Triggers + How to Help Them

Last night I was up far too late with a piping mug of pennyroyal tea feeling every ounce as gross as you could physically imagine from my medication’s side effects, and in that fog I cooked up at least ten drafts of this post that sounded as though treatment for my diabetes had never occurred. What precisely the issue is with writing at present, I will never understand, since it feels as though I have a hundred ideas and books I could draw from at a given time- and yet when I sit down here I find that I have nothing to say. Before I clicked off the computer for the night, I said a small prayer to Venus to help me out with what to talk about for this long overdue post. Calling a goddess to help with my issues is a really very low hanging solution to creative blocks, I know, but hear me out: if the specific deity that is the definition of abundance, creativity, and fertility can’t help me find the right plum to pluck off the tree- then who can? In simple point of fact I expected nothing from her, and instead was given a memory that struck like lightning. 

Once upon a time, I had a friend that thought they were very clever and witty about my personal life. In order to drive home the idea she kept reiterating verbally that I do not make choices she approved of when it comes to the men I desire, she shared with me an Instagram reel suggesting that you can determine if a man is good for you or not based on whether your inner child feels safe around them or not.

Well my dear reader, it turns out my snarky friend catapulted me into greater self awareness, since my inner child actually prefers the company and safety of the man our friend was attempting to insult to hers- and these days she and I no longer interact. Needless to say, my inner child feels much safer. 

She’s so safe now, in fact, that my inner child can be found in her spot where she clings on to the man’s back like a happy little pegomastax, brandishing a stuffed unicorn and babbling to him about nothing of any relevance to anything here, and she screeches intermittently at things she really likes. She is totally where she wants to be, and nobody knows which of them is louder since he’s rather loud too. 

The reason I share this story with you is not to poke fun at anything, or to grandstand about what emotional support looks like, but to explain that it was at this moment I started relentlessly choosing myself. It really was that simple, I visualized that the younger me would encounter this man and fully expected her to recoil or freak out like my friend did. Instead, she ran with little grabby hands and couldn’t wait to tell him about her day, her stuffed unicorn, and what she wanted to have for dinner. It was humbling to realize that she actually adores and feels safest around this man, which is why she’s so sad in his absence and disappointed in the quality of friends I kept around. That little girl and the fact that I had let her down to such a degree where it took this image being generated for me to realize I wasn’t choosing her or her wishes created its own sort of powerful grief. I had never consulted the younger me, but perhaps it wasn’t too late to make amends.

So I set out on a quest to begin honoring that child, and it started by letting her choose exactly what she wanted even if it meant making some massive changes in my life. In turn, a 16 year old Ephy showed up to defend the 8 year old from my unstable early parenting attempts that were mediocre at best. Then, a 24 year old Ephy showed up to protect them both using the peak of my scientific career to produce evidence for the methods I was employing. After her, a 27 year old Ephy was recovered who just wanted an escape from her grief about losing Tyler and felt like the others were in good hands, followed by a toddler who crawled her way into the room with the determination of a small creature gazing at candy. Finally, tears sprung to my eyes as I watched the 29 year old Ephy, who had fresh hope from learning to walk again and meeting a guy she really felt safe with, strode unsteadily out of the dark and back into the room with the 32 year old me who had managed to forsake them all for years. The room has now become quite full of young women that were all looking at me with hesitant, mistrusting eyes after a lifetime of me not choosing myself in favor of doing what I thought everyone else wanted from me. None of it is easy, but they’re all welcome here now.

 “Ephy Relentlessly Chooses Herself” would definitely be the full title of the last couple months. I’ve been setting off bombs in my personal relationships by speaking up for what I need, taking up space unapologetically to the point of being called selfish (a milestone moment for me because I tend to do too much for too long), setting boundaries both personally and professionally, adopting new habits for my mental and physical health to maintain the work that diabetic treatment has started, and I have finally been cleaning out all of the gunk that has accumulated from too many years of quiet self harm. Passive suicidal ideation has long been a thing of the past, as well as depressive thinking and a freeze response. The disloyalty I showed to myself and others that I love out of a desire to appease others and keep the peace disgusts me. You might say a complete renovation of the person that I am has occurred, even down to re-discovering my wavy hair for my teenager since she so kindly kicked the door off its hinges and told me to give her back, in her words, “my fucking proper natural hair you absolute ignoramous loser” before slamming the door off its hinges and grabbing her bellydance hipskirt on the way out. My hair has been defiantly curly ever since, and if we squint she definitely seems a little nicer to me since I started dancing again with her.

