"'Empathetically Correct' is the New Politically Correct"

[NickNaylor]

Article here: http://www.theatlantic.com/educatio...orrect-is-the-new-politically-correct/371442/

I'm curious to see what you all think about this new "trigger warning" trend. I'm not sure what my thoughts are on them. On the one hand, I recognize the need to be sensitive, and the last thing I'd like to do is cause anyone severe distress that could be easily prevented with these warnings. On the other hand, I can't help but worry this is an attempt to completely sanitize society and categorize everything a la Twitter hashtags. At some point, we have to accept that living in a crazy world has inherent risks to it, and there will be no way for us to completely eliminate every possible trigger that might cause distress. The argument being made by the pro-"trigger warning" crowd with respect to PTSD is, I think, fairly straightforward, but the devil is in the details. At what point do we say enough is enough? Is it with patients formally diagnosed with PTSD? Is it with people that simply get extremely upset when discussing certain topics? We haven't even begun to "think of the children!," and I eagerly await the argument on that front (that should be read with sarcasm).

My issue with this in particular is the focus on the university setting. I agree with the author's thesis here that this risks creating an extremely slippery slope of censorship and something alluding to "thoughtcrime" in the exact setting whose entire purpose is, theoretically, to prevent those things. I also wonder at what point does the responsibility becomes that of the individual to adapt to society rather than that of society to adapt to what ultimately amounts to a relatively small proportion of the population.

I'd be curious to hear the perspective of those in practice that may have had the opportunity to interact with these patients and have more experience with respect to understanding how valid these "triggers" are and whether this is a reasonable response to them.

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[dl2dp2]

You are asking practicing psychiatrists to purvey an opinion that's more about what's appropriate to teach in a college classroom in an English class. While I can see why such extrapolations can occur in your mind, I don't think that psychiatrists are really trained to make valid inferences about such questions. The job of a psychiatrist is to be practicing the most up to date evidence based medicine for people with mental illnesses. Some psychiatrists historically have become cultural critics (i.e. Lacan, etc.) but I think it's a mistake to use their MD hat to legitimatize their political opinion.

Secondly, in terms of PTSD, the most effective psychotherapeutic treatment is CBT, i.e. exposure. Clearly, in that sense people need to be "triggered" more, not less in order for the symptoms to eventually go away. I don't really think that this fact is even relevant in this conversation though, because the author isn't talking about treating an individual with PTSD, but about a certain aspect of critique of contemporary culture and what is considered canonical in an English classroom. What psychiatry can provide is irrelevant for that question, and psychiatry should in theory not be affect by these kinds of trends. In practice, psychiatry is affected by public opinions, which are partly affect by college English curriculum, but the causal chain of events is so circuitous that we might as well not think about it for the time being.

 

[touchpause13]

Nick, I think trigger warnings are intesting. They've been used in blogs for as long as I can remember, but I'm not sure they translate well to college classrooms. However there were times in college that I wish a trigger warning would have been given- the book I'm thinking of opened with a rape scene that lasted a good 10 pages. Like would it have killed you to at least give a heads up? I couldn't finish the assignment and actually went and talked to the professor about it - we worked it out so it wouldn't have a major impact on my grade.

 

[softballtennis]

You are asking practicing psychiatrists to purvey an opinion that's more about what's appropriate to teach in a college classroom in an English class. While I can see why such extrapolations can occur in your mind, I don't think that psychiatrists are really trained to make valid inferences about such questions. The job of a psychiatrist is to be practicing the most up to date evidence based medicine for people with mental illnesses. Some psychiatrists historically have become cultural critics (i.e. Lacan, etc.) but I think it's a mistake to use their MD hat to legitimatize their political opinion.

Secondly, in terms of PTSD, the most effective psychotherapeutic treatment is CBT, i.e. exposure. Clearly, in that sense people need to be "triggered" more, not less in order for the symptoms to eventually go away. I don't really think that this fact is even relevant in this conversation though, because the author isn't talking about treating an individual with PTSD, but about a certain aspect of critique of contemporary culture and what is considered canonical in an English classroom. What psychiatry can provide is irrelevant for that question, and psychiatry should in theory not be affect by these kinds of trends. In practice, psychiatry is affected by public opinions, which are partly affect by college English curriculum, but the causal chain of events is so circuitous that we might as well not think about it for the time being.

I am not sure about what a psychiatrist would say on being empathetically correct , but part of being a psychiatrist you have to be sensitive to you patients needs. You have to figuire out what triggers your patients, you have to either confront the fear or stop saying that. I know some people who get triggered by people saying suicidal ideation or homicidal ideation. All the psychiatrists I have met use are you having thought to hurt yourself or others? There is a difference though between meeting patient needs and a whole group of college kids. I don't know if we could generalize college kids as a whole , it is more on a individual bases what triggers someone.

 

[NickNaylor]

You are asking practicing psychiatrists to purvey an opinion that's more about what's appropriate to teach in a college classroom in an English class. While I can see why such extrapolations can occur in your mind, I don't think that psychiatrists are really trained to make valid inferences about such questions. The job of a psychiatrist is to be practicing the most up to date evidence based medicine for people with mental illnesses. Some psychiatrists historically have become cultural critics (i.e. Lacan, etc.) but I think it's a mistake to use their MD hat to legitimatize their political opinion.

