Trigger Warnings & Trauma-Informed Care

trigger warning (n): a statement at the start of a piece of writing, video, etc. alerting the reader or viewer to the fact that it contains potentially distressing material

Back when I worked in an urban clinic there one doctor would be rostered to cover ‘police cases’ i.e. cases of sexual assault. I dreaded this duty. We all have our weak spots, and sexual assault is one of those scenarios where it’s impossible for me to maintain professional detachment. But it was part of the job at that clinic, and it didn’t seem like an opt-out deal.

I wondered, what if I was a survivor of sexual assault? I was already so uncomfortable, how would I have managed if this was actually a trigger for me? Do our supervisors check to make sure we’re psychologically prepared for this kind of duty? Or is graduation from medical school supposed to guarantee a certain level of psychological fitness?

Recently I participated in a training session for healthcare workers on mental health. The group was discussing self-harm and suicide, a topic that was bound to come up in any kind of training around mental health. But the attitude of a few group members caught me off guard; they were dismissive and flippant. When someone used the phrase “attention-seeking” I had to step outside.

The debate around trigger warnings has gained in velocity and vitriol in recent years. Opponents of trigger warnings label and shame people with mental illnesses as weak. Social media has watered down the phrase so that it’s become a joke, a meme or a gif. Still survivors and their supporters try to carve out safe spaces, where people coping with trauma and depression can exist without sudden and painful reminders.

Should work be a safe space?

For healthcare workers, that would be impossible. We can’t predict what issues the next person will have. The patient is our first priority and we create safe spaces for them.

But what if we could create a work environment that protected the mental health of patients and staff too? What if we went to work acknowledging that other people might be dealing with trauma? What if we recognized the impact of trauma and proactively tried to reduce harm?

I don’t think trigger warnings are the best way forward. Jamaican society exists in a constant state of high tension, repeated trauma and triggers. Trigger warnings at work would be undermined by newspaper headlines, radio talk shows and social media. The added stigma against mental health would make the suggestion laughable at best and condemned at worst. But there might be a middle ground.

The mental health training session wrapped up with an introduction to trauma-informed care, a novel approach that will hopefully change the way we do things. Trauma-informed care emphasizes psychological and emotional safety for providers and survivors. A trauma-informed system realizes the widespread impact of trauma, recognizes signs and symptoms of trauma in patients, families, staff; integrates knowledge about trauma into policies, procedures and practices and avoids re-traumatization.

In a world besieged by natural disasters, civil wars and states of emergency, we need healthcare that is attuned to the realities of our experiences. If we are traumatized as a society we need a system that supports everyone, patients and providers, in achieving good health. Ensuring our organizations are trauma-informed is the best way forward.

2 thoughts on “Trigger Warnings & Trauma-Informed Care

  1. Great breakdown! At my job we provide services for people dealing with domestic violence and while I received training on how to recognize DV and how to best direct folks to services, but employees are not trained to deal with how the environment affects us. It seeps into your psyche and can weight you down. Are there any resources u can recommend for trauma-informed policies/ practices?

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    1. Hi Safiyyah! You’re absolutely right – the work we do can really sit with us.

      To answer your question, the training I spoke about was delivered through a US based NGO, so the resources they provided were from the US Dept for Health and Human Services. Here are some links to documents that outline the trauma-informed approach:

      https://store.samhsa.gov/system/files/sma14-4884.pdf
      https://www.integration.samhsa.gov/clinical-practice/SAMSA_TIP_Trauma.pdf

      I’m sure there are more resources out there, because just Googling “trauma-informed care” gives so many results!

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