Trigger Warning – Trigger warnings can be bad for you

Here is an abbreviated list of thoughts that are linked to traumatic stress:

1. I can’t deal with being upset

2. People can’t be trusted.

3. I am a weak person

4. I have to be on guard the whole time

5. You have to be careful because you never know what can happen next.

6. I can’t rely on myself.

This list is a sample of a much larger list of cognitions that are associated with PTSD. The thoughts are both understandable, but unhelpful. Together, the thoughts represent a thinking style that is harmful for people who have been traumatised. This thinking style is associated with negative thoughts about the self, negative thoughts about the world and self-blame. Thinking in these ways is associated with increased  severity of traumatic stress. Thinking in these ways also distinguishes who have been traumatised and don’t have PTSD from those individuals who have been traumatised and have PTSD*.

The beliefs above frame the sufferer as a weak person who lacks internal capacities. They make the sufferer vigilant about danger because they engender a sense that the world is dangerous. They also provoke an idea, and this is the really dangerous aspect, that something is wrong with the very substance of the person. This thinking makes them feel wreaked and ruined, stained and fragile.

It is one thing to be vigilant, to believe that something is wrong with you and believe that you can’t cope with the world, but imagine having a friend actively communicating those things to you. You would rid yourself of such a person would you not? But what if they were a well meaning person who was just…naive? They say to you “be careful” or “you can’t trust others”, or “I’ll protect you”. The intention seems good, but would it be good for you to have a friend like that repeating warnings to you and keeping you in a vigilant state?

Recently researchers at Harvard University gathered together 451 trauma survivors. They randomly assigned these trauma survivors to one of two groups. One group would receive “trigger warnings”, which is a statement that what the participant was about to encounter could be upsetting. The other group did not receive trigger warnings. Both groups read literature that was typical of High School English classes (a passage from Moby Dick, Flags for our Fathers, or Crime and Punishment). The researchers concluded “… that trigger warnings countertherapeutically reinforce survivors’ view of their trauma as central to their identity” **. That is, the trigger warnings helped to confirm that they are defined by the trauma they had been through, and that is the very thing that the trauma survivor is trying to escape.

If you really care about a survivor of trauma, don’t give them a ‘heads up’ that danger is just around the corner. If you do, you are unwittingly creating problems. We need to cease giving people trigger warnings, and stop communicating that they can’t handle life without our protection. If we actually care about friends and family members we will need to stop thinking that they are fragile. Sure they can be rattled, we are all rattled after horrible events. But even if they say, “I can’t cope” we need to say “you can’t cope…. yet“. We need to have faith in them, not faith in us. We need to provide routine and connection, but we also need to increase their exposure to the world with the belief that they will cope given the time they need. Most family members and friends of someone who has suffered do this really well. There remains in our culture people at universities and in media, who need to drop their naive and misguided notion that by giving people trigger warnings they are caring for people when they are making them worse.

Whenever I hear people’s stories of trauma, my heart sinks. After 20 years I’ve heard a lot of them. But my heart soars every time I see a patient learn that they are stronger than they thought and that happens a lot.

Dr Jonathan Andrews MAPS FCCLP, Clinical Psychologist.

Brisbane, Australia.

* Foa, E.B., A. Ehlers, Clark, D.M., Tolin, DM.F., & Orsillo, S.M. (1999). The Posttraumatic Cognitions Inventory (PTCI): Development and validation. Psychological Assessment, Vol 11(3), 303-314. https://doi.org/10.1037/1040-3590.11.3.303

**Jones, P.J, Bellet, B.W & McNally, R.J. (2020). Helping or Harming? The Effect of Trigger Warnings on Individuals With Trauma Histories. Clinical Psychology Science. You can find the pre-print version of the full article here