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6 posts from December 2011


How Triggers are Worked into the Group Therapy Process

By Diosa Moran, Registered Mental Health Counselor Intern

The dynamic of a therapy group often projects patterns and behaviors that are similar to existing relationships in our personal and professional lives. The sensitive connection or even disconnection between individuals in a group counseling setting can trigger an emotion or event from one’s life through an unconscious process.

Triggers between two individuals may bring up a long history of family relationships, highlighting issues of intimacy, hope, similarity, guidance or basic social skills. Professional issues may also be triggered, such as the relationships between a boss and an employee, networking connections, or mentor and mentee, exposing issues of authority, giving and receiving, and advice-giving.

Although any of these dynamics may occur in a process group, it is a limited list and simplified in what really occurs in group counseling. Group counseling is a deep and complex process between group members and therapist.

Triggers usually occur from some kind of trauma. I believe trauma is a transformative and comprehensive experience, which includes the story leading up to an event, the actual event and the aftermath of an event. A trauma is defined by what is real to an individual and not by another individual’s interpretation or perspective.

There are several ways triggers are worked into a group process, including projection, transference and scapegoating.


The process of projecting consists of projecting one’s own traits or quirks onto another simply because the dynamic between two or more individuals parallels that of another relationship elsewhere. For example, a woman in group counseling can all of a sudden take the role of nurturer towards another group member because of a behavior that parallels her own mother-daughter relationship.


At the White Picket Fence Counseling Center, one of our group guidelines is that we create and maintain a safe space and container for individual group members to interact, “act out,” and share information and emotions amongst each other. That includes the interactions that occur between the therapist and the group members, too.

Transference is similar to projection, except that it happens between the therapist and one of more of the group members. When the therapist is perceived as the "leader" of the group, group members will sometimes seek approval, advice or direction from the therapist, similar to the relationship between a parent and child or a boss and employee.

The benefit of these interactions occurring in a group setting is that sometimes the other group members will notice this pattern and reflect it back to the person involved, advancing growth for all.


Scapegoating is another central function of a group setting. Whether in personal or professional relationships, a scapegoat is someone who may be the most vulnerable or where others direct their tension or blame.

In a therapy group, members can sometimes unconsciously assign one member as the scapegoat, or sometimes will reassign another group member as the scapegoat. The dynamic of scapegoating can occur when individuals try to avoid assuming responsibility for their own behavior or actions. The person who becomes the scapegoat will often portray patterns of redirecting, dismissing and/or avoidance.

When triggers are worked out in a group process, it is a wonderful opportunity to witness microscopic behaviors and patterns that are being played out in real-life scenarios. The experience is transformational, sincere and real, and is one of the greatest advantages of group therapy!


When People Are the Triggers

In the recovery process from an eating disorder, you'll probably start by focusing on the food and your eating patterns. Once you've worked on those things, it will be time to turn you attention to your relationships – your emotional triggers.

You may feel triggered when people start talking about weight, dieting, the newest exercise program or the foods they're eating or not eating. Well-meaning friends and relatives may ask questions about what YOU are eating or not eating, or they may comment on your appearance.

Shopping for groceries or clothing can trigger many different issues around food and weight, and food is on display pretty much everywhere you go at certain times of year like the winter holiday season. Just seeing those huge quantities of food all in one place can be terrifying for someone in recovery from food addition, emotional eating, anorexia or bulimia.

Relationship issues can pop up just as often, where TV commercials, books or other people in your life can remind you of painful situations that are still unresolved. Sometimes you can get caught off guard by a reaction that feels out of proportion, like getting really upset about someone you don't even know.

When someone triggers you, usually it's because somewhere deep down it reminds you of an interaction with your family of origin. This is another reason that we welcome triggers in the therapy process. This is a great opportunity to work through something that you wouldn't have otherwise. 

You don't have to be afraid of triggers. You can learn to understand them and deal with them – not eat over them.



Use a Pen to Fight Your Triggers

One of the most helpful tools in 12-step recovery programs is the daily written inventory of what you did well that day, where you could improve, and if there is anything you need to set right with an apology or other action.

This practice can be extremely useful when you're learning how to cope with "triggers" – people, situations or foods that create an emotional response. For people recovering from anorexia, bulimia, food addiction or emotional eating, the first response to being triggered is to use their unhealthy eating behaviors.

By keeping a written record of what triggers you and bringing that to a therapy session or group, you can ask for help to learn how to change your default response and develop healthier coping mechanisms.

