Trauma trigger

A trauma trigger is a psychological stimulus that prompts recall of a previous traumatic experience. The stimulus itself need not be frightening or traumatic and may be only indirectly or superficially reminiscent of an earlier traumatic incident, such as a scent or a piece of clothing.[1] Triggers can be subtle and difficult to anticipate.[2][3] A trauma trigger may also be called a trauma stimulus, a trauma stressor or a trauma reminder.[4][5] The process of connecting a traumatic experience to a trauma trigger is called traumatic coupling.[6]

Avoiding a trauma trigger is a classic behavioral symptom of posttraumatic stress disorder (PTSD), a treatable and usually temporary condition in which people sometimes experience overwhelming emotional or physical symptoms when something reminds them of, or "triggers" the memory of, a traumatic event.[5] Long-term avoidance of triggers increases the likelihood that the affected person will develop a disabling level of PTSD.[7] Identifying and addressing trauma triggers is an important part of treating PTSD.[6]

A trigger warning is a message presented to an audience about the contents of a book or other media, to warn them that it contains potentially distressing content. Recent evidence supports the view that trigger warnings are not helpful for trauma survivors, but instead countertherapeutically reinforce survivors’ view of their trauma as central to their identity.[8]

Triggers

The trigger can be anything that provokes fear or distressing memories in the affected person, and which the affected person associates with a traumatic experience. Some common triggers are:

  • a particular smell[7][9] – such as freshly mown grass, the fragrance of an aftershave product, or perfume.[6] The sense of smell, olfaction, has been claimed as more closely connected to traumatic reminders than other sensory experience, given the proximity of the olfactory bulb to the limbic system.[10][11]
  • a particular taste[6] – such as the food eaten during or shortly before a traumatic experience
  • a particular sound[7][9] – such as a helicopter or a song[1]
  • a particular texture[1][12]
  • certain times of day[7][9] – for example, sunset or sunrise[1]
  • certain times of year or specific dates – for example, autumn weather that resembles the affected person's experience of the weather during the September 11 attacks,[12] or the anniversary of a traumatic experience[6]
  • sights[9] – for example, a fallen tree or a light shining at a particular angle[6]
  • places[7] – for example, a bathroom, or all bathrooms[13]
  • a person,[9] especially a person who was present during a traumatic event or resembles someone involved in that event in some respect[7]
  • an argument[7]
  • a sensation on the skin[6] – such as the feeling of a wristwatch resembling the feeling of handcuffs, or sexual touching for victims of sexual assault[6]
  • the position of the body[14]
  • physical pain[6][14]
  • emotions – such as feeling overwhelmed, vulnerable, or not in control[1][12]
  • a particular situation – for example, being in a crowded place[1]

The trigger is usually personal and specific. However, it need not be closely related to the actual experience. For example, after the Gulf War, some Israelis experienced the sound of an accelerating motorbike as a trigger, which they associated with the sound of sirens they heard during the war, even though the resemblance between the two sounds is limited.[15]

It has been suggested that the realistic portrayal of graphic violence in visual media may expose some affected people to triggers while watching movies or television.[1][16]

Trigger warnings
For other uses, see Trigger warning (disambiguation).

Trigger warnings are warnings that a work contains writing, images, or concepts that may be distressing to some people.[17] The term and concept originated at feminist websites that were discussing violence against women, and then spread to other areas, such as print media and university courses.[17] Although it is widely recognized that any sight, sound, smell, taste, touch, feeling or sensation could be a trigger, trigger warnings are most commonly presented on a relatively narrow range of material, especially content about sexual abuse and mental illness (such as suicide, eating disorders, and self-injury).[18]

In cautioning university faculty against the widespread use of trigger warnings, Richard McNally, a professor of psychology at Harvard University, noted that "Trigger warnings are designed to help survivors avoid reminders of their trauma, thereby preventing emotional discomfort. Yet avoidance reinforces PTSD. Conversely, systematic exposure to triggers and the memories they provoke is the most effective means of overcoming the disorder."[19] Similarly, Metin Basoglu, a psychiatrist specializing in trauma research, said that "instead of encouraging a culture of avoidance, [the media] should be encouraging exposure. Most trauma victims avoid situations that remind them of the experience. Avoidance means helplessness and helplessness means depression. That's not good."[20] Similarly, clinical psychologist Edna Foa has cautioned that, "If we act as though they cannot handle distressing ideas, we communicate the unhelpful message that they are not strong".[21] Psychologist Darby Saxbe has warned that trigger warnings “send the message that language itself is going to damage you, and that’s simply not true”.[21]

