Yes Trigger Warnings Do Help Me: Here’s How

I’ve talked before about trigger warnings, what they are, why they’re useful. It might seem like I’ve covered every element of the discussion possible. But there’s something odd that I’ve seen in discussions of triggers: no one is willing to say that they are the ones helped by trigger warnings.

I have many friends with a wide variety of mental illnesses, and many of them talk often and openly about their support for trigger warnings, but more often than not I see people say “I personally don’t find them helpful but I support them anyway.” Despite reading nearly every article about trigger warnings that comes across my radar, I can’t recall a single article that said “trigger warnings make my life easier.”

So I’d like to offer the perspective of someone who does find trigger warnings exceedingly helpful.

When I see a trigger warning, it’s very rare that I actually avoid the content it labels. I do not find TWs helpful as a way to curate my life into a happy little bubble that doesn’t include anything difficult or upsetting. First, that’s impossible and I spend much of my life dealing with things that are triggering anyway. Second, the point of the TW is ideally to allow people with mental illnesses to participate more fully in difficult discussions.

What IS helpful about TWs is that they let me know what’s coming. When someone talks about weight loss or self harm out of the blue it feels like I’m being smacked. Worse than that, because of the edges of paranoia that come with my depression and anxiety, it feels personal. It always, always, always feels like they’re talking about me or attacking me in some fashion, intentionally bringing up the things that make me feel the worst.

Now I realize that this isn’t rational and it’s something that I am working on fighting on my own terms, but the presence of the TW is enough to give me the space to realize that they want to have a discussion and also that they care about my well being. The TW is what lets me take a second to engage the more rational parts of my mind and lets me be gentle with myself.

In DBT there’s something called Wise Mind. It’s the balance between emotions and reason. When you’re in Wise Mind, you’re aware of your values and goals, and also capable of paying close attention to the facts at hand. TWs give me the space to try to be in Wise Mind. It’s that moment of mindfulness that makes me pull away from the strong emotional reactions I would have otherwise.

Sometimes when I see a trigger warning I choose to continue reading but I’m highly aware that if I need to close the window or go away for a while. that’s ok. It puts me in the mindset of self care rather than my typical mindset that sees disengaging as a failure.

Trigger warnings very rarely tell me that I should opt out of a conversation. Instead, they tell me that I’ll be safe if I try to engage. To some extent they’re a signaling mechanism that lets me know people care about my mental well being. But more than that they’re a reminder to me that I should be considering my mental health and engaging the skills that I have. And it gives me a heads up of what skills I’ll need to use based on what kinds of content will be there. If it’s weight related, I just skip all numbers. If it’s self harm related, I usually engage some kind of anxiety relief or self soothing (with a fidget or game).

When I don’t have the warning it hits suddenly and I don’t have coping skills at hand. It’s easy to get overwhelmed. It’s easy to let myself slip quickly into an anxiety attack, or even to use symptoms. TWs help me protect myself.

So when I see a TW, I feel safer. I know that I am safer because I take a minute to check in with myself and prepare for what might be coming. And I’ve found that I am almost never full on triggered by something that I’ve had warning for. It makes my life much easier and more than that it saves me from a lot of pain. Serious, real pain. That’s why trigger warnings are helpful to me.

Recovery In a World of Triggers

It’s extremely common for people with eating disorders to relapse at least once after feeling as if they’re in recovery or on their way to recovery. Some stats put relapse rates as high as 80%, although with more research on good treatment and long term support for people with a history of eating disorders, it’s likely that the number will go down. But unlike lots of other mental health problems, eating disorders live in a place where the bad behaviors are often praised, and triggers are basically everywhere all the time.

