On trigger warnings and double standards

Content note: PTSD, anaphylaxis

I have an old friend who I’ll call Sarah. Sarah has a rare, fatal allergy to chicken. If she eats chicken she can literally go into anaphylactic shock and die in a matter of minutes. Her allergy is so severe it can even be triggered by the smell of chicken being cooked.  She’s never had a full-on anaphylactic episode from inhalation alone, but she does have a powerful and deeply unpleasant reaction to it, and she doesn’t want to take any chances.

When Sarah was in graduate school she lived in a student apartment on campus. Because of her allergy, she was given the one apartment in the building that had its own kitchen. The other students shared a kitchen on the floor. Unfortunately, the shared kitchen was between her apartment and the way out of the building, so she couldn’t help but walk by past it.  And if she was coming or going when someone was cooking chicken, she couldn’t avoid the smell. And the reaction.

Sarah knows her allergy is inconvenient for the people around her.  She feels bad about this, although she really shouldn’t. When she moved into the apartment, she went and spoke to every other student on her floor, individually. She explained her chicken allergy to them and asked that if they planned to cook chicken, could they please just let her know in advance so that she could make sure she did not have to walk past the kitchen until they were finished. She didn’t ask them not to cook it at all, just to give her a bit of notice when they were planning to.

Most of the students did. One refused to. She didn’t refuse to Sarah’s face; she simply went ahead and cooked her chicken when she wanted without giving Sarah any warning. At least once that Sarah knows of, one of the other students reminded her of Sarah’s request; her response was something along the lines of that she couldn’t be bothered, and Sarah would just have to deal with it.

Just have to deal with an extreme allergic reaction that may not actually kill her, but could trigger symptoms that make her feel like she is going to die. Just deal with it. Because this neighbour couldn’t be bothered to give Sarah a heads-up so she could do what she needed to protect herself. Too much trouble.

You can see where I’m going with this. Sarah’s neighbour was behaving very much like the people who simply refuse to use trigger warnings before sharing material that might adversely affect others. In fact, they are worse because in many cases they are actively trying to dissuade anyone from using them. As obnoxious as her behaviour was, Sarah’s neighbour wasn’t, as far as she knows, going around telling the other students they shouldn’t be letting her know about the danger their chicken cooking might pose to her.

And that’s exactly what we are talking about – danger. Not offence. Not discomfort. Real, genuine harm. The word “trigger” is in there for a reason. It reflects the language used by clinicians and researchers when talking about conditions that make the people who have them susceptible to sudden, acute reactions, set off by things that would be more or less benign to others. Anaphylaxis is one such condition. PTSD is another. In fact, the two conditions often share symptoms – hyperventilation, dizziness, a feeling of being suffocated. The suffocation may more readily lead to actual death in an anaphylactic, but when you’re suffering repeated spells of really feeling like you are going to die, I’m pretty confident in saying that’s going to have a negative effect on your health. And psychiatric conditions do kill people, sometimes, at least indirectly. It’s not the same risk as eating something you have a fatal allergy to, but it’s not incidental or negligible, either.

Anaphylaxis and PTSD have something else in common, too, and that’s that they’re both unpredictable: the triggers aren’t necessarily only where you expect to find them. Sarah once nearly died after eating a “vegetarian” pizza, probably due to cross-contamination in the restaurant kitchen. Other allergic people’s triggers may be even harder to avoid, like peanuts. And not every allergic reaction is an anaphylactic reaction, either, just as not every read of potentially triggering material will actually set off the symptoms in someone with PTSD. But just because you don’t know whether or how someone is going to react to something isn’t a reason not to warn them when you know it’s something they might react quite severely to.  Letting them know allows them to decide for themselves whether the risk is one they feel able to take. Not letting them know gives them no real choice in the matter – even if it’s a day when they’re feeling exceptionally vulnerable, or left their epi-pen at home.

Ultimately, where you stand on trigger warnings says a lot about where you stand on mental health. If you think Sarah’s request for a heads-up was reasonable, if “may contain nuts” doesn’t provoke you into writing awful New Statesmen columns about the threat to culinary freedom, but you think PTSD sufferers should just grow a thicker skin and certainly should not expect other people to have any regard to their condition, then what you’re basically saying is that mental health doesn’t matter in the way that physical health does. Not an uncommon view, of course, but one I suspect many of those in the “anti-trigger warning” camp would be loath to admit they hold.  Either they do hold it, or they’ve entirely missed the point of what trigger warnings are about. There really is no third option.