I am teaching WRAP to a group. It’s my first time to facilitate a group instead of doing WRAP one-on-one with a client. We met for an hour last week to get started. I introduced myself, and we made a Comfort Contract for the class. A Comfort Contract is a group-directed list of guidelines to keep us all at ease talking to one another. I make these contracts with individual clients, too, but it’s vital for a group. Each member has to feel at ease.
We met again today, and we moved into the area of Triggers and a Trigger Action Plan. When a situation arises or an event occurs outside us that makes us feel particularly bad, it’s called a trigger. It may go so far as to worsen our symptoms. A very few examples of triggers include anniversary dates of losses or trauma, being overly tired, family friction, being judged or criticized, etc. The important thing to remember is that triggers are external to us.
In a WRAP class, we don’t stop at reminding us about the bad. We also gain power writing a Trigger Action Plan. An effective facilitator will reinforce this to the group. It’s easy to write a list of what makes us feel bad and have that snowball into actually experiencing the trigger. We take breaks, and we remember we are striving for recovery.
The Trigger Action Plan ideally contains some action to counter each triggering event or situation. Revisiting our Daily Maintenance List is high on the Action Plan. Are we doing everything we said that would keep us well? There are deep breathing exercises that anyone can learn to aid in getting through troubling emotions. Talking to a person we are close to is a valuable resource. Exercise cannot be underestimated in these situations either. The number of items on the Plan can go on and on.
The group went further today. We tackled the next section of WRAP, the Early Warning Signs and its accompanying E.W.S. Action Plan. While Triggers are external events that may cause us to feel bad, Early Warning Signs are internal. These signs indicate that all may not be well with us. Some examples are anxiety, forgetfulness, avoiding doing things on our Daily Maintenance List, increase in smoking, failing to buckle seat belt, etc.
The Early Warning Signs Action Plan is similar to the Trigger Action Plan. Each item relates to an Early Warning Sign. We may choose to meet anxiety with deep breathing or other relaxation exercises. Forgetfulness may cause us to renew our efforts at meditation. Avoiding doing things on our Daily Maintenance List is serious, and we may have to look deep and talk to a trusted friend about it. An increase in smoking may indicate a rise in stress, and we might decide to take extra rest and ask for assistance with responsibilities. Failing to buckle a seat belt is also serious, indicating a deeper issue that one might wish to bring up with a therapist or doctor.
Both Action Plans are important. They empower us. We don’t have to be hostage to our Triggers or to our emotions and their indicators.
It was at this point when things were winding down for the hour that something went awry for a participant. No sooner had I announced we were almost complete for the day, than she rushed from the room. Fortunately, this class took place at a center with lots of other people around, and one of the staff was soon by her side. She had not been feeling good since the morning, She bravely stated that her symptoms were worse. She was in distress, and the staff called an ambulance. I am sure she is now receiving the best care afforded by our local hospital.
I believe this incident illustrates why it is important to do WRAP with a certified facilitator and not alone. All people are vulnerable, and we with mental illness may have unique ones. A trained WRAP facilitator is often not a clinician but should have the experience to recognize a group member going off the beam, as it were.