It’s astounding to me that anyone manages to recover at all. I’ve been doing fairly well for about six months, but the longer I spend away from the eating disorder, the more I realize how many unhealthy messages there are all around me. I recently had a conversation in which someone who was well aware of my eating disordered history and who brands themself a skeptic and scientifically literature person suggested that a diet of 1200 calories was an appropriate form of weight loss. Almost every day I hear people talking about how unhealthy it is to eat sugar or carbs or gluten or really anything. No matter how many times I try to remind myself that what’s important is eating food that tastes good to me and eating enough food that I feel full, I am constantly and every day reminded that being hyper aware of diet seems to be synonymous with health.

And yes, there is good evidence that being at a mid range weight, not eating tons o sugar, and getting decent exercise are good for you. The problem is how to interpret that statement when your brain is built for all or nothing thinking and perfectionism, for guilt tripping you and punishing you. How do you find any sort of middle ground between “I am allowed to eat what I want” and “I should try to eat in a healthy manner”? This to me is what makes eating disorder recovery so hard. There is no cold turkey to eating disorders because food is always going to be part of your life, which means at least a few times a day you’ll be thinking about the thing that ruled your mind for so long.

In addition, there’s tons of conflicting information out there about what’s healthy. Even for someone who doesn’t have an eating disorder, sorting through the morass of studies and recommendations can be incredibly difficult, and reading about diet studies can be extremely triggering for someone with a history of an eating disorder. That means most of us just want someone to tell us what’s right, what’s ok. No one can and no one will, so instead we’re surrounded with a thousand different messages and left reeling about what is or isn’t appropriate food behavior.

The unknowing is almost more triggering than the obviously pro-skinniness, pro-dieting messages. The deep uncertainty about whether or not your weight is too high or too low, your diet is too unhealthy or too many calories or too few calories, or not enough veggies, that gets into your mind until you just want the clear rules again. Unlike nearly any other mental health problem, eating disorders circulate around something that’s considered completely acceptable to comment on publicly: food. And it’s a conversation that everyone wants to have, so no matter how you try to avoid it, you have a coworker who says “Oh I’ll be bad and have a cupcake” or a family member who says “I’m down 15 pounds!” in a tone of pride. Each time you try to retrain your mind to erase the disordered messages that say “skinnier is better”, someone else comes along and nonchalantly dismantles your hard work.

Perhaps worse is the fact that many people seem to believe that choosing a “this works for me” approach is unacceptable when it comes to eating. You must be doing what is the most healthy, backed up by evidence, best diet ever or you’re not healthy at all. That means that for someone who has an eating disorder and might have to take some shortcuts (like: if I feel hungry for x food I let myself eat x food so that I get enough calories), their (perfectly logical and healthy) choices are derided as illogical and unhealthy. Some of us know that we engage in unhealthy behaviors and have to accept that to get food in our bodies at all. Some of us need to ignore some of the research to convince ourselves that eating more than 1200 calories a day is necessary. Some of us need to be irrational in order to be healthy, and that’s ok.

On top of all of that, you carry your biggest trigger around with you every day: your body. The changes that happen in your body, even if they’re completely natural, are extremely noticeable to a brain that’s used to nitpicking every ounce of fat. The weirdest things will set you off. I found yesterday that I couldn’t fit into a pair of shoes that had been in my closet since last fall, and that my ring size appears to have changed. These are tiny little reminders that I’m moving into uncharted territory, things to be feared.

All of this is to say that I understand why the relapse rates of eating disorders are so high. I hate blaming diet culture for eating disorders, since a mental illness is not just a diet, but it is true that all the conflicting and horrible information about healthy eating has serious impacts on people trying to bring their eating back to a reasonable middle ground. The good news is that there are people who have managed to recover and stay healthy. The good news is that we’re allowed to set boundaries, remove ourselves from conversations filled with diet talk, block the hell out of triggering websites and ads. The good news is that we’re entitled to our own health and well being, no matter what anyone else says about the appropriate way to eat.

Between A Rock and a Hard Place: Triggers

Yesterday I was hanging out with my partner’s family having lunch and chatting. I generally like Partner’s family, and they’re very kind people. But I’ve only known them for a few months and I haven’t established a very close bond with them yet. That means they’re mostly unaware of my mental illness. It’s not uncommon for people with mental illnesses to be around others that have this level of acquaintance: you know them, you care about what they think, you respect their opinions, and you want the relationship to grow. But they don’t know about your mental illness.

