Many anxiety disorders, including PTSD are believed to be the failed ‘extinction’ of conditioned fear (Van Elzakker, Dahlgren, Davis, Dubois & Shin, 2014)
You will have heard of Pavlov’s dog experiment? He found that by repeatedly ringing a bell when food was presented to dogs, the bell became unconsciously associated with food and it’s sound would elicit salivation in the dog. The conditioned response can be unwound (or made ‘extinct’) if food is presented repeatedly over time without the bell ringing. The bell ceases to elicit a salivation response.
So it is with our crazy irrational over-the-top triggering when suffering from the disregulated nervous system of anxiety or PTSD. We can feel crazy because we get triggered into fear by a smell, a song on the radio, a fleeting glimpse of someone who reminds us of our abuser, the mention of our abuser’s name. The abuse has conditioned us to feel fear when those indirect stimuli appear. Even though we haven’t been in the firing line of abuse for months or years, the conditioning hasn’t become ‘extinct’.
How do we identify and turn off the triggering?
Triggers can be directly addressed when our nervous system is in a relaxed and safe enough environment to do so. There will be some triggers that are best avoided. We come to know what those are – essentially, the ones that shoot us straight into fear for our very lives (panic attack). But some can be unwound by creating a new association. Essentially, we can re-condition ourselves.
Conventional therapy for reconditioning a fear response is exposure therapy – gradually exposing the client to the actual situation or stimulus that they fear. Systematic desensitisation works by training in relaxation techniques, then exposing the client to, say, a picture of a spider, then a spider in a bottle at ever-decreasing distance. You can see how this might work.
The traditional Tibetan practice of Chod is the perfect visualisation method for us to take the sting out of things we fear. As with all Buddhist practices, we don’t choose to address triggers or scenarios that send us straight to panic, but the old generalised fears that hang around in the background and bother us from time to time. For example, the fear of becoming homeless and destitute. Often, our triggers represent bigger scenarios like this in any case – the fear of being abandoned with no way of saving ourselves, the fear of being shamed and ostracised by our survival group, the fear of living a pointless existence or of not being loved.
Chod begins with the essential practice of focusing inwards to our body and breath, and consciously relaxing our bodies. We can use a guided vocal track or a piece of music that over time, conditions us to go straight to that deep calm relaxed place. Then we focus our minds onto imagining our worst case scenario. Because we are imagining this, rather than being physically exposed to it, there is a level of safety in knowing that we can ‘switch off’ the movie we are running in our heads at any time. We allow all the fears we associate with this scenario to play out in our imagination. As we let the picture run, we continue to return to the relaxation and self-soothing techniques we have learnt to de-escalate the somatic and psychological symptoms of anxiety. We stay with this scenario for as long as we can tolerate it, or until the imaginary story naturally comes to an end.
We allow the picture to fade, and bring our attention back into our current surroundings, making particular note of the safety of where we are. We allow our awareness to shift from the frightening scenario to the safety and comfort of our now. If necessary, we offer kindness, compassion and tenderness to the frightened child or adult inside.
This practice is best done with a support person present if you are in the highly reactive (frequent triggering) stage of trauma.