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Thanks for joining us
for today's #PreTermChats about Triggers.
Kasia Pytlik joins us to answer your questions about your
Triggers. Kasia has been an NICU social worker both at Mount Sinai Hospital and
Sunnybrook Hospital over the last six years, supporting families with their
NICU journey. She currently splits her time between clinical work and parent
programming at Mount Sinai Hospital.
Q. What is a trigger and why do they happen?
A: A trigger is anything that sets off an
intense memory or flashback that brings a person back to the place and time of
their original trauma. When this happens, a person may have an emotional
reaction that is similar to the one he or she experienced at the time of the trauma.
Triggers are a very personal and individual thing, and therefore it is hard to
pinpoint what might actually be a trigger for you. Triggers are touched off by
our senses: sight, touch, sound, smell and taste. For former NICU parents, a
trigger may be a smell similar to that of the hand soap that was used at the
hospital your baby was at; beeps that sound like the ones on your baby's
monitor; or being physically present in the hospital that the trauma was
experienced in. Some of these triggers are more obvious than others, but it's
important to underline that everyone will experience their past traumas in
individual ways triggers, and it might be something that we least expect. It is
also important to note that even if you don't experience a trigger that is
connected to your trauma doesn't mean that you are "less traumatized"
or "emotionally stronger" than someone who does experience a trigger.
Everyone processes and assimilates their experiences in their own personal
Why triggers happen is a much harder question to answer because brain
functioning and memories are not completely understood. That being said,
sensory memory, and the emotions we attach to these memories, is a very
powerful thing--and it can be both positive and negative. Hearing our favourite
song that we played endlessly during that carefree summer when we were 16, or
eating a favourite meal that an older loved one used to always make us will
bring us right back to that moment in our life. Positive memories will usually
put a smile to our faces as we let ourselves get taken back in time. The brain
functioning and sensory memories that are working in these moments of positive
memories are the same ones that are at work when we experience a trigger that
causes a rush of negative emotions as well.
How long do triggers have an affect on my mental health and happiness?
A: This is hard to pinpoint, again, because
trauma and our trigger are so personal and individual. For some people,
triggers may be a life-long affliction. My grandmother lived through WWII and
still, years after the war and years of living in Canada, she would be struck with
fear every time a plane flew over her house.She told me as a young child while
she was babysitting me, that she would feel the fear, but then remind herself
that she was in Canada and safe, and slowly her fear would subside. There is no
right or wrong way to think, feel and respond after experiencing a traumatic
event. So don't judge yourself for the reactions you may experience with you
have a trigger. Your responses are a normal reaction, to an abnormal event.
Allow yourself to feel the emotions that come with a trigger, and allow
yourself the time and space to process your traumatic experience. For some
people, the trigger happens, and they are able to identify it, contain it and
have developed their own way of working through the emotions that come with the
trigger, like my grandmother did. Some triggers, however, are linked to Post
Traumatic Stress disorder (PTSD) and may actually ignite a PTSD episode. PTSD
is a serious and debilitating response to trauma that interferes with living
everyday life. For most people though, as time goes on, the intensity of a
trigger will begin to fade and/or you will develop your own ways to deal with
the triggering event.
Question from a Parent: I have
experienced PTSD from our rollercoaster experience with our little one in the
NICU and although I haven't had any issues as of recently, I am wondering how
to work through my triggers and PTSD so that a future pregnancy doesn't bring
on a series of anxiety attacks or just anxiety and stress in general?
A: For someone who had a traumatic pregnancy and
birth, it would be absolutely natural to have some worry and anxiety about
their future pregnancy. Worry and anxiety is a normal human emotion, that
everyone feels in their everyday life. It is normal to worry or to be scared of
something, but it is when chronic worry and intense anxiety that interferes
with how we would normally live out our lives that the worry and anxiety
becomes a problem. For those women having a subsequent pregnancy after
delivering prematurely, they will likely be followed very closely by a
physician who specializes in the women who have a history of early deliveries.
