What’s the harm in trigger warnings?

Some social media groups now won’t allow you to post anything without clearly labelling all the topics you’ll cover. The rise of trigger warnings seems a kind way of letting people manage their emotional load – but could it be doing more harm than good? What’s the evidence for the use of trigger warnings and could they be impacting on our emotional resilience?

There are a few things that inspire even the hardest of heart to negative emotions – the plight of a sick child, a parent lost too soon or the loss of a beloved pet. As we age, the list of traumas we have experienced only expands and we’re more likely to know someone who has died from cancer, lost a child or experienced sexual assault. 

The origin of the content or trigger warning

Triggers are defined as “psychological stimulus that prompts recall of a previous trauma” and originate from the original discovery of post traumatic stress disorder, first discussed in 1952 in the DSM-I as “gross stress reaction”. In 1978, this was revised to what we now recognise as PTSD, after the behaviours and stress reactions displayed by US veterans of the Vietnam War. 

For someone who has experienced war, obvious triggers might be very loud noises, like fireworks or cars backfiring. But less obvious stimuli could be any smells or tastes that might transport them back to a specific traumatic event.

Content or trigger warnings were originally conceived to alert readers or consumers of content that distressing content lay ahead – in the same way that TV continuity presenters will warn viewers of “strong adult content”, bad language or “scenes of a distressing nature”. So what could be the harm of that? Surely forewarned is forearmed and these warnings allow people to carefully curate what they view and experience?

Expansion of the warnings

In many groups that I frequent online, the trigger warning is employed for almost everything. From vomit (to protect emetophobes) to spiders, discussion of pregnancy (for those struggling to conceive) right up to and including financial privilege, weight loss, sex and sex toys, higher education, the end of a relationship, labour contractions (preferring the word ‘surges’) stress and sleep deprivation. 

It seems that whatever the subject, in some factions, it needs a content warning. 

What’s the harm in a trigger warning?

The evidence on the utility of trigger warnings actually seems scant and – more worryingly – appears to show that trigger warnings could be actively harmful. 

The Australian Spectator, harshly critical of Australia’s Monash University for formally introducing a trigger warning policy suggested that use of them “skew perceptions by highlighting certain elements.” Matthew Lesh, Head of Research for the Adam Smith Institute suggested that “the warnings tell students what and how to think about a piece of content, rather than allowing them to reach their own conclusions” 

He further argues that for those with existing ‘issues’, trigger warnings actively encourage them to “totally disengage from the material”, which “make[s] their fear worse”. He also rightly notes the common use of exposure therapy in psychology practice, which encourages people to [face] … anxieties, not [avoid] them”.

Reviewing the evidence

Some who oppose trigger warnings argue that traumatic fear is intense and experienced by a very small proportion of the population – indeed only a small faction of people who undergo very traumatic experiences will go on to develop PTSD. One US study surveyed 2,181 adults, of which over 89% of which had experienced traumatic experiences such as rape, natural disasters or serious accidents. Only 9.2% of those affected by the trauma had developed PTSD as a result. 

So how important is it that we protect ourselves from negative emotions that will provoke fear, disgust, anger or sadness?

The reality is that we of course only have control over so much. The internet – and Facebook in particular – does allow us to carefully control what we see. We have the ability to “hide posts” and educate Facebook about the kind of content we’d like to see. Its algorithms are carefully controlled to serve us more of what we’re interested in, in order to flog us product. Twitter also allows us to mute subjects, block people and hide content from our streams. 

Yet, in real life, we cannot control everything. We can’t control what people say, what they ask or what they present as. We cannot hide them, block them or mute them. Nor can we control seeing newborns when we’ve suffered loss, happy couples when we’ve ended a relationship or sick people when our own family members are dying. Sometimes the television suddenly seems to be serving you relevant adverts at every break, focusing on the very thing you’d like to avoid facing. From your tax return to your mother’s health problems, it’s all there prompting you to address your fears. 

Treating PTSD, as Lesh points out, relies heavily on not avoiding those triggers. Avoidance of the traumatic experience actually reinforces and strengthens trauma. Overcoming the trauma relies heavily on exposure therapy, something pioneered by clinical psychologists Edna B. Fora and Barbara O. Rothbaum. This therapy involves repeated recounting of the experience to the extent that it loses its power over the patient. Starting small, patients are prompted to face greater and greater aspects of what would be seen as triggering situations. Practicing confronting their fears eventually allows them to own the experience and reclaim themselves as separate from the experience, renouncing victimhood and redefining their identity as survivors. 

Trigger warning: empirical evidence ahead – direct evidence of trigger warning harm

Provocative as it is, the study entitled Trigger warning: empirical evidence ahead was one of the most crucial in displaying that trigger warnings could be actively harming those they are designed to help. 

The study asked hundreds of participants to read highly disturbing passages as well as more inane texts. Half of the participants were pre-warned of the disturbing content, the other half received no warning. Crucially, the participants who had been warned about potential distressing content were more anxious than those who had received none. However, that study was limited by not including any participants who were victims of trauma. 

A new study, by the same researcher, addressed that very question. 451 participants who had experienced trauma were recruited for the study and again it was discovered that trigger warnings raised the anxiety levels of those consuming disturbing content. The paper concluded that the warnings “countertherapeutically reinforce survivors’ view of their trauma as central to their identity.”

Don’t trigger warnings just allow us to opt out?

Apparently not, according to the latest evidence in from that same study. The evidence on whether people do use them as a shortcut to avoid trauma altogether is mixed and, on a totally anecdotal basis, I know that many people don’t take responsibility for their own mental health online, wading into debates they know will cause them stress, deciding not to simply hide posts or disengage from the conversation. What’s more, cognitive avoidance of what ails you is “really counterproductive”, argues Darby Saxbe, assistant professor of psychology at the University of Southern California. “It can have rebound effects, such as more flashbacks, because the memories aren’t fully processed.” 

A proponent of acceptance and commitment therapy (or ACT), Saxbe suggested to Slate in 2016 that no thought or belief “is deterministic, no memory so distressing or dangerous that you can’t build tolerance and acceptance and move forward”. The intention behind ACT is “to upend the internalized belief that any bit of text can wield damaging, identity-unraveling power.”  To prove “[y]ou are not your thoughts; you can rise above your memories.”

In many of my social media groups, if you don’t use a trigger warning, you’re in trouble and risk a mute or a ban for continual failure to use them. Despite it being a struggle to find empirical evidence in favour of their use, I think they’re here to stay. There’s minimal criticism of them except within scientific circles. The evidence against them doesn’t seem to have permeated the consciences of those who support them and perhaps never will. Only time will tell what impact this will have on the generation that many already refer to as snowflakes. I’ll continue to use them, despite my aversion to them. Essentially, because I don’t wish to be cut off from the support these social media groups provide. I just hope by continuing to use them, I’m not further contributing to the mental health issues that affect 1 in 4 of us.

There’s no content warning big enough to cover that sobering fact. 

 

Bibliography

—“The Stressor Criterion in DSM-IV Posttraumatic Stress Disorder: An Empirical Investigation,” Breslau, N., & Kessler, R. C., Biological Psychiatry, 2001

—“Treatment of Posttraumatic Stress Disorder: An Assessment of the Evidence,” The National Academies Press, Institute of Medicine, Washington, D.C., 2008

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