A therapist can take you through a role play where you actually rehearse what you will say or do differently the next time that situation comes up. You may also spend time looking deeper into what it is that triggered you in the first place. That awareness can be an important element of the healing process.

Your therapist can help you create a physical symbol of recovery so you can focus on that object until the trigger passes. I've known people to use a picture created in a therapy session, a stone or shell, a word or quote, a medallion or jewelry or even a pen with their name on it. This transitional object can effectively bridge the gap between the work done with the therapist and the triggering stimuli that takes place in everyday life.

The scariest thing about triggers is anticipating them. The first step towards gaining control over them is to capture them on paper and bring them down to size. Right then – triggers begin to lose their power.


Let's Get Triggered

For people with an eating disorder, emotional eating or food addiction, the holidays can be like a minefield of "triggers" – situations or foods that bring heightened anxiety and awaken the compulsion to use unhealthy eating behaviors.

Earlier in my career, I had been trained from the perspective that we shouldn't mention triggers or specific foods in therapy, in case someone would leave their session and binge, purge or restrict themselves right into relapse. Today things are different. It's not that we would ever purposefully provoke someone, but we know that triggers happen out in the world we live in.

Now, if someone is triggered, we know that she or he can come back and discusses that in a future session with the therapist or group. That way we can equip the person with valuable tools for handling similar situations in the future.

By trying to protect my clients from their triggers, I was actually denying them that chance to grow beyond them. Research, as well as my own clinical experience, has taught me that it doesn't help to avoid the triggers in therapy – and it's certainly not therapeutic.

My approach has changed and grown, just as my clients have. It's okay to be triggered in group or in therapy, as long as you process it, like we do here at the White Picket Fence Counseling Center. Whether that happens immediately, or whether you need to think about it and come back, it's important to look at what is happening.

I would even say that today we welcome triggers, and that's because there are certainly going to be triggers out there, especially during the holidays – in the grocery store checkout line, at the gas station and in conversations with friends, family and co-workers. The goal is to not only tolerate these triggers but to embrace them with no thoughts or feelings of hurting yourself.



Recommended Resources for Recovery from Eating Disorders




Here are a few recommended resources from the team at White Picket Fence Counseling Center.

Erika suggests...

Stand Up, Speak Out, and Talk Back: The Key to Assertive Behavior. By: Robert ALberti and Michael Emmons
Super Girls Speak Out: Inside the Crisis of Overachieving Girls. By: Liz Funk
Let It Go!: Breaking Free from Fear and Anxiety, By: Anthony Evans
Girls Speak Out: Finding Your True Self, By: Andrea Johnston and Gloria Steinem
Janet suggests...
An article by Mike Robbins titled, "Speak Your Truth - 3 Tips for Communicating Authentically" on the Huffington Post website.
Sandee recommends...
Crucial Conversations - Tools for Talking When the Stakes are High by Kerry Patterson, Joseph Grenny, Ron McMillan, Al Switzler
The Power of Communication, an article on Gurze Books website in Eating Disorders Review, a publication for professionals
These are just a few selections from our resources. We have many more to share with you! We are interested in your ideas, too. Let us know when we see you or contact us through the website.


What Does an Eating Disorder do for You?

By Erika Bent

There are many reasons why an eating disorder emerges. Eating disorders serve a purpose in our lives and can be a way for us to cope with pain and suffering. They can relieve stress. They can be a way to communicate our thoughts and fears. They can be a way to gain control over parts of our lives. It is important to investigate what our eating disorder does for us and how it is connected to parts of our lives.
For many individuals, an eating disorder is a way to communicate what is too difficult to say with words. We often may not realize that we internalize our fear of communicating our needs and wants, which in turn expresses itself through our eating disorder. Our eating disorder suppresses those other needs and wants via disordered eating behaviors (bingeing, purging, restricting, etc.). These behaviors act as a cushion or blanket that cover up the needs and wants that we are unwilling or unable to ask for.
In order to recover from an eating disorder, it is important to be able to express our needs and desires in a healthy manner. We can do this by communicating to our friends and family about what is bothering us and asking for support. We can find healthy coping mechanisms to relieve our stress or worries, such as journaling or collage. Therapy and support groups are also a healthy and safe way to express ourselves and gain the validation and support we need to thrive in our recovery.
Look into how your eating disorder may be serving you and explore ways to express those needs differently.