While some of it has been easy, lighthearted, and simple- like picking out a cute little Ring Pop candy for my 8 year old that I haven’t seen since I was that age at the grocery store and just putting it on my little altar as a reminder- some of it has been grueling. Ending friendships where I poured all of my creative essence and passion and did not feel the situation was reciprocal, stepping out of professional dynamics where my inability to be manipulated was leading to rude behaviors impacting my friends, voicing my discontent that everyone seemed to ignore the anniversary of my dog’s death and what it meant to me in my close personal life to receive no word from the people who meant the most, and sticking up for my privacy. These are very gunky things that no one really enjoys having to sort through, but I am committed to the process, even if I can’t see the outcome yet. Some days it’s disgustingly hard work that feels endless, while on others it makes me smile inside and feel a twinge of pride that I’ve managed to come this far. If it wasn’t a mixed bag, perhaps I’d feel more successful, but it would undoubtedly be more boring than the nonlinear road. 

And you know what? I bet my little pego’s favorite safe guy would be very proud of me too if he knew I was doing all this work, because it certainly isn’t easy and it has certainly impacted every level of the way I consume and process information. Maybe we’d even scream about it together and laugh at the end at how scary and silly growth can be. I am proud of me, proud of all the versions of me, for finally getting off my ass and really doing the thing even if nobody survives my cleanout to celebrate the milestone with me.

*****

I bet I know what you’re thinking right now: okay Ephy, fabulous therapeutic gobble and all that, but where are the BOOKS? Relax, darling, I’ve got you- and I’ve actually got a list of books I’ve been sorting through and will discuss where I’m at with each of them.

1. Lisa Lister’s VENUS: A Sacred Path, a Feminine Frequency, A Sensual Love Affair with Life

2. Amber V. Nicole’s The Book of Azrael

3. Christopher Buchlman’s Between Two Fires

4. Jo Piazza’s The Sicilian Inheritance

5. Jens Christian Grondahl’s An Altered Light

Where do I even start to explain how chaotic this list is, or the fact that I am currently reading five books at once? Well you see, it begins where these sort of things usually begin- my childhood. Ever since I was small, the rule was that you finish one book and then you start another- but there is simply nothing as boring to me as being chained to a single topic for a set period of time. The variety of creativity I prefer is wild, loud, dynamic, shifting. Even the people I prefer creatively are all exuberant and multifaceted, they have colorful pasts, witty humor that’s whip fast, and they can pivot on a dime to empathy when needed.

From the moment I picked up Lisa Lister’s Venus, I knew I was holding magic in my hands that I’ve been avoiding since I myself was a very tiny little girl. As a child, I loved marching around in all manner of fantasy tshirts with my curly hair running wild, and I loved to play outside even if the friends involved were not ideal. The idea of being in a dress and all made up wasn’t abhorrent to me, but I certainly didn’t feel it was for the everyday and so the characterization of the goddess of love always seemed very boring to me. Who cared about love, romance, all that jazz? I was interested in edgelord topics like dragons, and owning sharks that could devour people I didn’t like. In fact, at seven, I was writing entire little fantasy scenarios in which the other kids pissing me off would get eaten by sharks piece by piece and be sent to the school office for behavioral concerns. Charming, really, if I had myself for a child I would get a real chuckle out of it since I’ve grown into a modern Morticia. 