In a study directly assessing the effects of the provision of trigger warnings, it was found that, among people who were not currently experiencing effects of trauma, the provision of trigger warnings somewhat increased the participants' anxiety after reading a passage of text that included potentially disturbing content, but only for those who endorsed the belief that words can cause psychological harm. The warnings also reduced the participants' perception of their own and other people's natural psychological resilience (the idea that, despite the near-universality of traumatic experiences and the potential of a short-term acute stress reaction, the person experiencing trauma will be okay in the end).[22] A second study[8] similarly found no evidence that trigger warnings were helpful for trauma survivors, for participants who self-reported a posttraumatic stress disorder (PTSD) diagnosis, or for participants who qualified for probable PTSD, while substantial evidence was found that trigger warnings countertherapeutically reinforce survivors’ view of their trauma as central to their identity (consistent with previous evidence that a low belief in personal psychological resilience is a risk factor for developing PTSD in the future.[22]).

Journalist and novelist Jay Caspian Kang accused these warnings of "reducing a work of literature to its ugliest plot points".[23] Amanda Marcotte criticized trigger warnings as "less about preventive mental health care and more about social signaling of liberal credentials"[24]

In higher education

The American Association of University Professors has issued a report critical of trigger warnings in university contexts, stating that "The presumption that students need to be protected rather than challenged in a classroom is at once infantilizing and anti-intellectual."[25] Angus Johnston, a history professor of American student activism and social movements at the City University of New York, said that trigger warnings can be a part of "sound pedagogy", noting that students encountering potentially triggering material are "coming to it as whole people with a wide range of experiences, and that the journey we're going on together may at times be painful. It's not coddling them to acknowledge that. In fact, it's just the opposite."[26] Joan Bertin, director of the National Coalition Against Censorship has argued that " trigger warnings are counterproductive to the educational process".

In 2014, students at UC Santa Barbara passed a resolution in support of mandatory trigger warnings for classes that could contain potentially upsetting material. Professors would be required to alert students of such material and allow them to skip classes that could make them feel uncomfortable.[18] A professor at Texas A&M University argues "the purpose of trigger warnings is not to cause students to avoid traumatic content, but to prepare them for it, and in extreme circumstances to provide alternate modes of learning."[27]

In 2016, the University of Chicago sent a letter welcoming new undergraduates; affirming its commitment to diversity, civility, and respect; and informing them the college's "commitment to academic freedom means we do not support so-called 'trigger warnings'," do not cancel controversial speakers, and do not "condone the creation of intellectual 'safe spaces' where individuals can retreat from thoughts and ideas at odds with their own".[28][29]

