Trigger Warnings as an Impediment to Healing and Mental Health
So much conversation and debate after yesterday’s post about trigger warnings.
Most of the commenters here and elsewhere seemed to agree that:
- No, trigger warnings are not, by themselves, censorship.
- Stephen Fry was being a complete turd cabbage in his article.
But there was discussion of whether the concept of triggers and content warnings can go too far, and if we can reach a point where it all becomes damaging. One individual pointed to an article in the Atlantic as an example that was “better informed”: The Coddling of the American Mind: How Trigger Warnings are Hurting Mental Health on Campus, by Greg Lukianoff and Jonathan Haidt.
I started trying to respond to some of the points in that article, and after 1000 words, had only gotten through the first few paragraphs. So I’m trying a different approach, and zooming in on just one of their arguments:
[T]here is a deeper problem with trigger warnings. According to the most-basic tenets of psychology, the very idea of helping people with anxiety disorders avoid the things they fear is misguided. A person who is trapped in an elevator during a power outage may panic and think she is going to die. That frightening experience can change neural connections in her amygdala, leading to an elevator phobia. If you want this woman to retain her fear for life, you should help her avoid elevators.
But if you want to help her return to normalcy, you should take your cues from Ivan Pavlov and guide her through a process known as exposure therapy.
NO YOU SHOULD NOT, BECAUSE YOU ARE NOT A THERAPIST!!!
(If you are a trained and licensed therapist, please replace the previous statement with, NO YOU SHOULD NOT, BECAUSE YOU ARE NOT HER THERAPIST!!!)
Exposure Therapy and Systematic Desensitization are processes. They’re done in a controlled environment, with preparation and planning, which includes letting the patient know what’s coming. I.e., giving them a warning.
You might as well say, “Hey, Electroconvulsive Therapy is still sometimes used to treat depression, and you’ve been feeling down, so I’m gonna plug in this toaster and drop it into the bath with you!”
As someone who earned a degree in psychology, has been a rape counselor, has been in counseling, and married a license therapist, do me a favor and knock it off with the armchair psychologist crap before you seriously hurt someone.
Lenora Rose
April 13, 2016 @ 7:31 pm
Amen.
Muccamukk
April 13, 2016 @ 7:54 pm
I have a lot of very complicated feelings about mandatory warnings (as a fanfiction writer, I’ve seen an intense debate on the topic about every six months), but I feel like we can all agree that that essay is not well thought out.
Like, what?
Jayle Enn
April 13, 2016 @ 8:01 pm
That essay reads like the kind of self-congratulatory pseudoscience I’ve seen wafting out of 4chan from time to time.
Arinn Dembo
April 13, 2016 @ 9:33 pm
Agreed. In general, you never want to assume you have a right to cause others emotional pain without consent. It’s not your job to “fix” anyone else’s issues, regardless of what they are.
I’d also observe that Trigger/Content Warnings are generally for the benefit of people with trauma, not anxiety. “Exposure therapy” for a person suffering from anxiety is generally designed to help people to cope with situations that are actually perfectly mundane or normal. Anxiety disorders can turn a lot of mundane life events into a nightmare–receiving a phone call, going on a date, dealing with public officials can all seem insurmountably scary.
The goal is usually to de-sensitize someone and stave off a very negative reaction to a very normal challenge, so that people can Do The Thing and be…more high-functioning and happy.
I don’t know of any therapist who has the goal of deliberately de-sensitizing people to extraordinarily bad situations which should NOT be normalized and made part of every-day, high-functioning life. Rape, child abuse, torture, racism–they things may be common, but they are NOT functional parts of daily life that we all need to accept, and there’s nothing healthy about becoming de-sensitized to them.
In fact I’d argue it’s quite the opposite.
Hobbits! The Musical
April 13, 2016 @ 9:50 pm
“Exposure Therapy and Systematic Desensitization are processes. They’re done in a controlled environment, with preparation and planning, which includes letting the patient know what’s coming. I.e., giving them a warning.”