So needless to say, the topic of femininity for me has always been laced with horror and violence. The two things existed in perfect parallel, and while I was disinterested in beauty I was never bothered by or challenged by the concept of it.  I was never a tomboy who rejected the idea that I was a girl, or saw any issue with girliness, but I needed my own custom version. Yes a beautiful puffy gown and high heels were fine, but I needed to be riding in on a dragon and murdering the entire dinner party if they were mean to me. My feminine expression needed room for a little warranted action and meanness when the occasion called for it, for the aesthetic to be a bit darker and moodier. The nuances of femininity are discussed in Venus along with some very practical little rituals that I found grounding to work with even as a devotee of Venus already. A pleasant surprise was in store for me on this journey as I explored my inner girlhood and found that I adore her company, as does my 16 year old who guards her fiercely. For those that are not inclined towards books that encourage radical acts of self acceptance, I would say steer clear, though I would also not call this book a typical self help manual. It lacks any real plan in favor of the clear initiative to intuitively embrace one’s own Venusian synodic cycles and learn how to work with the energy as we carry on through the year. I discovered I’m a morningstar venus, and what that all entails, etc, but none of it holds agenda or timelines. For those not inclined towards astrology, simple little home rituals, or a good bite sized read to celebrate your own femininity- steer clear!

Next up we have The Book of Azrael. This book may or may not have entered my hands purely for the title, which instantly caught my interest because Azrael is one of the most underserved occult figures in all of modern history by modern audiences until very recently (shoutout to Will Ramos of Lorna Shore for all the references). I admit that I picked this book up at the store, knowing full well that it will very likely be some form of occult smut, and have decided to give it a go in my rotation anyway because I cannot forever sit here and pretend that shitting on an entire genre of books written by women and femmes feels good in my soul. There is something about the diabolical evil of shitting on products made by fellow femmes in this climate globally that curdles me internally, especially as we see so much of incel culture latching onto all forms of fantasy and drawing quite toxic lines in the sand about what constitutes higher quality writing. While I am a lover of traditional high fantasy, and one who really does not comprehend the desire or need for there to be sexual content in every product I consume, I cannot agree with demonizing an entire product category because of its content. If we’re going to criticize books for anything, I would prefer we criticize them for the style of the writing and the tone rather than the authors themselves or the content of the story- as the whole venture is meant to be fun and lighthearted. It feels integral to my personality to overcome this flaw in my behavior, and thus my hunt to find a book in that category I can consume without rage continues. Thus far, TBOA has been pleasant and tasteful, and though I am only a short way into it- I have high hopes this might be just the novel to scratch that itch and change my mind for the better. 

Christopher Buchlman’s Between Two Fires is the direct contrast to everything that we’ve been discussing this far. Contrary to all of my expectations, medieval horror is in fact the strongest addition to the genre that I have seen thus far and it would be a miracle if we were to receive a hundred such books that were modeled after BTF. The story starts following the saga of Thomas, a wayward knight that has joined a band of rogues that he is forced to slaughter when they attempt to rape a young girl who comes begging for their help to bury her father. The story is riveting in each chapter, and several times I have found my heart pounding in almost painful flops in my chest as the similarities to the cult sensation game A Plague Tale wash over me once again. Filled with fantastical elements, graphic depictions of gore, gruff sexual humor, little quips, charming dark elements that keep us immersed, and a plucky sense of adventure and familial warmth between the most unexpected characters possible- if there is a book for you to pick up and read from cover to cover, let it be Between Two Fires. Occasionally, the TikTok cult enthusiasts do in fact get it right after all, and I thoroughly look forward to picking up more of what Buchlman has published as a result. 

However, contrasting the darkness in BTF requires a very deft sense of (American) Italian drama that only Jo Piazza can offer. While The Sicilian Inheritance is a reread for me from years prior that blew me out of the water, it is easily the best reread I have had in awhile. The story is simple: Sara Marsala has tossed her life directly into the same meat grinder she would use in her restaurant. It is important to note for my Italian pegos that Sara Marsala has a name that is so generic we could die about it forever, yes I know my precious Italian pegos I hear your eyeballs even at this distance. Her husband Jack wants nothing to do with her, she may lose custody of her beautiful little daughter for whom the sun shines, and she’s up to her neck in debt. Unconscionably, the universe has audacity and so tragedy strikes and Sara’s fabulously resilient Aunt Rosie passes away at the exact moment where Sara’s life is plummeting, and it prompts an unexpected trip to Palermo to clear up Aunt Rosie’s affairs. This is a riveting tale about women helping women, featuring my primary deific correspondence, Astaroth. This book allowed me to discover parts of myself I didn’t even know were hiding beneath the waves of generations of beautiful, resilient, Sicilian women in my own family. Discovering my goddess at the center of the novel brought tears to my eyes, and to this day a chill runs down my arms when I think of my own beautiful nonna Rosalie who was so heavily demonized by my family for being miserable with her lot in life. It’s hard to picture a worse climate for a gorgeous Sicilian rose than the frigid and isolated rural existence of Massachusetts, but my nonna hung in there for a long time. 