See also

References
  1. "Post traumatic stress disorder (PTSD)". vvaa.org.au. Vietnam Veterans Association of Australia. 2015. Retrieved 4 February 2016.
  2. Kolk, Bessel van der (1994). "The body keeps the score: memory and the evolving psychobiology of posttraumatic stress". Harvard Review of Psychiatry. Lippincott Williams & Wilkins. 1 (5): 253–65. doi:10.3109/10673229409017088. PMID 9384857.
  3. Staff writer (2015). "Post traumatic stress disorders in rape survivors". survive.org.uk. UK: Survive. Archived from the original on 16 October 2015.
  4. Fagan, Nancy; Freme, Kathleen (February 2004). "Confronting posttraumatic stress disorder". Nursing. Lippincott Williams & Wilkins. 34 (2): 52–53. doi:10.1097/00152193-200402000-00048. PMID 14758331. S2CID 33910036.
  5. Foa, Edna B.; Keane, Terence M.; Friedman, Matthew J.; Cohen, Judith A. (2008-10-24). Effective Treatments for PTSD, Second Edition: Practice Guidelines from the International Society for Traumatic Stress Studies. Guilford Press. p. 274. ISBN 9781606237922.
  6. Goulston, Mark (2011-02-09). Post-Traumatic Stress Disorder For Dummies. John Wiley & Sons. pp. 39–41. ISBN 9781118050903.
  7. Lahad, Mooli; Doron, Miki (2010). Protocol for Treatment of Post Traumatic Stress Disorder: SEE FAR CBT Model : Beyond Cognitive Behavior Therapy. IOS Press. pp. 18–19. ISBN 9781607505747.
  8. Jones, Payton; Bellett, Benjamin; McNally, Richard (2020). "Helping or Harming? The Effect of Trigger Warnings on Individuals With Trauma Histories". Clinical Psychological Science. 8. doi:10.1177/2167702620921341.
  9. Foa, Edna B.; Keane, Terence M.; Friedman, Matthew J.; Cohen, Judith A. (2008-10-24). Effective Treatments for PTSD, Second Edition: Practice Guidelines from the International Society for Traumatic Stress Studies. Guilford Press. p. 107. ISBN 9781606237922.
  10. https://pubmed.ncbi.nlm.nih.gov/12633130/
  11. https://www.mediamatic.net/en/page/239167/nose-nostalgia
  12. Cori, Jasmin Lee (2007). Healing from Trauma: A Survivor's Guide to Understanding Your Symptoms and Reclaiming Your Life. Da Capo Press. p. 30. ISBN 9781600940613.
  13. Foa, Edna B.; Keane, Terence M.; Friedman, Matthew J.; Cohen, Judith A. (2008-10-24). Effective Treatments for PTSD, Second Edition: Practice Guidelines from the International Society for Traumatic Stress Studies. Guilford Press. p. 224. ISBN 9781606237922.
  14. Follette, Victoria M.; Briere, John; Rozelle, Deborah; Hopper, James W.; Rome, David I. (2017-09-28). Mindfulness-Oriented Interventions for Trauma: Integrating Contemplative Practices. Guilford Publications. p. 304. ISBN 9781462533848.
  15. Lahad, Mooli; Doron, Miki (2010). Protocol for Treatment of Post Traumatic Stress Disorder: SEE FAR CBT Model : Beyond Cognitive Behavior Therapy. IOS Press. p. 9. ISBN 9781607505747.
  16. Ephron, Dan (1 October 2006). "Battlefield flashbacks". Newsweek. Newsweek LLC. Retrieved 20 December 2007.
  17. "Trigger warnings: What do they do?". Ouch blog. BBC. 25 February 2014. Retrieved 25 February 2014.
  18. Jarvie, Jenny (3 March 2014). "Trigger happy". The New Republic. Chris Hughes.
  19. McNally, Richard (20 May 2014). "Hazards Ahead: The Problem with Trigger Warnings, According to the Research: Five studies you should read before you deploy a trigger warning". Pacific Standard. Retrieved 7 August 2018.
  20. Waters, Florence (4 October 2014). "Trigger warnings: more harm than good?". The Telegraph. Telegraph Media Group. Retrieved 4 February 2016.
  21. Waldman, Katy (2016-09-05). "The Trapdoor of Trigger Words". Slate. ISSN 1091-2339. Retrieved 2020-02-14.
  22. Bellet, Benjamin W.; Jones, Payton J.; McNally, Richard J. (2018). "Trigger warning: Empirical evidence ahead". Journal of Behavior Therapy and Experimental Psychiatry. 61: 134–141. doi:10.1016/j.jbtep.2018.07.002. ISSN 0005-7916. PMID 30077703.
  23. Caspian Kang, Jay (May 2014). "Trigger warnings and the novelists mind". The New Yorker. Condé Nast.
  24. Marcotte, Amanda (2015-05-21). "Why Are People So Triggered by Trigger Warnings?". Slate Magazine. Retrieved 2020-02-14.
  25. "On Trigger Warnings". American Association of University Professors. August 2014.
  26. Johnston, Angus (May 2014). "Trigger warnings: a professor explains why he's pro-trigger warnings". Slate. The Slate Group. Archived from the original on 2014-10-06. Retrieved 2014-09-30.
  27. Lockhart, Elanor Amaranth (28 Sep 2016). "Why trigger warnings are beneficial, perhaps even necessary". First Amendment Studies. 50 (2): 59–69. doi:10.1080/21689725.2016.1232623. S2CID 151901765.
  28. University Of Chicago Tells Freshmen It Does Not Support 'Trigger Warnings'
  29. Students were directed to https://freeexpression.uchicago.edu/ for more information.
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