Most of the time that’s totally fine, especially since it’s not too hard to decide that if someone is a total butthead about mental illnesses and runs around spewing stuff like “it’s all in your head” or “just smile more” you can decide that you simply don’t want to invest in the relationship and stop hanging around them. But sometimes you end up in a circumstance in which someone that you want and need to build a relationship with inadvertently starts triggering you.

So yesterday when the conversation turned to calories and weight loss, I really wasn’t sure what to do. These conversations are nearly always triggering to me, to one degree or another. Sometimes I can keep my reaction under control, but usually it means that I’ll spend the next hour to day thinking about calories and weight loss and fighting with myself over my own caloric intake.

What do you do when you’re in a situation in which you can’t disclose your discomfort without outing a whole other pile of things, but you can’t leave without harming a relationship? Are there tools available? Sure I could have set a boundary by just saying “Hey, I really don’t think weight is that important. Could we talk about something else?” or just changing the subject, but when you’re not in a position of power or comfort, that can be extremely difficult. There are all sorts of situations where it’s nearly impossible to set boundaries like that without risking social repercussions.

There are lots of distress tolerance skills that seem really applicable here, things like breathing exercises, soothing oneself with nice sensory experiences (finding the soft blanket in the room and cuddling it), taking a brief mental vacation until the topic of conversation is over, distracting yourself in some fashion (if there are kids around it’s always a good excuse to say you’re just going to go play with them). It’s hard, and it might require limiting time around people you’re not sure you can trust with your mental and emotional health, but as relationships get closer you can start setting clearer boundaries.

The problem in my mind is that it’s still considered socially unacceptable to discuss your mental health in a casual way. It creates situations like these where there will always be unspoken needs because we’re not allowed to speak of mental illness. While physical illnesses aren’t always treated much better, it isn’t considered totally weird or unacceptable to say “hey, can we not have nuts for dinner since I’m deathly allergic and will have a horrible reaction.” It’s considered healthy, logical, and reasonable, rather than oversharing, being demanding, or straining a relationship. For some reason saying “I have the equivalent of a mental allergy to this conversation, can we please stop talking about it?” is awkward and unacceptable, something that opens you up to questions about whether your problems actually exist, or even can lead others to purposefully trigger you.

This might be one of the smaller areas in which mental illness stigma exists. It’s the little times that you have to bite your tongue and just deal with other people metaphorically standing on your feet by discussing triggering or difficult things. But those little moments add up. Each time they happen you have to have an internal dialogue about what you’ll do and how you’ll cope. It uses up important resources. And it normalizes the idea that you don’t deserve to be able to ask for things, even if others aren’t directly sending that message. The unspoken rules of relationships say that until you know each other well, you act polite.

I’m going to try to make a promise to myself that I will attempt to be better at boundary setting, even in situations like these where it’s possible that it will harm the relationship. I don’t have to be rude, mean, or demanding, but letting people know what is harmful to me can go a long way towards normalizing the idea that it’s completely ok to have needs and wants, as well as openly express those needs and wants. It’s even ok to just say that you have a mental illness and invite no further discussion.

This kind of rock and hard place situation doesn’t have to exist. There is no logical reason that disclosing an emotional need should be inappropriate or unwise.┬áSo I am going to change something I don’t like by changing my own behavior.

Musings on Mental Health Activism

In a perfect world, all people would have a basic understanding of mental illness and respect that it is very real and painful. In a perfect world, if someone disclosed their mental health status and said that it affected their decisions and life, other people would respect that without requiring evidence, gory details, or an exact explanation of how serious it really was (are you sure it wasn’t all in your head?)

