# Dr Emily - When Are You Triggered?

An episode of [The Imperfects](https://invisiblenetwork.ai/podcast/1476501557), 30 Jul 2023, 49 min.

Audio: https://enrichment.soundstack.com/4vjqq8/episode.flightcast.com/ewf51ctoy3tjxau5uw9o8lhj.mp3

The phrase, “That’s triggering” or “I’m triggered”, has become more and more common. And while people are triggered by an event, or a topic, or even a scene in a TV show, what does it truly mean to be ‘triggered’? And should we really be avoiding triggering topics, or should we be exposing ourselves to them? In this extremely helpful episode, Dr Emily goes deep on triggers. She explains to Hugh, Ryan and Josh what it means to actually be ‘triggered’, and how we often use the term incorrectly. She also talks about the use of Trigger Warnings in shows and podcasts, like the ones you often hear at the beginning of The Imperfects. There’s a HEAP more fascinating information in this one so get your notebooks out and listen up to the brilliant Dr Em! To watch Susan David's Ted Talk, follow this link: https://bit.ly/3YfosA1 To delve further into the research around trigger warnings, follow these links: https://bit.ly/3KCvObB, https://bit.ly/3Kh6uHH, https://bit.ly/3q9hBLW, https://bit.ly/3Qeuwaa, https://bit.ly/3rOVrz2, https://bit.ly/3rPrNcV The Imperfects is not a licensed mental health service and is not a substitute for professional mental health advice, treatment or assessment. The advice given in this episode is general in nature, but if you’re struggling, please see a healthcare professional, or call lifeline on 13 11 14. See omnystudio.com/listener for privacy information.

## Transcript

[0:00] My name's Hugh.
[0:01] I'm a co-host on The Imperfects.
[0:03] I'm the son of Sri Lankan and English immigrants, and I call Australia home.
[0:07] We at The Imperfects acknowledge the Wurundjeri people of the Kulin Nation as the traditional owners of the land on which this podcast is recorded, and we extend our respects to the elders past and present.
[0:18] I've spent much of the last decade travelling around this country sharing stories.
[0:21] In doing so, I acknowledge and pay homage to the Aboriginal and Torres Strait Islander peoples' rich history of storytelling.
[0:28] I also acknowledge that whenever I talk about or practice resilience, there is no greater example than the one set by the world's oldest living culture.
[0:36] The Imperfects is not a licensed mental health service and is not a substitute for professional mental health advice, treatment or assessment.
[0:44] The advice given in this episode is general in nature, but if you're struggling, please see a healthcare professional or call Lifeline on 13 11 14.
[0:52] Quick, is anyone here a doctor?
[0:54] Yes, her name is Dr. Emily and she's a psychologist.
[1:00] Please welcome to The Imperfects, our very own Psychologist!
[1:06] Dr. Emily, welcome back to the studio in person, not in Perth, not in Perth-en, but in person.
[1:14] In Perth-en.
[1:14] Have you ever said that before?
[1:16] No.
[1:17] That's a good one.
[1:18] That is real good.
[1:19] And from Perth, if people are confused.
[1:21] Excellent.
[1:22] Thanks for having me.
[1:22] How are you, Em?
[1:23] I'm very good.
[1:24] Yeah.
[1:24] Great.
[1:25] Great to be here.
[1:26] So nice this year that you are in, I mean, you have been before, but just so nice having you here.
[1:30] Oh, it's the loveliest.
[1:31] Remember the days when you were on Zoom?
[1:33] So far away.
[1:35] The first time we did it, it took us like half an hour to get the mics working and sound working and now you're just coming and talking.
[1:42] This is pretty good.
[1:43] That actually blew our dad's mind that you were in Perth for the first ones.
[1:48] He was, when we were recording last time, he was looking after my kids and I came home and explained that we'd done these and he couldn't believe you lived in Perth and that we were able to record over Zoom with high-quality mics and sync it up.
[2:00] It was a real... Yeah, the technology aspect.
[2:03] Yeah, the technology and the fact that he couldn't tell.
[2:06] Hopefully people can't tell on those earlier recordings.
[2:09] Yeah.
