The suggestion that you’re about to be exposed to something unpleasant can actually make it worse.
According to urbandictionary.com (chosen to help me make a point), a trigger warning is “a warning before showing something that could cause a PTSD [post-traumatic stress disorder] reaction”. The crowdsourced site then goes on to disparage the idea entirely.
Although I’m going to express some ambivalence about the utility of trigger warnings, I don’t want to disparage PTSD. It is a real and distressing condition. What we now call PTSD has gone by other names, such as “nostalgia” (used by American Civil War soldiers) and “shell shock” (coined in World War I). PTSD is not, however, solely the experience of people who see combat.
A PTSD diagnosis requires you to meet a set of criteria. A central one is direct or vicarious experience of threatened or actual death, threatened or actual serious injury, or threatened or actual sexual violence. In short, a significant, serious and traumatic stressor. Perhaps as many as 90% of us will experience at least one of these things in our lives, but fewer than 10% of us will go on to develop PTSD. Experiencing trauma is a necessary but, on its own, insufficient criterion for PTSD.
That is because not all of us experience “intrusions” – unwanted memories, nightmares or flashbacks, and high levels of physical and emotional distress following reminders – associated with traumatic experiences.
Normally, our experiences are processed in the background so they can be filed away into the archive of our memory, losing emotional power as they dim. But for some people, and some experiences, that doesn’t happen – our emotional security guard locks down the archive before trauma can be catalogued and filed. Triggers elicit these unprocessed memories in all their vivid, undimmed unpleasantness so they’re effectively re-experienced in that moment and, again, the figurative security guard thinks he’s doing his job by closing the door.
Contemporary therapy for PTSD often involves helping the person hold the library doors open so the experience can be processed. One way this can work, as odd as it may sound, is to give someone something else to focus on while they work through the memory – such as watching a pendulum swing, or a finger moving.
But back to trigger warnings. People with PTSD can be, and are, triggered by things that happen around them. Unfortunately, you can’t assume triggers that are overtly reminiscent of a traumatic experience will be those cues. Warning that a movie includes violence cannot be assumed to trigger violence-related stress, whereas otherwise innocuous things might. You can’t necessarily predict triggers.
And the assumption that helping someone avoid potentially triggering material is beneficial may be just that. Indeed, avoidance of trauma-related thoughts or reminders is also a diagnostic criterion for PTSD, and avoidance, as a general rule, is a relatively maladaptive coping mechanism.
At the same time, people with PTSD can prepare for exposure to potentially triggering material, and that is a good thing.
Problematically, there is also reason to think that people who do not experience PTSD can be worse off after a trigger warning. They can be likely to infer that material is traumatic and potentially experience greater emotional distress than they otherwise would.
So, at best, trigger warnings are modestly helpful for people who do experience PTSD, and potentially harmful for people who don’t. You have been warned.
This article was first published in the January 12, 2019 issue of the New Zealand Listener.