Headache triggers: To avoid or not to avoid, that is the question

Traditional clinical advice in the management of headaches is to avoid trig ger factors. There is a danger, however, that avoidance of triggers results in a sensitisation process whereby tolerance for the triggers decreases, i n a manner analogous to increments in anxiety arising from avoidance of anx iety-eliciting stimuli. Reported here are six single-case experiments in wh ich the aim was to desensitise headache sufferers to an experimentally vali dated trigger, namely "visual disturbance". The results demonstrated that r epeated, prolonged exposure to a headache trigger led to desensitisation wi th participants experiencing less visual disturbance, less negative affect and less head pain in response to the trigger. These findings have theoreti cal significance as they speak to the issue of the aetiology of chronic hea dache, and practical significance as they suggest that a key aspect of curr ent management may contribute to the disorder becoming worse rather than be tter.