[2:10] which is also a testament to your brilliant performance.
[2:13] And also to jam.
[2:14] Yes.
[2:15] Editing skills.
[2:16] Yeah, that is true.
[2:17] Definitely.
[2:18] Yeah, with all the delays and things like that.
[2:21] Dad's handle on technology.
[2:23] Probably typical of a lot of dads, but I do remember the first – I remember going out to a restaurant with him, Tram Tram, the restaurant it was called.
[2:30] Tram Tram?
[2:31] Yeah.
[2:31] On a tram?
[2:32] Tram Tram.
[2:32] I remember Tram Tram.
[2:33] It was very close to the Bournemouth cinema.
[2:34] Bournemouth.
[2:35] Here we go.
[2:35] Black brain sauce.
[2:37] Beef and black bean sauce.
[2:39] That was my meal every single.
[2:40] Oh, God.
[2:40] That's such a you order.
[2:43] Yeah, what's it?
[2:43] Hawaiian pizza or beef and black bean sauce?
[2:45] It's the Hawaiian of Chinese food, isn't it?
[2:49] Or is it chicken and cashew?
[2:51] Yeah, that is.
[2:51] Yeah.
[2:52] With the pineapple.
[2:53] Is there one with pineapple in it?
[2:55] Maybe Sweet and sour pork That's the trifecta isn't it Beef and black bean I'm a bit too gourmet for that What's your favourite gourmet meal Hugh Ham and pineapple pizza But with basil on it Something you wouldn't be laughing at if we weren't
[3:24] That's wonderful.
[3:25] Dr. M. I have no segway from that.
[3:30] It's a shame.
[3:32] But what, you know, every month, obviously, you bring in something to talk about, maybe from like a past episode of ours that you expand on.
[3:39] But today, what are we talking about?
[3:42] So I actually didn't want to or I didn't feel like there was an appropriate episode to kind of tie back to today.
[3:49] But I wanted to talk kind of quite broadly about the notion of triggers.
[3:54] Like trigger warnings or triggers in general?
[3:57] So triggers and then kind of moving into a discussion about trigger warnings.
[4:01] Gotcha.
[4:01] Yep.
[4:02] Gotcha.
[4:02] Okay, wow.
[4:03] We do those at the top of a lot of episodes.
[4:06] Yeah.
[4:07] And we consult you in that process a lot.
[4:10] Yes.
[4:11] Obviously.
[4:11] Yeah, and I mean, I've got some personal opinions about it, which I might share a little bit later.
[4:15] But maybe before we get to trigger warnings, we might have a look at kind of first of all understanding very basically like, well, what is a trigger?
[4:21] I mean, maybe it makes sense, but thinking about us talking about this, I feel like I'm about to walk onto a minefield.
[4:32] Like it feels quite nerve wracking to talk about triggers because of the nature of triggers.
[4:37] Okay.
[4:38] Yeah, and so that's so interesting that you say that too, Ryan, because there is almost like an anticipatory anxiety that shows up even when we're exposed to a trigger warning.
[4:48] Ah, interesting.
[4:51] So at the start of a show, like one of our shows, for example, you hear a trigger warning.
[4:55] Well, yeah, so I will get to that because there is actually some specific research about the impact and benefit of a trigger warning.
[5:05] But the reason that we're looking at trigger warnings is because so often in these episodes in popular culture, we are surfacing uncomfortable, maybe at times distressing material.
[5:21] And so I wanted just to start off by understanding what does it mean to be triggered?
[5:27] And so I'm even kind of curious, you know, from your point of view, what's your sense of like, what does it mean to be triggered?
[5:34] Do you guys have a sense of that?
[5:35] I do because I remember in a...
[5:40] session with my psychologist talking about something that had happened.
[5:44] And I never considered to be that what had happened to me was that I'd been triggered.
[5:49] And she said, that is a classic example of being triggered, which unfortunately, I can't remember exactly what it was, but I remember that it was going about my normal day, feeling good, feeling like I can take on the world and then being confronted with something that took me back to a traumatic incident that had happened in the past.
[6:08] and then spiralling off the back of that stimulus and that it sort of caught me off guard and blindsided me that I didn't expect it.
