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Dr. Dawn-Elise Snipes PhD, LPC-MHSP, NCC
Executive Director, AllCEUs.com
 Define a trigger
 Define a craving
 Explore the concept of stimulus
generalization
 Discuss the function of triggers
 Explore triggers in terms of mental health
symptoms
 Explore how cravings can lead to obsessive
thinking
 Review the stages of the recovery process
 Identify potential relapse triggers at each
phase and appropriate interventions
 Physical or cognitive stimulus
 Which causes a physical or cognitive reaction
 To either repeat (pleasure) or avoid (pain) the
stimulus
 Any pleasurable activity is associated with
elevated dopamine levels
 Triggers can be
◦ Auditory
◦ Visual
◦ Olfactory
◦ Tactile
◦ Cognitive
Visual Stimulus
 Innate/unconditioned
 Learned
◦ Experience (Trial and error)
◦ Observation
◦ Education
Purpose: Generally survival
 Sight---bright sun, something headed to
your face
 Sound---loud noise, heartbeat
 Smell---pleasant, noxious
 Touch--- pain, temperature
 Taste--- Pleasant or noxious
Purpose: Generally reward, avoiding
punishment, survival
 Sight--- Bottle, Snow
 Sound---Music, Sirens
 Smell---Smoke, Brownies
 Touch--- Hot stove, wool sweater
 Taste--- Coffee, Reeses ice cream
 Thought-- Lice, Thanksgiving
 Engaging in a behavior that produces
dopamine release produces a reward, so you
are likely to do it again.
 Generalization occurs when a reminder
(stimulus) for the behavior occurs in different
settings
 Triggers for eating as an infant birth- 3
months
◦ Hunger
◦ ***Internal states: Sleepy, fussy, sick
 Triggers as a baby 3months to a year
◦ Hunger
◦ Time (circadian rhythms)
◦ Sites: Bottle, others eating
◦ ***Internal states: Sleepy, fussy, sick
 Triggers for eating as a toddler
◦ Hunger
◦ Time (circadian rhythms)
◦ Sites: Bottle, others eating
◦ ***Internal states: Sleepy, fussy, sick, boredom
◦ Smells
◦ ***Places: Car, store, watching television
 Triggers for eating as a toddler
◦ Hunger
◦ Time (circadian rhythms)
◦ Sites: Bottle, others eating
◦ ***Internal states: Sleepy, fussy, sick, boredom
◦ Smells
◦ ***Places: Car, store, watching television
◦ And… the generalization continues
 What is the reward/benefit?
 Use (associated stimuli)
◦ Sight
◦ Sound
◦ Smell
◦ Touch
◦ Taste
◦ Thought
◦ Setting
 What is the survival benefit of this reaction?
 Types of Triggers
◦ Sight
◦ Sound
◦ Smell
◦ Touch
◦ Taste
◦ Thought
◦ Setting
 What is the survival benefit of this reaction?
 Types of Triggers
◦ Sight
◦ Sound
◦ Smell
◦ Touch
◦ Taste
◦ Thought
◦ Setting
 What is the survival benefit of this reaction?
 Types of Triggers
◦ Sight
◦ Sound
◦ Smell
◦ Touch
◦ Taste
◦ Thought
◦ Setting
 What is the survival benefit of this reaction?
 Types of Triggers
◦ Sight
◦ Sound
◦ Smell
◦ Touch
◦ Taste
◦ Thought
 It is impossible to address every trigger
 Triggers represent a desire for a reward, to
avoid punishment or to survive
 Triggers serve a function
 Many triggers are "wrongly" conditioned
 Mindfulness and Riding the Wave are two
crucial skills to help clients deal with triggers
and cravings
 What are cravings
◦ A desire FOR something (commercials do this)
◦ Can become obsessive
 Questions
◦ What do you crave/want?
◦ WHY do you crave/want it?
◦ Is this healthy and beneficial?
◦ How else could you meet this need/deal with this
craving?
• When we do something that aids in our survival,
the limbic system rewards us by releasing dopamine
• The more rewarding the behavior, the more dopamine
(and other pleasure chemicals) are released
• Prolonged engagement in an addiction can lead the
brain to stop producing as much dopamine as it
naturally does
Stage Duration
Withdrawal 1 to 2 weeks
Honeymoon 4 weeks
The Wall 12 to 16 weeks
Readjustment 8 weeks or longer
Copyright AllCEUs.
Unauthorized training or
commercial use prohibited
 Lasts 1 to 2 weeks
 Craving
 Depression
◦ Low energy
◦ Difficulty sleeping
◦ Increased appetite
◦ Difficulty concentrating
 Anxiety
 Irritability
Copyright AllCEUs.
