[cthalupa]

The problem is they are explicitly arguing that all of our best science is that trigger warnings are counter productive for getting better. Just a quick google search of 'scientific support for trigger warnings' will get you all sorts of meta analysis, RCT results, etc. on this. At best they don't seem to actually do anything, and at worst, they actively impede your ability to get better.

That doesn't mean it's a matter of willpower, but it does suggest that avoiding your triggers or trying to use trigger warnings to prepare you for dealing with them provides no benefit. Your use of the word avoid pretty much sums up the core problem here - on a personal enjoyment of day to day life level, avoiding your triggers makes perfect sense. On the long term healing and not being traumatized by them level, you don't want to do that. (Edit: This isn't to say try taking exposure therapy into your own hands and just surround yourself with the stuff. None of this is a replacement for guided therapy. But specifically going out of your way to avoid these things is 'avoidant behavior' and is pretty much universally recognized as being a bad thing when it comes to dealing with PTSD etc.)

That being said, I believe everyone should be able to disclaim what they want and that people can choose how they approach their own self-care, even if it isn't supported by the science.

[Anvoker]

They are a tool like anything else.

Exposure and Response Prevention therapy works. You will never get fully well without exposure. However, it requires that you find stimulus of a magnitude that makes you uncomfortable, but doesn't send you outright spiraling. You need to keep steady while experiencing it for a while.

Content warnings give you the ability to estimate what intensity of negative stimulus you will experience, and this is important when dealing with actual triggers.

Not everyone is yet at the phase where they can handle a certain level of exposure. For some unfortunate cases it takes a long time to be well enough to start being able to handle exposure.

That being said, I do think content warnings need to be specific, not generic. The most useful ones are spoilers, not generic messages to put you on guard. Careful Ao3 authors do a better job at this than most games. There are technical solutions that allow interested parties to get this information without having to spoil the default audience, but we live in a busy world that has a lot of things to care about other than this.

[cthalupa]

Everything you wrote sounds really good in theory - it passes the smell test for me, and I believed it for a long time because it seemed perfectly logical. It all just Made Sense to me in an intuitive manner.

But there's pretty universal agreement that avoidant behavior isn't a good thing. There's a difference between the awful idea of trying to self-manage exposure therapy or forcing exposure and allowing yourself to be exposed to things in the manner that matches the 'real world.' If someone wants to put 'Dead Dove' on their ao3 and provide a a trigger warning because the fic is based around that thing, then yeah, that's one thing. I wouldn't recommend someone go watch Hostel if their trauma is at all related to that either. But most media that has triggering content aren't anywhere near those extremes. And obviously, if the trauma just occurred, it's a whole different thing. But if the studies that show an increase in avoidant behavior from trigger warnings are right, it's increasing a bad thing. If the studies that show a 'forbidden fruit' effect are right, then it's a negative for the proposed benefit from trigger warning proponents.

But most studies show no increase or negligible increase in avoidance for the study participants, including trauma groups. So if that's the case, they aren't doing what proponents are saying is their core benefit, either.

Meanwhile quite a few show an increase in anxiety from the warning itself, which is obviously a negative.

I'm open to the idea that there might be some effective way to do trigger warnings - more specific warnings up to spoilers, or something couching it in context of how this relates to recovery and how to manage it, etc. etc. - something along those lines. There's certainly plenty of precedent for a general idea being right and the initial implementations of it being bad. But proving that is going to come down to someone figuring it out and getting studies that show positive impact.

[red_admiral]

Before we had Trigger Warnings as a term, we had movie and game ratings that said what you'd see if you watched/played: violence, blood/gore, nudity ... steam still does this, and as long as you don't use the politically charged TW expression, no-one seems to mind. For example, "Skyrim contains Blood and Gore, Intense Violence, Sexual Themes, Use of Alcohol, and Language."