Also? Research in relation to complex PTSD (not accepted as a thing by all professionals yet) shows that exposure therapy may actually be the complete WORST path to take and increase the problem exponentially. So Yay for your take on this and Beep!wrong answer! to the writers of that article.
I find trigger warnings useful in the same way you mentioned – to decide if I want those images in my head or not. Doesn’t matter if they’ll set off an episode, maybe I just don’t want them in the first place.
bev
April 13, 2016 @ 10:51 pm
This was pretty much exactly what I thought when I read the quote Jim pulled from the Atlantic article. Only my own reaction involved less articulateness and more silent, guttural screaming.
Jesse the K
April 13, 2016 @ 10:55 pm
http://dsq-sds.org/article/view/4652/3935
Angela Carter expertly answers the “pandering to whiny students” rhetoric by bringing her experience with teaching and trauma. She details how trigger warnings function as actual accommodations for actual disabled people.
“Teaching with Trauma: Disability Pedagogy, Feminism,
and the Trigger Warnings Debate”
Angela M Carter
Disability Studies Quarterly, Vol 36, No 2 (2016): Winter 2016
free open access
http://dsq-sds.org/article/view/4652/3935
Alyce Duckworth
April 13, 2016 @ 11:49 pm
Great posts about trigger warnings, Jim! I’m in total agreement with both. My professional opinion as a Licensed Clinical Social Worker who’s specialized in trauma for at least the past 16 years, is that Lukianoff & Haidt are Dumb Asses.
I’ve become somewhat lazy and more rebellious in my post grad. school years, and thus will not be providing citations for the following info. However, if anyone is truly interested, I can provide sources.
In relatively recent years, we have learned more and more about brain processes and plasticity. With that knowledge, it seems highly likely that exposure therapy and even plain ol “talk therapy” can entrench and deepen the brain pathways involved in intransient trauma responses. In fact, many brain theorists, including myself, believe that the verbal processing center of the brain cannot communicate with the trauma processing centers (beginning with the Amygdala) at all. Thus, techniques that activate and involve both the right and left hemispheres of the brain, and transcend mere verbal processing, are key to actually resolving trauma and building new brain pathways. Just a couple examples of these techniques are Eye Movement Desensitization and Reprocessing (EMDR) and Brainspotting.
Having said all of that, I realize my point is moot, because, as you stated so eloquently, individuals without training, clinical licensure, sufficient supervised experience, and an official controlled client-therapist relationship should NEVER recommend interventions that impact another person’s psyche and brain chemistry.
Erica
April 14, 2016 @ 12:05 am
You make a very good point, though I believe that desensitization therapy for rape survivors (say) isn’t about desensitizing the survivor to being raped itself but to more benign situations that trigger a panic attack because they’re associated with rape in the person’s mind. These things could include the smell of the assailant’s cologne, the song that was playing on the radio during the assault, or even having consensual sex.
Whether being able to read or see certain kinds of entertainment and educational materials without being triggered is essential to a normal, happy life may depend in part on the kinds of things that trigger the person and on the survivor’s own desires or goals. But it’s absolutely the case that forcing a triggering situation on someone with no warning is not going to help them and will likely make the situation worse.
Sally
April 14, 2016 @ 12:58 am
OMG, I’m not going to read the whole article, the bit you quoted Jim has me riled enough.
As a lawyer and social worker, as well as a person who has suffered trauma I’ve been really interested in the last 2 posts – but I was having trouble formatting a reply without a lot of obscenities. My metaphorical forehead is heavily bruised from all the metaphorical headdesking I’ve been doing. Alyce, thanks for putting in words what I wanted to say.
legionseagle
April 14, 2016 @ 2:13 am
I think the essay is pushing a certain right-wing point of view which covers a lot of issues. That said, I think trigger warnings in academia are a band aid solution for a lot of problems which are being pushed under the carpet, specifically limited and diminishing funds, time and appetite for proper student counselling and pastoral care, coupled on the one hand with a student and parent body who are being forced into being hyper-consumerist because they are paying the purchase price of a medium sized house for the degree in question, and a reactive faculty who, having been forced into this consumer law framework, are acting like all large corporations who are terrified of lawsuits and are slapping, “May contain nuts” labels everywhere and nowhere, while being terrified to carry out a proper risk assessment of the assembly lines because actually they suspect that peanut dust (in many universities’ cases, in the form of Professor Emeritus Gropey McGropeface) has been leaking into the production facility for years and if they ever try to do anything more effective the backlog of lawsuits will overwhelm them.
