Trigger Warnings Part 2: It’s not coddling; it’s informed consent.

TW: Mentions of animal abuse (as a trigger, not detailed or visual)

The Coddling of the American Mind argues that trigger warnings are terrible for pretty much the usual reasons: students believe they have a “right not to be offended” and want to pass classes without actually engaging with the material, and besides, bringing up triggers in class isn’t harmful–it’s *exposure therapy.*

However, there is a deeper problem with trigger warnings. According to the most-basic tenets of psychology, the very idea of helping people with anxiety disorders avoid the things they fear is misguided. A person who is trapped in an elevator during a power outage may panic and think she is going to die. That frightening experience can change neural connections in her amygdala, leading to an elevator phobia. If you want this woman to retain her fear for life, you should help her avoid elevators.

But if you want to help her return to normalcy, you should take your cues from Ivan Pavlov and guide her through a process known as exposure therapy. You might start by asking the woman to merely look at an elevator from a distance—standing in a building lobby, perhaps—until her apprehension begins to subside. If nothing bad happens while she’s standing in the lobby—if the fear is not “reinforced”—then she will begin to learn a new association: elevators are not dangerous. (This reduction in fear during exposure is called habituation.) Then, on subsequent days, you might ask her to get closer, and on later days to push the call button, and eventually to step in and go up one floor. This is how the amygdala can get rewired again to associate a previously feared situation with safety or normalcy.

Students who call for trigger warnings may be correct that some of their peers are harboring memories of trauma that could be reactivated by course readings. But they are wrong to try to prevent such reactivations. Students with PTSD should of course get treatment, but they should not try to avoid normal life, with its many opportunities for habituation. Classroom discussions are safe places to be exposed to incidental reminders of trauma (such as the word violate).

First off, the description of exposure therapy is correct, but it doesn’t remotely match up with random exposures to triggers in a class. Since my personal triggers are graphic violence, particularly to children and animals, I’ll use that as an example.  If a course reading contains a graphic depiction of, say, someone killing a dog, being assigned that reading does not include a gradual habituation process where first you read a bland factual summary about the dog being killed, then on another day, you read something with a little more detail, and weeks or months later, you read through the whole description. You just read the whole thing if it’s assigned, or you don’t, and you’re penalized accordingly.  Or, I don’t know, maybe we could have some system of reasonable accommodations for people with disabling mental health issues, or give people a heads up about disturbing material before they encounter it?

Secondly, exposure therapy, like any other ethical medical treatment, is based on informed consent. A key component of the treatment is that the *patient* gets to decide when to stop, with no ill consequences, and that the therapist tells them what will happen before it does. If I have *chosen* to work on my triggers in this manner, and you, my mental health professional, show me images or descriptions of animal abuse, in a situation where I can freely walk away, you’re providing exposure therapy. If you, who are not my mental health provider, email me video footage from a slaughterhouse with the intention of making me “face my fears,” what you’re providing is emotional abuse.  Yes, even if you’re doing it “for my own good.” In the same way, you can’t claim that exposing a student to a trigger in class is “exposure therapy” unless you’ve informed them and gotten their consent ahead of time and ensured they have the ability to opt out without penalty.  Which is…basically what providing trigger warnings does.

Granted, there will be some triggers that you can’t adequately warn for, either because they’re highly individual and not predictable (e.g., someone with PTSD who is triggered by yellow shirts because that’s what their rapist was wearing) or because they’re too central to the subject matter.  I don’t do well with gore, so I would not expect to take a class on horror and be excused from reading that might be triggering (which could be the whole syllabus). But that doesn’t mean, necessarily, that I should also fail a class on 20th Century fiction if I couldn’t stomach reading the end of The Pearl*.

Additionally, a key thing a lot of people overlook with exposure therapy is that “nothing bad happens” is not just physical.  If that were the case, then every misguided “awareness” Facebook post I’ve seen with graphic dog abuse pictures would have desensitized me, and by this point, I’d be able to calmly watch Pitbulls and Parolees without my husband pre-screening and fast-forwarding. And yet, just today, I had to ask him to stop reading me a story from a humor site just because it had the phrase “put the cat in the microwave.” Dude, no, I do not want that mental image. For me to actually be desensitized, I have to go through real exposure therapy, in the appropriate baby steps, with a real medical professional.  Random exposure to triggers is not exposure therapy and it can make things worse.

Having a panic attack, or even hanging out on the edge of one, is a highly unpleasant experience. It is, all by itself, something bad happening.  Having a panic attack in a classroom, witnessed by 10-20 peers who you might like to make a good impression on, and who will definitely tell everyone else as soon as class ends, not to mention a professor you like and respect, has to be a deeply unpleasant experience. And instead of habituating you to the trigger, it could add another layer of bad experience onto your fear of that trigger.

Also, I find it weird that one of the common arguments against trigger warnings in college is that students should be getting real professional help if they have mental health issues, and that teachers shouldn’t be expected to provide it, and yet I frequently see exposure therapy brought up in the same argument.  Look, I agree that teachers aren’t mental health professionals (and even those teachers who are, their students are not their patients), but that means that they also should not be providing exposure therapy.

There were some good points in the article, which I plan to discuss in a future post, like the potential for pre-conditioning someone to respond negatively to a potential trigger, and the problems with a group of people who don’t have the relevant mental illness or mental health experience sitting around trying to come up with lists of potential triggers and casting way too wide a net.  But that’s all for next time.

*I did actually read it in high school. I don’t remember if it was truly triggering or just garden-variety disturbing, but it definitely cemented my deep dislike of Steinbeck as an author.