22 Comments

Thanks for writing on this important topic with me! Looking forward to more collaborations in the future!

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It was an honor. I love our collaboration! What should we do next? Let’s ask our subscribers!

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I think there are two issues with these types of studies.

First, content or trigger warnings should be specific, rather than vague. The study linked about "trigger warnings may increase trauma survivors ..." used the following trigger warning: “TRIGGER WARNING: The passage you are about to read contains disturbing content and may trigger an anxiety response, especially in those who have a history of trauma”. This is broad enough to be meaningless. Trigger warnings should be specific, like TW: rape or TW: descriptive violence. These are much more useful to people who have actually had trauma, because they can make an informed decision.

Second, content or trigger warnings are not for the general public. I mean, they can be helpful to especially sensitive people, but the studies almost all just have general people, rather than targeted people. Trigger warnings are meant for people with 'triggers'.

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I agree that the majority of the trigger warnings we see are too vague to be helpful to some people who may be affected by the content such as information about the death of a child.

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This is interesting research to read but it feels somewhat dismissive of my lived experience as someone with PTSD, and that of others who’ve experienced trauma, especially in using it as a justification for not using trigger warnings. I find them helpful, many other people are open about finding them helpful and asking for them to be used as broadly as possible, and as it says in the article most college students report finding them beneficial. So although I know it’s not meant to read this way, it does feel a bit like being told “well, the research says you’re wrong”.

In a similar vein, I also previously suffered with CFS/ME, which “the research” insisted for years that the best treatment was Graded Exercise Therapy, whilst actual people with ME reported over and over again that it actually made them worse. Finally it seems that they are being listened to, and in the UK at least GET has been removed from the NICE guidelines on treatments for CFS/ME. I value research highly, but I think when the results come into direct conflict with the lived experience of the people it impacts, we need to be looking very closely at why that is.

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Thank you for sharing your lived experience with this issue. I agree that it is a complex issue and in the end we all need to make the decision of what we need to do personally for our mental health.

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Yes, I feel the same way. Content notes/warnings are in imperfect tool and not all survivors agree that they are helpful, but multiple friends with PTSD and students I used to teach have told me that content warnings help them decide when to opt out of certain content. It would feel deeply disrespectful to tell them “well actually the research says they make things worse for you/you’ll read it anyway.”

And I agree with other commenters that specificity matters! I don’t think the example about the friend teasing an anecdote about a mutual friend is very similar to, say, a professor telling students that a passage read aloud in class will include a graphic description of rape. In the latter, students have a choice to leave the room to avoid risking a panic attack in public (real example)

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Thank you for your comment and for sharing that real example.

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This is interesting research. There are times where I've found content warnings helpful (or maybe you could call these "content categorizations") is in choosing books or movies. I subscribe to the Book of the Month Club. When you read the description of that months selections, there is a section that says "Good to Know" and this is where details like sensitive themes, length or style of the book are listed. If it says, for example, "sexual assault," "death," "child death," or "graphic violence," I can decide whether I'm up for that genre of read. I'm a huge reader and I personally strongly dislike not having any idea that a book with have a death of a child. I find these kind of content categorizations helpful.

Social media is a whole different animal, I think, because people are just scrolling and looking without much intention. Most people will tap on "sensitive content" just automatically out of curiosity. Social media is designed to be this way.

Maybe, if people chose to use CWs or TWs, we need to call them content categorizations instead of triggers. Tell people factually what they will be looking at/reading instead of telling them what they will feel.

(Edited for missing word)

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I like this framing: “Tell me what this is” vs. “tell me what I will feel.”

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Thank you for sharing your comments particularly around the content categorization aspect with books and movies. I agree that there are some topics that I may not be ready to ready about or watch at specific times.

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Yes - agreed! It's hard to capture that aspect of "timing" in experimental studies that happen at a single time point

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I’m so grateful for this post. I think about this often. As an educator of students who are getting ready for college, and as a writer who writes about disenfranchised/stigmatized grief (particularly perinatal loss), I feel like I’m always weighing a sense of wanting to protect with wanting to spread awareness and empowerment around topics that we are otherwise not preparing people to handle or understand.

