Trigger Warnings

Last night my girlfriend had a runny nose, so I went and got a mostly-empty roll of toilet paper and tossed it to them.  I'm one of those funny people who likes bouncing lightweight objects off of others, so it bounced off their chest.  Immediately they started gasping for air like I'd hit them with a fastball.  They dove to the ground and gasped for air, wailing loudly and unnaturally.  Their brother came running and asked what's wrong.  "I'm fine," still wheezing.  "Well, you don't sound fine."  "I'm sorry."  They say that a lot, "I'm sorry," when the PTSD is acting up.

Most people seem not to understand how PTSD really works.  In this case, the glimpse of the toilet paper being casually tossed in the air triggered a physical response, due to its visual similarity to the casual toss of a tear gas bomb that they've previously been exposed to.  As soon as they were hit with a very lightweight TP roll and not a heavy smoldering cannister, they consciously were aware that nothing was wrong, but by then their body had already involuntarily gone into defense mode: restricting airways to keep the gas out.

They apologize a lot, and it makes me sad, because I'm not the one who deserves an apology.  It was a complete accident that I triggered them, and now the best future action is to hand items to them instead of tossing them, to avoid a similar situation.  Even saying "hey, here's your toilet paper" and waiting for comprehension before tossing it would have made a difference (oh hindsight).  This is what's known as a trigger warning, because it is a warning to precede something that would otherwise be triggering without the warning.  That makes all the difference: warning, no trigger; no warning, trigger.

I've seen people get offended by that concept.  It really is a weird thing, as though basic medical facts are something non-medical persons should deny on a whim.  I've seen it framed as "censorship".  I find that odd, because censorship would involve not engaging in the triggering behavior at all, rather than warning about it and then doing it anyway as is typically done.

I've also seen some disagreement between "real PTSD" and "sensitive feelings".  Again I find that odd, because it is a medical fact that abusive behaviors sustained over time are as traumatic as brief life-threatening situations.  This is known as Complex PTSD.  For example, my girlfriend already had sustained trauma from abuse before they ever stepped into a combat zone, and they would never say that the former is somehow more preferable to the latter.

Somewhat more complicated is the issue of exposure therapy, and whether people with PTSD need exposure to recover.  First off, this is not always the case.  Some patients get worse from exposure therapy, not better.  Second, exposure therapy must be supervised by a medical professional!  Trigger warnings are used in non-medical settings because we recognize that we're not medical professionals with the ability to regulate a patent's response to the material, and as a result we could be making their medical condition worse.

So who should be using trigger warnings and for what?  Clearly if I care about my girlfriend, I should take into account their particular needs.  What about my blog?  I try not to get too graphic - I could be wrong, but humans often are, and I'm willing to edit anything to add a warning if the need for a particular one is pointed out.  What about the classroom?  Well, schools are required to comply with ADA accessibility accommodations, and PTSD is disabling, so it's up to the school to work toward making sure everyone has equal access to the same education.  Can we adequately warn everyone about everything?  Probably not, but aim for the moon, and even if you miss, you'll land among the stars.