"TW 1.0" as I remember it - the first time I heard the TW term - was a thing where professors told students in advance if a lecture contained material that could upset some students, I think it started when someone teaching a course on criminal law in a law degree told students in advance "[TW:] next week we will have the lecture on the law around rape and sexual assault". Properly practiced, that's not exposure therapy that's being polite to your students (though why not put your whole syllabus up at the start of term, if you can?) It was also not intended to let you skip that topic - it's pretty important to know about if you're training in criminal law! - just to let you know in advance when it's coming up.

If you're teaching a course on the history of the British Empire in India, you're at some point going to need to cover the Bengal famine, the Amritsar massacre, the mutiny (aka. first war of independence), the practically-a-civil-war during partition, and a lot of other things. Mind you a "content note: British Empire" at the start of the course would probably cover all bases.

The choice of "trigger" that already means something in therapy was perhaps unfortunate, and nowadays I think "content warning" or even "content note" is preferred.

The real problem though was how students, who were neither trained therapists nor seemed to have consulted any, redefined and enforced their version of TW to the point that the term got tainted in the public view.

Basically, if you have anything like PTSD, you need an actual therapist not the collective hivemind of twitter (instagram these days?).

[cthalupa]

Generally agree with basically everything you wrote.

For me it's not even really political - I certainly am not aligned with the "heterodox" community that has been so actively against them. I think if people want to put trigger warnings on things, they should be able to make that choice, and people should be able to abide by them if they think they want to as well.

The issue is how it is framed as being important for helping people heal, like several people have spoken of it being important for in this thread. And I don't think the game/movie ratings ever really purported to be a part of that - indeed, it's always been more of an age appropriateness thing from my understanding.

If all of this was just "People should be able to make informed choices about the content they consume" and no one on any side was making claims about the mental health benefits for people with PTSD or similar, I think it would be a nonissue.

> Basically, if you have anything like PTSD, you need an actual therapist not the collective hivemind of twitter (instagram these days?).

100%. Far far far more likely to get through it and overcome the trauma with a good professional guiding you through the process. Social media is just going to have you doing silly things like writing gr@pe or gr*pe as if somehow using a euphemism that you already map back to the original word is helping and it wasn't originally just trying to get around content filters.

[p-t]

This is why I generally prefer CW/Content warning; it is basically saying "this is what this contains", instead of putting any implications of it being triggering. So CW: suicide, for example, is just for anyone who doesn't really want to read about suicide at the moment, whether it's because they want a more upbeat story or somebody they knew just died

[retsibsi]

"it does suggest that avoiding your triggers [...] provides no benefit"

This is the part I'm sceptical of. When I look this up, I mostly find articles like https://theconversation.com/proceed-with-caution-the-trouble... (and the underlying studies), which mainly address the question of whether reading a trigger warning and then consuming the potentially triggering content is better than just consuming the potentially triggering content without a warning.

(The article also mentions a finding that trigger warnings have "no meaningful effect on an individual's [...] avoidance of this content"; but I think that's entirely compatible with a world where most people consume the content regardless of the warning, some are more drawn to it because of the warning, and some (including the few who are truly vulnerable) avoid it because of the warning. The effect on those vulnerable few is what's most relevant here. The article does briefly mention "unhealthy avoidance behaviours", but in the context of one university's opinion and without supporting evidence.)

What's the best evidence against trigger warnings as a means of enabling traumatised people to make an informed decision on when (and whether) to confront their triggers?

[cthalupa]

> The article does briefly mention "unhealthy avoidance behaviours", but in the context of one university's opinion and without supporting evidence.)

There's not much additional context here because avoidant behavior is basically universally understood to be a bad thing when it comes to the long term treatment of PTSD (this is separate from immediately/short-term after the event - different situation there) - there's no real serious argument against this idea, so when avoidant behavior is discussed it doesn't require context on why that behavior is a bad thing, in the same way that a an article targeted at cardiologists isn't going to explain why poor ejection fraction is an issue - it's baseline knowledge for the target audience.

The results are mixed on whether it encourages avoidance - some studies like https://www.sciencedirect.com/science/article/abs/pii/S00221... indicate that it does, others found no effect or negligible increases.