M
April 14, 2016 @ 7:18 am
Okay, the way I look at trigger warnings is this: it shows you that something is affecting you, and therefore, it’s something that you need to work on. It’s a broad statement, and not one I’m trying to apply to victims of sexual trauma (or other serious cases for other people) in the sense of: just get over it! I suffer from anxiety and depression myself, and yes even I have a few triggers as well, not that I’m trying to boast about them. Still, my point being is that okay, this trigger is obviously affecting your mental health, and may at some points your every day life in the physical sense. Then the best thing to do is to seek someone out to get help, because to be able to unpack it, to understand it, and to know what it is, will help the person on the road to recovery.
Dana
April 14, 2016 @ 7:54 am
That article was one of the dumbest things I’ve ever read in the The Atlantic.
Isabel C.
April 14, 2016 @ 7:58 am
Depends on what it is and how you feel, though.
I have friends who really really don’t want to interact with media that has dental trauma, or harm to children or pregnancy issues. They live their everyday lives fine, and I don’t think they’re losing out majorly by not watching Marathon Man or Call the Midwife (much as I love CtM), any more than I’m missing out by never watching Trainspotting. (I’m fortunate enough not to have triggers, AFAIK, but I know that’s a movie I never need to see.) So “need to work on” or “best thing to do” isn’t necessarily true.
Grace Alexander
April 14, 2016 @ 9:06 am
I commented on Facebook, and will drop in here with a condensed version. Because the idea of some fucking asshole deciding he or she knows what my mental / emotional health needs and springing “therapy” on me has me so angry I’ve been grinding my teeth over it since YESTERDAY.
I was cult raised. You don’t WANT to know the shit I’ve lived through. Take just about any word, including mental, emotional, verbal, physical, sexual, spiritual – and tack the word abuse on behind it.
I’m a profoundly damaged person. I am cognizant of this fact. I don’t do well in large groups, I don’t do well with confrontation, my brain is a constant churn of worst case scenarios and I’m more than a bit sociopathic.
I am also extremely good at faking. I can sit through “Big Love” or “The Village” and laugh my ass off even while I’m being swept back to parallels in my own childhood. But Hound Dog really bothered me, Sybil sent me into a frozen, shuddering, sick to my stomach panic and A Child Called It went in the trash half finished.
Most people who meet me would have zero idea how messed up I am if I didn’t happen to be extra frank and open about my past in an effort to raise awareness of what thousands of kids go through every year (honestly, I promise you, you know someone who was in a cult. You just don’t know they were in a cult. It’s like the women you know – statistically, at least 1 in four and probably more like 1 in two have been raped or molested. We are good at hiding these things.)
The majority of the first 23 years of my life is a massive black hole. I saw one therapist who had experience in cult survivors after I got out, and she wanted to do memory regression. I told her extremely politely not only no but fuck off and die no. She snippily told me that she predicted a 100% chance of my having a complete psychotic break by age 30 if I “refused help”.
I’m now almost 42. I’ve gotten bits and pieces back over time, nightmares that I can realize are flashback memories, not dreams. My brain allows me that slow seepage and doesn’t push more than I can handle on me – I’ve woken up screaming a few times, but I’m able to differentiate between the past and present.
