Triggers and Cravings in Addiction Recovery
Channel: Doc Snipes
Date: 2017-05-19

Dr. Dawn-Elise Snipes is a Licensed Professional Counselor and Qualified Clinical Supervisor.  She received her PhD in Mental Health Counseling from the University of Florida in 2002.  In addition to being a practicing clinician, she has provided training to counselors, social workers, nurses and case managers internationally since 2006 through AllCEUs.com Triggers and Cravings in Addiction Recovery
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What is a trigger
~    Physical or cognitive stimulus
~    Which causes a physical or cognitive reaction
~    To either repeat (pleasure) or avoid (pain) the stimulus
~    Any pleasurable stimulus is associated with elevated dopamine levels
~    Any painful or distressing stimuli trigger the fight or flight reaction
What is a Trigger
~    The same trigger can be positive or negative depending on the:
~    Frequency of the reinforcement/punishment
~    Intensity of the reinforcement/punishment

Goals
~    Trigger
~    Competing response (IMPROVE, ACCEPTS)
~    Eliminate/counter condition trigger
~    Approaches
~    Continue the chain:
~     Trigger Depression  Coping Skills (competing response)
~    Break the chain
~    Eliminate the trigger (cognitive distortions, low self-esteem)
~    Eliminate the negative aspects of the trigger (bridge, Kenny, source of resentment or determination)

Unconditioned triggers
~    Purpose: Generally survival
~    Sight—bright sun, something (ball, fist) headed to your face, inability to access caregiver
~    Sound—loud noise, heartbeat
~    Smell—pleasant, noxious
~    Touch— pain, temperature, hugs
~    Taste— Pleasant or noxious
Conditioned Triggers
~    Conditioned triggers are things that in themselves have no meaning to the person.
~    Sight— Bottle, Snow
~    Sound—Music, Sirens
~    Smell—Smoke, Brownies
~    Touch— Hot stove, wool sweater
~    Taste— Coffee, Reeses ice cream
~    Thought– Lice, Thanksgiving

Where do they come from?
~    Learned
~    Experience (Trial and error)
~    Positive/Reward:
~    Brownies  Positive feelings
~    Get good sleep  More energy, better mood
~    Negative:
~    Brownies  Blood sugar crash and upset stomach
~    Getting good sleep  Less time with friends
Where do they come from?
~    Learned
~    Observation
~    Positive/Rewarding
~    Dad drinks after a hard day  gets less angry
~    Dad exercises after a hard day  gets less angry
~    Negative/Punishing
~    Dad drinks after a hard day  gets a hangover, grumpy the next day
~    Dad exercises after a hard day  cant move tomorrow and cranky
Trigger to Obsession/Compulsion
~    Trigger
~    Pleasure—I really want to do that again because it makes me happy or eliminates pain
~    Smell brownies cant wait for them to be done
~    New relationship & cant wait to see them again
~    Gambling can’t wait to get that big win again
~    Trigger actual or memory of pain/distress hopelessness, helplessness  intensification of depression/anxiety/anger or escape
Why Do I Care
~    Knowing triggers for the behavior to be eliminated will prevent the client from being triggered and moving on to obsessive thoughts or the behavior.
~    Smoking
~    Knowing positive triggers can help create a treatment plan
What is a Trigger
~    Triggers can be:
~    Auditory
~    Depression: Taps, music, children playing
~    Anxiety: Sirens, phone ringing, sudden loud noises, creaking floor boards
~    Addiction: Anything that triggers depression/anxiety
What is a Trigger
~    Triggers can be:
~    Visual
~    Depression: Grandma’s old house, pictures of abused animals/children, television shows
~    Anxiety: Messy house before mom comes, bridges
~    Triggers can be:
~    Olfactory (Smell)
~    Depression: Hospital smell, smell of smoke, cologne/perfume
~    Anxiety: Smell of smoke, smell of hospital
~    Addiction: Cigarette smoke, bar/casino, baked goods, alcohol
~    Happiness: Flowers, cologne/perfumes,
What is a Trigger
~    Triggers can be:
~    Cognitive
~    Depression/Anxiety: Cognitive distortions
~    Addiction: Distress Intolerant thoughts
~    Happiness: Empowerment, Self-Esteem, Hopefulness
The Problem of Generalization
~    Generalization can occur when characteristics of one instance of something are attributed to all instances
~    Engaging in a behavior that produces dopamine release produces a reward, so you are likely to do it again.