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Identify triggers that activate trauma memories and systematically compare the original trauma context with the present reality to reduce flashback intensity.
When something triggers a trauma memory, your brain responds as if the danger is happening right now. This worksheet helps you identify the trigger, recall what was happening during the trauma (then), and list all the ways the present moment is different (now). Practising this discrimination helps your brain update the memory so the trigger loses its power over time.
Use when the client experiences trauma-related re-experiencing triggered by stimuli that share perceptual features with the trauma (e.g., sounds, smells, visual cues). Central to Ehlers and Clark's approach for updating stimulus discrimination.
Explain that PTSD triggers work because the brain has linked certain sensory cues to the trauma, causing 'then' to feel like 'now.' The worksheet helps the brain learn to discriminate between the past danger and the present safety.
Begin with less distressing triggers before progressing to the most activating ones. For clients with multiple sensory triggers, create separate worksheets for each modality. Use in-session practice with controlled trigger exposure to model the process.
Ensure the client has adequate grounding skills before using this tool, as deliberately attending to triggers can initially increase re-experiencing. Avoid if the trauma memory has not been sufficiently processed through reliving or narrative work to provide a coherent 'then' context.
The key therapeutic mechanism is helping the client identify concrete, specific differences between 'then' and 'now' in the moment of being triggered. Encourage multi-sensory discrimination — what they can see, hear, feel, and smell NOW that differs from the trauma. Repeated practice strengthens the updated memory context.
Suitable for clients working with ptsd, trauma, trigger discrimination, then vs now, cbt, ehlers, clark, flashbacks, grounding. This tool can be used as a standalone worksheet or as part of a structured homework plan.
Create a free account to access 10 worksheets per month.
Practise and record the use of grounding techniques when experiencing flashbacks, dissociation, or overwhelming emotions.
Explore how the traumatic event has affected your beliefs about yourself, others, and the world.
Write a structured impact statement exploring how the trauma has affected your beliefs about safety, trust, power, esteem, and intimacy.
Prepare for a visit to the trauma site, record predictions, and process the experience afterwards to update the trauma memory.