Liz Unruh (Host): Hello listeners and thanks for tuning in to the Well Within Reach podcast brought to you by Riverside Healthcare.

I'm your host Liz Unruh and joining me today is Robin Motz who is an outpatient clinician at Riverside's Pathways program and today we're going to be talking about coping with triggers and challenges in the real world.

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Host: Thanks for joining us today, Robin.

Robin Motz, LCSW: Thank you.

Host: Before we get started, can you just tell us a little bit about yourself and your background?

Robin Motz, LCSW: Yeah, so I've worked in the mental health field for about 20 years. I'm a Licensed Clinical Social Worker. I'm also a Certified Clinical Trauma Professional and a Certified Alcohol and Drug counselor. So I worked with Riverside for about a year and a half.

Host: Wow, so you have a wide variety of background in the mental health realm.

Robin Motz, LCSW: Yes.

Host: That's great. So I'm sure this is a topic that comes across a lot in all those different areas is coping with the triggers and the challenges.

Robin Motz, LCSW: Absolutely.

Host: So before we get like too far into it, can you explain what triggers are and how they would manifest in our daily lives?

Robin Motz, LCSW: Absolutely. Triggers are anything that would set us off. So they create and increase emotions that are hard to deal with or that we just want to avoid. Triggers are all around us and we experience them daily. They can be predictable or just appear out of the blue. Triggers can be people, places, noises, memories or thoughts, dreams, nightmares, movies, music, traffic, stores, and a lot of different environments.

Host: Yeah, for sure. I can definitely see when people are saying, Oh, I'm triggered by that, by traffic.

Robin Motz, LCSW: Yes. Yes.

Host: And being stuck in traffic for sure. Can you explain the relationship between triggers and mental health challenges?

Robin Motz, LCSW: Yeah. When we experience a trigger, we have increased emotions and thoughts, and these can be unwanted and really difficult for us to manage. Triggers can increase stress and can create a crisis situation for us. When stress, emotions, and our difficult thoughts increase, we experience difficult types of mental health challenges such as anxiety, panic attacks, depression, flashbacks, struggles with concentrating and thinking, irritability, struggles with interacting and being around others.

We can also have increased stress in a lot of different areas, and it just makes it really hard for us to make rational choices and use good problem solving skills.

Host: Yeah, I could see that. I know triggers can kind of come out of not to say nowhere, because they're obviously caused by something, but, um, it can definitely set you down. Even if you're having the greatest day, it can turn your day around very, very quickly.

Robin Motz, LCSW: Absolutely.

Host: Yeah. So when it comes to coping with these triggers, what are some essential strategies an individual can use?

Robin Motz, LCSW: One of the first things we need to do is increase our awareness of what our own triggers are. If we know what these are, we can work to avoid situations and be proactive to protect ourselves. This can be very difficult to do. We need to work on asking ourselves questions as to what specifically happened when we felt triggered, what thoughts we were having, is it connected to any other situation, and why do we specifically feel that way. We also need to be aware of how we typically respond to triggers, so we can work to challenge difficult reactions and thoughts as they occur.

We also need to be aware of how our own body signals and warning signs impact us. So these can be rapid breathing, feeling hot, a rapid heartbeat, feeling like our chest is tightening, muscle tension, headaches, balling up our fists, sweating, bouncing our leg, and inability to sit still. When we start to become aware of our own body signals, we can work to use different coping skills to calm our body down, which helps calm our thoughts and we can make better choices.

Calming skills can include taking a walk, deep breathing, slow breathing, music, showers or baths, wearing comfortable clothes, having a soothing blanket, meditation or spiritual practices, or really anything that helps us to feel good, relaxed, and it's safe for us. Other type of coping skills that can help us calm our thoughts and emotions are talking to a trusted friend or family member, journaling, using positive social media outlets or apps, exercise, walking, spending time in nature or at parks, meditation or spiritual practices, taking care of our hygiene, playing games, art and creative activities. Everybody's different and we have different activities that we can enjoy and that can be helpful for us.

Host: Yeah, for sure. I know being able to self-identify things that trigger us is going to be a big part of being able to, I don't want to say like combat, but to overcome and understand when something triggers us. Like, okay, this is what we need to do to kind of turn that day back around. Yes, for sure. And we're going to take a quick break to talk about primary care.

We're going to take a quick break to talk about finding a primary care provider. Riverside knows that health, especially your mental health, is your greatest asset and that your primary care provider is your partner in health. If you're starting out on your mental health journey, a great first step would be talking to your primary care provider. If you don't have a primary care provider, Riverside can help. Find a primary care provider that fits your needs at riversidehealthcare.org/primarycare.