Secondly, in terms of PTSD, the most effective psychotherapeutic treatment is CBT, i.e. exposure. Clearly, in that sense people need to be "triggered" more, not less in order for the symptoms to eventually go away. I don't really think that this fact is even relevant in this conversation though, because the author isn't talking about treating an individual with PTSD, but about a certain aspect of critique of contemporary culture and what is considered canonical in an English classroom. What psychiatry can provide is irrelevant for that question, and psychiatry should in theory not be affect by these kinds of trends. In practice, psychiatry is affected by public opinions, which are partly affect by college English curriculum, but the causal chain of events is so circuitous that we might as well not think about it for the time being.

Of course - an MD does not a qualified cultural critic make. However, given that psychiatrists have worked with the patients around which this debate is formed, surely there is some sort of opinion to be offered. I think you're mistaking me offering up a topic for informal discussion with a tangential (at best) expertise on the topic with asking for some kind of APA-grade statement about this issue. Given that still tangential relation, however, I'm still curious as to your opinions irrespective of how ill-placed you or I may think they are.

 

[HealthHare]

I think using trigger warnings in the university setting is a fine idea as long as it doesn't limit access to reading provocative literature. There's a big difference between removing books from syllabi, and giving students ample information about the subject matter they are about to read.

One positive I can see from implementing these warnings is that they can promote dialogue and allow the people most sensitive to the subject matter to receive help. The article mentioned the one girl seeing a counselor after speaking to her professor about the difficult emotions that emerged from reading the book she was assigned. If trigger warnings can lead to more people receiving help for their internal conflicts, then their use should definitely be encouraged, just as long as they serve to supplement, rather than sterilize the material.

 

[shan564]

Of course - an MD does not a qualified cultural critic make. However, given that psychiatrists have worked with the patients around which this debate is formed, surely there is some sort of opinion to be offered. I think you're mistaking me offering up a topic for informal discussion with a tangential (at best) expertise on the topic with asking for some kind of APA-grade statement about this issue. Given that still tangential relation, however, I'm still curious as to your opinions irrespective of how ill-placed you or I may think they are.

The reason why it's hard for us to comment is because such a comment would require us to make a broad sweeping judgement about how patients with a particular diagnosis will respond to a particular stimulus. One of the challenges to being a good psychiatrist (or anywhere else in medicine) is being able to figure out what will be appropriate for any particular patient. Some people are ready to confront certain provocative literature, while others aren't. I think it's reasonable to have a warning for these sorts of things, and in an ideal educational environment, I think that a teacher should be able to work with a student to find a way around it on a case-by-case basis. But there's such a stigma on victims suffering from PTSD and other mental illnesses that it'll be hard to achieve that. I realize that I didn't offer a solution there, but that's because it's a complicated problem with many smart people who are already working on it extensively, and my armchair exposure is inadequate to come up with a superior option.

But that was my psychiatrist hat. From the perspective of an educator, I'd say that it's up to the professor to decide what a student must learn in order to satisfactorily claim that they are knowledgeable about a particular topic. If a student is unable to satisfy those requirements, then they haven't learned enough... regardless of the reason for that. Maybe they need more treatment for their mental illness before they're capable of learning enough, and as unfortunate as this is, it's part of the struggle that the student is faced with because of their bad luck.

We can comment better about issues if they're framed in the context of medical education rather than English literature or the like. If I were unable to do my Ob/gyn rotation because of some sort of PTSD trigger in the Ob/gyn setting (which seems completely imaginable), then I'm not yet ready to be a competent doctor. If I were unable to do my surgical rotation because I had a manic episode triggered by the long hours and inadequate sleep, the same would be true. Or if I were unable to tolerate epic ward rounds on IM because I have really bad plantar fasciitis. Or if I were unable to learn BLS/ACLS because of a physical disability. Or if I was unable to pass chemistry in undergrad because I was born with a low IQ.

Of course, those examples don't translate directly. And at the very least, I think that we live in a society where a school should be able to make accommodations for a student suffering from a medical or psychiatric illness in a manner that will work around the illness while providing minimal compromise to their educational experience.

 

[EEGNeurofeedback]

The reason why it's hard for us to comment is because such a comment would require us to make a broad sweeping judgement about how patients with a particular diagnosis will respond to a particular stimulus. One of the challenges to being a good psychiatrist (or anywhere else in medicine) is being able to figure out what will be appropriate for any particular patient. Some people are ready to confront certain provocative literature, while others aren't. I think it's reasonable to have a warning for these sorts of things, and in an ideal educational environment, I think that a teacher should be able to work with a student to find a way around it on a case-by-case basis. But there's such a stigma on victims suffering from PTSD and other mental illnesses that it'll be hard to achieve that. I realize that I didn't offer a solution there, but that's because it's a complicated problem with many smart people who are already working on it extensively, and my armchair exposure is inadequate to come up with a superior option.