I’m lucky. A lot of people cannot. It’s not that I’m “better” or “stronger”. I am just… lucky. And I appreciate a culture that’s slowly moving towards kindness and understanding and “not being an asshole”. Fry has been problematic for a long time. As is obvious, there are still plenty of assholes out there. But I always appreciate knowledge, and trigger warnings help me decide if I want to be exposed to something. I don’t expect everyone around me to censor their speech. But I see no harm in being freaking KIND.
This ended up being very much NOT condensed, sorry Jim 😛
Sheila
April 14, 2016 @ 10:00 am
Hugs to everyone here with triggers (if you want them). I wanted to upload a picture of Meerkats having a group hug, but you’ll have to imagine it.
How arrogant do you have to be to decide that you know what therapy someone else needs without ever talking to them?
Muccamukk
April 14, 2016 @ 10:39 am
Mmmm. While I don’t disagree with everything you’ve said, some of the first universities to try warnings on academic content are ones known for student supports as well, with very mixed results (I’m thinking of experiments at Oberlin College). It does seem like a haphazard poorly thought out approach can do harm as well as good though, or at least be ineffective.
I don’t know if you were ever on Slactivist, but at one point they were slapping warnings in bolded red all caps all over things, which was great if you wanted to see RAPE RAPE RAPE all over the page. (Again, why I like “Content Notes.”)
The one time I got a content warning in school was in an English class before the teacher showed gory scenes from McBeth, which when you say, “This may upset some people, but you’re welcome to leave.” right before you show the thing, to a class of 36 people, honestly no one’s going to leave. Right up there with, “I will totally respect anyone who doesn’t go on this mission.”
Jim C. Hines
April 14, 2016 @ 10:44 am
Seconding Isabel’s comment. Mental health, therapy, recovery, etc. are too complex for one-size-fits-all statements. “Something is affecting you” isn’t the same as “something is affecting you in a detrimental way.” And if something *is* detrimental, there are a lot of ways to deal with it — one of which is by checking for content warnings.
There are certainly times when it’s best to get help, unpack it, and so on. I just don’t want us to oversimplify, if that makes sense?
M
April 14, 2016 @ 11:05 am
I think it does, Jim. I’m just trying my best here to understand trigger warnings and how while they are helpful, how they can also impact public discourse. I’ll never say they’re a form of censorship, It’s just a very complex subject and I do stand by the need for these kinds of warnings; I’m just worried about them easily being abused by people to close public discourse on topics that need to be discussed, or to police people on what they’re saying, even if the person is not on the path of trying to hurt the person who is outing them. For example someone trying to make a joke that is at no ones expense but a person decides to take it way too personally and calls them out anyway by using trigger as a form to shut that person down. But this doesn’t mean that when a person experiences a trigger they should be ignored, it’s just that will all good intentions of anything, people will find ways to use it to their advantage.
Z
April 14, 2016 @ 1:18 pm
I don’t really think this argument holds up. Just as a blanket “you should use exposure therapy” is not a one-size-fits-all solution, the “you are not a therapist, you can’t help” isn’t either. There are plenty of situations where you don’t need a psychology degree to do good, and we encounter them all the time – when a friend comes to you for relationship advice, or wants to open up to you about some past trauma, or similar. The correct response has never been “oh, better not, I’m not your therapist.” I do see the point of warning off random schmucks from trying to desensitize a women they don’t know to elevators, but that’s not the typical case – it’s usually your friend who needs help, and the correct solution is to talk about it, offer to help, make sure they know what’s going on and are willing to try it, and then do something about it.
Jim C. Hines
April 14, 2016 @ 1:24 pm
You’re starting out by arguing against blanket, one-size-fits-all statements, and ending by stating, “The correct solution is…”
Nowhere am I saying you shouldn’t listen to your friend or offer to help. Nowhere did I suggest if a friend wants to open up about something they’ve experienced, you should tell them to shut up because you’re not a therapist.
There’s a huge difference between, “All right, let’s talk. I’ll listen, and if you want advice, I’ll see what I can come up with.” and “As your friend, I’m going to begin therapeutic techniques and processes I’m not actually trained to do, but hey, what’s the big deal, right?”
