When the Past Shows Up in the Present: Understanding Triggers and Healing Through Bottom-Up Therapy

Triggered

Imagine walking into a grocery store on a quiet Saturday morning. The smell of cologne from someone passing by suddenly makes your chest tighten. Your heart races, your stomach knots, and without warning you feel on edge and unsafe even though nothing in the store poses a real threat. You tell yourself, “I’m fine, I’m safe.” but your body is already reacting as if danger is here.

This is what it feels like to be triggered. A seemingly ordinary event, a smell, a sound, or a tone of voice, can awaken a memory stored deep in the body from a past trauma. Even when our rational brain knows we’re not in danger, our nervous system may respond as though we are.

How Trauma Impacts Relationships

Trauma doesn’t just affect the person who carries it, it also impacts the people around them. Research shows that trauma survivors often struggle with emotional regulation, trust, and intimacy (Herman, 2015; Cloitre et al., 2005). This can lead to misunderstandings in relationships. A partner may interpret withdrawal as rejection, or irritability as anger toward them, when in reality it’s the survivor’s nervous system responding to an old wound.

For families, trauma can ripple across generations. Studies on intergenerational trauma demonstrate how unprocessed pain can subtly influence parenting styles and attachment patterns (Yehuda & Lehrner, 2018). In everyday life, this might look like difficulty staying present, avoiding closeness, or unintentionally recreating old dynamics of fear or control.

The Science of Triggers: Brain, Body, and Emotions

So why do trauma triggers feel so powerful? Neuroscience has given us some answers.

When a traumatic event occurs, the brain’s amygdala (our threat detector) becomes hyperactive, encoding danger signals. At the same time, the hippocampus, which helps place memories in time and context, may not function properly (Rauch, Shin, & Phelps, 2006). As a result, traumatic memories are often stored not as a coherent story, but as fragmented sensations, images, or emotions.

This is why trauma is often felt in the body first: a pounding heart, tight chest, or nausea before any conscious thought arises. Bessel van der Kolk (2014) describes this as the body “keeping the score.” Triggers re-activate those body-based memories, pulling someone back into survival mode, fight, flight, or freeze, even when no real danger exists.

Bottom-Up Therapy

Traditional “top-down” therapies often focus on thoughts and beliefs, helping clients reframe how they understand themselves and the world. While this can be powerful, trauma is not only stored in our thoughts, it is imprinted in the nervous system and body.

Bottom-up therapy works differently by engaging the parts of the brain that are most impacted by trauma. When a person is triggered, the amygdala (our alarm system) becomes overactive, while the prefrontal cortex (responsible for logic, reasoning, and calming the system) often goes offline. Meanwhile, the brainstem and limbic system, which regulate survival responses and emotions, dominate the experience (Rauch, Shin, & Phelps, 2006). This explains why simply telling yourself to “calm down” rarely works when the body feels unsafe.

Bottom-up approaches, such as EMDR (Eye Movement Desensitization and Reprocessing), Accelerated Resolution Therapy (ART), Somatic Experiencing, and Sensorimotor Psychotherapy, start by working with the body and sensations rather than trying to reason through them. 

Clients often describe bottom-up therapy as gaining tools for their body as well as their mind to recognize when the nervous system is in survival mode and gently guiding it back to calm. Over time, this allows the body to release the grip of traumatic memories so that the past no longer dictates the present.

Summary

Trauma can feel like an uninvited guest showing up in the middle of everyday life. With the right support, healing is possible. Understanding that triggers are not signs of weakness, but rather the body’s way of remembering and protecting itself can be the first step toward compassion for yourself.

References

• Cloitre, M., et al. (2005). Treatment of PTSD related to childhood abuse: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 73(3), 549–559.

• Herman, J. (2015). Trauma and Recovery. Basic Books.

• Levine, P. A. (2010). In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness. North Atlantic Books.

• Payne, P., Levine, P. A., & Crane-Godreau, M. A. (2015). Somatic experiencing: Using interoception and proprioception as core elements of trauma therapy. Frontiers in Psychology, 6, 93.

• Rauch, S. L., Shin, L. M., & Phelps, E. A. (2006). Neurocircuitry models of posttraumatic stress disorder. Biological Psychiatry, 60(4), 376–382.

• van der Kolk, B. (2014). The Body Keeps the Score. Viking.

Yehuda, R., & Lehrner, A. (2018). Intergenerational transmission of trauma effects: Putative role of epigenetic mechanisms. World Psychiatry, 17(3), 243–257.