Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking
  • About KevinMD | Kevin Pho, MD
  • Be heard on social media’s leading physician voice
  • Contact Kevin
  • Discounted enhanced author page
  • DMCA Policy
  • Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices
  • Group vs. individual disability insurance for doctors: pros and cons
  • KevinMD influencer opportunities
  • Opinion and commentary by KevinMD
  • Physician burnout speakers to keynote your conference
  • Physician Coaching by KevinMD
  • Physician keynote speaker: Kevin Pho, MD
  • Physician Speaking by KevinMD: a boutique speakers bureau
  • Primary care physician in Nashua, NH | Kevin Pho, MD
  • Privacy Policy
  • Recommended services by KevinMD
  • Terms of Use Agreement
  • Thank you for subscribing to KevinMD
  • Thank you for upgrading to the KevinMD enhanced author page
  • The biggest mistake doctors make when purchasing disability insurance
  • The doctor’s guide to disability insurance: short-term vs. long-term
  • The KevinMD ToolKit
  • Upgrade to the KevinMD enhanced author page
  • Why own-occupation disability insurance is a must for doctors

The controversy that surrounds trigger warnings

Maria Yang, MD
Conditions
May 24, 2016
Share
Tweet
Share

A reader I respect asked me for my thoughts on trigger warnings.

Per Wikipedia, trigger warnings are “warnings that the ensuing content contains strong writing or images which could unsettle those with mental health difficulties.”

Let’s put aside the last part of that definition, “those with mental health difficulties”, as some articles suggest that trigger warnings are not limited to those with mental health difficulties. Part of me wonders why that fragment is in there.

First, some relevant clinical information, as trigger warnings as described in popular press are commonly paired with post-traumatic stress disorder (PTSD):

DSM-5 has loosened the definition for trauma. Affected individuals do not have to directly experience the trauma (“exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways”). Parameters to describe reactions to the trauma, however, still exist. In a previous post I reviewed the other DSM-5 criteria for PTSD.

The vast majority of people who experience trauma as described in DSM-5 do not go on to develop PTSD. Yes, people may experience symptoms in the days to weeks following the event. Most people, though, incorporate the events into their lives and move on. This is a testament to human resilience.

One of the most effective treatments for PTSD and other conditions related to anxiety and fear is “exposure,” delivered in a gradual process called “systemic desensitization.” For example, if a woman was a victim of rape and has symptoms of PTSD, the therapist and woman build a hierarchy of anxiety-inducing experiences related to the rape. The least anxiety-inducing experience may be her thinking about the facts of trauma. The most anxiety-inducing experience may be her wearing the exact same clothes she wore that day, going to the location where the rape occurred, and describing, out loud, what happened. Something in the middle may be her walking past the location where the rape occurred.

The therapist helps the patient learn coping skills to recognize, acknowledge, and manage anxiety and other uncomfortable reactions. They then work through the hierarchy, from least anxiety-provoking to most anxiety-provoking, until the patient is able to meet and overcome the anxiety associated with the traumatic event.

Do note that avoiding cues associated with the trauma is not included in the descriptions above.

So, back to trigger warnings:

Different people respond to cues in different ways. Some victims of rape don’t have any visceral reactions when they hear or talk about rape. Some do. Some people only have visceral reactions if they smell something from or see certain objects associated with the traumatic event.

Who decides which triggers are worth mentioning and which are not? Does anyone have the right to tell someone else what is a trigger and what isn’t?

People have different capabilities to cope with stress. I mean no disrespect in the following sentence: Some people have never learned how to deal with themselves. They don’t know what to do when they feel angry or sad or frustrated. No one ever taught them what to do with those emotional energies. They have a skills deficit.

Thus, for some people, the best way they’ve learned to take care of themselves is to ask for trigger warnings. That strategy has worked for them and, as a consequence, they continue to use it. The feeling of empowerment is much preferable to feelings of discomfort.

For all of us: You feel the way you feel. It’s neither right nor wrong. People may tell you that you’re overreacting or “too sensitive,” but that’s about them, not about you. You feel the way that you feel.

Emotions aren’t simply reactions. Emotions give us information about the situations we’re in. They help us decide on next steps. We certainly prefer some emotions to others. All emotions, though, serve a function. Avoiding them often causes more problems.

