The Other Autism

EP33: The Science Behind Trigger Warnings (and Why I Don't Use Them)

March 20, 2024 Kristen Hovet Episode 33
The Other Autism
EP33: The Science Behind Trigger Warnings (and Why I Don't Use Them)
Show Notes Transcript Chapter Markers

Here's a deep dive into the controversial topic of trigger warnings. I explore the ongoing debate surrounding the effectiveness and potential dangers of trigger warnings, particularly for those who have experienced complex trauma. I highlight the latest research on trigger warnings, their impact on emotional responses, learning outcomes, and more.

Don't miss this episode where I challenge the common usage of trigger warnings and explore trigger warnings' influence on those they're supposed to protect most.

Watch this episode on YouTube.

If you'd like to know more about topics discussed in this episode, check out:

"Trigger Warning Efficacy: The Impact of Warnings on Affect, Attitudes, and Learning" by Guy Boysen et al.

"A Meta-Analysis of the Efficacy of Trigger Warnings, Content Warnings, and Content Notes" by Victoria Bridgland et al.

"I Was Wrong About Trigger Warnings" by Jill Filipovic

"Helping or Harming? The Effect of Trigger Warnings on Individuals With Trauma Histories" by Payton Jones et al.

"What Does It Mean to Be Triggered?" By Zawn Villines 

Theme music: "Everything Feels New" by Evgeny Bardyuzha.

All episodes written and produced by Kristen Hovet.

To submit a question to possibly be answered in a future episode, please email kristen.hovet@gmail.com

Become a patron on Patreon!

Buy me a coffee!

Kristen Hovet:

Today I'm doing something a bit different. I'm going to be discussing trigger warnings. While this topic isn't directly related to autism or autism research, it does come up a lot in content related to autism and neurodiversity. It's actually almost a given these days that any content that includes discussion of sensitive topics will have trigger warnings. But just because something is pervasive doesn't make it best practice, nor does it make it safe, specifically psychologically safe in this case.

Kristen Hovet:

It's recently come to my attention that some listeners think I should include trigger warnings at the beginning of The Other Autism episodes, show notes, and on the accompanying website. I realize that I cover a lot of sensitive topics. This has come up now a handful of times, so I decided to devote an entire episode to this. My thinking is that if this has come up so many times, many of you must be sitting there wondering why I don't include trigger warnings. I think I did actually include trigger warnings in an episode or two, but for the most part I avoid them and I avoid any kind of content warnings or anything like that. You may think this episode isn't relevant to you and you might be considering whether or not you want to stick around to listen, but anyone interested in psychology or mental health will likely enjoy learning about what I found when I looked at the research into trigger warnings, and a lot of the research is quite recent. I will say that I have been working in communications for more than a decade now, mostly in science and health communications, and this topic of trigger warning has existed for a very long time. Also, as many of you know, but just for the sake of newer listeners, I was doing a master's degree program in counseling psychology before I switched to a master of health studies program, which I completed just this past December. I have a special interest in psychology and a lot of the work I do in research communications, certainly not all, but a lot, ends up being related to psychology in some way. All that to say, I have really taken time to explore the topic of trigger warnings and their effectiveness. It's been one of my, I guess you could say, favorite topics over the years that keeps coming up. As far back as 2016, I'd say before the research on trigger warnings really took off,

Kristen Hovet:

I interviewed Dr. Suzanne Pineles about her thoughts on trigger warnings. Dr. Pineles is a psychologist at the National Center for PTSD in the United States and it was her view at the time that trigger warnings can come with a lot of unforeseen harms and psychological consequences, which is perhaps surprising in a time when we have come to expect them or take them for granted. And Dr. Pineles's feedback came at a time preceding a lot of the research on trigger warnings. Her views came mostly from a very deep understanding of post-traumatic stress disorder, other trauma-related conditions, as well as clinical experiences of working with those with complex trauma. Turns out, the research has since supported much of what she told me. I think it would seem to most of us that trigger warnings are helpful or beneficial, and that was definitely what I used to think, especially when I first heard about them. But in many ways, they're actually contrary to trauma-informed care and trauma-informed approaches.

