Complex Triggers
Explain the difference between a trigger and a craving.
A trigger is something that causes emotional or behavioral distress; a craving is an intense desire to engage in a specific behavior.
What’s the difference between regulating and suppressing emotion?
Regulating is managing emotions in healthy ways; suppressing means pushing them down without addressing them.
What is a cognitive distortion?
Cognitive distortions are inaccurate or biased ways of thinking that worsen mood or behavior.
What’s the purpose of a relapse prevention plan?
It helps prevent escalation by identifying early signs and strategies.
What’s a belief about yourself that’s changed since starting treatment?
I used to believe I was broken, but now I know I’m healing.
How can interpersonal relationships serve as both supports and triggers?
A partner can be supportive but might also unknowingly pressure or invalidate feelings, becoming a trigger.
How does emotional dysregulation increase the risk of relapse?
Dysregulated emotions can lead to impulsive decisions, like quitting therapy or self-isolating.
Give an example of “all-or-nothing” thinking and how it could contribute to relapse.
“If I’m not perfect, I’m a failure”—this thinking can lead to giving up entirely.
What are three elements that should be in every crisis plan?
Warning signs, coping strategies, and emergency contacts.
How do your emotions influence your thoughts and behaviors?
When I’m sad, I start to think nothing matters—and I stop reaching out.
Describe a time when a positive event led to a relapse or emotional setback.
Ex: Getting a new job caused anxiety and imposter syndrome, which led to depressive symptoms.
Describe the “window of tolerance” and how it relates to managing intense feelings.
The window of tolerance is the emotional range where we can function well—outside of it, we shut down or become overwhelmed.
What distortion is at play: “If I struggle again, I’m a total failure”?
That’s “catastrophizing” and “labeling”—believing one struggle defines your entire worth.
Describe a time when a safety plan helped you or someone you know.
Ex: When I was anxious and suicidal, I followed my crisis plan, which included calling my therapist and going for a walk.
What’s something you’ve done to cope that surprised you with how effective it was?
Writing poetry actually helped me regulate way more than I expected.
How do internalized beliefs (e.g., “I’m a burden”) act as covert triggers?
Internalized beliefs like "I’m unlovable" can cause shame spirals and lead to self-isolation.
Share a grounding technique and the science behind why it works.
Deep breathing activates the parasympathetic nervous system, calming the body and mind.
Identify and reframe this thought: “Nobody cares, so why bother?”
Reframe: “I feel alone right now, but that doesn’t mean no one cares.”
Create a “Relapse Emergency Checklist” with 4 actionable items.
1) Breathe, 2) Journal, 3) Text someone, 4) Use distraction technique.
Describe how stigma (internal or external) has affected your recovery journey.
I used to avoid therapy because I didn’t want to be labeled as “crazy.”
Analyze how a trauma history can influence relapse vulnerability.
Trauma can cause hypervigilance and emotional dysregulation, making stress responses more intense and frequent.
Role-play: You’re overwhelmed with anxiety. Walk through a regulation plan in real time.
Pause, identify my emotion, ground with 5-4-3-2-1, and text a support person or write in a journal.
Explain how distorted thinking impacts behavior and emotional outcomes using a CBT model.
In CBT, thoughts lead to feelings, which drive behavior—distorted thinking warps this process.
Design a short “Crisis Script” for calling a support person or hotline.
“I’m not okay right now. I need help. Can you stay on the phone while I calm down?”
Reflect: “The part of me that wants to relapse is trying to protect me from _______.”
“The part of me that wants to relapse is trying to protect me from rejection and feeling out of control.”