The request for trigger warnings may not represent a need for coddling. It may reflect a need for greater validation. When we feel like no one understands where we’re coming from or what we’ve experienced, sometimes we try harder to make others listen to us with hopes that they will then understand us.

As social creatures, we build our identities in relation to others. Context matters. Perhaps the request for trigger warnings is a reaction to the limited support and acknowledgment we received when we experienced trauma. This is an opportunity to not only advocate for ourselves, but also to advocate for others who may still feel uncomfortable expressing their own distress. Feeling empowered is much preferable to feeling uncomfortable.

Do people want trigger warnings because we, as a society, are unwilling or unable to talk about the horror, helplessness, and terror that accompanies trauma?

If people can ask for trigger warnings, that means that they have voices that others can acknowledge, hear, and respond to. What about all the people in the world who don’t have a voice? And are yet unable to escape trauma? The request for trigger warnings can be noble, but does little for others who are currently experiencing and recovering from their own traumas. Not talking about something doesn’t mean it will go away.

Furthermore, the underlying assumption of trigger warnings is that people who have experienced trauma can’t handle life. Not only is this assumption wrong, it is also dangerous.

As I noted above, most people who experience trauma do not develop PTSD. For those who do develop PTSD, they can and do recover. That doesn’t mean that recovery is easy, quick, or painless. Like anything important, it takes time and energy.

Because we build our identities in relation to others, requests for trigger warnings could send the message that people who have experienced trauma will never recover. It can also suggest that people who have experienced trauma are “defective” or, as in the Wikipedia definition, have “mental health difficulties.”

To be clear, there is a role in alerting people to potentially disturbing experiences. Movie ratings do this: That “R” rated movie has violence, nudity, and drug use. This information serves a purpose for parents and viewers of films. If you find the film disturbing, you can use the energy from your own emotional reaction to write a letter of umbrage to the filmmaker, avoid similar films in the future, or tell your friends not to see the movie. However, how you react to the film doesn’t mean that everyone else will react in the same way. It also does not mean that film makers must heed your requests to provide warnings about its content.

Given that people respond to cues and deal with stress in different ways, people have unique emotional reactions to events, and avoidance is not an effective treatment for anxiety and trauma-related disorders, requests for trigger warnings are ultimately short-sighted and will not help people learn about themselves, grow, and recover.

Maria Yang is a psychiatrist who blogs at her self-titled site, Maria Yang, MD.

Prev

The enemy is not death. The enemy is needless suffering.

May 24, 2016 Kevin 4
…
Next

What it takes to be a great doctor: Master the fundamentals

May 24, 2016 Kevin 5
…

Tagged as: Psychiatry

< Previous Post
The enemy is not death. The enemy is needless suffering.
Next Post >
What it takes to be a great doctor: Master the fundamentals

ADVERTISEMENT

More by Maria Yang, MD

  • A doctor’s COVID-19 advice to physician leaders

    Maria Yang, MD
  • When a patient in jail lacks impulse control

    Maria Yang, MD
  • Does medical school train students to become managers or leaders?

    Maria Yang, MD

Related Posts

  • New CDC warnings underscore how vaping is smoking 2.0

    Daryl Pearlstein, MD
  • The burden of the badge: an MD student’s response to the FIGS controversy

    Palak Patel
  • Advocating for people with disabilities: People First Language

    Leonard Wang
  • Qualifying conditions for medical marijuana

    Patricia Frye
  • Settlements in the opioid cases need these non-negotiable conditions

    Rosanne Aulino, RN
  • What does Kelly Loeffler’s health plan do to coverage for preexisting conditions?