[6:16] I didn't ask for it.
[6:17] And it kind of just hit me.
[6:18] And then suddenly I was ruminating in this previous traumatic way of thinking.
[6:25] Yeah.
[6:26] But I just can't remember what it was.
[6:27] It was about 10 years ago.
[6:28] So I can't remember what the thing was, but does that sound?
[6:30] Yeah, absolutely.
[6:32] The example that I think of, which is sort of like an example that you often see in films, is like a war veteran who's been at war and then they'll come back to their normal life where they go back home and they stop serving.
[6:49] Yeah.
[6:49] And then a plane might fly past and then that sort of triggers like a memory, like a traumatic memory from when they were, you know, fighting at war and there were planes and fighter jets and things like that.
[7:00] Is that, that's a different sort of trigger, I guess.
[7:02] Yes, but I think that is, that's a really important one that I want to talk about also.
[7:08] But also, Josh, I think your example is really great.
[7:11] and really exemplifies that experience of kind of this out of the blue kind of sense of being very taken aback.
[7:18] Yeah.
[7:19] And so if you kind of look at the very definition in some ways, it's like the activation of aversive emotional experience in response to an internal or an external stimuli.
[7:30] So can you say that again?
[7:31] Aversive.
[7:32] What's aversive?
[7:32] So unpleasant, uncomfortable experience, an emotional experience that is activated by the surfacing of memory networks
[7:45] that are either based on an internal activation, and I'll explain that in a second, or an external one.
[7:52] So an internal activation might be something like a racing heart.
[7:56] So you might suddenly become aware that your heart is beating fast and that might trigger a memory of a time when you were being attacked, for example.
[8:06] Oh, God.
[8:06] Yeah.
[8:07] So we get like our internal responses are also, I guess, a place of vulnerability to be triggered, if that makes sense.
[8:15] An external trigger is something that's in our external environment like the plane going overhead.
[8:21] It could be like people having a conversation.
[8:23] It could be the weather.
[8:24] It could be the time of year, smells, music, sound.
[8:28] Something you hear on a podcast.
[8:30] Yes, exactly.
[8:30] I guess it could be absolutely anything, couldn't it?
[8:32] Yeah, it can be.
[8:33] Yeah, yeah.
[8:34] But what I kind of want to differentiate is the difference between what is a trigger for someone that's experienced trauma and what we, you know, I think really often we just use the word so easily to say I was triggered.
[8:50] Oh, yeah.
[8:51] So is there a triggering of a traumatic experience for you or is the trigger that it's surfacing discomfort?
[9:00] Okay, gotcha.
[9:01] Discomfort that is new discomfort as opposed to bringing up past trauma.
[9:06] Or just like, is it like Penny's example when she hears people say, oh, I'm so OCD because I like having a tidy bathroom.
[9:13] No, you like having a tidy bathroom.
[9:16] OCD is this crippling mental illness.
[9:18] It's very different.
[9:19] In the same way that I'm triggered might be someone says, oh, we're going to do hill sprints today.
[9:25] Yes.
[9:25] And you go, oh, I'm triggered because that's such an unpleasant thing to do as opposed to like, you know, maybe someone was in a car crash when they're a kid and they hear a really loud smash and they're triggered by their memory of a car crash.
[9:38] Yes.
[9:39] Okay.
[9:39] Yep, 100%.
[9:40] Because I think really what has happened probably like –
[9:44] Probably over the last kind of five to ten years is that we've started to use this word trigger in a really – this is not intentional but kind of in a trivial way.
[9:53] So, we can say like, you know, I went down to the shops and there was no pie and I was triggered.
[10:01] You know, like I was triggered.
[10:02] Basically, what happens is there I experienced an unpleasant emotion.
[10:06] But it's sort of set as a joke.
[10:07] Yeah.
[10:08] Or, you know, maybe you're having a conversation and this is actually kind of even moving into more serious topics.
[10:13] You might be watching a movie and there's a breakup in the movie.
[10:17] And so that surfaces some memories of your breakup.
[10:22] And so in that sense, you know, you could say I got really triggered because I was watching this movie.
[10:25] Yeah, or I'm finding it's very triggering.