Kristen Hovet:

Before I get into the research on all of this, I wanted to take a moment to thank Caitlin, Dave, and Nicole for their super generous one-time shows of support to The Other Autism podcast. Thank you so, so, so, so much. I also wanted you to know that I save the notes you include with your donations. They go into a special folder and I will cherish them forever. I also wanted to thank the 10 people who have now joined The Other Autism's Patreon, which is still brand new and finding its way. Check out links in the show notes to either send in a one-time show of support through the Buy Me a Coffee website or, if you're interested in monthly support, you can join the Patreon and what that gives you is exclusive content and access to The Other Autism community. I just opened the group chat on Patreon, which works through the Patreon smartphone app. This provides a way to privately chat with me and other Patreon members who are specifically part of The Other Autism's Patreon page. Any questions about Patreon or anything covering what I've just talked about, you can always email me at kristen dot hovet at gmail dot com. The email address is also, as always, in the show notes. What kind of exclusive content will Patreon members get? Well, they're currently getting behind the scenes photos and videos, as well as extra content from some recent podcast episodes.

Kristen Hovet:

I'm also planning on developing The Other Autism reading episodes, which are audio-only and feature me reading to listeners. I plan to read about a chapter or so in each of these episodes, depending on the book, and will continue until we finish the book. The books I read will come from the public domain, so we don't run into any copyright issues. I'm thinking about starting with 20,000 Leagues Under the Sea, which I've never actually read. This idea came about from several listeners emailing me and also commenting on YouTube about how they find my voice soothing, and some have even requested episodes of me just talking about anything. But instead of just anything, I think reading books would actually be best for this. Also, I love books, so I think this kind of works well as Patreon content.

Kristen Hovet:

If there's interest, I will also start accepting Patreon members' questions that I will answer on Patreon exclusively, meaning you have to be a paid Patreon member to view those. These questions would be advice column- type questions, but in addition to my responses, we could also crowdsource responses from other patrons. The cool thing about Patreon is you can sign up using your real name or you can create a username so no one knows your identity. The link to the Patreon is in the show notes, but if you'd like to head there now, check out Patreon. That's P-A-T-R-E-O-N dot com, forward slash TheOtherAutism, all one word. If you're interested in non-monetary ways to support the show, please head to YouTube, if you aren't there already, hi people on YouTube, to like and subscribe. If you're listening on Apple Podcasts or Spotify or wherever else you get your podcasts, please consider leaving a rating and or a review. It really, really helps in terms of getting new listeners and telling the algorithm to do its thing.

Kristen Hovet:

So trigger warnings. It's important to start by saying I don't judge or think any less of anyone who uses trigger warnings or expects them. The intentions behind trigger warnings are kind, sweet, noble. The intentions are not what I'm questioning. With the use of trigger warnings, people want to show solidarity and support for those who have experienced trauma or, in some cases, for those who have specific phobias. They want to protect these folks and, by giving trigger warnings, they hope to help them in their journey towards healing.

Kristen Hovet:

Proponents of trigger warnings state that these warnings increase inclusivity and help those with post-traumatic stress disorder avoid re-experiencing symptoms such as flashbacks. They also believe that trigger warnings help give people the opportunity or choice to engage or not engage with sensitive content or at least help them prepare to engage with the content. Critics of trigger warnings, on the other hand, think that trigger warnings threaten free speech, academic freedom, and that they hamper learning. They also believe that trigger warnings prevent people from engaging with certain material that could actually be beneficial to them, even if challenging. These critics think that trigger warnings impair the building of psychological resilience and lead to unreasonable or unrealistic expectations about the world. All told, critics of trigger warnings think we could actually be doing harm to survivors of trauma in the long run. Trigger warnings, they say, might actually reinforce the importance of their past trauma, making trauma central to their identities or personalities. Indeed, people who view their trauma this way, as core to who they are, tend to have worse and longer-lasting trauma-related symptoms. Before we go any further, I think it's important to really define trigger warnings.