So once again I traipse happily along a story that has so much emotional memory, as trauma triggers are being detonated at will and there has been little comfort to February and March, and I remember that I am the realization of all of my nonna’s dreams. A single childfree woman by choice, living a creative life that inspires her, passionately in love with every day I get to be me, walking away from things that are only meant to drain me, fighting relentlessly to try and help other women, and eating great food while life goes down in the meantime. From time to time we all could do with revisiting our roots, and if there is anything that provides a healthy escape from the humdrum of the modern crises that are facing this world- it’s a gorgeously elaborate journey through Sicily. 

Finally, we come to An Altered Light, my final triggering book by Jens Christian Grondhahl. This book has vexed me as it sat upon the shelf for years now, and I constantly do the same routine with it: pick it up, read about 40 pages, put it back down, vow to finish it later. Well, it’s later, and it’s high time I worked through this triggering book amidst all the other triggering books that I am choosing this season. The story is one that is stark and mundane and yet teeming with complexity as we peel back the surface layer- and for deeply loyal people, it hits sensitive wounds. You see, reader, there is nothing I despise so much in all the world as infidelity and this book dives deeply into that precise topic. Irene Beckman discovers her husband Martin is cheating on her, and she’s about to go on an epic saga as she processes that harm in her life and the little ripples that spread from that poor decision on his part. I suspect that by the end of the story, there will be a new soft spot in my heart for Irene, for I keep returning to her story and thinking of my own mother and more like her that struggle with this exact dilemma. Grondhahl’s writing style is impossible to dislike, however, as his other works have kept me captivated and the only thing truly hindering this one is the subject matter and the very personal place that it hits inside me. 

And so, as far as books go, that is where we currently stand. While I am very sorry not to have a singular book to showcase on this go round, I am actually quite proud of the fact that there is a lot of inner work and therapeutic benefit being applied to both my life as a whole and my reading habits are reflecting it. It will be a good day to envision a future where I can read through a novel and feel no flicker of self doubt and disgust at infidelity, or avoid historical figures because of my own poor choices having consequences. If redemption is possible, this booklist is proof of it, because I will successfully trigger my way to glory even if it manages to disgust and frighten me in the process. With determination, a little elbow grease, and a very grumpy Italian girl, all things are possible. 

Buonanotte my little pegos, I’ll see you much sooner next time.

You thought we were totally done, right? Guess again, here comes the scientist.

So let us now foray into just what I mean when I say “triggers”, because I’m sure for many of you there is a large misconception happening medically due to the volatile social climate that has produced pseudoscientific infographics aplenty surrounding “trauma”. When we speak about post-traumatic stress between us, there are a few things that are not up for debate with me as what I experience is lifelong and I’ve donated the majority of my life in service of this cause within the scientific community. Ready? Here we go:

1. Not all of what you see on social media is reality. When it comes to information pertaining to PTSD and cPTSD online, skepticism is your best friend. While the addressing en masse of the concept of trauma is an exciting idea in theory, unfortunately misinformation is rampant, and that the buzzwords frequently associated with diagnostic terminology are often misused to the detriment of the patients who need accurate phrasing to receive adequate care. When we call everything a triggering event, simply put, nothing actually is. Triggers have two categories: emotional and physical. Of the two, the emotional triggers are far longer in duration and far sneakier, while the physical triggers tend to be more bodily disruptive and visibly obvious to the naked eye.

2. Post traumatic stress disorder (PTSD) and complex post traumatic stress disorder (CPTSD) are wholly separate diagnoses that range in a sliding scale of severity and require seriously varying methods to treat them, and do not relent over the lifespan in a significant portion of individuals impacted. Not all post traumatic stress can be or will be healed, and knowing that is crucial so that we don’t enforce this idea that an involuntary nervous system response is in some way the patient’s fault for being unable to overcome.

