- Experiencing or witnessing a traumatic, life-threatening event can result Post-traumatic Stress Disorder (PTSD).
- PTSD is characterized by by recurrent reminders of the trauma, hypervigilance, emotional dysregulation and avoidance.
- Trigger warnings, designed to protect trauma survivors may be countertherapeutic if they prevent people from processing their trauma.
One of the few positives to stem from the ongoing COVID-19 pandemic is our increased willingness to talk about mental health or the lack thereof. While struggles with mental illness are nothing new, misperceptions, stigma, and discrimination have long been an impediment to honest conversations about how we think and feel. Even the experience of significant trauma wasn’t always recognized as a legitimate cause of distress. Combat veterans who experienced cognitive, mood or memory changes as the result of trauma were often seen as mentally weak. Freud initially believed that childhood abuse contributed to mental illness but later discounted his female patient’s accounts of sexual abuse arguing that they were in fact fantasies. In many cases victims of trauma are blamed for their own misfortune to reduce other’s sense of vulnerability.
It doesn’t help that we are wired to avoid discomfort, whether it is physical or psychological in nature. Just as we learn to avoid touching a hot stove burner, we also find temporary relief from avoiding thoughts or reminders about a trauma. But ignoring the burner won’t prevent a house fire and ignoring our responses to trauma doesn’t make them go away. When people experience a life event that is so threatening, scary, or overwhelming that they can’t control their thoughts and feelings in the moment it can have a profound impact on their brain.
While we still don’t understand the underlying mechanisms at the brain level, the impact is enough to disrupt sleep patterns and cause nightmares, to create intrusive flashbacks and panic attacks and to result in emotional dysregulation and hypervigilance. Such post-traumatic stress symptoms can persist for years and are associated with depression, anxiety, substance abuse and a higher risk of suicide. While it makes sense that our brain creates strong trauma-related memories to ensure that we avoid future danger with PTSD people experience emotional and autonomic responses even when they know cognitively that what they are hearing is thunder, not gunfire. These responses are so aversive that people often adopt the strategy of avoiding any situation or cue that might trigger the response again.
Unfortunately, this can be difficult in the real world unless you limit yourself to interacting only with people who know what your triggers are and avoid leaving familiar places that feel safe. The irony is that for both PTSD and anxiety the evidence-based treatments of choice all involve helping people face the situations and memories they are afraid of, so they can learn how to manage their thoughts and diffuse their automatic emotional responses.
This is not a quick or easy process, and is best done in a supportive clinical setting. While this is the preferred clinical approach, something quite different has been happening in the social sphere where the concept of “trigger warnings” has become ubiquitous. This shorthand for telling people that they may find upcoming messages or pictures disturbing debuted first online, but has now become a common practice in the media classrooms and workplaces.
Although the warnings were initially intended to protect survivors of sexual violence, the term is now used to signal violence or trauma of any sort as well as political, racial or moral topics people may find disturbing. But refusing to listen to a news story about a violent event we don’t condone, or a belief we don’t agree with is a far cry from experiencing an autonomic response to cues related to a specific trauma we have endured. Furthermore, there is little to no evidence that trigger warnings reduces distress in trauma survivors. A study published in 2020 by Jones, Bellet and McNally indicated that trigger warnings did not protect trauma survivors from distress and “counter-therapeutically” reinforced the view that being a trauma survivor was now a key part of their identity.
How One Really Overcomes Trauma
In a cruel twist, assuming that we have to protect people from reminders of their trauma may actually be giving them the message that they have to spend the rest of their lives being labeled as survivors who can’t face the things that happened to them. Of course, graphic, overwhelming images or stories of trauma can disturb even non-traumatized people and it takes effort and time to process trauma, especially if it was perpetrated by other humans. But many survivors find that taking charge of the narrative they tell themselves and others and refusing to let the things that have happened define them is the true path to recovery.
While it is clearly a well-worn cliché, there is a reason that we tell people who get right back on the horse after a fall. The longer you avoid the thing you fear, the larger it grows in your own imagination. Acting as though the best way to cope with discomfort is to avoid it does little to solve the problem. Certainly, trauma survivors deserve to have the support and time they need to process what has happened to them, but rather than viewing trigger warnings as a signal to hide we need to view the topics behind them as both personal and social calls to action. While it would be unfair to expect that all trauma survivors can or want to be advocates for people who have shared their experiences, some do find that speaking out to prevent future abuses is empowering.
Others find power in pursuing non-trauma related activities that give them a sense of meaning and belonging. But if those of us who want to be supportive put more energy into changing the circumstances that led to their adverse experiences and less time signaling that we must be caring people because we have noticed they are upset, it might make a real difference.