[10:27] Yeah.
[10:27] Yeah.
[10:28] And yes, it's triggering.
[10:29] So yes, it's activating some, you know, some difficult, unpleasant emotions, but
[10:36] But that, even that experience, is different from the activation of a trauma memory.
[10:43] And so what we're differentiating there is the difference between trauma and discomfort.
[10:49] Could a breakup be traumatic though?
[10:53] Yes, it can.
[10:54] Yep.
[10:55] Absolutely.
[10:55] And so if it is, then it's traumatic.
[10:56] Yeah.
[10:56] Is that what you're saying?
[10:57] I'm just trying to figure out.
[10:58] And I know that this is kind of difficult to disentangle in some ways.
[11:02] And I guess when I'm talking about trauma, I'm probably talking about PTSD.
[11:07] So, you know, if you were to meet criteria for post-traumatic stress disorder.
[11:12] And one of the hallmarks, for example, of PTSD is the experience of flashbacks.
[11:20] So if it's okay, I might explain that.
[11:22] Yeah, absolutely.
[11:23] Because I think this really relates to what I'm talking about in terms of a trigger.
[11:26] Yeah.
[11:27] So a flashback is different from remembering.
[11:31] I want to be really clear about this.
[11:34] It's different from remembering.
[11:36] It's defined as re-experiencing.
[11:38] Okay.
[11:40] So is the difference you choose to remember, you don't choose to flashback or no?
[11:46] Yeah.
[11:49] You don't choose to flashback and you may not choose to remember, but there's a difference in the neurobiological response of a remembering and a re-experiencing.
[11:58] Okay.
[11:59] Because what happens is when you, if you're in a traumatic event, let's just say it is using like a war veteran experience.
[12:11] In that time when you're experiencing threat, your limbic system, which is like the kind of reptilian part of your brain, which is really responsible for the fight or flight response, that is constantly being fired.
[12:25] And interestingly, what we know is that the way that the brain processes incoming information is from the bottom up.
[12:34] So at the bottom parts, if you imagine like an inverted triangle, the bottom parts are the most primitive, the primitive parts of the brain, the parts that are responsible for the fight or flight response in some ways.
[12:48] And then information then gets kind of filtered up to the more advanced evolutionary adaptive parts of the brain.
[12:55] So like the thinking part of the brain.
[12:57] So in the space of a traumatic event, what happens is that we get this incoming stimuli.
[13:02] It's processed at the bottom of the brain and it needs to stay there because you need to fight whatever it is that is kind of attacking you.
[13:10] Okay.
[13:11] Yeah.
[13:12] What happens though to memory in that part of the brain is very different to the processing of normal everyday life memory.
[13:21] Okay.
[13:22] Okay.
[13:23] So the limbic system does not have capacity to tell time, and this is really important.
[13:31] The limbic system, which is the part that processes that difficult traumatic event, cannot differentiate time, past or present or future.
[13:40] All it's focusing on is immediate threat.
[13:44] So if we take the war veteran, he comes home from war,
[13:49] He then walks down the street and here's a car backfire.
[13:53] The limbic system, bang, on.
[13:55] Cannot differentiate time and activates us into the re-experiencing of the trauma.
[14:02] So that's a flashback.
[14:04] We get full – and if you were to look at the functioning of the brain and the activity in the brain –
[14:10] we're getting high activation in the limbic system as though, like if you could map the brain in a flashback, it would be as though that person was actually in the moment of trauma.
[14:23] So it's not remembering and it's actually experiencing the trauma again.
[14:25] It's not remembering.
[14:25] It is re-experiencing.
[14:27] As if the danger is real now.
[14:29] Yeah.
[14:29] Yep.
[14:29] So the brain cannot differentiate.
[14:32] The limbic system cannot differentiate between what was then and what is now.
[14:36] Yep.
[14:37] And so for that person that is experiencing flashbacks, it's often, not always, but often it can be triggered by sensory information.
[14:47] So sound flashbacks.
[14:49] Odour and smell is a very big one.
[14:53] Music.
[14:54] And sometimes they can be very out of the blue kind of stimulus that will activate this.