To make a medical analogy, nobody’s saying that if your friend cuts off their finger, you can’t help to put pressure on the wound, or put the finger on ice and drive them to the hospital. However, you probably shouldn’t grab duct tape and a staple gun and try to surgically reattach the finger yourself.
Jim C. Hines
April 14, 2016 @ 1:40 pm
Hi Alyce! 🙂
Amy’s been studying and learning EMDR, so I’ve heard a little about it, but I’m definitely out of the loop on some of the most current research and practices. I wasn’t aware of Brainspotting at all — may need to ask about that.
Interesting to think about the boundary between the trauma centers of the brain and the rest, and the limitations of talking (verbal brain) in addressing those traumatic responses and pathways.
Lyndon
April 14, 2016 @ 2:32 pm
Even before thinking about it, the “let’s take a cue from 1901 science!” part was for me a Clue that the authors might not have done a reasonable amount of useful research.
Laura
April 14, 2016 @ 3:10 pm
“In fact, many brain theorists, including myself, believe that the verbal processing center of the brain cannot communicate with the trauma processing centers (beginning with the Amygdala) at all.”
This is one reason why I’m looking forward to starting an advanced degree in art therapy.
Grace Alexander
April 14, 2016 @ 4:49 pm
Muccamukk,
Fellow fan fic writer *high five* – and a while back I actually covered the idea of content warnings as part of a bigger piece over at rapekulture.com (Jim, slap me down if links aren’t allowed?)
http://www.rapekulture.com/2016/01/25/ao3-teens-and-the-concept-of-consent/
Muccamukk
April 14, 2016 @ 5:04 pm
Nice essay. AO3, for the most part, has been working out pretty well.
I think there’s a big difference between fandom, which is what I’ve been talking about as a semi-anarchic grassroots thing, and academia and pro-publishing, which has a system put in place from the top down. I know a lot how one works, and very little about the other
Though I tell you, I wish I could get content warnings on romance novels the same as I get on fic.
Sistercoyote
April 14, 2016 @ 5:38 pm
I would be interested in knowing more about the studies, if you have a chance, because I’ve reached a point where Talk Therapy isn’t helping me get past a couple of blocks and I’d like to know what else I could look for.
If you’re willing, of course.
Liz Schiller
April 14, 2016 @ 7:07 pm
I’m not Alyce Duckworth (also not a therapist or mental health professional) but I’ve done a LOT of reading and had some personal experience with trauma and with EMDR. If it’s OK to link to my own site, I’ve got information about therapies that seem to be the most effective for healing trauma, and useful links. http://ptsdmusical.com/trauma-treatments/
The best long book I know on the topic is Bessel van der Kolk’s The Body Keeps the Score; the best shorter, more mass market book I know on the topics is Childhood Disrupted: How Your Biography Becomes Your Biology and How you can Heal by Donna Jackson Nakazawa. Both are also noted on the links page.
Alyce Duckworth
April 14, 2016 @ 11:22 pm
You’re very welcome! I experience the state you describe regularly
Alyce Duckworth
April 14, 2016 @ 11:29 pm
Hi!! Yes, check out: Brainspotting, neurofeedback, somatic experiencing therapy, NIA, and Body Code/Emotion Code Therapy I you’re interested in these methods. I LOVE the brain, and I get to present on the impacts of trauma in the brain often! Liz’s link in her reply below contains a wonderful explanation of that barrier between trauma and other processing centers… Hi, Amy, too!!! That’s so cool she’s learning EMDR!
Alyce Duckworth
April 14, 2016 @ 11:30 pm
Awesome!!!!
Alyce Duckworth
April 14, 2016 @ 11:32 pm
Yes!! Bessel van der Kolk is one of my favorites!!! Also, the description in the link you sent is superb!!! Thank you!
