Using Trigger Worksheets to Cope with Anxiety

The word “trigger” has gained widespread usage and understanding, particularly in discussions about mental and emotional well-being. In this article, we’ll discuss various anxiety triggers clients may experience and provide guidance on utilizing trigger worksheets to help clients cope.

The Oxford dictionary defines a trigger as something that will “cause (an event or situation) to happen or exist.” 

Anxiety triggers, more specifically,  can be defined as anything that induces an anxiety-based reaction—whether it’s emotional, behavioral, cognitive, or physiological. 

The trigger makes someone feel or think that they are threatened in some way. 

To help clients identify and respond to triggering incidents, therapists can utilize tools and worksheets—like our general anxiety coping worksheet and more practical coping with triggers worksheet.

Many therapy clients are dealing with emotional triggers and present with some form of anxiety. Coping with triggers can be a heavy burden, and clinicians need to be well-equipped to help their anxious clients face this challenge. 

There are three main components necessary to helping clients understand their anxiety: 

1. Identification of triggers
2. Awareness of reactions to the triggers 
3. How to respond to the triggers

Helping clients identify triggers

As with many elements of therapy, helping the client gain insight is at the foundation of the therapy process. 

When working with clients to identify triggers, providing psychoeducation and thoughtfully placed questions can advance this process. 

Anxiety trigger worksheets can also be a great tool to support clients with this work. First, let’s look at several key elements for clients to consider when working to improve insight into their anxiety triggers.

What are the various types of triggers?

Some clients may be well-versed in triggers, while others may have little awareness. For clients with less understanding, clinicians can start by offering education on what can be considered a trigger. 

Nearly anything can be a trigger for anxiety—people, places, things, situations, or circumstances—depending on the person’s past experiences and traumas. Some examples could include: A tone of voice, a drive past their childhood home or neighborhood, a plane ride, a cousin’s presence, or change in body posture.

Categorization of triggers can sometimes be helpful for identifying themes or patterns in the client’s anxiety. 

Triggers linked to the past

Many anxiety triggers are rooted in experiences from the past. Therefore, explicit or implicit memories may be anxiety triggers. 

Assisting clients in revisiting their personal histories can be a practical and effective means to uncover the array of anxiety triggers they currently experience. 

If the clinician decides to explore this route, it is important to ensure the client is ready and prepared with coping skills, as past exploration can sometimes be a trigger itself. If a clinician does not have specific training in trauma, they may need to consult with a trauma specialist or refer the client to one. 

Singular versus multiple cumulative triggers

Triggers are often thought of as one-time events that strike quickly and push a person past their threshold. While this is often the case, multiple anxiety triggers can also accumulate over time. Some triggers may be more subtle and not cause a massive reaction, but they nudge the person closer to their threshold. In these cases, several events or situations can compound and build upon one another. 

It is important to help clients identify whether their anxiety was triggered by one experience or by a chain of experiences accruing over time.

Real threats versus perceived threats

There are instances where there are true threats to a person’s safety that trigger them. In these cases, it’s appropriate and necessary for dangerous situations to trigger a fear response. For clients facing true threats to their safety, it is important to discuss safety plans with them.

There are also instances where an anxious feeling perceives danger, but the reality of the situation poses no true threat to the person. It is important to help clients sort through and gain awareness of real threats versus perceived threats when they experience anxiety. 

Anxious reactions to triggers

Becoming familiar with anxiety triggers is the first important step for clients, and it’s also important for clients to be aware of their reactions to the triggers. These are the specific ways that a client experiences an anxious reaction.

Reactions to triggers may present themselves as:

• Increased worry and rumination
• Physiological shifts such as a racing heart 
• Emotional changes like an overall sense of dread 
• Behavioral changes such as avoiding other people 

These are the signs for the client that they are anxious or feeling threatened in some way. 

Clients will likely have varying reactions depending on the various types of triggers they may encounter. Naming and identifying their reactions empowers them to have an ability to respond or cope in effective ways. 