[15:00] But what happens then for the person that's re-experiencing that is that they are literally in a fight or flight response, sometimes a freeze response or dissociation.
[15:10] And for that person, that's a very different experience to if you're triggered remembering a breakup, for example.
[15:18] Does that make sense?
[15:19] Yeah.
[15:20] Yep.
[15:20] Yep.
[15:20] Yep.
[15:20] Totally.
[15:21] Yep.
[15:21] Okay.
[15:22] It can make you really upset thinking about it, but that's not like that's been triggered.
[15:26] Yeah.
[15:26] Yeah.
[15:27] You're upset remembering it.
[15:28] Yes, exactly.
[15:29] And so, you know, if we think about, you know, for example, listening to content, listening
[15:34] and let's just say we're talking about a traumatic topic, then for people that have PTSD or have had really significant traumas in their life, that may genuinely trigger, for example, a re-experiencing of their own trauma.
[15:51] But not always.
[15:52] So we don't always know.
[15:54] So sometimes the discussion of a particular topic is not always going to trigger you.
[16:00] Sometimes it can be literal like a smell when you walk out the door and bang, I'm back there again.
[16:06] So again, that's really different from remembering something that is painful, remembering something that is hard, or remembering like a time when there was a struggle.
[16:19] and being upset by that.
[16:20] Yeah.
[16:20] Yeah.
[16:21] Yeah, that makes total sense.
[16:23] So you're probably working your way towards this, but by giving a trigger warning, you're almost heightening someone.
[16:30] So one of the factors that almost predicts the severity of a trauma response and also the likelihood of recovery is avoidance.
[16:42] So...
[16:43] What we know, what is kind of very clear in the research, in practice, in therapy, is that the more we avoid discomfort, the more we avoid the triggers, the bigger the problems.
[17:00] Oh, okay.
[17:01] So this is a really kind of key aspect when it comes to thinking about the utility of a trigger warning.
[17:07] And I do need to preface this by saying that there are absolutely times when this is going to be very important for you.
[17:15] you may very much need a trigger warning and you may need a trigger warning for a certain period of time.
[17:22] But my fear is, and this is certainly backed up by the research, that if we continue to avoid difficult topics, whether it's from a trauma response or whether it's from a painful experience, if we continue to avoid, our life becomes very limiting, very narrowing,
[17:43] And it suppresses our capacity for spontaneity, for enjoyment, for engagement in the world because our kind of primary goal is to avoid being triggered.
[17:56] Yeah.
[17:57] Yeah.
[17:58] Is it almost like getting triggered can release the pressure a little bit?
[18:02] Like it can be unpleasant, but it's almost like a bit of an exposure therapy in a way.
[18:08] Yeah.
[18:09] So if you do look at the treatment for trauma, part of it is around kind of systematic or gentle exposure to the trauma, to the trauma memories.
[18:20] And in fact, if we were to look at EMDR, you know, that process is about reprocessing the memories so that they can then be sorted appropriately almost.
[18:31] EMDR stands for?
[18:33] eye movement, desensitisation and reprocessing.
[18:36] Yep.
[18:36] Yep.
[18:38] And, you know, a lot of the approaches to trauma work, all of them involve exposure in some capacity to whether that's sensation, exposure to sensation in the body, whether it's exposure in disclosing the experience and,
[18:55] You know, whatever framework is being used, the goal is never avoidance.
[19:00] The goal is never around getting rid of, pushing away, forgetting.
[19:06] It's about integrating.
[19:08] It reminds me because Jam, she did EMDR for a period of time to try and deal with a specific traumatic thing in her past and,
[19:20] And when it was being explained to her how it works, exactly like you're saying, and this is now making so much more sense in understanding the difference between flashbacks and remembering, is that...
[19:34] The problem was is that when she would, and I'll check with her before we use this, but when she would think about this certain thing or time in her past or something would come up or she would hear something, she would, I guess, have these flashbacks and have this response, this sort of like fight or flight response like you're talking about.
[19:59] What EMDR does, and it did work for her with this specific thing, is she was told that like, you won't forget it.
[20:08] It's not like wiping memories.
[20:10] This is like turning, it's transforming a flashback into a memory.
