Jeff Levy, LCSW
Mental Health, Relationships, Trauma, Identity
Jeff Levy, LCSW
(originally posted on Branching Out; The Live Oak Blog, and Linked In, August 2016)
More and more I hear people asking for trigger warnings when there is a chance something someone may say or do will evoke emotional pain. This is happening on college campuses where students are asking faculty to provide warnings about difficult classroom material, as well as in mental health organizations, where clinicians are asking colleagues to provide warnings before talking about a difficult case. Innumerable articles have been written that either support or challenge the idea of trigger warnings.
It makes sense to be warned about potential pain however, on an everyday basis in our own lives and in the lives of our clients, there is often no warning about the trauma or violence that we might experience. Trauma informed practice may not be about proactively and explicitly predicting all possible painful experiences in order to prepare for them or avoid them. Instead, it may be about acknowledging our inability to do such predicting. It is then incumbent upon us to respond with emotional presence, compassion and sensitivity when we find ourselves, our clients, or our students in a place of pain or anguish.
I Want to Warn My Clients
Rob was a social worker who saw me monthly for clinical consultation. He is a solid clinician and someone whose practice is trauma-informed. During our work together, he made the decision to change office locations. He found an office space that was larger, had more windows, and afforded him access to other amenities that his current office did not have. Still, he had anxiety about this change as it related to the reactions of his clients.
“The hallways in my new building are darker than the hallways in my current building,” he explained one day. “And because I’ll have this office all to myself, I’ll be able to furnish it the way I want to, so there will be different art, a different couch, and different chairs. I’m thinking that I’ll tell my clients about these changes in our last session at my old space—-I want to avoid triggering them.”
“What if they are triggered?” I asked. “What if a client comes in and tells you she is angry about the dark hallways? Or someone says the artwork on your walls reminds them of the time in their life when they were abused? Or someone tells you that he felt safe in your old office, but the new office feels too large and the arrangement of the furniture makes him feel trapped?”
He looked at me with both surprise and curiosity. “Well,” he answered, “I wouldn’t want them to feel any of those things. That’s why I want them to know about these changes before they happen. I want to be transparent and predictable in my clinical work. That’s an important part of creating safety and is a core value of my work.”
I offered a gentle challenge: “What do you think might happen if you tell your clients about some changes but not others? What if the things you warn them about aren’t the things about your move that are triggering? Or, what if warning them makes them feel more triggered? Or your warning isn’t “enough” to avoid a strong, emotional reaction?”
I Want To Avoid Causing Pain
Angel was a school social worker who was seeing me for clinical consultation. After a few years working together, she decided to leave her job and return to graduate school for another degree. She had been a social worker at the same high school for six years, so she had known many of the seniors for four years.
She worked in a neighborhood where there were high rates of unemployment, daily incidents of violence, and many young people who were growing up in single parent households or were being raised by extended family. Experiences of loss were regular.
“I’ve started to tell some students I’m leaving,” she explained one day. “And while some have had no reaction, there are other students who I know feel connected to me and I’m afraid they will feel like I’m just another person who is abandoning them.” I’m sure she wasn’t prepared for my response: “Well, you are another person who is abandoning them.”
She was clearly dissatisfied with me. “I can’t believe you just said that! My supervisor at school told me this was a wonderful opportunity for my students to have a different ending with me than they have had with other people. He said I can make this a positive ending for them!”
I understood what her supervisor was saying. In fact, I am a person who, for many years, had said the same thing to people who were leaving their jobs and were in the process of telling clients about their departure. But as the years have progressed, I’ve come to believe that ending relationships with clients, especially those for whom abandonment and loss is a theme, cannot be a “good” ending. We can’t find a way to tell people about our leaving that doesn’t have potential to ignite flames of sadness, anger or rage, or doesn’t result in someone refusing to see us for the remainder of our tenure.
I tried to elaborate with Angel: “No matter how you choose to tell your students you are leaving, and no matter how much you try to explain it is not about “them,” you can’t avoid triggering old and unresolved feelings about past losses. In fact, trying to be so “careful” with how you tell them might result in your conversations feeling less authentic both to you and to your students. I wonder what it would be like to tell the truth; to be present to any feelings that arise, and to acknowledge that your leaving may be causing them pain?”
I could see Angel’s eyes tearing. “I don’t want to cause them pain,” she said quietly. I have been in Angel’s place countless times, so I understood how she was feeling. “I get it,” I shared. “But in an effort not to cause them pain, you might be more likely to have the same kind of ending they have experienced in the past: one that doesn’t allow for a host of reactions, one that is defensive, and one that is abrupt. Maybe by allowing for the pain and being present to it, you are actually more likely creating space for an ending that is different than others.”
Trauma is Everywhere
Separate but related, I can think of many instances when I was working in child welfare talking to young people who were living in neighborhoods in Chicago where community violence was an everyday occurrence. When I asked or remarked about the extent to which they had been exposed to trauma, many of these young people told me they didn’t see their growing up as traumatic; that the violence they experienced, along with the loss of family and friends to violence, were so everyday they were not considered particularly “traumatic.” That isn’t to say that the violence wasn’t experienced or the losses weren’t felt. It is more about how violence and trauma were a part of everyday life; that being prepared for something “bad” to happen was “normal.”