Kristen Hovet:

A trigger warning is any statement given at the beginning of some piece of media, like an article, podcast, book, TV show, film, etc. to help audience members prepare for or avoid content that may trigger memories, emotions, or mental states related to their past traumatic experiences. The purpose of trigger warnings is to help a person, specifically someone with acute stress disorder, post-traumatic stress disorder, or some other trauma-related disorder, avoid distress, discomfort, or anxiety. Trigger warnings differ from older content labeling, which is labeling that's provided as guidance for parents or caregivers, for example, to alert them to content that they may wish to keep from their kids. Or sometimes it's helpful to be alerted to content we might not want to view or play in the workplace around colleagues and supervisors. Content labeling is more of a way to help contextualize content so that the audience member can judge the appropriateness of viewing or showing someone else the content at a specific time and specific place. Content labeling is for everyone, regardless of mental health or emotional status.

Kristen Hovet:

While there is often overlap on the types of content where you'll see or hear both content labeling and trigger warnings, such as content covering sexual or physical abuse, trigger warnings originated on online feminist message boards around the year 2008 to specifically protect trauma survivors from confronting sensitive material. And then the use of trigger warnings very rapidly expanded to classrooms, social media platforms, and to virtually every type of media that exists. Interestingly, trigger warnings are a kind of community-based intervention, but they took off in terms of usage without the rigorous scientific evidence we've come to expect from this type of community-based intervention or action. You'll now see or hear them used on content covering a variety of topics, including talk about police, racism, animal cruelty, crime, death, alcohol use, bodily fluids, eating disorders, scars, nightmares, seizures, being paralyzed, masturbation, suffocation, body shaming, and the list goes on and on and on and on. Discussions and public debate about trigger warnings have often been very politically charged and complex. Most importantly, they have been data-poor or terribly lacking in evidence.

Kristen Hovet:

For a bit of personal background, my initial suspicions about trigger warnings came about as someone with complex trauma, and these suspicions came about after I initially was very excited about trigger warnings. So I've explored my own triggers in great detail, often alongside a therapist, and I know they aren't as basic as the mention or description of someone else's trauma, even if that trauma is quite related to or aligned with my own. Some people might get triggered from these types of mere mentions or descriptions, but my triggers are very specific and have to do with specific, and the key here is combined stimuli. As in, to be triggered, I need all these various stimuli to be happening at pretty much the same time. My triggers are related to specific smells, while also being in a specific scenario, feeling very specific ways in my body, and surrounded by specific people or types of people. Even certain kinds of light are key elements in my personal triggers, or at least some of them.

Kristen Hovet:

Also, trigger warnings cover obviously bad experiences or scenarios that many find disgusting or gross, but a lot of us are triggered by what most people would think of as totally neutral or even happy situations or scenarios. For example, I'm triggered by talk of menopause or mention of pregnancies, deliveries, the having of babies in general. I'm also triggered by the sights, sounds, and smells of state fairs and carnivals, if they have certain elements in place. And this dates back to partially memory- blocked, shadowy, incredibly traumatic experiences from childhood. I know others who are triggered by representations of happy families or families sitting around to give gifts or eat dinner or celebrate holidays. Others I've read about are severely triggered by the sights and sounds of springtime, people playing baseball or other team sports, or the sight of golf carts in the rain. So how do you put trigger warnings on this type of content? I mean, this type of content, this sort of neutral or happy content, is no less triggering than the content that's obviously disturbing, like rape or murder. It's just different. You'd have to add trigger warnings to literally everything, every single type of content, to cover the full range of potential triggers that someone with trauma, especially complex trauma, might experience.

