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Are Trigger Warnings Helpful?

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Seth J. Gillihan, PhD - Blogs
By Seth J. Gillihan, PhDClinical psychologistJanuary 14, 2020

In recent years there has been debate about the usefulness of trigger warnings, especially on college campuses. These warnings are often given by professors when course content could be upsetting to students with a history of trauma, and many students have come to expect them. For example, survivors of sexual assault may want to know if a book for the course includes events that could trigger memories of their trauma. 

I’ve occasionally used trigger warnings myself, especially when the material could actually lead to harm. For example, I warned podcast listeners when my interview with a physician included graphic descriptions of medical procedures; for some people these descriptions cause a fainting response, which would be catastrophic if the person were driving.

On the other hand, I have concerns as an anxiety and trauma therapist about trying to shield students and others from potentially distressing material. Avoiding things that trigger upsetting feelings is one of the main factors that keeps a person stuck in anxiety. The most powerful way to reduce fear is to meet it directly; in cognitive behavioral therapy (CBT) we use a gradual and systematic approach called exposure therapy.

Countless research studies have shown that exposure is a highly effective way to reduce fear and anxiety relatively quickly. For example, this approach can effectively treat phobias like a fear of dogs in a single session of about two hours. Exposure is also a key part of CBT for posttraumatic stress disorder (PTSD). Participants in this treatment are invited to revisit the memory of their trauma, which makes it less upsetting over time. The treatment also involves facing reminders of the trauma that may be distressing but are not necessarily dangerous. For example, someone who had stopped driving after a car accident would work toward getting behind the wheel again. 

I used these approaches myself after I was assaulted a few years ago. I found myself wanting to avoid the part of the parking lot where the attack had occurred—even though the danger was long past—but I knew that confronting the fear would be helpful to my recovery. It was emotionally painful the first time I walked over the ground where it has happened and vividly recalled the scene from the day of the assault. It also felt like a mastery experience because I had overcome my urge to avoid, and had reclaimed a part of my walk home that was rightfully mine. From that point on I no longer felt compelled to take the long way around to avoid a trauma trigger. My single trauma was relatively mild, but the treatment principles are the same for those with more severe or prolonged trauma histories.

Professor and psychologist Dr. Jonathan Haidt has been vocal in his criticism of trigger warnings. He and others argue that such warnings not only shut down conversation about important topics, but do little to protect the most vulnerable students. “There’s certainly no evidence that they’re helpful,” said Haidt, based on a handful of studies that have been done. “They don’t even help people with anxiety disorders to confront difficult passages in literature with less anxiety—and some studies have shown possibly some small backfire effects.” For example, one study found that trigger warnings for literary passages can lead readers to see themselves—and people in general—as more emotionally vulnerable, and can even increase the anxiety a person feels when they read the passages.

Haidt and his co-author Greg Lukianoff describe the effects of trigger warnings at length in their 2018 book, The Coddling of the American Mind. Their biggest concern with trigger warnings and similar well-intentioned measures is that they promote the “myth of fragility”—that “what doesn’t kill you makes you weaker” (as suggested by findings from the study above). They argue instead that people are anti-fragile, meaning they require challenge and adversity in order to grow. Exposure therapy is built on this recognition of anti-fragility.

There may also be longer-term costs of shielding young people from things that upset them, especially for when they experience a world without these kinds of protections. “In college there are guardrails everywhere,” said Haidt. “And then you graduate into a world where there are no guardrails, and people are deliberately trying to throw offensive things at you on the Internet.”

At the same time, it’s hard to argue that traumatized students should be exposed to upsetting material against their will. “What many professors agree is good practice is just to be clear at the beginning of the semester what the course is going to cover,” said Haidt. But he notes that professors should take care not to suggest that “some of these ideas are dangerous” or that “some of the books may upset you.”

“Say, for example that this is a class on human rights, and there are graphic accounts of torture,” said Haidt. “It’s appropriate to say that upfront—just don’t present it as though you expect some students to be harmed by it. What a terrible way to share an expectation of fragility with your students.”

This approach is similar to the exposure therapy I practice, in which the client is always in control of the exposures. As a therapist I don’t expose people to their fears, but instead invite them to do so themselves as they’re ready. This approach is not only humane, but is also the most effective; deliberately facing one’s fears does a lot more to reduce anxiety than when the exposure is accidental or is caused by someone else.

So trigger warnings can be offered in the spirit of anti-fragility—not because students are children who must be protected, but because they are autonomous beings who have some degree of choice in when and how to confront their painful past.

If you find that your traumatic memories are frequently triggered, talk about it with someone you trust, and consider seeking professional help. The ability to heal from trauma is built into your nervous system. You are anti-fragile. 

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About the Author
Seth J. Gillihan, PhD

Seth J. Gillihan, PhD, is a licensed psychologist with a private practice in Haverford, PA. He is author of The CBT DeckRetrain Your Brain, and Cognitive Behavioral Therapy Made Simple, and co-author with Dr. Aria Campbell-Danesh of A Mindful Year: 365 Ways to Find Connection and the Sacred in Everyday Life. Dr. Gillihan hosts the weekly Think Act Be podcast, which features a wide range of conversation on living more fully.

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