How to Identify Your BPD Triggers

Many people with borderline personality disorder (BPD) struggle to identify triggers that exacerbate their symptoms. Sometimes people with BPD feel that their reactions come "out of the blue," when in fact there are particular situations and events that consistently trigger symptoms. Triggers can range from minor things like a song or movie to something more serious, such as an individual.

This exercise will help you identify your unique triggers, helping you manage your symptoms. Before working on an exercise like this, be sure to talk with your therapist to make sure he agrees you are prepared for this 20-minute activity.

1. Take out a piece of paper and a pen or pencil. Find a quiet, private place to record your thoughts during this exercise. Be aware that this exercise may cause you some distress because you'll be thinking about situations that trigger your symptoms, so plan to do something soothing afterward.
2. On your piece of paper, make three columns. On top of the first column, write "Trigger." On top of the second column, write "Emotion." On the top of the third column, write "Response to Emotion."
3. Call to mind the last time you had an intense negative emotional response. This could be intense anger, loneliness, fear, sadness, shame, or emptiness. Under the "Trigger" column, write whatever event was happening just before you had the emotional response. Remember, a trigger can be an internal or an external event—it may have been something that happened in the environment around you, such as a fight with a friend, or it may have been something that happened in your mind, such as a memory or thought. 
4. In the "Emotion" column, write the emotional responses you had to the trigger. It's okay if you have multiple emotional responses. If you struggle to identify emotions, you can leave this column blank, but try your best to identify at least one feeling you had in reaction to the trigger.
5. In the "Response to Emotion" column, write the response you had to the emotions you wrote in the second column. For example, perhaps you felt intense shame in response to the trigger, and then you engaged in self-harm. Or, maybe you felt anger but used coping skills to manage your anger effectively. Whatever your response was to the emotion, record what happened.
6. See if you can identify two or three recent times that you have experienced intense emotional responses. For each of these episodes, repeat steps three, four, and five.
7. Now, take a look back at the list you have created. In particular, look at the column labeled "triggers." Do you notice any pattern developing? That is, are there particular types of triggers that come up repeatedly for you? See if you can identify one or two categories of triggers that consistently bring up strong emotions. For example, many people with BPD report that experiences of perceived rejection are a strong trigger for their intense emotional responses.
8. Keep this piece of paper, and after you experience episodes of intense emotion, add to your list by reflecting on the event that triggered the emotion, the emotional response you had and what you did in response to that emotion or emotions. See if you can identify other patterns of triggers.
9. As you add to your list, you will begin to be able to predict situations that trigger you. Having this knowledge will help you to create a plan for coping with triggers.
10. Share your list with your therapist. He will be able to identify coping skills or strategies you can practice and use to better handle these triggers.