Kristen Hovet:

But what does the research say? Before getting into some of the trigger warning- specific research, I'd like to talk about some research or knowledge regarding post-traumatic stress disorder or PTSD. An article by Payton Jones and their team cited past PTSD research conducted by various teams from 1986, 1999, 2003, and 2018. This collection of evidence found that, although avoidance of triggers or reminders of trauma, quote, reduces anxiety in the short run, it maintains or worsens PTSD in the long run, end quote. Avoidance is simply not a good coping strategy for those with PTSD and definitely not a good long-term strategy if you're hoping to improve, reduce symptoms, or even lose your PTSD diagnosis altogether.

Kristen Hovet:

Still citing this body of PTSD-related evidence, the researchers state that one main element of standard treatment for trauma-related conditions includes, quote, graduated prolonged exposure to trauma cues, end quote. Which is especially useful for long-term well-being, especially when this exposure takes place in controlled settings. All told, they state, avoiding trauma cues is likely to be, quote, much more harmful for trauma survivors in the long term, end quote. Jones and their team also noted that only around 4% of traumatic events result in PTSD. While many people assume that PTSD is widespread, the majority of trauma survivors actually don't go on to develop PTSD. Many also tend to assume that trauma leads to permanent psychological change, but this is far from the truth. Psychological resilience goes a long way in reversing the damaging effects of trauma.

Kristen Hovet:

In their own original research, Jones and their team endeavored to find out whether trigger warnings improve psychological and emotional coping in trauma survivors when they're exposed to sensitive or triggering material. They found, quote, substantial evidence that trigger warnings increase the degree to which participants viewed their worst event as central to their life narrative, end quote. And those with the worst PTSD symptoms had increased anxiety when they were given trigger warnings as opposed to when they were not given trigger warnings. They conclude that, quote, this effect is ironic in the sense that trigger warnings may be most harmful to the individuals they were designed to protect, end quote.

Kristen Hovet:

Jones and their team, quote, find no evidence-based reason for educators, administrators, or clinicians to use trigger warnings, end quote. And that using unvetted interventions such as trigger warnings is irresponsible to victims of trauma. In a series of three studies, Guy Boysen and their team looked at trigger warnings in the context of education and teaching. If effective, the researchers wrote, quote, trigger warnings should decrease distress and increase learning, end quote. The general idea is that if individuals are not distressed and not overly anxious, then learning will be better or will improve. And if trigger warnings help avoid distress or anxiety, then trigger warnings therefore support or improve learning and, by extension, support or improve education in general, or so the thinking goes.

Kristen Hovet:

I'm going to briefly summarize the results of this team's findings because I really want to save room for the meta-analytic research I found, which is scientific analysis of several studies all about the same topic. If you'd like to read this research for yourself, the link is in the show notes along with the other studies I cover here. So in the first study, Boysen and their team set out to discover if trigger warnings given on content related to sexual assault influence emotional responses to sensitive material, whether trigger warnings affect test performance related to sensitive material, and whether trigger warnings have the same effect on people with and without traumatic experiences related to the sensitive content. The research team found that positive emotions decreased and negative emotions increased after exposure to sensitive content, regardless of whether or not a trigger warning was given to the study participants. In other words, sensitive content is going to have an impact on you, regardless of your history with trauma. Challenging content is challenging. Also, trigger warnings did not improve test scores among participants with or without a history of traumatic experiences. Lastly, and most interesting to me in this first study, is that the participants who had trauma related to the sensitive content, their positive emotions were significantly lower with the trigger warning than when no trigger warning was given. In other words, they were more negatively impacted by the material when it came with a trigger warning. These are the people we are trying to protect with trigger warnings and they're being more negatively impacted.