Alas, this is not the world we live in. Disclosing mental health status often comes with a round of questioning and well intentioned but utterly unhelpful suggestions (have you tried exercising?) that can quickly put one on the defensive. I personally have felt pressure when writing about my mental health to engage in the “just how bad was it?” defensiveness, pre-emptively listing out symptoms and consequences to illustrate that no really, this needed to be taken seriously.

Nearly every article I read about mental illness feels the need to either specify that depression is a serious illness (if it’s a scientific or research based piece) or take a large chunk of its time to describe the internal experience (if it’s on the subjective side). There’s certainly nothing wrong with that impulse, and subjective descriptions of mental illness are incredibly important to increasing awareness and understanding, but almost never do I see someone write about an experience they had that was influenced by their mental illness without focusing heavily on symptoms and vivid, graphic descriptions.

This makes sense to some extent, but it seems odd to me that we cannot have mental illness be an influence in our lives without going the extra distance to explain the exact details. In the world as it stands, there is not enough understanding of mental illness to mention it as a factor without making your statement/article/conversation about mental illness.

Here’s where I get hung up.

As someone who wants to increase understanding and awareness of mental illness and mental health issues, as someone who is aware of these dynamics and the ways in which stigma against mental illness contributes to the requirement that mentally ill people prove how hard things are for them every.single.time, do I proceed by molding myself into the Good Depressed Person and patiently describing over and over (in the level of detail required by my listener to really understand) what it’s like in my head? Or is there something radical in simply letting myself say “I am depressed and that led to x, y, or z” without backtracking, explaining, or questioning myself?

There may be space for both of these options in the world of mental health activism. It’s easy to see how speaking openly about the internal experience of mental illness is part of activism. It very clearly increases awareness and understanding, and can help others respect the seriousness of a mental illness, as well as the fact that it is not a choice or a lifestyle. There are downsides though. I worry that making personal stories a constant factor in every discussion of mental illness sets an unhealthy precedent that people’s stories are required to be public. I worry that we’re painting a picture of mental illness that feeds into certain romantic notions of things like anorexia, while playing into the voyeuristic pleasure some people get in hearing about disturbing and graphic symptoms. I see this especially in discussions of self harm when the questions immediately turn to how deep, how often, where, pics.

It might be that having both tactics is the best choice so that we can continue to educate others about mental illness in a serious way while also recognizing that sometimes it isn’t the only or overwhelming factor in an individual’s life. Sometimes it’s just a part of life, like a twingy ankle or allergies. It gets in the way, but it doesn’t destroy.

Again, ideally, this could be a great way to move forward in activism. The problem comes with the lived experience of trying to mention your mental illness without defending it. People push. People overlook it. People argue and debate and yell after you’ve said you’re triggered. People invoke all the stereotypes of mental illness that you’ve been working so hard to fight against (lazy, taking the easy way out, not trying hard enough). These things, even if you know that they are unwarranted and are ignoring a very real factor (mental illness) hurt.

I don’t think anyone is obligated to always educate others when they talk or write about their mental health. You’re allowed to say “this thing triggered me, which relates to the rest of what I’m talking about in ways x, y, and z” without having to explain how your triggers came to be, what triggering looks like for you, and exactly how real and serious the experience was. I just don’t know how to let people do that while protecting them from the less informed folks who will take that as an opportunity to berate them for not liking triggery thing, or for not being able to cope with a situation, or whatever the case may be. And I don’t know how to recognize that people 100% have the right not to explain themselves while also knowing that these incidents might not help the larger aims of mental health activism.

This is the forever balancing act of oppressed groups that want to make things better. In order to gain the rights and treatment you know that you should have, you often need to play by the damaging rules of society as it is, putting you in a place to get hurt and perpetuating those same rules. How radical can we be in acting as if the world had already accepted us? While it might be idealistic and forward thinking to expect everyone to know about mental illness, does it actually do anyone any good when it comes to securing rights and reducing stigma?

There are no clear answers here about the “right” way to approach discussions about mental health or activism, but I wish we knew better how to help improve the world around us without making ourselves so vulnerable.