Speaking to the GTA population, there is mental health support through Mount
Sinai's Perinatal Mental Health Team http://www.mountsinai.on.ca/.../maternal-infant.../ ,
and Women's College Hospital's Reproductive Life Stages program http://www.womenscollegehospital.ca/.../mental-health/RLS/
These programs do require a physician's referral,
but if you are working closely to with your OB, she may ask if you want a
referral to the program without you initiating the conversation. You may also
be linked up with a perinatal social worker at your delivering hospital who can
support you through the anxieties of your next pregnancy. If your physician
doesn't bring up mental health supports, be a self-advocate and bring it up
yourself. Having holistic health care means caring for your mental health as
I talk more about ways to minimize the occurrence
and impact of triggers with another question--read on for that :)
What resources are out there for me to speak with others who may be going
through the same thing?
A: A first step may be speaking with your
family physician about how you are feeling, and any resources that may be
available in your community is always a good way to find some support.
Additionally, your local public health department will likely have supports available through
their Healthy Babies, Healthy Children program (found only in Ontario). Calling
Telehealth Ontario is also another option (1-866-797-0000). This is a 24 hours,
7 days a week service available to get confidential and valid health advice and
information from a registered nurse. The Canadian Premature Babies Foundation
has started an online support group for NICU parents (http://cpbf-fbpc.org or https://www.facebook.com/.../CanadianPreemieParentsSuppo.../ )
If you were linked up with a NICU social worker while in the NICU, connect with
her to see if there are any local support groups available
What can I practice at home to help me deal with triggers?
A: Some might groan at this, but exercise is
something that can really help stabilize your nervous system. The release of
endorphins that come with exercise, along with the physical movement of your
body, can help bring your mind back to it's natural equilibrium. Thirty minutes of
exercise on most days is what is recommended. Exercises that have total body
movement like fast walking, running, swimming, playing soccer or basketball,
and even dancing. Bring on the Zumba!
It's also important to get out and socialize. You're natural inclination may be
to withdraw from those around you, but the isolation may make things worse. You
don't have to talk about the trauma--doing every day things, and developing a
routine may bring some comfort. For some, talking about the trauma may be
exactly what they need to do, so joining a support group can help. Hearing
about how others coped with triggers, and knowing that you aren't the only one
facing the same problems can help in your own recovery.
It may sound cliche to say, but getting enough sleep, avoiding alcohol and
drugs, and eating a well-balanced healthy diet can go a long way in minimizing
triggers and your ability to contain them when they do occur.
When you are in the midst of trigger, there are some ways to minimize the
impact of them by self-regulating your nervous system. You can calm yourself
using techniques such as mindful deep breathing, and grounding techniques. A
grounding technique that you could use is sitting still in a chair and focusing
all your attention on one item in the room. Make note of the colours, it's
size, where in the room it is positioned. After doing this, you may notice that
your breathing has slowed, and is deeper, and calmer. Like most things,
exploring different ways to control and calm the emotions that come with
trigger will help you develop your own ways of minimizing the impact triggers
have one you.
A question from a parent: I feel like noone understands me. I get anxious
everytime I go to the doctor, and my family makes me feel like there's something
wrong with me. Is this normal for a parent who has spent long periods of time
in the NICU/Hospital?
A: Absolutely, getting anxious about having
to see a doctor after spending a long period of time in the hospital is a
normal reaction to have. I'm sorry to hear that your family isn't as supportive
as they could be. Our family and friends may not really understand everything that
occurred during your baby's NICU stay, and may not truly appreciate how
traumatic an NICU admission can be. With any traumatic event, grief comes along
with it. Even if the traumatic experience didn't include a death. You're
grieving the loss of a long and healthy pregnancy; you're grieving the loss of
all that excitement that came along with what you envisioned your pregnancy to
be. Many people will not understand your grief, but that doesn't make it less
real for you. As well, processing that grief has no timeline. As with a lot of
things, the healing that comes from a traumatic event is so personal and
individual that some may have a longer or shorter time to process the grief and
trauma they've experienced.
If you are really looking for someone who does understand you, there are
support groups available through your public health department. If you're not a
group person, linking up with a counsellor, or a therapist may be the thing
that you need to help support you through this part of your life. It doesn't
mean you'll have to see that therapist forever either; even one or two sessions
can help validate some of the feelings you have and provide an outlet to
someone who is removed from your everyday life. It's amazing how liberating one
feels after a good session of talking it out.
Question from a parent: What if I feel like I cannot deal with it on my own?
It's been years, and it's just not going away... who should I talk to? Who CAN
I talk to?