    Robert Laszewski

More in Conditions

  • Health insurance incentives and alternatives to opioids for chronic pain

    Molly Candon, PhD and Daniel Clauw, MD
  • Communicating health to children: a pediatrician’s guide for parents

    Joey Skelton, MD
  • The truth about short-term opioid prescribing and opioid use disorder

    Kayvan Haddadan, MD
  • How spinal cord stimulation offers relief for chronic pain

    Kayvan Haddadan, MD
  • The rhythm of healthy aging: Moving beyond health care metrics

    Gerald Kuo
  • Managing acute heart failure: evidence from the DOSE trial

    Benjamin P. Geisler, MD, Jeffrey L. Greenwald, MD, and Kathy May Tran, MD
  • Most Popular

  • Past Week

    • Politics and fear have replaced science in U.S. pain management [PODCAST]

      The Podcast by KevinMD | Podcast
    • Evidence-based medicine vs. clinical judgment: a medical student’s perspective

      Jay Pendyala | Education
    • The controversy over Maintenance of Certification for grandfathered physicians

      Bernard Leo Remakus, MD | Physician
    • How hindsight bias distorts clinical medicine

      Olumuyiwa Bamgbade, MD | Physician
    • When side effects are actually a cry for help with medication costs

      Shuchita Gupta, MD | Physician
    • The hidden math behind physician hiring costs and recruitment

      Timothy Lesaca, MD | Physician
  • Past 6 Months

    • The dangers of vertical integration in health care

      Stephanie Waggel, MD | Policy
    • Why does sex work seem like a more viable path than medicine in 2026?

      Corina Fratila, MD | Physician
    • The 9 laws of health care quality: Why metrics miss the point

      Constantine Ioannou, MD | Physician
    • Politics and fear have replaced science in U.S. pain management [PODCAST]

      The Podcast by KevinMD | Podcast
    • From Singapore to Canada: a blueprint for primary care transformation

      Ivy Oandasan, MD | Policy
    • How board certification fuels the physician shortage crisis

      Brian Hudes, MD | Physician
  • Recent Posts

    • Why measuring muscle mass matters more than tracking your weight [PODCAST]

      The Podcast by KevinMD | Podcast
    • Health insurance incentives and alternatives to opioids for chronic pain

      Molly Candon, PhD and Daniel Clauw, MD | Conditions
    • Independent medical practice: Why private clinics are essential

      Marcelo Hochman, MD | Physician
    • How hindsight bias distorts clinical medicine

      Olumuyiwa Bamgbade, MD | Physician
    • Do no harm: Why physician burnout requires bottom-up reform

      Desiree Francis, MD | Physician
    • Institutional distrust in health care: Why a doctor lost faith

      Joshua Mirrer, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 4 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Politics and fear have replaced science in U.S. pain management [PODCAST]

      The Podcast by KevinMD | Podcast
    • Evidence-based medicine vs. clinical judgment: a medical student’s perspective

      Jay Pendyala | Education
    • The controversy over Maintenance of Certification for grandfathered physicians

      Bernard Leo Remakus, MD | Physician
    • How hindsight bias distorts clinical medicine

      Olumuyiwa Bamgbade, MD | Physician
    • When side effects are actually a cry for help with medication costs

      Shuchita Gupta, MD | Physician
    • The hidden math behind physician hiring costs and recruitment

      Timothy Lesaca, MD | Physician
  • Past 6 Months

    • The dangers of vertical integration in health care

      Stephanie Waggel, MD | Policy
    • Why does sex work seem like a more viable path than medicine in 2026?

      Corina Fratila, MD | Physician
    • The 9 laws of health care quality: Why metrics miss the point

      Constantine Ioannou, MD | Physician
    • Politics and fear have replaced science in U.S. pain management [PODCAST]

      The Podcast by KevinMD | Podcast
    • From Singapore to Canada: a blueprint for primary care transformation

      Ivy Oandasan, MD | Policy
    • How board certification fuels the physician shortage crisis

      Brian Hudes, MD | Physician
  • Recent Posts

    • Why measuring muscle mass matters more than tracking your weight [PODCAST]

      The Podcast by KevinMD | Podcast
    • Health insurance incentives and alternatives to opioids for chronic pain

      Molly Candon, PhD and Daniel Clauw, MD | Conditions
    • Independent medical practice: Why private clinics are essential

      Marcelo Hochman, MD | Physician
    • How hindsight bias distorts clinical medicine

      Olumuyiwa Bamgbade, MD | Physician
    • Do no harm: Why physician burnout requires bottom-up reform

      Desiree Francis, MD | Physician
    • Institutional distrust in health care: Why a doctor lost faith

      Joshua Mirrer, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today

Copyright © 2026 KevinMD.com | Powered by Astra WordPress Theme

  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

The controversy that surrounds trigger warnings
4 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...