How to respond to anxiety triggers

Reactions to anxiety triggers often feel unavoidable in the moment. The goal for clients, however, is to help them develop enough awareness and preparedness so that they can respond intentionally and effectively to their triggers and subsequent reactions. 

In addition to therapy, utilizing our trigger worksheets and coping with triggers worksheets could help clients find ways to cope with triggers. 

A conscious, intentional response recognizes the anxious reaction occurring, determines the actual level of threat, and takes action to effectively manage the situation. 

This can look like diaphragmatic breathing for the person whose heart rate is increasing, facing the feared situation for someone encountering their phobia, setting a boundary with a triggering person, or attempting to safely leave a dangerous situation. 

These helpful responses that the client identifies can be kept as a note on their phone, a written note in their pocket, or prompted by trigger worksheets. It is helpful to have an aid for remembering effective responses when a client’s brain is preoccupied with an anxiety reaction. 

The following are common challenging situations that clients may need support in learning how to respond: 

What to do when someone triggers you on purpose

Triggers are sometimes instigated by the intentional actions of other people.  

We need to be aware there will be times when someone triggers you on purpose.

These triggers still deserve a thoughtful response from the client. This may come at an interpersonal level or at a more macro level—such as in instances where the client doesn’t have a relationship with the triggering person and should focus on adapting coping skills to handle similar antagonists in the future. 

Teaching the client assertive communication through worksheets, self advocacy, and boundaries can be a good first step. 

Boundaries are asking for more or less of what the client needs and then sticking with a planned response if the problematic behavior continues. Boundaries should be viewed and expressed as a way for clients to keep themselves safe, and not as a way to punish the other person. Setting boundaries can also keep the relationship in as positive a state as possible by reducing the triggering behavior. 

Clients may also need to implement internal work and coping with triggers skills to reduce their reactivity to the triggering stimuli from the other person. 

One of the things the clinician may help the client process is whether this is a person the client wants to keep an ongoing relationship with. If it is not, the client’s best action may be to remove themselves from that relationship. 

How to deal with trauma triggers in a relationship

When a client has a history of trauma and many of their present triggers link to their past, they need strategies to prevent their trauma from triggering maladaptive reactions in  their current relationships. 

Helping clients develop a practice of being mindful of their reactions and how they impact the people around them is essential. As their awareness grows, they can communicate with others about what is happening for them and why they react to a perceived threat that doesn’t actually exist. This should be done only if the client feels it is safe and appropriate to share these details. 

When the other people in the relationship have awareness, it provides a chance for more empathy, patience, and understanding in the relationship. 

If the other people are causing the triggers, it offers them the opportunity to lovingly work on their triggering behaviors—and trigger worksheets can help them identify how to stop retriggering the client. 

Specifically applied coping skills for the triggers will be very important for the client. These may be skills to calm their own nervous system, soothe their racing thoughts, ask for a time-out to calm down for a period, or directly communicate their needs. 

Trigger worksheets

Trigger worksheets can help clients identify their anxiety-inducing triggers. In addition to using an “identify triggers” worksheet, it can also help clients note the specific anxiety reactions triggers induce for them, and find healthier responses to deal with these situations. 

Trigger worksheets walk clients through identifying their singular or cumulative triggers, categorizing the type of trigger, and determining if there are any links to past experiences. These worksheets can also help them to determine whether they are reacting to a real or perceived threat. 

Finally, anxiety coping worksheets prompts them to name their anxious reactions and conceptualize what coping skills or responses they could use for those triggers. 

Trigger worksheets can take the term “trigger” and prompt clients to give it individualized meaning for themselves. 

This type of work rewinds situations, brings moments into slow motion, and breaks triggers down into smaller, more manageable pieces. In turn, writing about and reflecting on triggering events offers clients the opportunity to respond more effectively in the future and reduce the power that anxiety triggers hold over their lives.

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