[20:13] Yes.
[20:14] Yep.
[20:15] And so it's amazing.
[20:17] It was incredible because she could then think about this thing.
[20:21] and not be triggered by it.
[20:25] It's quite phenomenal.
[20:26] So even if we look at the experience of memory, if you remember a positive memory, usually what will happen is that you can remember the beginning, the middle and the end of that memory.
[20:39] So it's very chronological and it will be really ordered sequentially and kind of appropriately.
[20:46] Mm-hmm, mm-hmm.
[20:47] But you won't necessarily remember the kind of sensations that you're experiencing in that pleasant memory.
[20:55] I'm not sure if you can kind of think of anything off the top of your head.
[21:00] Yep.
[21:01] So you may not remember the sensations in the body necessarily.
[21:05] It won't hold as the same emotional valence or intensity that a negative memory will hold.
[21:11] Oh, sorry.
[21:12] Can you say that again?
[21:14] The pleasant memory does not hold the same intensity of emotion that in comparison to a negative memory.
[21:21] Gotcha.
[21:22] When it comes to trauma memory, what's really different about trauma is that, and this is part of the process of EMDR certainly, is that memory is often really fragmented, unordered,
[21:36] It might be really clear and vivid in parts and then really foggy and confused in other parts.
[21:42] And so, you know, that really highlights what's happening in the brain at that time of the experience of trauma is it interrupts or impairs our capacity for the brain to integrate and process memory appropriately.
[21:55] So it's like having a really messy filing cabinet.
[21:58] We can't, it's almost like, you know, something could fly in through the door and all of a sudden I'm activated.
[22:04] Like things have kind of been brought out of the filing cabinet and I had no idea that was going to happen.
[22:09] And this is, and I guess this is what makes the world very scary for a lot of people.
[22:13] Yeah.
[22:14] Because leaving the house, you kind of open yourself up to potential triggers.
[22:19] If certain, if there are certain things out in the street or worried about seeing certain people or whatever it might be, it's sort of, it feels safer to avoid it.
[22:29] Yes.
[22:29] But then obviously that's not the case.
[22:31] Yeah, and then we know that that avoidance then ultimately leads us to a whole host of really negative outcomes in the longer term.
[22:39] So, you know, when it comes to looking at, I guess, trauma memory and trigger warnings, the big question for me is,
[22:49] What's the utility of them if we know that avoidance doesn't actually help us?
[22:57] But how can we also equally support people that are experiencing or have experienced really traumatising and traumatic experiences?
[23:05] I imagine the big difference between being triggered and...
[23:14] something like EMDR or any kind of work with a psychologist is that you're going into revisiting that moment with incredible care and expertise and wisdom and guidance as opposed to doing it without a parachute by yourself.
[23:34] And I guess that would be the initial thought is like you want to avoid the jumping out without a parachute option.
[23:40] But, yeah, but it's...
[23:43] Yeah, it's really complicated, it seems, from the outside.
[23:49] Yeah.
[23:50] I mean, we do trigger warnings, obviously, to protect our listeners, to support our listeners, but it's also a bit about protecting us a little bit.
[23:59] Like, we don't want to get in trouble for upsetting someone.
[24:01] Like, this podcast exists for the opposite reason.
[24:03] We want to help people as much as possible.
[24:05] Yeah.
[24:05] And the thought of doing the opposite is so awful.
[24:09] So we had that extra thing in as a barrier to – because I will often get messages from people to say, just saying I was triggered by you didn't give me – and now just hearing what you're saying, what they actually meant was just saying something that you told me reminded me of a sad memory or a bad memory of my life.
[24:29] They weren't triggered.
[24:31] They were – it reminded – it made them feel a bit unpleasant.
[24:33] Yeah.
[24:34] And, yeah, so that's really interesting.
[24:38] But with the trigger, without wanting to jump too far ahead, but with the trigger warnings, though, I think what they do in lots of shows and things, they're all over the place now, which is, I don't know, I feel like it's a good thing because I feel like it gives the listener the choice because they can still choose.
[24:59] And I think from what you're saying, Em, I think,
[25:03] you're encouraging the person to still listen to the episode, even if the trigger warning applies to them.
