Trauma trigger

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A trauma trigger is a psychological stimulus that prompts recall of a previous traumatic experience. The stimulus itself need not be frightening or traumatic and may be only indirectly or superficially reminiscent of an earlier traumatic incident, such as a scent or a piece of clothing.[1] Triggers can be subtle and difficult to anticipate.[2][3] A trauma trigger may also be called a trauma stimulus, a trauma stressor or a trauma reminder.[4][5] The process of connecting a traumatic experience to a trauma trigger is called traumatic coupling.[6]

Avoiding a trauma trigger is a common behavioral symptom of posttraumatic stress disorder (PTSD), a treatable and usually temporary condition in which people sometimes experience overwhelming emotional or physical symptoms when something reminds them of, or "triggers" the memory of, a traumatic event.[5] Long-term avoidance of triggers increases the likelihood that the affected person will develop a disabling level of PTSD.[7] Identifying and addressing trauma triggers is an important part of treating PTSD.[6]

A trigger warning is a message presented to an audience about the contents of a piece of media, to warn them that it contains potentially distressing content. A similar concept, the "NSFW" or "not safe for work" warning, is meant to identify content that most people find uncomfortable or inappropriate due to its sexual, violent, or otherwise objectionable content.

TriggersEdit

The trigger can be anything that provokes fear or distressing memories in the affected person, and which the affected person associates with a traumatic experience. Some common triggers are:

  • a particular smell[7][8] – such as freshly mown grass, the fragrance of an aftershave product, or perfume.[6] The sense of smell, olfaction, has been claimed as more closely connected to traumatic reminders than other sensory experience, given the proximity of the olfactory bulb to the limbic system.[9][10]
  • a particular taste[6] – such as the food eaten during or shortly before a traumatic experience
  • a particular sound[7][8] – such as a helicopter or a song[1]
  • a particular texture[1][11]
  • certain times of day[7][8] – for example, sunset or sunrise[1]
  • certain times of year or specific dates – for example, autumn weather that resembles the affected person's experience of the weather during the September 11 attacks,[11] or the anniversary of a traumatic experience[6]
  • sights[8] – for example, a fallen tree or a light shining at a particular angle[6]
  • places[7] – for example, a bathroom, or all bathrooms[12]
  • a person,[8] especially a person who was present during a traumatic event or resembles someone involved in that event in some respect[7]
  • an argument[7]
  • a sensation on the skin[6] – such as the feeling of a wristwatch resembling the feeling of handcuffs, or sexual touching for victims of sexual assault[6]
  • the position of the body[13]
  • physical pain[6][13]
  • emotions – such as feeling overwhelmed, vulnerable, or not in control[1][11]
  • a particular situation – for example, being in a crowded place[1]

The trigger is usually personal and specific. However, it need not be closely related to the actual experience. For example, after the Gulf War, some Israelis experienced the sound of an accelerating motorbike as a trigger, which they associated with the sound of sirens they heard during the war, even though the resemblance between the two sounds is limited.[14]

It has been suggested that the realistic portrayal of graphic violence in visual media may expose some affected people to triggers while watching movies or television.[1][15]

Trigger warningsEdit

Trigger warnings are warnings that a work contains writing, images, or concepts that may be distressing to some people.[16] The term and concept originated at feminist websites that were discussing violence against women, and then spread to other areas, such as print media and university courses.[16] Although it is widely recognized that any sight, sound, smell, taste, touch, feeling or sensation could be a trigger, trigger warnings are most commonly presented on a relatively narrow range of material, especially content about sexual abuse and mental illness (such as suicide, eating disorders, and self-injury).[17]

Among people without traumatic experiences, "trigger warnings did not affect anxiety responses to potentially distressing material in general."[18] Studies disagree on whether trigger warning cause transient increases in anxiety in those without traumatic experiences.[18][19][20] For participants who self-reported a posttraumatic stress disorder (PTSD) diagnosis, or for participants who qualified for probable PTSD, trigger warnings had little statistically significant effect.[21][20] Effect sizes on feelings of avoidance, decreased resilience, or other negative outcomes have been "trivial" in controlled research environments.[19][20]

Controversy in higher educationEdit

The American Association of University Professors issued a report critical of trigger warnings in university contexts, stating "The presumption that students need to be protected rather than challenged in a classroom is at once infantilizing and anti-intellectual. It makes comfort a higher priority than intellectual engagement and—as the Oberlin list demonstrates—it singles out politically controversial topics like sex, race, class, capitalism, and colonialism for attention."[22] This view is supported by some professors such as Richard McNally, and some medical practitioners, such as Metin Basoglu and Edna Foa.[23][24][25] They believe that trigger warnings increase avoidance behaviors by those with PTSD, create a culture that decreases resilience, and more geared towards political virtue signaling.[23][24][25][26]