A: First off, I'm so sorry to hear that
you've not been feeling like yourself for so long! It must be so challenging
(and frustrating!) not being able to live your truest self. Your family doctor
is someone that you can speak to about this, and she/he can also refer you to a
therapist, or counsellor in your community. You can also self refer to a
counsellor. Here is a link of where you can find qualified therapists in your
Keep in mind that finding the RIGHT therapist is important. It's okay to see a
few different therapists to get a feel for what their therapeutic style is.
Professional therapists are aware that their frist-time clients do this, and
shouldn't be offended if you decide to get support elsewhere. When seeing your
therapist for the first time, make a note of some key details: do you feel
comfortable and safe when talking about your problems with this person? Do you
feel like the therapist understands you, or is making an effort to see where
you are coming from? Were your concerns taken seriously, and not minimized? Did
your therapist treat you with compassion and respect? You may find it difficult
to trust someone right away, but with time do you think you could grow to trust
I think it's also important to note that reaching out for support from a
professional does not, by any means, indicate that you are "weak", or
'flawed", or "incapable". There is still so much stigma attached
to reaching out to mental health supports in our society. But if you had a
broken arm, EVERYONE would be urging you to see a doctor! Our mental health
should be no different. It is absolutely hard to reach out for support
sometimes. We don't want to be a burden. We want to be "strong
enough" to get through it on our own. Sometimes reaching out for
professional support IS the strongest thing that you can do. And as mentioned
already, just because you link up with a therapist does not mean this is a long
term commitment. Sometimes just a few sessions is enough to help us process our
experiences in a way that we are able to incorporate them into our life story,
so that we are able to fully engage and focus on our current moment in life.
I had my daughter at 33weeks very suddenly, and a week later my sister had a
still born at 37 weeks. As a family, I am still dealing with the grief and
trauma from both, and while personally I believe my sister had a much more
difficult experience, I often find my sister discounting my experience, and my healing from my
birth and grieving the loss of my nephew. Do you have any tips on how to handle
my sister grief while still honouring my trauma?
A: I am so sorry to hear this,
(name). The best thing that you can do for your sister is to listen to her
(when she feels like talking about it), and try not judge the thoughts and
feelings that your sister is going through. This will be really tough for your
entire family to go through, and it will take time for her to heal and process
her time. Grief is a natual response to any sort of loss in life, and giving
both yourself, and your sister, permission to feel the grief will go a long way
in both of your healing journeys. You have a double whammy of having the task
of not only being there to support your sister, but also of having to process
your own NICU truama and grief. Be kind to yourself, and try to practice as
much self-care as you can at this time (while also caring for a newborn). If
your sister is not currently receiving professional support, encourage her to
do so. And be aware that it may be difficult for your sister to see your
daughter, as least in the first little while. This may hurt, but giving your
sister her space to process this life experience may be the best thing for her
TB: It's comforting knowing we are
on the right track. It's been just over a year, and my sister has always been
great with being around my daughter, and now she has a daughter of her own. I'm
very open and considerate of how she is feeling, but sometimes if I do something
that I feel helps me heal, it triggers for her and I have mixed emotions on the
best course of action.
A: Healing is never a smooth ride--it's messy
agonizing ride. I wish I could give you a textbook way to remedy how to
naviagate both of your journies at the same time. But, with many things, what
may help one person, may be a trigger another person. Which is exactly what has
happened between your sister and you. The single best way to minimize the
affect of this is to keep your communications with your sister open, honest,
and compassionate. Your sister sounds understanding of your own grief. As long
as she is able to understand where you are coming from with your own healing
techniques, then this may lessen the impact the trigger may have on her. You
can even premptively say "I'm going to do something that will help me
heal, but I recognize that this may be triggering for you--so I'm giving you an
out to not participate in x-y-z and I promise that I won't take it
This has been a fantastic and supportive chat, filled with tons of information
and resources. Thank you Kasia, for your expertise on the topic of Triggers and
taking the time out of your day to be here with us.
chat will be taken from here and posted as a blong on www.lifewithababy.com in the next few
days. This is so those of you who missed the chat or want to refer back to the
resources have it all in one place.
Thank you again for joining us and we look forward to chatting again soon for
our monthly #PreTermChats!
#Triggers #NICU #MtSinai #NICU #Preemie #PreemiePower #Premature #PrematureBirth #Sunnybrook #Neonatal