Triggers: What Are They, What To Do

I realize that I said I was going to be taking a blog break until this Thursday, but something happened to me last week that I really felt the need to write about and I wanted to do so while it was still fresh. Before I start the post, I want to add the caveat that this whole incident was very emotional and very upsetting for me. I am somewhat angry at some of the people involved, however that is primarily because I am hurt and afraid. I’m going to do my best to keep this post from becoming accusatory or rambling, but if it starts to go in that direction, that’s why.

I want to talk about triggers. A few days ago, I posted on Facebook about something that was triggering to me. I specified that I had been triggered. I was surprised at the response I got. Many people argued with me, told me I was wrong and that what had upset me was good and necessary, and even gave graphic descriptions of why it was so necessary (which was another exercise in being triggered). After things calmed down somewhat and I reiterated that I was being triggered and upset by their comments, I had one person mention to me that the had never heard of a trigger before: they didn’t know what I was talking about and so they didn’t understand that what they were doing was going to hurt me.

I was surprised. I live in a context where trigger is a common word. But I needed this reminder that it’s not something that everyone knows about, and that intelligent and well informed people may still need some explanations. So with that in mind, here’s a primer on what a trigger is, some basic do’s and don’ts of how to react to someone’s triggers, and a brief description of what it feels like to be triggered.

A trigger is an intense, uncontrollable, emotional reaction to something. It is typically a term reserved for someone with a mental illness because it is more than simply being upset or bothered by something. Triggers generally are related to past traumas that have left your brain impacted in some way. This means that when you see or hear or experience something that is a trigger, your emotions completely take over and you are in extreme, intense distress almost immediately. In its immediacy it is similar to an anxiety or a panic attack, although unlike those it doesn’t require that the individual react in certain ways. One could react to a trigger with a panic attack, but one could also react by sucking it up and dealing with it (which is what people are often expected to do).

A trigger is not the same as throwing a temper tantrum over something small, although it might appear to be so from the outside. It is also not weakness or simply being “oversensitive”. To take a parallel from physical health, let’s imagine you had broken your ankle. A trigger is like those elements of the ankle that never heal, only in your brain. Triggers are indications of where trauma has injured your brain. Being triggered is somewhat like being kicked in a broken ankle. It hurts, it’s scary, and you cannot stop that it hurts and is scary. The fact that you might have a friend who would laugh off getting kicked in the ankle doesn’t mean that you’re wrong for being hurt. It simply means that you have different situations.

Triggers can be all sorts of things depending upon the difficulties that an individual has faced before. For a vet, it could be loud noises, or the sound of helicopters. For someone who was raped, it could be the color of the curtains in the room it happened. For someone with an eating disorder it could be talk of calories and dieting. Triggers come in all shapes and sizes and don’t always make sense from the outside, but they’re simply about what sets off certain scripts and chain reactions in your brain.

So if you’re around someone and they say that they’ve been triggered or that something is triggering, what should you do?

First and foremost, accept that they are triggered by what they say they are triggered by. Respect them to know their own mental health better than you do, and whatever you do don’t tell them that they’re overreacting, that they shouldn’t feel the way they feel, that it’s inappropriate or wrong to feel what they feel, or that they should be able to deal. These statements are all very invalidating of the experience of being triggered: a trigger is not an opinion or an argument. It’s not something you can disagree with or argue with. It’s an experience. That would be like telling someone that you don’t agree with how much it hurt them to step on their broken ankle. It simply doesn’t make sense to say. So accept what they have said, don’t argue with it, and don’t tell them it’s wrong.

As a corollary DO NOT intentionally trigger someone. It’s important to remember that you’re not doing anything edgy, heroic, cool, or badass by ignoring someone’s triggers. You are not telling someone that you won’t put up with bad behavior or temper tantrums, you’re not teaching them about how harsh the real world is, you’re not “just having some fun”. You are being intentionally cruel. You are looking at an open wound and deciding what you can throw in it to make the person scream. This is a sick exercise. Don’t do it.