3. While PTSD and CPTSD have been critically underdiagnosed inside of the last two decades, particularly in adolescent girls, our trend towards diagnostic mania in the United States has produced an unbelievable epidemic of pseudoscience claiming to work with these disorders that can end the lives of individuals who are most vulnerable. These are not trivial diagnoses, they are severe conditions that require expert care as suicidal ideation is often at the forefront of the diagnosis. Advocating for these individuals requires a compassionate approach and should not be undertaken lightly, and should not be done without medical oversight as part of a treatment modality from licensed professionals. 

4. While I am NOT a medical professional currently licensed to diagnose or treat post traumatic stress, I can tell you firsthand as an experiencer of it for my entire lifespan that mishandling a patient one time can have severe consequences that can and will permanently alter that person’s life. We need more discussion surrounding the idea that not all adverse events encode as traumatic memories, urgently, but we also need significantly more clear communication and compassion so that we are not constantly going round in circles rather than finding strategies out of a persistent state of nervous system distress. 

With that out of the way, off we go. 

Initially, I dreamed that I would write this part of the blog post as the most scientific version of myself- aged at around 24-27 when I was at the apex of my career. It was a golden time, filled with charts and logistics, data and simple days where the maximum stress was contemplating my rodent brain dissection technique and how it might be improved. In those days, the manner in which I spoke about post-traumatic stress was eerily clinical, and you’d never imagine that my weekends were filled with occasions where I would sit on the bathroom floor waiting for the next wave of horrors to strike my body. Though I look upon the time period with great fondness since it padded out my resume, that is not the voice that I will be using to explain what happens to me when I am triggered. I have outgrown using a clinical tone to explain something so incredibly personal, and I think it would do me a disservice. With all due respect to those versions of me, the 32 year old us has most certainly got a grasp on how to discuss this matter with readers.

Further, and more candidly, the last several weeks have had me returning to difficult places and moments of great insecurity- and so I’ve decided to make this section about how to actually help me (and maybe someone else out there) through a post traumatic episode without the whole event becoming one big horrible memory.

*****

When my traumatic stress becomes activated, my entire face burns and the room fades away to nebulous details that my eyes can no longer take in as the edges recede to a black vignette. This is an entirely involuntary process, and doesn’t happen because of things like a song playing or a color being presented anymore as it did when I was 18, but now it is usually due to a series of events or words that strike up my pattern recognition and send the signal to my emotional centers unconsciously that we are about to experience something deeply horrible.. again. Much of the maintenance of post-traumatic stress lies in being forced into routines that will reduce the chances of that pattern recognition being required to activate and protect me, so flying into hypervigilance happens effortlessly if the pattern is matched from the environment I am in. 

If I am standing, I must suddenly sit down, locate a toilet mentally, and prepare for the impact and flood of memories I have not signed on to experience. Mentally, a checklist happens at rapid speed in which I tick down my needs and my ability to access them at a given moment, and I begin robotically making requests of whoever I am around for aid. Quite suddenly a moment of washing the dishes becomes making a calm request to help get me to a couch, and to get me an ice pack or a cold drink of water so I can focus on something that is not my brain and what is happening at the peripheral level. The first clue that anyone else can have is that my face suddenly either loses all color or reddens considerably, and my eyes will glaze over entirely as I’m receding, in my voice you will hear either a stutter or a tone change that is quite difficult to miss as things slide elegantly off the rails. In some instances I fall eerily silent, and while I am not dangerous it can very often be frightening- so to avoid terrorizing my company I will begin speaking compulsively to signal I am not dangerous. Unfortunately, if you’ve ever heard me do this chatter, you know I don’t tend to pick the best topics so it may sound quite disjointed- and completely unrelated to whatever we were discussing prior.

What’s unseen to you at this moment is that my stomach loses all sensation as my sweat freezes on my body, and fainting could be imminent if I'm not extremely careful with the sort of feedback I allow my brain to process as the lens of awareness narrows. My breathing slows as my heart rate increases rapidly in my chest and the whole chest cavity begins fluttering painfully and squeezing, it’s like having your chest squeezed in a tight fist that travels in a pulse all the way up to your throat. This is the time period where what I do not do, is begin picturing all of the medical nonsense that could follow episodes of panic like this- my heart exploding in front of you, collapsing in an embarrassing heap on the floor, suddenly needing to vomit- you name it, I’m avoiding thinking about it. My breathing will start to sound very forced as I manually slow it down, primarily so I don’t self-fulfilling prophecy my way into you running for the hills and saying I’m a lunatic. 