Unauthorized training or
commercial use prohibited
 Vulnerabilities
◦ Situations or conditions that make it more difficult
to remain optimistic and enthusiastic
 Emotional
 Physical
 Situational
 Cognitive
◦ Need to be minimized or eliminated
 Lasts about 4 weeks (until newness wears off)
 Increased energy, enthusiasm, and optimism
 People often feel they are “cured” when they
reach this stage
 Family members often view this as the
beginning of a relapse
 Often coincides with discharge from residential
 Excellent time to find “exceptions”
Copyright AllCEUs.
Unauthorized training or
commercial use prohibited
 Lasts about 12 to 16 weeks
 Hardest stage of recovery (Reconditioning)
 Symptoms
◦ Depression
◦ Irritability
◦ Low energy
◦ Loss of enthusiasm
Copyright AllCEUs.
Unauthorized training or
commercial use prohibited
 Symptoms
◦ Anxiety
◦ Easily overwhelmed
◦ Body and brain still recovering from effects of
substances
◦ High risk of relapse
Copyright AllCEUs.
Unauthorized training or
commercial use prohibited
 People
 Places
 Things
 Times
 Activities
 Feelings
 Lack of self care
Copyright AllCEUs.
Unauthorized training or
commercial use prohibited
 Triggers are stimuli that prompt a
response
 Craving is the repeated thought or
sustained desire for that response
 Triggers can be good or bad
 Most people with addictions and/or
mental health issues have multiple
triggers that need to be reconditioned
 Addiction causes changes in the brain
 Using produces feelings of escape or
euphoria which become associated with
people, places and things.
 When exposed to those people, places or
things, people may begin to have
cravings
 When faced with unpleasant emotions or
situations, people may also have cravings
 Recovery involves
◦ Becoming aware of triggers and their function
◦ Eliminating or minimizing vulnerabilities
◦ Creating new associations
◦ Developing new ways to feel good and deal
with stress.
 If you have watched and participated in this
program for CEUs, login to the classroom at
AllCEUs.com and take the quiz.
 If you have watched and participated in this
presentation, and want CEUs, but have not yet
registered, purchase access to the quiz and
certificate at: https://www.allceus.com/live-
interactive-webinars/

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Triggers and Cravings - Live Webinar

  • 1. Dr. Dawn-Elise Snipes PhD, LPC-MHSP, NCC Executive Director, AllCEUs.com
  • 2.  Define a trigger  Define a craving  Explore the concept of stimulus generalization  Discuss the function of triggers  Explore triggers in terms of mental health symptoms
  • 3.  Explore how cravings can lead to obsessive thinking  Review the stages of the recovery process  Identify potential relapse triggers at each phase and appropriate interventions
  • 4.  Physical or cognitive stimulus  Which causes a physical or cognitive reaction  To either repeat (pleasure) or avoid (pain) the stimulus  Any pleasurable activity is associated with elevated dopamine levels
  • 5.  Triggers can be ◦ Auditory ◦ Visual ◦ Olfactory ◦ Tactile ◦ Cognitive
  • 7.  Innate/unconditioned  Learned ◦ Experience (Trial and error) ◦ Observation ◦ Education
  • 8. Purpose: Generally survival  Sight---bright sun, something headed to your face  Sound---loud noise, heartbeat  Smell---pleasant, noxious  Touch--- pain, temperature  Taste--- Pleasant or noxious
  • 9. Purpose: Generally reward, avoiding punishment, survival  Sight--- Bottle, Snow  Sound---Music, Sirens  Smell---Smoke, Brownies  Touch--- Hot stove, wool sweater  Taste--- Coffee, Reeses ice cream  Thought-- Lice, Thanksgiving
  • 10.  Engaging in a behavior that produces dopamine release produces a reward, so you are likely to do it again.  Generalization occurs when a reminder (stimulus) for the behavior occurs in different settings
  • 11.  Triggers for eating as an infant birth- 3 months ◦ Hunger ◦ ***Internal states: Sleepy, fussy, sick  Triggers as a baby 3months to a year ◦ Hunger ◦ Time (circadian rhythms) ◦ Sites: Bottle, others eating ◦ ***Internal states: Sleepy, fussy, sick
  • 12.  Triggers for eating as a toddler ◦ Hunger ◦ Time (circadian rhythms) ◦ Sites: Bottle, others eating ◦ ***Internal states: Sleepy, fussy, sick, boredom ◦ Smells ◦ ***Places: Car, store, watching television
