"Trigger Warnings"

After writing my last post, on PTSD, I started thinking about the current controversy over "Trigger Warnings," labels that are being placed on some class materials by some college professors. This term misappropriates a concept from mental health treatment. A content warning label is not a "trigger warning."The so-called "trigger warnings" are not really trigger warnings at all, as I will explain:

The concept of a "trigger" that incites symptoms has been used for some time in the study of PTSD (post traumatic stress disorder). For example, it has been observed for many decades that some combat veterans are triggered by the sound of explosions to re-experience combat experiences in a dissociative state. People who have been raped and who have PTSD as a result may experience a triggering of symptoms by a wide variety of stimuli: Some may experience anxiety when alone with a man, during sex, or when exposed to something only tangentially related to the rape--this could be anything from a song that was playing while they were being raped to a particular smell. Clinicians who work with people with PTSD, and researchers who study PTSD, know that a traumatized individual may have very individual, specific, triggers. Thus, it's impossible to predict in advance what might trigger PTSD symptoms in a person with PTSD without knowing that person.

Content warning labels have been used for a long time for movies, and more recently, for record albums. All movies are given a rating for content, the purpose of which is to alert parents that some content might not be appropriate for children. Warning labels on music, which began in the 1980s, perform a similar function. Content warning labels were not designed to help people with PTSD, but to provide information for the general public, especially parents.  Are such warning labels appropriate for college reading materials? College students aren't children and college reading assignments aren't entertainment, but may in fact be designed to provoke or challenge.

A college professor doesn't know individual students at the start of the semester, and can't possibly know whether the class will include students with PTSD, and in any case, what their triggers would be. Many students with PTSD can often figure out, by looking at synopses of books, films or other material that they will have to view for class, whether the materials might contain triggering material. But depending on the individual's triggers, it might also be impossible to predict. What is absolutely certain, however, is that it would be impossible for the professor to predict what material might be triggering to any particular student. And even if it was possible for the professor to know in advance that particular material would be triggering to a particular student, is it the professor's responsibility to warn the student? This puts the professor in the role of mental health clinician, a role most college professors are not qualified or licensed to fulfill.

From a clinical perspective, this type of discussion might be beside the point. Therapists don't counsel PTSD patients to avoid triggers. We don't tell rape survivors to avoid men, or tell Iraq combat veterans to avoid driving so that they won't think about roadside bombs. We help people develop coping skills, tell them that their symptoms are likely to subside over time, and encourage them to NOT avoid triggers, because to do so can increase the fear and create a phobia. This is precisely why the area of PTSD triggers is best left to mental health clinicians and not college professors from unrelated fields. I read a comment from a philosophy professor, in The New York Times, that she gives "trigger warnings" so that students with PTSD can meditate or take medication before exposing themselves to difficult material. As a therapist, I encourage meditation for people who can benefit, but I would never counsel anyone to take an anti-anxiety medication prior to reading a book. This could set the stage for a bad habit. This is not the purpose for which anti-anxiety medication is prescribed.

If a college student had such severe PTSD that she or he was unable to read or view triggering material without experiencing disabling symptoms for hours or without having a suicidal, homicidal or psychotic episode, that person should not be in college at all. College is a stressful environment and persons who are severely psychiatrically ill do not belong in college. However, few PTSD sufferers fall into this category. For most students with PTSD, attending therapy to improve coping skills and process the trauma in a safe environment is enough to be able to attend classes and complete all assignments. There is also the fact that some people with PTSD may have to  acknowledge that for the rest of their lives, they are going to experience some discomfort from certain stimuli that would have no affect on most people. Many people learn to live with symptoms from medical or psychiatric problems, because treatment often doesn't mean a 100 percent cure.

As I thought about this topic, it occurred to me that perhaps what I'm saying here is obvious, and maybe I am missing the point: Maybe the point isn't to help PTSD sufferers at all. Maybe the point of these so-called "trigger warnings" is to alert students to the professor's opinion about the material. Maybe what these "trigger warnings" really do is alert students to the fact that the professor finds the material troubling, and to suggest that the students should also find it troubling. I hope this isn't what's really going on, because it would be a violation of the basic principle of a liberal arts education, which is to teach students independent critical thinking.