Do trigger warnings work?

New research suggests trigger warnings may not work as intended – but their right-wing politicisation makes re-evaluation complicated.

by James Greig
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06 December 2021, 8:00am

Having formed the basis of one of the longest-running culture war disputes of the last ten years, trigger warnings are as controversial today as ever. Just as their usage is becoming more normalised in certain contexts, such as academia and publishing, new research is emerging which appears to suggest either that they don't work, or have a detrimental effect. Because trigger warnings have been politicised to the extent that they have, it can be difficult to question their efficacy without sounding like Ben Shapiro. But if it is the case that they're not actually helpful for people with trauma, then we shouldn't shy away from admitting this. The problem is that the evidence for either side remains ambiguous.

Right-wing critics love to characterise trigger warnings as an indulgence, something demanded by a generation too immature, pampered and molly-coddled to face reality. In light of this, one thing we should insist upon is the extent to which trauma is a real thing that severely impacts people's lives. In The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma, psychiatrist Bessel van der Kolk writes, "trauma produces actual physiological changes, including a recalibration of the brain's alarm system, an increase in stress hormone activity, and alternations in the system that filters relevant information from irrelevant." Anyone who experiences these symptoms is deserving of more support and sympathy than the Right will ever afford them. But whether or not trigger warnings meaningfully help these people is contested, and it's not uncaring or reactionary to acknowledge this ambiguity. In fact, if we want to better help people with trauma, then doing so is a necessary task."

"Trigger warnings can be helpful in some cases, as they allow people to decide if they want to engage with the material being presented – whether it is in a social media post, newspaper article, lecture or TV show," says Sarita Robinson, a member of the British Psychological society who specialises in trauma. "They can help people to brace themselves if exposure to potentially upsetting material is unavoidable. For example, take a medical student who needs to attend a lecture on cancer, but has recently lost a loved one to that disease. A trigger warning about the lecture topic can allow them to put self-care measures in place."

What's important to understand about trigger warnings is that they aren't designed for your average person who doesn't want to get bummed out by an upsetting scene in a novel. One criticism you hear a lot is that the category of 'trauma' has been expanded to include just about anything, which means that trigger warnings are now required for evermore frivolous topics. This is sometimes referred to as 'concept creep', and there's an element of truth to the idea: trauma has become a reflexive way of describing emotional distress. Today we see it applied to all manner of quotidian occurrences, from break-ups to the loss of a pet, which might once have been described as merely 'sad'.

But trigger warnings aren't about the avoidance of everyday pain. They're specifically intended to help people with post-traumatic stress disorder (PTSD), a condition which, according to one 2014 study, affects 3.7% of men and 5.1% of women in the UK. This is a substantial minority (which, given the high prevalence of abuse and sexual violence in our society, isn't surprising). Many of these people will have undergone experiences that even the most crotchety old Telegraph columnist would be forced to concede were traumatising. "We've all been traumatised. It's part of living," claims a recent article criticising trigger warnings, published in right-wing magazine Spectator. As well as being untrue, this corresponds with the very 'concept creep' which many conservatives claim to stand against. Not everyone is traumatised; in fact, it's possible to go through horrific experiences without ending up with trauma. This isn't about strength of character, to be clear — there are all sorts of variables which can determine where or not an experience is traumatic. Where both the Right and the Left falter, sometimes, is their neglect of the fact that PTSD is a specific diagnosis with specific symptoms and parameters.

The problem with some of the research which suggests trigger warnings don't work, (such as this 2018 study by Harvard) is that they include participants who don't have PTSD. The inclusion of these people is kind of irrelevant: if I have no trauma related to, say, sexual assault, then obviously it's not going to make much difference to me whether I'm given a trigger warning prior to being exposed to a depiction of it. I might find it upsetting, disturbing, or scary, but if I'm not traumatised then I'm not going to be 'triggered.' That said, the study also found that the inclusion of trigger warnings had little effect on people who had experienced trauma: according to the researchers behind the study, "These analyses suggest trigger warnings have trivial effects even among people for whom such warnings may be specifically intended." They continue: "College students are increasingly anxious … and widespread adoption of trigger warnings in syllabi may promote this trend, tacitly encouraging students to turn to avoidance, thereby depriving them of opportunities to learn healthier ways to manage potential distress." But you could argue that "may" is doing a lot of work here: such an outcome is speculative, and not supported by the findings of the study itself.

If you look at the research on trigger warnings as a whole, there's an emerging consensus that they don't have much of an effect either way. But even the more critical studies only claim trigger warnings cause "small adverse side effects". Taking this research at face value, there isn't a strong body of evidence to suggest that they cause substantial harm. Admittedly, "while trigger warnings don't help people, they only cause minor psychological damage!" isn't a compelling argument for their continued usage. It also makes sense that confronting your triggers head-on might diminish their potency over time. But then we also have to weigh that up with the fact that lots of trauma survivors do, subjectively, feel that they're useful. It's possible to misunderstand your own mental health, but, at the same time, we should be critical of any research which dismisses people's accounts of their own experiences as entirely "wrong". If you're a trauma survivor, and you think that trigger warnings help you, that should be taken into consideration. While there is no consensus among trauma survivors about trigger warnings (you'll find plenty of people with PTSD who don't find them useful), there is something to be said for listening to the people who are affected by a problem about what works best for them.

While trigger warnings are most often talked about within the context of academia, their inclusion in the world of publishing is becoming more common. It's a topic which authors tend to feel strongly about one way or another; some consider it tantamount to a kind of censorship, while for others, it's an important way of making their work accessible. Alison Rumfitt, author of the recently published horror novel Tell Me I'm Worthless, is someone who's decided to include one at the beginning of her book, advising readers about its frank depictions of trauma, fascism and sexual violence. "I think content warnings are generally good and useful," she says. "We should avoid standardised ones -- I think that's the way which content warnings could lead to censorship. If an author wants to include a content warning, they should be allowed and encouraged to do so, but if they don't want to, then there should be no judgement."

Someone who's taken a different approach is Gretchen Felker-Martin, author of the upcoming post-apocalyptic horror novel Manhunt, who has decided not to include a content note. "Personally, I don't put trigger warnings in my books," Gretchen says. "Between the jacket copy and the covers, the reader gets a good idea what they're getting into, and of course they're welcome to ask a friend who has read my work if this book contains such and such a thing, but my preference is for readers to go in not knowing any granular details."

"Beyond that," she continues, "part of me bridles at being expected to flatten out all these terrible traumatic things into a list of scary words. It's just not how I navigate the world, and I think it encourages people with trauma -- like me -- to think of themselves as fragile and incapable of engaging with rough subject matter. The truth is, every depiction of these traumatic things is different, and sometimes it might upset you, and you might have to deal with that, but sometimes it might open up some new part of your psyche, might give you catharsis or a deeper understanding of yourself and others. So, my books are for people who feel ready to risk getting hurt. It's okay if that means some readers don't want to pick them up."

All in all, we shouldn't be loyal to the idea of trigger warnings simply because the worst people in the world oppose them. If it's true that they don't work, or cause more harm than good, then we should be open to that idea. But this realisation would have to come from people with PTSD themselves. It can't be a top-down imposition or an ideological coup, snatching away a measure which many do find helpful and necessary. You can't just tell people that the things they find helpful aren't actually helpful, no matter how much evidence you have to back up your position. Until such a consensus develops among people with PTSD, calls to abandon trigger warnings outright should be treated with suspicion.