[25:12] Because I think what, what if we don't have the trigger warning, then there's no choice.
[25:16] It's giving them the heads up for it to come out of nowhere and,
[25:19] That is scary.
[25:21] But if there's a trigger warning, then you can listen to it and go, okay, I'll brace myself for this thing, which could be triggering to me.
[25:30] But at least I know it's coming and I can choose to confront it as opposed to not having the option.
[25:37] Benim, is your concern that a lot of people will opt out and not expose themselves?
[25:41] Well, like, I mean, it's really interesting because the research actually – so what I might do actually is I'll start at the origins of the trigger warning to give us like a context for this.
[25:52] So trigger warnings started actually in internet chat rooms in like the – I think it was like –
[26:01] maybe even the late 90s.
[26:04] And the chat rooms were around discussions of sexual assault and there was primarily female discussion chat rooms.
[26:12] And so warnings were being posted about like, you know, this may cause some distress if you read it.
[26:18] But those warnings weren't instituted by or on the basis of any prior research or instituted by psychologists or medical professionals.
[26:28] So before that, there were no trigger warnings?
[26:30] No, no.
[26:31] That's amazing because I'm just thinking of like all the episodes of like Law and Order and whatever, you know, like back in the 90s.
[26:37] There would have been like viewer discretion is advised or like ratings obviously give us an indication as to what's appropriate and things like that.
[26:46] But the advent of the actual trigger warning was around kind of like the late 90s with the advent of like online chat rooms.
[26:54] Mm-hmm.
[26:55] And then colleges in the US got onto the important, you know, perhaps the importance of having trigger warnings for the content that was being presented in their university classes.
[27:08] And so like a lot of the professors and staff were advised that you need to let students know that this is what the content is that you'll be discussing and to give appropriate warnings to protect the students.
[27:21] And that kind of then from US colleges then branched out into, obviously, into like social media, into media, TV, podcasting, obviously, that we now kind of really have an effort to focus on advising people that there may be something that's uncomfortable or traumatic that will be about to be discussed.
[27:43] And it comes really from such a place, I think...
[27:46] or I hope, from care.
[27:48] And if we think about, you know, why we're doing this here, you know, in my mind this is like the sense of being able to hold really compassionately the listeners and to know and to signal to them that we care for you and we care that you're okay so this is why we have a trigger warning.
[28:06] And like from that point of view, you know, from a conscientious point of view that makes a lot of sense.
[28:12] But...
[28:13] From about 2018 and since 2018, there has been quite a significant amount of research that has come out that has actually said that they don't do anything.
[28:25] Trigger warnings don't.
[28:26] And or some more to that.
[28:29] So first of all, I think it was from around 2018, basically they kind of assessed the impact of a trigger warning and their research found that essentially it didn't do anything.
[28:41] It didn't...
[28:43] a trauma response or it didn't cause a trauma response, it just did nothing basically.
[28:47] So no difference between having a trigger warning or not.
[28:51] And then there was some further research that was conducted that actually showed that for some people, there were two outcomes.
[28:59] For some people it increased anticipatory anxiety.
[29:03] So that means that when you hear the trigger warning, it might actually bring about some anxiety about what I will then hear or what I will then be exposed to.
[29:13] but didn't actually necessarily result in a subsequent feeling of anxiety.
[29:18] Yeah.
[29:18] Okay.
[29:19] So it's just the anticipation.
[29:21] Is it more to do – because, yeah, trigger warning or no trigger warning for a podcast, for example, or anything, it probably makes so much more of a difference –
[29:33] the level of like care and compassion that the hosts or writers take in discussing it.
[29:39] So it's like, if you're just like, you know, cowboys talking about this really sensitive topic and having no care or compassion to who might be listening to it, that's obviously going to be hard to listen to as opposed to even without a trigger warning, if you approach it really sensitively.
[29:55] Yeah.
[29:56] I think that's really key.
[29:57] And I think...
[29:59] That's also why we don't just want to kind of slap on a trigger warning and then be not responsible for the care and concern of people in the actual discussion.
[30:07] Interesting.