If someone opens up enough to you to tell you that they’re vulnerable in a certain state, the best thing you can do is ask them how you can help. Validate what they’re feeling, tell them that it must be horrible, and then ask if there’s anything you can do to help them avoid things that really hurt them that way, or help them when they’ve been triggered. Different people need different things when they’re distressed, so asking them what helps them is very important. If at all possible, try to do this when they’re not in the middle of being triggered.

Remember that when someone has been triggered, they are not themselves. If they’re typically someone whose statements are open to discussion, typically someone who’s analytical and wants to discuss things, typically someone who can just deal with whatever life throws at them, know that those things may not be the case when they’re in this extremely vulnerable state. Remember that you might need to give them a bit more space, or treat them a little more gently than you typically would. If they don’t want to talk about whatever has triggered them, let that rest. If they don’t want to solve whatever problem has triggered them, let that rest. If they simply need to vent, let that rest. They’re hurting.

So all of this discussion has been fairly hypothetical, but I’d like to finish by giving you a concrete example of what it feels like when you’ve been triggered. I’m going to use the example that prompted this whole post because it’s the most fresh in my mind and because I’ve spent a lot of time reliving it recently so I feel it will be the most vivid and descriptive. (Note: there is a trigger warning for eating disorders on this)

Earlier this week I went to Starbucks. This was out of the ordinary for me, but I had a Starbucks gift card so I went to Starbucks. I walked in and looked at the menu and there, listed next to each and every drink was a calorie count. I felt my whole body involuntarily tense, my breath catch. I nearly turned and left the store, or bolted for their restroom. All I could think about was that I deeply wanted to stick my fingers down my throat and puke up everything I had eaten for the last week. I wanted to leave this store and go home and hide where I would not be tempted by food, where I could wait until my body shriveled away and passed out, where I could safely avoid food for at least the next week. All these thoughts ran through my head immediately.

I took a deep breath and shoved them away so that I could get in line. I had to go to work and I was exhausted. I needed some caffeine. I stood in line with my mind racing and racing. I had to get a small. I had to get the lowest calorie count thing available on the menu, even if I didn’t like it. NO, fuck the calories, I should get the HIGHEST calorie count just to prove that I can. Or maybe a compromise, maybe if I just get a small of what I actually wanted I’d be ok. No that wouldn’t work, it was a full breakfast worth of calories and I don’t eat breakfast. Breakfast is unacceptable.

I barely remember getting to the register and ordering something in a haze. It bothered me for the rest of the day, and I threw up a post on Facebook about how distressed I was. I got comment after comment about how calorie counts are necessary, about all the hidden calories in our food, about the obesity epidemic, graphic descriptions of the size and calorie counts of Starbucks drinks and how they were going to lead to death from obesity. I have not been able to stop thinking about calories and this incident ever since. I imagine I will never go to Starbucks again.

I’m worried about going to restaurants now, something I’d finally been starting to get over. I keep replaying over and over how much I keep eating and wondering how many calories are in each dish. I had stopped thinking about calories for a long time, and now they’re hiding in the back of my mind again. I’m terrified that my diet is entirely unhealthy, that I’m going to give myself diabetes, that I’m going to become obese and get heart disease. I have been unable to focus at work during an incredibly important time, I have found myself dissociating extremely badly, I have almost cried at work. I’ve been unable to sleep, constantly composing responses in my mind that justify why I was hurt, struggling to let myself eat, struggling against the impulse to self harm or to purge.

It feels as if my mind simply can’t shut off or won’t shut off because the most important thing in the world has presented itself: calories. And now I need to react, protect myself, run, escape in any way possible. That is a trigger.

P.S. For anyone who thinks that triggers don’t exist or are made up 1.Go fuck yourself and 2.There is a great deal of psychological research into the ways the brain is injured by trauma and how that affects the way someone functions for the rest of their life. It’s real. Figure out google and find some articles.