Alyce Duckworth
April 14, 2016 @ 11:47 pm
I also wholeheartedly recommend Bessel van der Kolk’s writings and the link Liz posts in her reply below. Francine Shapiro, mother of EMDR, wrote an excellent book recently that is very readable and can help guide you through basic EMDR techniques. She also includes MANY citations to the research. The book is called “Getting Past Your Past”. There is a wealth of research on the International EMDR website, EMDRIA.org
Also, check out the Brainspotting website… I think it’s Brainspotting.org I would STRONGLY recommend looking for a therapist trained in either EMDR, Brainspotting, or Emotion Code / Body Code Therapy. Any of the three will get you processing beyond talk. I describe Brainspotting as EMDR on steroids; and, having experienced around 18 years of my own personal therapy, I think Emotion Code / Body Code therapy is the fastest of all! Best of luck to you!!
Isabel C.
April 15, 2016 @ 8:15 am
Well, I think it depends on context.
If I make a “your mom” joke, unknowingly, in front of someone whose mom died recently, it’s totally reasonable for them to say “…er, could you not in front of me?” and the better part of friendship or even civility for me to respect that.
Likewise, there’s–as someone on the previous thread pointed out–a pretty long tradition of TV shows running a “may contain scenes of X which might be disturbing for some viewers” warning before programs featuring certain types of content.
There are also, certainly, topics and so forth where I feel like the content warning is baked in. If you’re uncomfortable with fantasy violence, you don’t play WoW. If you’re uncomfortable with frank discussion of sex crimes, do not go into law enforcement. And I have no patience for people who get all snippy about overhearing me swear, though I try not to do it around elderly relatives or other people’s children.
As with anything, I think you have to adjust for context, and there’s never going to be a perfect solution. But the concept is good.
Isabel C.
April 15, 2016 @ 8:19 am
And also, all of these situations involve a friend *coming to you and asking*, whereas the would-be therapists opposed to trigger warnings are proactively telling traumatized people what would be best for them and/or society.
I’m not too fond of people who offer unsolicited advice in most situations, and I don’t care what degrees they have. The dentist who comments about how much sugar I eat, unless we’re in their office and I’ve made an appointment, can fuck off just as readily as the “friend” who decides I need to know his opinion on my sex life.
Sistercoyote
April 15, 2016 @ 12:12 pm
Awesome–thank you!
Sistercoyote
April 15, 2016 @ 12:13 pm
Thanks–and thanks for the well wishes!
I will definitely look into all of these.
Jane James
April 17, 2016 @ 8:39 am
My reasoning when deciding to add a warning is not that people may avoid the content but they may need to prepare themselves to encounter the triggers. If I see a warning and I am feeling fragile I may bookmark the piece and come back to it. It didn’t occur to me that such warnings were seen as ‘don’t read this it’s triggering’, I’ve seen them as ‘put your protective mechanisms in place before reading’ advisories.
Tony
April 17, 2016 @ 5:24 pm
I must be out of the loop. I wasn’t aware there was a discussion on *mandatory* warnings.
Dr G
April 23, 2016 @ 7:49 pm
A relevant point about avoidance vs exposure in the case of traumatically induced conditioned responses (eg phobias, PTSD) is that there is a big difference between what might be called “single issue” anxieties eg a fear of spiders or elevators or whatever, and those surrounding more complex trauma. What you’ve said about exposure therapy needing to be done by an expert in the case of phobias applies exponentially in the case of complex trauma.
For example the trauma around rape might often involve not only the incident itself but also prior adverse childhood experiences and subsequent negative interactions with health care, law enforcement, media and the person’s own social network, resulting in complex and overlapping traumas, anxieties and triggers. In treating complex trauma a lot of effort goes into developing a safe and supportive relationship with the therapist before any exposure is used, and into assessing what is a suitable level of exposure (the concept of a “window of tolerance”) precisely because there is a substantial risk of retraumatising the patient if exposure therapy is poorly done. It’s not something you can throw pop psychology at (“just stop avoiding it, facing up to it is good for you”) or even a well-intentioned but poorly-informed approach.
Scylla Kat
June 9, 2016 @ 10:49 am
I love you now. I love Ms. Carter for this.