Trauma and Trigger Warnings

By Dr. Tyson Bailey

Imagine for a moment that whatever scares you the most (spiders, clowns, the girl from The Ring) is hiding around the corner from you. In the first scenario you have no warning and are left do deal with your emotions from the surprise encounter. In the second scenario, you have some warning that this is going to happen and have a choice about how to proceed (leave the situation, face the fear, use a freeze ray). My guess is that many would go with having a warning. Not only because of the ability to use a freeze ray, but knowing something is coming allows us to prepare and make a choice based on a mindful analysis of our skills as opposed to reacting to fear.

Now consider the lives of people who have experienced trauma, which can be defined as an event that is “extremely upsetting, at least temporarily overwhelms the individual’s internal resources, and produces lasting psychological symptoms” particularly when the exposure has been repeated over time (e.g., sexual abuse by a parent, emotional neglect, sexual trafficking). When the stimulus that activates your fear system could be present at any time, how do you prepare? While there are many therapeutic interventions to help with this process, there has been a movement to add “trigger warnings” within college campuses that has been causing quite a stir, particularly for those schools that have banned or discouraged their use.

Trigger warnings: A brief history

There appear to be a number of thoughts on when trigger warnings were developed. For me, it seems they are grounded in the “viewer discretion is advised” notices that have been on TV for as long as I can remember. While it seems these were primarily designed for parents, they served the function of letting viewers know there might be content not suitable or emotionally activating for some viewers. The term “trigger warnings” itself appears to have started on the Internet, to help those who have experienced trauma to be aware of content that might bring up distress. Bottom line, the idea of alerting people to potentially distressing content is not a new idea.

Let’s not be black and white

Given any tool that we have, there is an opportunity to use it in more or less effective manners. If I’m using a hammer to build a house, I’d guess it would be hard to find someone who would say that’s an inappropriate use of the tool. If I run around the streets striking people in the head, then I’m going to have some problems (unless, of course, I’m fighting zombies beside Daryl Dixon). So is true with trigger warnings. We know that avoidance can perpetuate the various types of distress that can come in the wake of trauma. However, to imply that the use of trigger warnings inherently promotes avoidance is not just a fairly rigid interpretation — it also ignores a lot of the literature. For instance, if a person dissociates (e.g., experiences themselves or part of the environment as unreal, retreats into a fantasy-based world) as a method of mediating distress and they experience an unexpected trigger, then they aren’t actually healing or resolving their symptoms. If we think about avoidance on one side and being emotionally flooded beyond the person’s ability to cope on the other, the results are essentially equally problematic.

Those on the side of eradicating trigger warnings have stated that they are “coddling” to students or otherwise exacerbate their symptoms by promoting avoidance. However, most professors that use them do not consider it a reason to skip class or not be present, but instead, provide students a warning so they can prepare for what is to come (e.g., bringing their equivalent of a freeze ray). I would certainly agree that it is critical to understand how the avoidance process works and to look for opportunities to overcome this problematic way of interacting with one’s emotions; however, Judith Herman’s seminal work has shown how important it is to ensure that people have the necessary skills to maintain safety and stability in their lives to ensure they can effectively process traumatic events.

Treatment

The unfortunate reality is that many college students have been repeatedly traumatized, an experience that is not well represented in trauma research studies. The few studies that have been completed show that people in these circumstances tend to need a greater number of sessions and have more complex symptom presentations than those who have experienced only a single trauma. Regardless of whether a person has experienced trauma once or numerous times, the most robust finding in research is that the therapy relationship trumps therapeutic techniques. Many college counseling centers do not have enough staff to provide the consistent, long-term care needed to help people overcome the effects of repeated truamatic events, and sometimes don’t even have clinicians trained in interventions to assist those who have just been traumatized. It’s critical that consideration be given to students who don’t have access to long-term treatment that would reduce the need for trigger warnings in their lives.

Concluding thoughts

Trigger warnings are about choice and empowerment–providing people with the knowledge that something difficult is coming, so they can create a plan for how to manage their emotions during the experience. Will some people use this as a way to avoid? Possibly. It’s equally possible that someone gets triggered in a class and has significant difficulty returning because of the negative association. As is true with much of psychology, what we must find is the middle ground. Inform people not only that traumatic material may be present, but also give them information on what to do if they are triggered. Suggesting, in any way, that students who find trigger warnings helpful simply need to go to therapy ignores the complexity of their overall experience and the therapeutic process. Let’s put our efforts toward ending child abuse, sex trafficking, and the other experiences that give rise to the need for trigger warnings, instead of focusing on eliminating this useful tool.

Dr. Tyson Bailey is a partner in a trauma-informed group practice in Washington. His practice focuses on the assessment and treatment of posttraumatic conditions. He is currently an associate editor for Psychological Trauma: Theory, Research, Practice, and Policy. Dr. Bailey is also an author on the forthcoming American Psychological Guidelines on the assessment of posttraumatic reactions in adults. Take This’ clinical director is fairly convinced Dr. Bailey is the proud owner of a Time Turner.