I also remember talking to a client from Israel immediately after the 9/11 attacks. He was confused and even a little amused—though not in an insensitive way—how we Americans were having such extreme reactions. He wanted to be clear with me that he understood the attacks were horrible, and he expressed his anger and sadness about the lives that were lost. At the same time, like the young people I worked with from violent neighborhoods, he wanted me to understand that for him, and for so many in the world, trauma and violence are part of daily life. He knew that at any time, there could be a bombing in his neighborhood, and he was not warned in advance that it was going to happen.
In a piece for Salon.com on trigger warnings, Rani Neutill, a self-identified feminist and “recovering academic” wrote: “if you promote trigger warnings in subjects that are supposed to make people feel uncomfortable, you’re basically promoting a culture of extreme privilege, ’cause I’m pretty sure that the trans women who are being murdered weekly, the black men who are victims of police brutality daily, and the neighborhoods in America that are plagued by everyday violence, aren’t given any trigger warnings. Let’s be honest: life is a trigger.”
While Neutill wrote about her experiences teaching at the college level, she speaks to the idea that trigger warnings might be “contrived;” that they don’t account for the lives of many of us who experience marginalization, discrimination and systematic/institutionalized “isms.” She also discusses the idea that discomfort has the potential to generate change, growth, and even activism. When we try to avoid any kind of discomfort—including trying to avoid anything potentially painful—we may be foreclosing the possibility of change, which is the very antithesis of what we hope to generate through therapy and through education.
Who is Asking for the Trigger Warning?
Where the call for trigger warnings originates is an important consideration. In Rob’s case, and I think for Angel as well, the need to “warn” clients about possible triggers was coming from their own need to protect their clients, and to equally protect themselves, from dealing with pain. For both of these compassionate social workers and for many of us, it is triggering to cause others pain and to deal with the repercussions of causing such pain.
In such instances, the need for a trigger warning actually comes from our own desire not to be “triggered” by triggering others. Still, I know that there is no way we can predict everything that may cause pain and no way we can predict all the reactions each person may have to things we do or say. In fact, trying to do so can be paralyzing. For much of the world, trauma and violence are an expected, albeit unwelcome, part of existence.
I had an experience recently where I was presenting a case to my colleagues for consultation. My client’s history was rife with violence, and I found myself carrying pieces of our sessions with me throughout the week. I sought consultation, in part, to help me deal with my own reactions.
I told my colleagues that I was hesitant to describe one particular experience of my client’s because of how much it triggered me. One person asked which experience I was referring to. When I answered her question, thinking this would also be the most troubling for her, she validated my reactions, but told me there was another of my client’s experiences that was most triggering for her; reinforcing the subjectivity of trauma and the impossibility of universal warnings.
There are other instances when our clients or our students ask us to share as much as we can about anything that might be painful or triggering. The better we know our clients and their histories, the greater the likelihood that we can provide this kind of “heads up.”
And for those of us who are students, asking to be warned about readings, discussions, or classroom activities that might be violent or troubling is reasonable. It’s just impossible to always know what will be troubling to whom, or how providing a trigger warning actually makes material more triggering.
Might Trigger Warnings be a Privilege?
Some things we can and do predict. I tell my clients with as much notice as possible when I will be away on vacation and who will be my back-up therapist while I am gone. If there is some policy change at my agency, I tell clients as soon as I know so that if it impacts our work together, we can talk about it. When I am sick and have to cancel appointments, I ask my clients how it was to miss our appointment, and how it felt for me to cancel.
I also try to predict as much as possible in the graduate courses I teach about trauma. I am explicit that the books and articles we read will be rough, and the material will be intense. I also invite discussions in the classroom about how class material resonates with our personal histories, including histories where marginalization, oppression, and exposure to violence have gone unacknowledged and unprocessed.
Even with all that predicting and care, all of us (clients, students, and teachers) have inexplicably intense reactions. Even when I think I’ve covered all my bases, there is something that punctures the present and accesses the past in a way none of us could have known would occur.
The best we can do is to be aware and open. For ourselves, this means making sure we learn, develop, and access the skills to self-regulate; to remain present in the moment while also taking care of ourselves without fleeing the room. Just as therapy is a microcosm of the world outside of therapy, the classroom is a laboratory for developing and practicing the skills we need when working with our clients. The therapy space and classroom are also places to talk about difference, systems of oppression, and the impact of privilege—we just cannot provide universal warnings about how these discussions will impact any of us.
In our clinical work, in our work with colleagues, and in our work with students, it is absolutely important for us to create and support safety. I ask that we consider, however, that guaranteeing safety and guaranteeing an absence of discomfort or pain is impossible. Warning one another about any and all possible factors that compromise safety is impossible as well, and potentially disempowering in its implication or assumption of what we can and cannot “handle.”
My young clients and my Israeli client remind us, and Rani Neutill more explicitly reminds us, that it is a privilege not to have to think about violence or be reminded of pain and loss. Life has no trigger warnings. Nor can it. And in our clinical work and in the classroom, there can be no such guarantee either.
“Someone I loved once gave me a box full of darkness. It took me years to understand that this too, was a gift.”
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