Kristen Hovet:

In the second study, Boysen and their team looked at the same research questions as in their first study, but instead of sexual assault, they used content related to suicide. They also had the same or similar findings to the first study, but they also found that the study participants who received trigger warnings believed more strongly that trigger warnings are necessary than participants who did not receive trigger warnings. In other words, exposure to trigger warnings seemed to make people expect them or view them as necessary when any content covers any challenging topic. Also, interestingly, those participants who received trigger warnings believed that these warnings are necessary for everyone, not just those who'd experienced trauma. And in their third study, Boysen and their team replicated the first two studies, which were done in adult participants, in college classrooms with college students. They found that trigger warnings in these groups had similar efficacy and impacts. All told, the research team concluded that trigger warnings are ineffective tools when it comes to reducing distress in people with personal traumatic experience with sensitive material. Additionally, they concluded that trigger warnings do not help increase or improve learning.

Kristen Hovet:

The most interesting findings, in my opinion, came from a recent 2023 meta-analysis conducted by Victoria Bridgland and their team. The team looked at all current empirical studies on the efficacy and effects of trigger warnings, with a focus on response affect, avoidance, anticipatory affect, and educational outcomes. To break down these terms, response affect involves emotional reactions to the actual sensitive material, such as a passage about sexual assault. Avoidance is the blocking of one's own exposure to specific content or material. Anticipatory affect involves emotional reactions to the trigger warnings themselves, before being exposed to the sensitive material. And educational outcomes, in this context, involve comprehension or understanding in the sense of, do trigger warnings help someone better comprehend the specific content in question? When it came to response affect, the research team found that trigger warnings had very little impact on response affect. Contrary to both sides of the trigger warning debate, there was really no overall impact on emotional reaction to the sensitive material itself. In other words, trigger warnings do not mitigate or reduce distress or anxiety. They don't do much of anything, in this regard.

Kristen Hovet:

One explanation could be that people simply see the trigger warnings and ignore them, gloss over them. But this doesn't explain the research results related to the increased negative emotions and increased distress that occurs during the anticipatory period, in other words, the time directly following the viewing, seeing, or hearing of the trigger warning, but before exposure to the actual sensitive material. When it came to avoidance, the research team led by Bridgland found that trigger warnings had a negligible effect on avoidance. Their findings matched previous research showing that people are very unlikely to avoid content when they know it'll be distressing or alarming. In fact, studies found that when people were given the choice between options with or without trigger warnings, they were more likely to choose the content that came with warnings. This could be the result of the so-called and well-documented forbidden- fruit effect that shows that alarming content is often seen as more attractive or desirable than other content.

Kristen Hovet:

The researchers write that, quote, taken together, the current study and other research suggests that trigger warnings do not seem to be an effective method of preventing vulnerable populations from engaging with distressing stimuli, end quote. And here the term vulnerable populations refers to those with PTSD or other related conditions. When it came to anticipatory affect, the researchers found that trigger warnings increased distress and anxiety, consistent with concerns from critics of trigger warnings. These findings were supported by both subjective scales, in the form of participants self-rating, and objective scales, in the form of physiological and psychological measures. The researchers note that, quote, this finding appears to be consistent across the different trigger warning types used across studies, attesting to the robustness of this effect, end quote. They also note that the increase in anticipatory affect could indicate that people are bracing themselves for upcoming negative emotional impacts of the sensitive material.

Kristen Hovet:

Finally, when it came to educational outcomes or comprehension, Bridgland and their team found that trigger warnings have no effect on the comprehension or understanding of the material in question. If anything, trigger warnings can increase apprehension, anxiety, and distress when it comes to participating in learning environments. So not really something that you would want in universities or college settings, or really any setting when you're learning. The researchers concluded that trigger warnings are, quote, fruitless, although they do reliably induce a period of uncomfortable anticipation, end quote. And that, quote, trigger warning should not be used as a mental health tool, end quote. So, in conclusion, and to wrap up episode 33, if you're wondering why I don't include trigger warnings, I hope this serves as a suitable and extensive- enough response. If you have any comments or questions, as always, my email address is in the show notes. Well, that's all I have for you today. Thank you so much for being here. Until next time, bye.

Discussion on Trigger Warnings in Media
The Controversy of Trigger Warnings