Every show with a suicide now has a disclaimer with a suicide hotline at the beginning. Is there any evidence that these warnings make a positive difference?
Every show with a suicide now has a disclaimer with a suicide hotline at the beginning. Is there any evidence that these warnings make a positive difference?
There’s evidence that trigger warnings actually worsen anxiety and are counterproductive
The way to treat anxiety is to face the source of anxiety to try and change your relationship and reaction. The best way to do this is via controlled access that exposes one to the trigger gradually in a context that has no risk of harm (eg a media depiction, discussing the concept, building up to discussing the source of trauma that led to the phobic response if applicable)
Trigger warnings enable active avoidance. This sensitizes one to the aversive stimuli and makes the phobic response stronger. As a result when one encounters the stimulus (eg a friend, family, celebrity etc commits suicide, suffers an eating disorder, etc) your resilience to the trigger is now even lower and the response is more likely to be more significant than it was before.
That said education on access to resources like 988 or other warm lines can lower suicide rates, maybe. Research is more mixed here because it’s difficult to prove causation
I’d be interested in seeing these studies.
These two paragraphs seem to contradict each other. Controlled access in a safe setting like a media depiction sounds great. That’s exactly what trigger warnings are for. How can you possibly do controlled exposure without knowing if the content is there or not?
Incorrect. Trigger warnings inform you that the content is present in the media you’re about to watch. What you do with that information is up to you.
https://journals.sagepub.com/doi/10.1177/2167702620921341 - the bigger takeaway from this one is that trigger warnings reinforce trauma as a central part of the traumatized individuals identity but they did find some incidence of drawback/harm
https://journals.sagepub.com/doi/10.1177/21677026231186625 meta finding no benefit and actually can cause an anticipatory reaction making the person more engaged with the material
There are others, this is just what grabbed from 30 seconds on google scholar. Its been a bit since I’ve done more serious lit review and it’s not like I keep a directory of papers I’ve read
The issue is the culture surrounding trigger warnings. Let’s be real here, people looking for trigger warnings are generally (perhaps overwhelmingly) not looking for material to help with their exposure therapy. They are looking for a “warning” to help them screen material to avoid. The issue is that this creates an unrealistic expectation that is incompatible with the real world. You can avoid suicide, sexual assault, eating disorders, or whatever in your media (maybe) but real life won’t sanitize itself or warn you. You will encounter these topics, whether through the news, careless speech from friends, or even intrusive thoughts of your own. Research continues to show that avoidance of upsetting topics can worsen anxiety and ptsd symptoms
To your final point the idea of it helping to create a choice isn’t even as clear cut as you describe
https://journals.sagepub.com/doi/10.1177/21677026221097618 content warnings actually increase the likelihood someone will view problematic content. This point is further reinforced by similar findings in the meta linked above
So you have a system that ultimately makes creators feel like they’re doing something noble, that is likely at best useless and potentially harmful. Said system increases the likelihood that a person will view the problematic content but also enables the reality that a person will simply avoid the things that provoke their anxiety which again is more strongly established as harmful
https://www.sciencedirect.com/science/article/abs/pii/S0005796712001064 - ptsd worsens with avoidance
https://www.sciencedirect.com/science/article/abs/pii/S0962184904000290 - anxiety disorders do the same
One tricky thing here is that existing literature is really examining the potential effects of trigger warnings in and of themselves, devoid of context or non-immediate decision making. Does seeing a literal trigger warning make someone feel less anxious? Almost certainly not, why on earth would it?
In studies that find no or slight negative effect, the outcomes are immediate measures. How do you feel right now? If it assesses decision making, it’s whether you do or do not immediately consume the content.
But for trauma survivors the potential to be triggered is always in flux, always dependent on everything else going on in your life, often set off by things that seem unrelated or irrational. Trigger warnings give someone a choice in that exact moment for what to do based on what they believe they can* manage. Yes, it may promote avoidance, but avoidance can increase feelings of agency that allow for reduced avoidance behavior in the future.
As an example from the great college campus syllabus trigger warning kerfuffle: I assign chapters from Durkheim’s Suicide in some seminars, as well as complementary readings with less obvious titles. My students get a warning about this ahead of time, but they don’t get to just skip that part of the class. Some things students have done: scheduled extra therapy sessions during those weeks, read in small groups in the library instead of isolated in dorm rooms, missed a class meeting and made up for it with office hours and a short additional assignment (so they didn’t out themselves to their peers with a panic attack in class). It’s about agency and self-assessment.
A screen with a suicide hotline number isn’t going to magically make someone ok with seeing suicide represented, but it offers an action the person can take to regain agency.
*Or just want to manage. Sometimes you’re just living your life and not super in the mood for exposure therapy, and if you can get your brain somewhere else for a while that’s a very good thing.
What do you propose as the solution, then? Without any up-front disclosure of the triggering content being present, how can anybody make the choice whether or not to expose themself to it?
Thank you.
A big part of why I have severe anxiety to this day is because I was exposed to traumatic things far too young/quickly. I was pushed into situations where I was not ready or emotionally/mentally equipped to handle. Constantly.
Exposure is only good if a person is ready for it. Desensitization is only helpful when you are equipped to handle such a thing.
I had an ex who would say that we were doing one thing, then take me to do something completely different, then boast that he was “helping me”, which only heightened my fears in the end. As a foil to that, I had an ex after that who was encouraging and supportive and kind, and gently led me into the same situations, where I knew what I was getting into. Guess how which one had me overcoming my fears?
Exposure works best if you are prepared for the exposure and have the support you need in those kind of situations.
I am always thankful for trigger warnings.
good points! this is a decent depiction of exposure therapy.
TW have an odd history. they originally were very useful, because one thing you forgot to mention about exposure therapy is all the work that needs to be done leading up to it. you have to have physical grounding skills in place before exposing someone to adverse stimuli.
so imagine you have severe PTSD from SA and a college class is gonna show a film that depicts it in an ugly scene. it could fuck up your whole semester to have traumatic stress symptoms come back unexpectedly. I’m talking panic attacks, flashbacks, mood disruption, difficulty controlling violent impulses, difficulty concentrating, difficulty connecting with others… PTSD can be wild.
so the prof might give a TW on the syllabus, so people just dont come in that day if they don’t wanna see it.
nowdays TW is just “here’s a thing you dont like!” not “here’s something that could potentially ruin your life again”