According to Trivium frontman
Matt Heafy, who wrote the lyrics for the song and co-wrote the music with guitarist and backing vocalist
Corey Beaulieu, "A Gunshot to the Head of Trepidation" is written from the point of view of a child who is either a victim of
child abuse or a witness to
domestic violence, and is described by the vocalist and guitarist as "the punching bag for the underdog". Speaking in a track-by-track commentary of the album released on
Spotify in 2015, Heafy explained that "the outcome of the story of this song was that someone was able to create something out of [being abused]", and that it means "putting that terror away ... by allowing yourself to grow from it and learn from it and not harm yourself or anyone around you negatively from it". The gang vocals during the later stages of the song were recorded while the album was being mixed at
Andy Sneap's Backstage Studios in
Ripley, Derbyshire. They were performed by Heafy, Smith, Sneap, Chad Sunderland and
Gizz Butt. ==Promotion and release==