You know, I love science as much as anyone, maybe more, but I have grown to dread the phrase “…according to the research”.
They say that “Confronting triggers, not avoiding them, is the best way to overcome PTSD”. They point out that “exposure therapy” is the best treatment for trauma survivors, including rape victims. And that this involves reliving the trauma and exposing yourself to traumatic stimuli, exactly what trigger warnings are intended to prevent. All this is true. But I feel like they are missing a very important point.
YOU DO NOT GIVE PSYCHOTHERAPY TO PEOPLE WITHOUT THEIR CONSENT.
Psychotherapists treat arachnophobia with exposure therapy, too. They expose people first to cute, little spiders behind a glass cage. Then bigger spiders. Then they take them out of the cage. Finally, in a carefully controlled environment with their very supportive therapist standing by, they make people experience their worst fear, like having a big tarantula crawl all over them. It usually works pretty well.
Finding an arachnophobic person, and throwing a bucket full of tarantulas at them while shouting “I’M HELPING! I’M HELPING!” works less well.
And this seems to be the arachnophobe’s equivalent of the PTSD “advice” in the Pacific Standard. There are two problems with its approach. The first is that it avoids the carefully controlled, anxiety-minimizing setup of psychotherapy.
The second is that YOU DO NOT GIVE PSYCHOTHERAPY TO PEOPLE WITHOUT THEIR CONSENT.
If a person with post-traumatic stress disorder or some other trigger-related problem doesn’t want psychotherapy, then even as a trained psychiatrist I am forbidden to override that decision unless they become an immediate danger to themselves or others.
And if they do want psychotherapy, then very likely they want to do it on their own terms. I try to read things that challenge my biases and may even insult or trigger me, but I do it when I feel like it and not a moment before. When I am feeling adventurous and want to become stronger in some way, I will set myself some strenuous self-improvement task, whether it be going on a long run or reading material I know will be unpleasant. But at the end of a really long and exasperating day when I’m at my wit’s end and just want to relax, I don’t want you chasing me with a sword and making me run for my life, and I don’t want you forcing traumatic material at me.
Scott Alexander, “The Wonderful Thing About Triggers”, Slate Star Codex, 2014-05-30.
April 4, 2015
QotD: DO NOT GIVE PSYCHOTHERAPY TO PEOPLE WITHOUT THEIR CONSENT
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