Most of the time, humans can overcome adversity. Most recover from even the ugliest traumas and vilest human experiences—war, rape, domestic violence, natural disasters—without lasting psychological damage. Remarkably, we have evolved to be far more resilient than we might think ourselves.
In some cases, however, people are unable to successfully adapt after experiencing trauma, and exhibit a cluster of symptoms known as post-traumatic stress disorder (PTSD). The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) conceptualizes PTSD as a disorder that develops following exposure to actual or threatened death, serious injury or sexual violence. This can occur as a result of directly experiencing a traumatic event, but also as a result of witnessing it in person as it happens to another person; learning about the traumatic experience of a close family member or friend; or through repeated exposure to the sequelae of traumatic events (for example, paramedics and police who frequently recover dead bodies may develop PTSD).
PTSD can involve recurrent, involuntary and intrusive memories, dreams or flashbacks, psychological distress or marked psychological reactions to cues that symbolize or resemble some aspect of the traumatic event. Its symptoms include negative changes to cognition and mood, changes in physiological arousal and reactivity and the persistent avoidance of trauma-related cues, colloquially known as triggers.
Trigger warnings are meant to alert individuals that what they are about to encounter may prompt PTSD symptoms (e.g., intrusive memories). One might think that trauma survivors living with PTSD would benefit from such warnings. Yet, empirical evidence suggests otherwise.
Avoidance of triggers is not a cure for PTSD. It is a symptom of the disorder itself. As Richard J. McNally, Harvard’s Director of Clinical Training, has written, “Trigger warnings are countertherapeutic because they encourage avoidance of reminders of trauma, and avoidance maintains P.T.S.D.” Clinical psychologists work with their patients to help them overcome maladaptive strategies like avoiding triggers and developing healthier coping strategies, via evidence-based therapies.
The original impulse behind the introduction of trigger warnings might have been all noble—though psychologically misguided—but since then there has been considerable mission creep. It is obvious that trigger warnings have completely lost their original purpose when students demand that professors use them in syllabi, lectures and emails to preface what may be uncomfortable content (such as the discussion of particular books). Instagram users routinely add trigger warnings to posts that simply recount current events. I have come across YouTubers using trigger warnings prior to broad discussions of abortion, weight loss, brain injury and sexually transmitted diseases.
However, the real problem is not that trigger warnings infantilize young adults. The authors of a report shared by the American Association of University Professors get closer to the heart of the matter:
The presumption that students need to be protected rather than challenged … is at once infantilizing and anti-intellectual. It makes comfort a higher priority than intellectual engagement … it singles out politically controversial topics like sex, race, class, capitalism, and colonialism for attention. Indeed, if such topics are associated with triggers, correctly or not, they are likely to be marginalized if not avoided altogether by faculty who fear complaints for offending or discomforting some of their students … In this way the demand for trigger warnings creates a repressive, “chilly climate” for critical thinking in the classroom.
Setting aside the implications for freedom of speech, intellectual debate and critical thinking, the unwarranted use of trigger warnings is distasteful. Equating an emotionally inconvenient experience to a PTSD trigger belittles trauma survivors. Among my peers, I have often noticed a fascination with pathologizing everyday experiences that are simply part of what it means to be human. It is not uncommon to see individuals self-diagnosing depression because they suffer from the occasional low moods that are part and parcel of navigating the vicissitudes of life; or claiming to have OCD simply because of a preference for tidiness or a penchant for organisation.
More alarmingly, in recent years, many commonplace experiences have been labelled traumatic. But challenging and difficult experiences are not synonymous with trauma. We have specific psychiatric criteria that define what makes an event traumatic specifically in order to distinguish such events from ordinary human experiences. In clinical practice, the term trauma is often reserved for events such as war, threatened or actual physical or sexual assault, severe accidents, kidnapping, torture, natural disasters, catastrophic medical events (e.g., waking up during surgery) and other nightmarish experiences.
Even in such cases, most trauma survivors will not develop PTSD. As of 2008, the lifetime prevalence of PTSD in Canada (i.e., the proportion of people who meet the clinical criteria for PTSD at some point during their lifetimes) was estimated to be approximately 9.2%, and the rate of one-month PTSD (i.e. PTSD experienced within the past thirty days) was thought to be around 2.4%. The 12-month prevalence of PTSD in US adults is 3.5%, while in most European, Asian, African and Latin American countries, it is only 0.5–1%.
There is plenty of evidence to suggest that, for PTSD sufferers, trigger warnings not only do not work but could be doing more harm than good. In a 2020 study conducted by Payton Jones and colleagues, 451 trauma survivors were randomly assigned to read passages either with or without a trigger warning. The researchers found no evidence that trigger warnings helped either people with a self-reported PTSD diagnosis or people who qualified for a probable PTSD diagnosis, even when the passages matched the survivor’s own personal traumatic experiences. Surprisingly, they found that the use of trigger warnings had a counter-therapeutic effect. They reinforced the idea that the survivor’s trauma was central to who they were, which is one of the thought patterns clinicians try to break. Trauma survivors are much more than just vessels of their painful memories or personalities moulded by the horrific events they suffered.
In another 2020 study, conducted by Benjamin Bellet and colleagues, the researchers found that trigger warnings not only failed to reduce anxiety about distressing content, but increased anxiety among 462 students with no prior history of trauma. In the authors’ words: “Ironically, trigger warnings may (temporarily) worsen the well-being of the very people they are intended to help.” These are not random examples. A meta-analysis of five experiments involving 1,600 participants found that the presentation of trigger warnings elicited an emotionally negative waiting period before the target content, and was ineffective in helping participants mitigate the negative reactions that followed.
A 2019 study also found that trigger warnings provided no benefits. Participants displayed similar levels of negative emotions and avoidant behaviour with and without a trigger warning. The authors concluded that trigger warnings failed to reduce negative emotion, intrusive thoughts or avoidance, and even when they did observe positive effects—effects that might suggest that trigger warnings could be helpful—these effects were so small as to lack any practical real-world significance. A 2017 study of 107 college students demonstrated that trigger warnings even increased physiological markers of anxiety (such as higher respiration rate) prior to watching a movie clip, compared to simply seeing the rating PG-13 or receiving no warning at all.
A series of three 2018 experiments came to the following conclusions about trigger warnings. First, they elicit negative emotional expectations of upcoming content. Second, they prompt the subjects to avoid this content (a psychologically maladaptive coping mechanism). Third, they decrease some people’s negative emotional reactions to the content. While this third effect may seem to provide grounds for optimism, the effect was only observed in individuals who believed that trigger warnings are a way of coddling people, rather than protecting them. Those who believed that trigger warnings protect vulnerable people did not benefit from their use. The authors concluded the paper by noting that they are unsure why trigger warnings failed to help the very people who valued them most.
There is, then, limited empirical support for the use of trigger warnings. The best state of our current knowledge suggests that the practice of issuing trigger warnings is futile at best and counterproductive at worst. Trigger warnings don’t seem to help people and may instead harm them. We ought to stop using them.