Since the publication of the American Association of University Professors' report, other professors, such as Angus Johnston, have supported trigger warnings as a part of "sound pedagogy."[27] Other supportive professors have stated that "the purpose of trigger warnings is not to cause students to avoid traumatic content, but to prepare them for it, and in extreme circumstances to provide alternate modes of learning."[28]

Universities have taken different stances on the issue of trigger warnings. In a letter welcoming new undergraduates, the University of Chicago wrote that the college's "commitment to academic freedom means we do not support so-called 'trigger warnings'," do not cancel controversial speakers, and do not "condone the creation of intellectual 'safe spaces' where individuals can retreat from thoughts and ideas at odds with their own".[29][30] Students at UC Santa Barbara took the opposite position in 2014, passing a non-binding resolution in support of mandatory trigger warnings for classes that could contain potentially upsetting material. Professors were encouraged to alert students of such material and allow them to skip classes that could make them feel uncomfortable.[17]

While trigger warnings have garnered significant debate, few studies have investigated how students typically respond to potentially triggering material. In a 2021 study, three hundred and fifty-five undergraduate students from four universities read a passage describing incidences of both physical and sexual assault. Longitudinal measures of subjective distress, PTSD symptoms, and emotional reactivity were taken. Greater than 96% of participants read the triggering passage even when given a non-triggering alternative to read. Of those who read the triggering passage, those with triggering traumas did not report more distress although those with higher PTSD scores did. Two weeks later, those with trigger traumas and/or PTSD did not report an increase in trauma symptoms as a result of reading the triggering passage. Students with relevant traumas do not avoid triggering material and the effects appear to be brief. Students with PTSD do not report an exacerbation of symptoms two weeks later as a function of reading the passage.[31]

See alsoEdit

ReferencesEdit

  1. ^ a b c d e f g "Post traumatic stress disorder (PTSD)". vvaa.org.au. Vietnam Veterans Association of Australia. 2015. Retrieved 4 February 2016.
  2. ^ Kolk, Bessel van der (1994). "The body keeps the score: memory and the evolving psychobiology of posttraumatic stress". Harvard Review of Psychiatry. Lippincott Williams & Wilkins. 1 (5): 253–65. doi:10.3109/10673229409017088. PMID 9384857.
  3. ^ Staff writer (2015). "Post traumatic stress disorders in rape survivors". survive.org.uk. UK: Survive. Archived from the original on 16 October 2015.
  4. ^ Fagan, Nancy; Freme, Kathleen (February 2004). "Confronting posttraumatic stress disorder". Nursing. Lippincott Williams & Wilkins. 34 (2): 52–53. doi:10.1097/00152193-200402000-00048. PMID 14758331. S2CID 33910036.
  5. ^ a b Foa, Edna B.; Keane, Terence M.; Friedman, Matthew J.; Cohen, Judith A. (2008-10-24). Effective Treatments for PTSD, Second Edition: Practice Guidelines from the International Society for Traumatic Stress Studies. Guilford Press. p. 274. ISBN 9781606237922.
  6. ^ a b c d e f g h i Goulston, Mark (2011-02-09). Post-Traumatic Stress Disorder For Dummies. John Wiley & Sons. pp. 39–41. ISBN 9781118050903.
  7. ^ a b c d e f g Lahad, Mooli; Doron, Miki (2010). Protocol for Treatment of Post Traumatic Stress Disorder: SEE FAR CBT Model : Beyond Cognitive Behavior Therapy. IOS Press. pp. 18–19. ISBN 9781607505747.
  8. ^ a b c d e Foa, Edna B.; Keane, Terence M.; Friedman, Matthew J.; Cohen, Judith A. (2008-10-24). Effective Treatments for PTSD, Second Edition: Practice Guidelines from the International Society for Traumatic Stress Studies. Guilford Press. p. 107. ISBN 9781606237922.
  9. ^ https://pubmed.ncbi.nlm.nih.gov/12633130/
  10. ^ https://www.mediamatic.net/en/page/239167/nose-nostalgia
  11. ^ a b c Cori, Jasmin Lee (2007). Healing from Trauma: A Survivor's Guide to Understanding Your Symptoms and Reclaiming Your Life. Da Capo Press. p. 30. ISBN 9781600940613.
  12. ^ Foa, Edna B.; Keane, Terence M.; Friedman, Matthew J.; Cohen, Judith A. (2008-10-24). Effective Treatments for PTSD, Second Edition: Practice Guidelines from the International Society for Traumatic Stress Studies. Guilford Press. p. 224. ISBN 9781606237922.
  13. ^ a b Follette, Victoria M.; Briere, John; Rozelle, Deborah; Hopper, James W.; Rome, David I. (2017-09-28). Mindfulness-Oriented Interventions for Trauma: Integrating Contemplative Practices. Guilford Publications. p. 304. ISBN 9781462533848.
  14. ^ Lahad, Mooli; Doron, Miki (2010). Protocol for Treatment of Post Traumatic Stress Disorder: SEE FAR CBT Model : Beyond Cognitive Behavior Therapy. IOS Press. p. 9. ISBN 9781607505747.
  15. ^ Ephron, Dan (1 October 2006). "Battlefield flashbacks". Newsweek. Newsweek LLC. Retrieved 20 December 2007.[dead link]
  16. ^ a b "Trigger warnings: What do they do?". Ouch blog. BBC. 25 February 2014. Retrieved 25 February 2014.
  17. ^ a b Jarvie, Jenny (3 March 2014). "Trigger happy". The New Republic. Chris Hughes.
  18. ^ a b Bellet, Benjamin W.; Jones, Payton J.; McNally, Richard J. (2018). "Trigger warning: Empirical evidence ahead". Journal of Behavior Therapy and Experimental Psychiatry. 61: 134–141. doi:10.1016/j.jbtep.2018.07.002. ISSN 0005-7916. PMID 30077703.
  19. ^ a b Bellet, Benjamin W.; Jones, Payton J.; Meyersburg, Cynthia A.; Brenneman, Miranda M.; Morehead, Kaitlin E.; McNally, Richard J. (December 2020). "Trigger warnings and resilience in college students: A preregistered replication and extension". Journal of Experimental Psychology: Applied. 26 (4): 717–723. doi:10.1037/xap0000270. ISSN 1939-2192.
  20. ^ a b c Sanson, Mevagh; Strange, Deryn; Garry, Maryanne (July 2019). "Trigger Warnings Are Trivially Helpful at Reducing Negative Affect, Intrusive Thoughts, and Avoidance". Clinical Psychological Science. 7 (4): 778–793. doi:10.1177/2167702619827018. ISSN 2167-7026.
  21. ^ Jones, Payton; Bellett, Benjamin; McNally, Richard (2020). "Helping or Harming? The Effect of Trigger Warnings on Individuals With Trauma Histories". Clinical Psychological Science. 8. doi:10.1177/2167702620921341.
  22. ^ "On Trigger Warnings". American Association of University Professors. August 2014.
  23. ^ a b McNally, Richard (20 May 2014). "Hazards Ahead: The Problem with Trigger Warnings, According to the Research: Five studies you should read before you deploy a trigger warning". Pacific Standard. Retrieved 7 August 2018.
  24. ^ a b Waters, Florence (4 October 2014). "Trigger warnings: more harm than good?". The Telegraph. Telegraph Media Group. Retrieved 4 February 2016.
  25. ^ a b Waldman, Katy (2016-09-05). "The Trapdoor of Trigger Words". Slate. ISSN 1091-2339. Retrieved 2020-02-14.
  26. ^ Marcotte, Amanda (2015-05-21). "Why Are People So Triggered by Trigger Warnings?". Slate Magazine. Retrieved 2020-02-14.
  27. ^ Johnston, Angus (May 2014). "Trigger warnings: a professor explains why he's pro-trigger warnings". Slate. The Slate Group. Archived from the original on 2014-10-06. Retrieved 2014-09-30.
  28. ^ Lockhart, Elanor Amaranth (28 Sep 2016). "Why trigger warnings are beneficial, perhaps even necessary". First Amendment Studies. 50 (2): 59–69. doi:10.1080/21689725.2016.1232623. S2CID 151901765.
  29. ^ University Of Chicago Tells Freshmen It Does Not Support 'Trigger Warnings'
  30. ^ Students were directed to https://freeexpression.uchicago.edu/ for more information.
  31. ^ AMA 11th Edition (American Medical Assoc.) Reference List Kimble M, Flack W, Koide J, Bennion K, Brenneman M, Meyersburg C. Student reactions to traumatic material in literature: Implications for trigger warnings. PLoS ONE. 2021;16(3):1-18. doi:10.1371/journal.pone.0247579

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