Self-Triggering: Understanding Individuals Who Seek Reminders of Trauma

Abstract

Posttraumatic stress disorder (PTSD) is a syndrome in which reminders of a traumatic event suffered in the past engender distressing reexperiencing symptoms in the present (e.g., flashbacks, intense physiological and emotional responses). Current models of PTSD hold that survivors avoid such reminders, which maintains the syndrome. However, numerous online accounts of survivors, several case studies, and a sparse empirical literature suggest that some may in fact compulsively seek reminders of trauma (i.e., “self-trigger”) despite the distress these reminders engender. Further, such behaviors do not anecdotally appear to bring about symptom reduction. The proposed studies constitute the first systematic investigation of self-triggering through multiple methodological lenses. In Study 1, I conducted an initial exploration of the prevalence, clinically relevant features, and motives of the behavior through the use of self-report surveys. This study determined that self-triggering likely occurs at a non-trivial rate in the population of trauma survivors, was more likely among survivors of interpersonal and recurrent traumatic events, and was associated with more severe PTSD symptoms. Self-triggering occurred via a diverse array of methods, and was driven by a diverse array of motives. Among these motives, the desire to make meaning of trauma was the most closely associated with the frequency of self-triggering. In Study 2, I sought to identify a more comprehensive set of motives for self-triggering through the use of inductively-oriented qualitative methods. This study provided convergent support for the presence of many of the motives identified in Study 1. This study also identified a host of other motives that encompassed interpersonal and moral functions, such as establishing solidarity with other trauma survivors and protecting oneself and others from traumatic events in the future. In Study 3, I tested functional models of self-triggering to shed light on how it might exacerbate PTSD severity. I conducted this inquiry through the use of a quasi-experiment that examined which traumatic reminders survivors were likely to approach, and which personal characteristics made participants more likely to approach reminders. I tested two different models of self-triggering in this study. One model understood self-triggering as an emotionally avoidant attempt to make meaning of trauma, and the other understood it as an attempt to seek identity-relevant stimuli related to trauma. Neither of these a priori functional models were wholly supported in this study. However, the effects observed underscored the importance of the desire to make meaning of trauma as a driver of self-triggering behavior. Further, the pattern of results pointed to the possibility that self-triggering is iatrogenic insofar as it represents an effort to confirm maladaptive beliefs about trauma. Taken together, these studies establish self-triggering as a clinically relevant behavior among trauma survivors that can be driven by a diverse array of motives. Notably, the desire to make meaning of trauma appeared to be the most consistent driver of the behavior across studies. More broadly, these studies prompt consideration of problematic approach behaviors alongside avoidance behaviors in the diagnosis and treatment of PTSD.