Further, because I am autistic in tandem to experiencing severe post traumatic stress, the information seeking regions of my brain kick into overdrive to begin searching for the facts of the situation far before my body has physically caught up to the reality of what is transpiring, and so the contrasting motion shears against me and I feel myself being torn in two very starkly different directions. If you are an observer witnessing this firsthand, you will find me trying frantically to look up information while being inundated with symptoms so severe I cannot regulate them, and you would quietly wonder if perhaps I am not in fact experiencing acute psychosis. It’s sad, really, but you will find me robotically going straight to the information sources that would likely most hurt me- in order to try and get details about the thing so that I can reconcile with what precisely I am in the water with. Unfortunately, PTSD has historically always presented in such a manner where schizophrenia is the common misdiagnosis (OConghaile & DeLisi, 2015)- primarily due to the reality that as my body is entering this state, I am reliving old states of being and old memories involuntarily. While you may have a choice to say that you will not recall the way that you felt on May 6th 2011, I unfortunately cannot stop remembering the date if my life depended on it. It would be nice to “just leave that behind”, but sadly there is no physical reality where I can access that option. 

While I cannot change the state of my brain, and I cannot fight the physical symptoms that involuntarily take hold while I am triggered, what I can do is advocate in such a manner where my expectations are realistic for those witnessing events. Everything that I have disclosed here is a best case scenario, in other words- a scenario in which I am not at your cousin’s wedding experiencing post traumatic stress because your mother has just told me that I’ve gained weight and will surely lose all the things I have worked to gain in my life because of it. What I am describing in this section is a stereotypical triggering episode, in which within 10-15 minutes of concentrated effort, I can become regulated and things can proceed with minimal damage. However, experiencing many of these events multiple times per week is not only detrimental to one’s health- but is also the reason why I am largely a mental health advocate that accentuates the idea we need to be very clear and open with our boundaries and vocal in excess. If I do not convey that I experience these events, or how I would like to stop experiencing them, I can hardly be surprised when they repeat themselves- and ultimately that responsibility falls on my shoulders alone to make changes as necessary. There is no expectation for anyone to cope “well” or “considerately” with my disability except in the way I treat myself- so please take any pressure off if you’re a well meaning third party reading this. 

*****

So if we boil this down, what are the steps?

1. The moment the post traumatic stress activates, I need to be able to say something, whether it be a code word or a phrase that kicks your brain into gear and three things are known: we need privacy, we need information, and we need a toilet. 

2. Depending on the severity of the trauma, I will either need you to stay with me or I will need privacy to try and collect myself and disengage from the memory. It’s my job to tell you which I need at a given moment and communicate clearly.

3. If you do stay with me, try not saying too much but just sitting and letting me talk unless I directly ask you to respond to me verbally or share thoughts. I may tell you about what I’m experiencing, I may need to discuss just about anything else until the traumatic memories pass over me. Once they lift, my tone will return to normal- just let it ride. 

4. If I am information seeking, and you can help me, please help me. Facts, screenshots, information, information, information. Anything that can help me witness what’s in front of me without running away from it so my brain can find a solid place to land. The faster we put the autistic seeking parts into a state of calm- the faster I can fully come back.

5. If I faint, please don’t call emergency personnel unless I ask directly for them. It’s very humiliating and if we’re in the USA it’s very expensive here. No one needs to be bothered with what amounts to a brief medical episode that will pass unless I’m actually injured. 

6. If you do not stay with me during the episode, please guard the door and block all access to me from well meaning others until I am able to get myself back on my (metaphorical or literal) feet. This is your moment to be a COLOSSAL guard dog and vent some rage in the name or protection. I will not be angry. 

In conclusion, here are some fabulous images from Ressler et al. 2022 that illustrate the neurobiology of a post traumatic stress disorder to send us off and help you understand what’s happening on my brain’s behalf: