orange juice on their fingers or detectable in their breath makes me turn off them, despise them, even hate them. Really though, what is happening is I am hating my abusers, and projecting those strong visceral feelings on the innocent everyday orange consumer.
I was annoyed with my therapist for eating a orange and ruining my therapy! That is irrational. I know that! She didn’t know beforehand that I took issue with the smell of oranges, because its never come up in conversation. She didn’t deliberately bring one of my triggers into therapy. It was unplanned and unknown and unexpected for both of us.
I felt like I hated her in that moment, but I don’t really. It was just a reflection of the intensity of my reactions to unexpected reminders of my traumatic background.
Triggers affect all the senses. A trigger can be a smell (as in this case), a sight, a sound, a taste or the feel of something against our skin.
WHOOSH. We are back there; being assaulted, being abused, being mistreated, hurting, afraid, vulnerable, powerless, helpless, drowning on horrible feelings.
I have not yet recovered from the orange situation. I had an awful evening post-therapy, and this morning has been equally crap. I am sitting typing with the aid of calming diazepam in my system, after yet another panic attack this morning. The orange legacy may persist. Who knows for how long?!
Triggers are so overwhelming in their effects, and unfair.
I would love to be a person who was OK with citrus fruit!
But I’m not.
My PTSD volcano is ready to erupt at the smell of an orange, even an orange eaten five minutes earlier in a separate room by your therapist who you’ve known for years and you trust and like and who you know wants to help you and not harm you.
This is why I get annoyed at people who are impatient with my PTSD symptoms, and think I should be over the past by now. How can I be over this when my brain goes into fight or flight full adrenaline mode at the smell of a satsuma?! My brain hasn’t forgotten, and it’s bloody hard to stop a volcano erupting isn’t it, yet some people seem to think I am capable of this.
If I could NOT be bothered by the scent of a satsuma, I would! If I could be cool with my therapist snacking on citrus fruits before our session of course that’d be my preference.
But the power of oranges to make my PTSD volcano erupt is too great. The power of the senses and the memories they evoke is too instinctive and automatic.
I am fully aware my orange issues put me in the category of “unusual” but my life has been unusual, and I cannot stop the flood of stress hormones and physiological/neurological changes that occur when PTSD triggers arise.
She tried to reassure me, but the hour and a half that I was there and she was trying to engage with me were bloody hard, because all I was doing was fighting off memories and strong body, auditory and visual memories of ritual abuse. That took a lot of effort and the session was exhausting and emotionally draining.
I wanted to self-harm there and then and I told her that. When panic builds and emotions build and bodily tension builds I habitually crave that release- that physical pain to externalise the mental torture; the adrenaline rush, the distraction, the punishment for getting upset over something as small as an citrus fruit.
She said in a calm voice…. “ok, you’ve been triggered…you want to self-harm because you’re distressed and that is what you feel an impulse to do when you feel triggered and upset, but you know you can’t self-harm, so what else can you do?”
I furrowed my brow in full concentration while my mind swirled. I tried to purposefully direct my attention to different pathways other than the “I must hurt myself right now” option which was not possible and not desirable.
I can’t remember whether I thought of anything. I think instead I just cried in desperation. “Crying is a good safe release” she said reassuringly, so I cried more and more, punctuated by bits of listening to her soothing voice and me describing what was happening in my brain and body as a running commentary.
I had the bright idea that I distract myself to cope. She was pleased at this evidence of proactive successful problem solving on my part and positively reinforced that, verbally giving me the equivalent of a gold star for my progress in psychological coping strategy theraputic learning! I showed her pictures on my phone of my daughter on the night of her school prom. We talked about plans that were coming up and she attempted some “therapist-client jokes”. I told her that her banter wasn’t funny :P (because I can be very blunt at times) and then fortunately she said some things that were actually funny so I forgave her and slightly smiled a bit to diffuse the ‘orange-generated therapy-ruining’ tension between us.
I’m low. I’m miserable. I’m not as far forward as I hoped I was. I’m a victim of my unrealistically high expectations of what I “should” be able to do at this point in my mental health/PTSD survivor treatment journey.
When I met with a lady from the victim charity I explained I’d been having psychological treatment on and off for 4 years, and saying that out loud made me feel quite poorly, especially considering that many people trying to access NHS mental health treatment will wait upwards of a year for six measly sessions of CBT. Why am I not better yet? I asked myself. Will I ever get better?
This is what I’ve learned though…..
Recovery is something you fight for everyday. Sometimes I just need to rest and recoup my energy from that fight. It’s OK not to be OK, especially when you’re having mental health treatment. Psychological treatment is helping, but my illnesses are still there. The PTSD volcano is always there, no matter whether it is dormant or erupting. I can’t remove the possibility completely of volcanic eruptions, because the PTSD is a volcano that sits beneath my skin and will continue to sit there. My hope is just that in time the volcano will erupt less times, and less violently.
I don’t think I’ll ever like the smell of oranges though. :(