But that was my psychiatrist hat. From the perspective of an educator, I'd say that it's up to the professor to decide what a student must learn in order to satisfactorily claim that they are knowledgeable about a particular topic. If a student is unable to satisfy those requirements, then they haven't learned enough... regardless of the reason for that. Maybe they need more treatment for their mental illness before they're capable of learning enough, and as unfortunate as this is, it's part of the struggle that the student is faced with because of their bad luck.

We can comment better about issues if they're framed in the context of medical education rather than English literature or the like. If I were unable to do my Ob/gyn rotation because of some sort of PTSD trigger in the Ob/gyn setting (which seems completely imaginable), then I'm not yet ready to be a competent doctor. If I were unable to do my surgical rotation because I had a manic episode triggered by the long hours and inadequate sleep, the same would be true. Or if I were unable to tolerate epic ward rounds on IM because I have really bad plantar fasciitis. Or if I were unable to learn BLS/ACLS because of a physical disability. Or if I was unable to pass chemistry in undergrad because I was born with a low IQ.

Of course, those examples don't translate directly. And at the very least, I think that we live in a society where a school should be able to make accommodations for a student suffering from a medical or psychiatric illness in a manner that will work around the illness while providing minimal compromise to their educational experience.

Yes, we should and we do so by law.

 

[deleted480308]

(non-physician non-teacher opinion)

I think the idea of trigger warnings for classwork as a "heads up" can be considerate and basically act like the parental content ratings for movies in theatres. Having a requirement from anyone but the professor to remove items from the syllabus in a college class is ridiculous to me. I'm just imagining someone getting a Lit. degree without reading Canterbury Tales, Great Gatsby, or Count of Monte Cristo...a refugee socialism/economic student not wanting to read about "blood diamonds"...or a christian/muslim humanities student not wanting to look at paintings or sculptures that aren't fully clothed

 

[touchpause13]

(non-physician non-teacher opinion)

I think the idea of trigger warnings for classwork as a "heads up" can be considerate and basically act like the parental content ratings for movies in theatres. Having a requirement from anyone but the professor to remove items from the syllabus in a college class is ridiculous to me. I'm just imagining someone getting a Lit. degree without reading Canterbury Tales, Great Gatsby, or Count of Monte Cristo...a refugee socialism/economic student not wanting to read about "blood diamonds"...or a christian/muslim humanities student not wanting to look at paintings or sculptures that aren't fully clothed

I don't think anyone wants things removed, that's not the purpose of a trigger warning. It's just a "hey btws there's a super graphic rape scene in this book"

If I was a prof I would ask at the beginning of the semester if anyone wanted trigger warnings for violence (rape, war, torture, what have you) I would give them to individuals. That way it would avoid people who don't want them from getting bitchy.

 

[deleted480308]

I don't think anyone wants things removed, that's not the purpose of a trigger warning. It's just a "hey btws there's a super graphic rape scene in this book"

If I was a prof I would ask at the beginning of the semester if anyone wanted trigger warnings for violence (rape, war, torture, what have you) I would give them to individuals. That way it would avoid people who don't want them from getting bitchy.

But some people are asking for individual students to have a "right" to skip materials without grade penalty.... http://dailynexus.com/2014-03-07/a-s-resolution-policy-aims-to-protect-students-from-ptsd-triggers/

I'm fine with that sort of thing if the professor doesn't find it consequential, but I have concerns with either entire campus policies or at some point legal requirements

 

[touchpause13]

But some people are asking for individual students to have a "right" to skip materials without grade penalty.... http://dailynexus.com/2014-03-07/a-s-resolution-policy-aims-to-protect-students-from-ptsd-triggers/

I'm fine with that sort of thing if the professor doesn't find it consequential, but I have concerns with either entire campus policies or at some point legal requirements

Hmm I was not aware of that. Thanks for correcting me.

I guess I'm kind of torn. I think in general, college campuses kinda suck at addressing mental health concerns and that they should be accommodating towards students who have these types of problems. However, it would be doing a disservice to the students' education to cut out chunks of the coursework. There is no way that a student should be able to skip out on reading a significant portion of book load, if they felt like they needed to they either A) should not have signed up for that class, because it's addressing a subject manner they can't handle or B) should not be enrolled in school at all, because they are having serious problems. But if we are just talking about a few assignments or courses, that shouldn't completely mess up a student's grade. For the class I had a problem in, I had some extra credit I was able to pull from and still got an A.

 

[smalltownpsych]

A good example from my own clinical practice regarding triggers. My patient returned from the war, friends pressured him into watching movie that was triggering, he got triggered, the MPs had to be called. Fortunately, they understood what my patient was dealing with and chastised his "friends" instead of arresting my client. We do need to have some understanding of trauma responses and educate people about that. Will lazy/unethical/cheating people use it as an excuse? Of course. People like that will use anything as an excuse. Makes it hard for the people who really are trying to cope with and heal from their trauma.

Also, to add to comment about exposure that was made previously. Of course, exposure to triggering stimuli is an essential part of treatment, but re-traumatizing will exacerbate symptoms so there is a fine line to walk for the optimal treatment.