And we're back. So, we talked about understanding what triggers you, and you started talking about some of the coping skills, but what are, if something triggers somebody, what are some of those coping skills that individuals can incorporate into their daily routines? I know that you started listing some, but are there some that you can kind of put into your daily routine to overcome those triggers before they happen?

Robin Motz, LCSW: Yeah, absolutely. So our routines are really important and helpful with managing any type of mental health challenges. They can help us with directing and managing activities, our tasks and responsibilities. Our own self care is incredibly important to implement daily, and this looks different for everybody.

For some, it may be daily hygiene. For others, it may be going to the gym, spending quiet time by ourselves, or spending time with family and friends. When we can practice self care and calming skills every single day, we begin to develop patterns that help us manage stress, instead of remaining in a crisis or high stress state when triggers happen.

Host: Yeah, for sure. You know, you've given us a lot of examples of different coping skills. You've given us a lot of examples of different coping skills that, people can use. But how would somebody determine if something's most effective for them personally?

Robin Motz, LCSW: Absolutely. So the first thing is asking ourselves what has happened to us in the past and to actually be helpful for us to calm down, what actually makes us feel good, calm, and relaxed and is safe for us. Looking at what has helped us in the past really helps us to know how we can predict behaviors or our reactions in the future. And if we're struggling with finding what's going to work for us, finding a therapist, a support group, a spiritual leader, or a trusted friend or family is really helpful.

Host: Yeah, I could definitely see that that trusted friend or family, someone that under, understands or might be able to help you get past that is definitely an important thing. So there are moments where we might have an intense emotional distress that's triggered by a past trauma that we've had. What type of coping mechanisms can an individual turn to, to have that, like, immediate relief to start being able to go towards overcoming that trigger?

Robin Motz, LCSW: So, triggers that are associated with past trauma often make us feel very unsafe and vulnerable. They can lead us to have flashbacks, nightmares, avoidance, fears, and can be really devastating to us. When those happen, we need to find ways to be and feel safe. This may include walking away or removing ourselves from a situation. If we are already in a safe environment but feel unsafe due to a trigger, we need to find ways to remind us and confirm that we are safe. This includes we call grounding activities, so paying attention and focusing on what is around us that is safe, what are things that we can see, what are things we can feel, what are things that we are hearing.

All of these can help us with redirecting our thoughts and our minds to the present moment instead of re-experiencing or focusing on a difficult memory or time. Other coping skills which can really help us with trauma reactions include deep breathing, guided meditations, listening to safe music, journaling, using any type of relaxation skills, calling a trusted friend or family member, using a fidget toy or a stress ball, finding our pulse and focusing and taking slow deep breaths, and also focusing on positive memories, pictures, and positive affirmations and self talk.

Host: Yeah. And that's why it's important to learn and understand what coping skills work for you so that when you need that immediate relief, you know some of those ones that work for you already.

Robin Motz, LCSW: Absolutely.

Host: My last question today if you could offer advice on how loved ones can support someone who is struggling with triggers and mental health challenges; what particular things could you use to encourage the use of coping skills?

Robin Motz, LCSW: Absolutely. First and foremost is just be patient. So there are times that we all struggle, and we can't find the words or express our thoughts, and we really need to be mindful that when someone is in a situation of high stress or emotions, they may not be able to communicate clearly or make clear decisions.

So it's incredibly important that we are being supportive, being patient, and that we are also sharing with each other what our specific triggers are, what does it actually look like for us when we are struggling, and what do we need from others. So this may include that we need to have some space or that maybe we need to be around people.

Everybody is different and responds differently, and we need to be open to this and ensure that we are not expecting other people to handle situations like we do. So, giving people time and giving them space to really calm down, use their coping skills, and also reach out to community resources is really important.

Host: Yeah, for sure. I know that, and like you said, we all deal with different challenges differently, but being able to support and maybe be that loved one that someone can reach out to is really important.

Robin Motz, LCSW: Absolutely.

Host: Well, thank you for joining us today, Robin.

Robin Motz, LCSW: You're welcome.

Host: And thank you for tuning in to the Well Within Reach podcast with Robin Motz of the Riverside Behavioral Medicine and your host, Liz Unruh. To learn more about the services provided by Riverside's Behavioral Medicine Department, visit our website at riversidehealthcare.org or call our Central Intake Department at 844-442-2551.