To be clear, I'm not definitively stating it causes avoidant behavior - I am saying that it might, which would be one of those 'worst case' scenarios.

Trauma groups have been part of the meta-analysis that indicate no real change in avoidance, and some have had the 'forbidden fruit' impact even in trauma groups, but it's in similar quantities as the ones that show an increase in avoidant behavior.

Fundamentally, trigger warnings just don't make a lot of sense to try and argue in favor of from a 'helping people with their PTSD' standpoint if you believe the science.

1) For them to have the effect you claim is desirable, they would need to avoid the content - but avoidant behavior is a negative when it comes to overcoming PTSD

2) The science largely indicates that it doesn't cause them to change their behavior at all in this manner - so the desired effect, it doesn't seem to do anything.

3) There's some evidence that it might increase avoidant behavior (science would call this bad!) and some evidence it might increase people exposure due to the 'forbidden fruit' effect (which would be bad from the supposed desired effect, and not necessarily good from the scientific standpoint - unnaturally being pushed towards something might also be negative vs. more 'natural' exposure, particularly when coupled with the upcoming point)

4) A variety of studies have shown that they increase anticipatory anxiety in people when they appear, which is of course a negative for anyone. I haven't been able to find any studies particularly engaging on this specific topic of anticipatory anxiety from trigger warnings + follow up exposure from the 'forbidden fruit' effect so this isn't something backed by science like the rest, but my gut instinct is that it would be more likely to be negative vs. something more organic. I could very well be wrong there.

I don't see any combination of piecing together these studies that could lead to a belief that trigger warnings provide value from a therapeutic standpoint.

[retsibsi]

Can you point me to some strong evidence that it's reliably counterproductive to avoid reading a book or watching a show that contains a trigger? I get that avoidance, in the sense of trying to push away all thoughts of the trauma and avoid all possible reminders, is generally considered counterproductive. And exposure, at the right times and in the right ways, can be very helpful (or absolutely necessary). But there's a big difference between those facts and the idea that it's bad for a PTSD sufferer to have the option of sometimes deciding not to actively expose themselves to triggering media.

[cthalupa]

https://www.ptsd.va.gov/understand/what/avoidance.asp

> A combat Veteran may stop watching the news or using social media because of stories or posts about war or current military events.

https://www.verywellmind.com/ptsd-and-emotional-avoidance-27...

> The avoidance cluster of PTSD symptoms involves efforts to avoid distressing memories, thoughts, or feelings, and external reminders like discussions about the traumatic event or encounters with people or places associated with it.

I don't see how specifically avoiding content that contains triggers is anything but avoidance behavior as discussed above - avoiding the news or discussions about war is pretty explicitly facilitated by TW - before the clip plays on the news, by people posting it at the top of their social media content, etc. And media with the content would fall in line pretty explicitly as an "external reminder"

Like, I don't think someone who has been physically tortured and dealing with PTSD should watch Hostel or other torture porn, and I don't think a vet with PTSD should watch a compilation video of some of the worst horrors of war. So I'm not arguing for massive exposure or intentional forced exposure, etc. But the fundamental issue is that going out of your way to prevent yourself from being exposed to it at all, which is what TW facilitate if they were to work, is pretty definitionally avoidant behavior.

[watwut]

> At best they don't seem to actually do anything, and at worst, they actively impede your ability to get better.

No, trigger warnings do not actively impede your ability to get better. That argument rests on random trigger being framed as "exposure therapy like" event. The exposure therapy is not done by random unprepared exposure to the triggering material with no follow up. Nor by random exposure in public setting.

[cthalupa]

Except we have some studies that show they lead to and reinforce avoidant behavior, e.g. https://www.sciencedirect.com/science/article/abs/pii/S00221...

Some also showed no evidence of this, but avoidant behavior is pretty much universally considered to be a specific maladaptive behavior when it comes to treating PTSD in the long run. It has nothing to do with the idea that it is the same as exposure therapy.