There is also the fact that some people can arrange, through racial/gender/class privilege, to not engage with upsetting things, whereas others who hold more marginalized identities are often forced to witness or experience trauma on a daily basis. And helping professionals like educators and doctors are then obligated to help to heal that trauma -- when really, this should be a more collective responsibility.

It’s a complex issue.

Right now, mt overall inclination is to hand over autonomy to my audience here and let people subscribe or unsubscribe as they need to for their own well-being, rather than colluding in a culture of fragility and stigmatizing of certain narratives that ultimately doesn’t serve the cause of collective liberation.

To me, this is one possible implication of the conclusions here -- that we can be caring and ethical by leaving aside the CW/TW, and not just by putting it in. Does that seem right to others here? Open to other perspectives.

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Thank you for your perspective as an educator. Like you I am very interested in hearing other thoughts as this is a complex issue.

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As you reference at the end of your article, people make assumptions about human behavior based on "common sense" and anecdotal experience. Perhaps the biggest challenge is the assumption that the mental health profession is subjective bc it doesn't fit the medical model. Given human behavior's complexities, the practice is exactly what it needs to be.

WE know mental health is as vital to our existence as physical health, but cultural norms have prejudiced society to place greater value on one over the other. We don't equate the word "medical" with "disorder." We don't discourage or shame people for seeking medical care. We don't tell people they should be able to treat physical illnesses without medical intervention. We don't assume we know as much as medical specialists.

Other assumptions about mental health I believe are rooted in paternalism and academia - equating doctoral degrees and research positions w expertise. Of course, these assumptions further stigmatize mental health and isolate people.

Mental health has never been more relevant than it is right now. Some say the country is in the midst of a mental health pandemic (and I agree).* While clinicians and researchers continue yeoman's work, we must also advocate for the field as a whole - even if it means starting where the client - the American people - are.

* See Dr. Bandy Lee's article, "Mental Health Pandemic" https://open.substack.com/pub/bandyxlee/p/mental-health-epidemic?r=2iucmn&utm_campaign=post&utm_medium=web

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Thank you for sharing this comment and for continuing to lift of the extreme importance of mental health and mental health care. Thank you for pointing out the article. It is an important one!

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THIS! Beautiful example of why we need to look at research rather than rely on what "seems" true based on our intuition. At the same time, as you mentioned, effects might vary for individual people. Most studies focus on average results. Your milage may vary. Geeking out a bit here, but looking at how many people responded this way versus that way is also useful.

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I agree it is important to go to the research but also important to realized that every person is an individual with their own background and needs, and we need to honor and respect that.

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This newsletter post is so interesting! As someone who has GAD, anticipatory anxiety is a very real concept, so I can definitely see how trigger warnings could have the opposite effect. Oftentimes, people will give me a trigger warning about a movie or show, and my immediate question is, "Okay but how bad is it?" I imagine trigger warnings would probably be more useful to those with very severe trauma--like people who actually can't view certain content without breaking down. From what I've learned, anxiety and fear is healed through gradual exposure, and I'm sure people who are still in that hypervigilant after-trauma state probably can't handle viewing certain triggering content. I have also found warnings useful when very real and graphic videos circulate the internet. Unfortunately, very awful videos involving real people and real situations will be posted on the internet at random, so I have seen people (while not posting the video) give a warning to help people avoid coming across it. Nonetheless, this research makes sense. Amazing post and I can't wait to see more!

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Thank you for sharing your personal story and how you use trigger warnings

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What interesting and surprising results. I do wonder if more research on the "forbidden fruit effect" might yield different results when looking at relevant and specific trigger warnings for people with PTSD or who otherwise have specific triggers they want to avoid. I think that the research is very important in its message that nondescriptive trigger warnings don't work for (what I see as) the original purpose of TW, which is to empower people to make informed decisions about the content they interact with.

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I love your idea on the “forbidden fruit effect” and the need for more research on it.

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