Thursday, August 13, 2015

So, about that Atlantic piece on trigger warnings...

This one doesn't have any fun gifs, because it's just not that kind of post. Sorry. Next time, I'll work in some silly.

My social media has been blowing up with The Atlantic article on trigger warnings that came out this week. That, of course, followed up immediately with the usual roster of angry responses and taking it too far, unhelpful agreement. I try not to get sucked into this conversation anymore, because it's so maddening. It just...these are the times when I realize that my specific circumstances kind of obligate me to keep informing fellow educators about PTSD, and it's exhausting trying to push that particular boulder up the hill. But, that's all just to explain this long and rambling post, which I have nowhere better to put than here. So, here's one version of my trigger warnings rant, because someone on Facebook asked me for it.


I really have no problem with content warnings. I use them myself. It says something like "we will discuss issues and review material about race, sex, class, sexual orientation and culture. If you find disagreement on these subjects uncomfortable or cannot participate calmly and respectfully in a conversation about them, then this isn't the right section for you." What I do not do, under any circumstances, is allow student to opt out of material because it makes them uncomfortable. I would if it were going to TRIGGER--which is a flag word for PTSD, a specific disorder with very specific symptoms and pathways--them. But, it isn't. Because that isn't how triggers work.

Before anyone thinks I'm full of shit, here are my bonafides: I've had PTSD, I did my dissertation research on violence and trauma, and I have for many years taught traumatized vets in the home city of the Pacific fleet. If anything, I am uniquely qualified to witness the realities of trauma in the classroom. And it doesn't work like ANYBODY writing seems to think, which leads me to believe that very few of the people writing about it have any real experience with it.

Here's the thing about PTSD: it has little to do with content or conversation.The worst classroom PTSD events I've seen in my teaching life have been caused by events, not material. One was a woman who'd been shot in a carjacking. Her PTSD was so severe she could no longer drive nor leave her suburban town. In her class, we watched 2 movies dealing with violent crimes against women, one with a gun. Because of her DSS status, I had been prepared for her to need to step out or take some other anxiety-managing steps. But, no. She was fine with the material. The compartmentalization techniques of the logic class were ultimately very helpful to her, so much so that I collaborated with her psychiatrist briefly on her case plan. BUT--our classroom was near the auto yard. The day there was a big backfire, she hit the floor in a cold sweat, full-scale flashback. Sound is a major trigger.

The other big event in class was with a veteran who'd survived a sniper only to be IEDed later. Someone came up behind during a heated conversation, and there was a full meltdown. Typically, the soldier's back would have been to the wall, as that's a standard move to take with PTSD cases, especially vets (who always tend to half-watch their six). But, because it was a classroom full of separation-service vets (either at the end of careers or mustering out due to injury), it hadn't been possible to put everyone with their back to the wall, and in a classroom with a rear door, that poses problems. Surprises , especially body proximity surprises, are a major trigger source. Several other members of that classroom recognized the event for what it was, and so we were able to clear physical space for the anxiety to flash over, and the traumatized vet's service dog was able to help him calm. That was a group event. It was better that he wasn't alone. It was better we were all there (including the service dog, of course). And, again, it had nothing to do with the conversation or content, but with suddenly seeing a person behind him.

You'll notice that neither of these events has anything to do with content. And that's the way of it for my own PTSD (now almost entirely resolved). Sounds, smells, and surprises--particularly body-proximity, and/or from behind--are all major sources of trigger. Fiction, conversation, ideas? Not at all. In fact, ideas and conversation--finding new ways to approach the ideas around the trauma--are crucial to healing. Avoidance does not contribute to healing in the long term. Don't believe me? Believe Dr. David Riggs who writes "Because these memories and feelings are unpleasant, you may have the urge to avoid the triggers. Avoiding things that make you uncomfortable is normal and will make you feel better in the short run. But in the long run, this avoidance will make things worse. If the pattern continues, you can make your problems worse. Instead of avoiding triggers, it is probably better to learn how to manage your reactions when they are triggered." Avoidance is a management strategy for newly-diagnosed PTSD, but that's about all. Resolving PTSD relies upon more subtle methods.

I have two significant problems with the trigger warning debate. The first is that the discussion tends to use the language of neurological trauma--PTSD--to describe all people who have had negative experiences. While microaggressions and bad experiences of all types take a psychological toll, that is not the same as trauma in a neurological sense. Also, not all of what we call trauma creates PTSD (and therefore, the potential to be triggered). It doesn't create flashbacks, or the other physical symptoms of PTSD. Mixing the language of pain with that of neurological trauma/PTSD not only makes sure that those who have had negative experiences and could use the chance to consider, evaluate and understand them are sometimes guarded from doing so, it helps to undermine understanding of those--such as a decade's worth of returning veterans now in the classroom--who face the neurological realities of PTSD. If we water down the language, when it's already hard to get the VA to treat PTSD and help vets who have it, I worry that it only enables DoD's avoidance of the issue.

The other problem is that trigger warnings are used by conservative college administrations to stifle academic freedom. Some campuses (including one at which I work) curtail the use of "controversial content" to avoid making waves. One of their flags for content review and removal is the "trigger warning". The logic is that if it is going to be too upsetting to students, then we shouldn't be teaching it. That's just several kinds of wrong.

Cognitive dissonance is a real, and important, part of learning. The hard conversations rile us up and often bring up our most painful moments. It makes sense to provide a neutral space in which to think the hard thoughts, and to moderate the conversation around it. That's the role of a teacher--to guide and to provide space. Trauma, however, is both not the same thing and not something that will be ameliorated by limiting the conversation or opting out of the curriculum. PTSD healing requires an integrated therapeutic plan. At most, a teacher can be included in that plan (as, ultimately, I was with the gunshot survivor). Never should the teacher step in and pre-emptively play psychiatrist "just in case". We're not qualified, and most importantly, by doing so we're not helping.

If you don't know much about PTSD, but would like to know more, here are some resources:

American Psychological Association (APA)
Phone: (800) 374-2721

Anxiety Disorders Association of America (ADAA)
Phone: (240) 485-1001

Freedom from Fear (FFF)
Phone: (718) 351-1717

International Society for Traumatic Stress Studies (ISTSS)
Phone: (847) 480- 9028

National Alliance on Mental Illness (NAMI)
Phone: (800) 950-NAMI (6264)

National Center for Posttraumatic Stress Disorder (NCPTSD)
Phone: (802) 296-5132

National Center for Victims of Crime (NCVC)
Phone: (202) 467-8700

National Institute of Mental Health (NIMH)
Phone: (866) 615-6464

Screening for Mental Health (For Military)
Phone: (781) 239-0071

The Sidran Traumatic Stress Institute
Phone: (410) 825-8888


TL;DR: trauma and discomfort are different, and treating them as the same does a disservice to all students, but especially those struggling with PTSD.