  • 13.  Triggers for eating as a toddler ◦ Hunger ◦ Time (circadian rhythms) ◦ Sites: Bottle, others eating ◦ ***Internal states: Sleepy, fussy, sick, boredom ◦ Smells ◦ ***Places: Car, store, watching television ◦ And… the generalization continues
  • 14.  What is the reward/benefit?  Use (associated stimuli) ◦ Sight ◦ Sound ◦ Smell ◦ Touch ◦ Taste ◦ Thought ◦ Setting
  • 15.  What is the survival benefit of this reaction?  Types of Triggers ◦ Sight ◦ Sound ◦ Smell ◦ Touch ◦ Taste ◦ Thought ◦ Setting
  • 16.  What is the survival benefit of this reaction?  Types of Triggers ◦ Sight ◦ Sound ◦ Smell ◦ Touch ◦ Taste ◦ Thought ◦ Setting
  • 17.  What is the survival benefit of this reaction?  Types of Triggers ◦ Sight ◦ Sound ◦ Smell ◦ Touch ◦ Taste ◦ Thought ◦ Setting
  • 18.  What is the survival benefit of this reaction?  Types of Triggers ◦ Sight ◦ Sound ◦ Smell ◦ Touch ◦ Taste ◦ Thought
  • 19.  It is impossible to address every trigger  Triggers represent a desire for a reward, to avoid punishment or to survive  Triggers serve a function  Many triggers are "wrongly" conditioned  Mindfulness and Riding the Wave are two crucial skills to help clients deal with triggers and cravings
  • 20.  What are cravings ◦ A desire FOR something (commercials do this) ◦ Can become obsessive  Questions ◦ What do you crave/want? ◦ WHY do you crave/want it? ◦ Is this healthy and beneficial? ◦ How else could you meet this need/deal with this craving?
  • 21. • When we do something that aids in our survival, the limbic system rewards us by releasing dopamine • The more rewarding the behavior, the more dopamine (and other pleasure chemicals) are released • Prolonged engagement in an addiction can lead the brain to stop producing as much dopamine as it naturally does
  • 22. Stage Duration Withdrawal 1 to 2 weeks Honeymoon 4 weeks The Wall 12 to 16 weeks Readjustment 8 weeks or longer Copyright AllCEUs. Unauthorized training or commercial use prohibited
  • 23.  Lasts 1 to 2 weeks  Craving  Depression ◦ Low energy ◦ Difficulty sleeping ◦ Increased appetite ◦ Difficulty concentrating  Anxiety  Irritability Copyright AllCEUs. Unauthorized training or commercial use prohibited
  • 24.  Vulnerabilities ◦ Situations or conditions that make it more difficult to remain optimistic and enthusiastic  Emotional  Physical  Situational  Cognitive ◦ Need to be minimized or eliminated
  • 25.  Lasts about 4 weeks (until newness wears off)  Increased energy, enthusiasm, and optimism  People often feel they are “cured” when they reach this stage  Family members often view this as the beginning of a relapse  Often coincides with discharge from residential  Excellent time to find “exceptions” Copyright AllCEUs. Unauthorized training or commercial use prohibited
  • 26.  Lasts about 12 to 16 weeks  Hardest stage of recovery (Reconditioning)  Symptoms ◦ Depression ◦ Irritability ◦ Low energy ◦ Loss of enthusiasm Copyright AllCEUs. Unauthorized training or commercial use prohibited
  • 27.  Symptoms ◦ Anxiety ◦ Easily overwhelmed ◦ Body and brain still recovering from effects of substances ◦ High risk of relapse Copyright AllCEUs. Unauthorized training or commercial use prohibited
  • 28.  People  Places  Things  Times  Activities  Feelings  Lack of self care Copyright AllCEUs. Unauthorized training or commercial use prohibited
  • 29.  Triggers are stimuli that prompt a response  Craving is the repeated thought or sustained desire for that response  Triggers can be good or bad  Most people with addictions and/or mental health issues have multiple triggers that need to be reconditioned
  • 30.  Addiction causes changes in the brain  Using produces feelings of escape or euphoria which become associated with people, places and things.  When exposed to those people, places or things, people may begin to have cravings
  • 31.  When faced with unpleasant emotions or situations, people may also have cravings  Recovery involves ◦ Becoming aware of triggers and their function ◦ Eliminating or minimizing vulnerabilities ◦ Creating new associations ◦ Developing new ways to feel good and deal with stress.
  • 32.  If you have watched and participated in this program for CEUs, login to the classroom at AllCEUs.com and take the quiz.  If you have watched and participated in this presentation, and want CEUs, but have not yet registered, purchase access to the quiz and certificate at: https://www.allceus.com/live- interactive-webinars/