[30:09] But if we kind of keep following that research, they also then found that-
[30:15] If this is kind of a concept which is specific to trauma and PTSD, but in giving a trigger warning, what it can sometimes do is reinforce the belief that trauma is central to my identity.
[30:34] And the belief that trauma is central to who I am or the traumatic experience is central to who I am predicts more severe PTSD.
[30:43] Wow.
[30:45] So I just feel like I need to kind of explain that again.
[30:48] Basically, in terms of like from a therapeutic point of view and a clinical approach, when we believe that the trauma is all our life, like it takes over all our life, that's the idea that it's central to my identity.
[31:01] Yeah.
[31:02] And so a trigger warning by saying like you're about to hear something that is traumatic, this particular research found that it reinforced the belief that trauma is central to my life or central to my sense of self.
[31:15] Yeah.
[31:16] and that that can then predict more severe PTSD.
[31:19] Why can it predict more?
[31:21] So it's not the trigger warning that predicts more, but it's the centrality of trauma to identity that predicts more severe PTSD.
[31:29] Gotcha.
[31:29] Gotcha.
[31:30] Yeah.
[31:30] Okay.
[31:31] So rather than trauma being on the periphery of your life, which is probably what we want to work to in terms of healing and processing of trauma, rather than it being on the periphery, it takes over my whole experience.
[31:44] So rather than it being something that happened to you, it is who you are.
[31:47] Yeah.
[31:48] Sort of.
[31:48] Yes, exactly.
[31:49] Yeah.
[31:50] Yeah.
[31:50] Gosh, that's so interesting.
[31:51] Yeah.
[31:52] Wow.
[31:52] And so then there's another piece of research which kind of, yeah, I find really interesting and that is that...
[32:01] They looked at the choices that people make when they hear a trigger warning.
[32:05] And so you would assume, and this is the basis for a trigger warning, is that if you're given a trigger warning, it does one of two things.
[32:12] Either it gives you an opportunity not to listen, not to watch, so then you opt out.
[32:17] So that's kind of the basis of a trigger warning.
[32:21] Or the intention would be that with a warning, we're given appropriate time to prepare ourselves for the exposure in some ways.
[32:31] So you'd say in 35 minutes we'll be discussing this, is that right?
[32:36] No, I guess what I'm saying is that the intention of a trigger warning is one of two things, either to get you to opt out of listening to it or to give you time to prepare.
[32:46] I took that very literally, not even literally, just wrong.
[32:50] I took that very wrong.
[32:51] Okay.
[32:51] So this research actually says that despite the trigger warning, people forge ahead anyway.
[32:59] So people actually aren't opting out.
[33:01] And of course there's going to be individual differences.
[33:04] I know that there are people out there that will make choices not to.
[33:07] But overwhelmingly.
[33:08] But generally speaking, yeah.
[33:11] People, and this is kind of almost that idea of like driving past a car crash, we have this natural curiosity to know, to see, to hear.
[33:22] So how often do people not look?
[33:26] So this research is really testing to the fact that despite the trigger warning, people forge ahead anyway.
[33:33] And to what degree?
[33:35] Because it sounds like the most important demographic for people...
[33:41] that a trigger warning should work is someone who does have PTSD.
[33:48] Is there any, and sorry to throw this question at you, but is there any breakdown in that research of the people who most need to avoid at a certain point in their life, so people with PTSD, that they push ahead anyway?
[34:02] Yes.
[34:03] Yeah, and I think that's a really tricky question.
[34:05] I don't know the breakdown specifically of that research.
[34:08] And again, I don't want to be suggesting that people go and listen to content that is very overwhelming for them.
[34:15] I think we want to be careful about that.
[34:16] Yeah, yeah.
[34:17] I was just interested to see if it was actually –
[34:22] if to take your point of like what we actually would in an ideal want them to do, whether it was having the same ill effect with people that were most importantly needing to avoid them rather than people who just don't want to experience unpleasant feelings.
[34:40] Yeah.
[34:40] Yeah.
[34:41] So I guess kind of breaking down there between –
[34:43] The people that might have quite significant PTSD versus the people that might be concerned about remembering an unpleasant event.
[34:50] Yeah, exactly.
[34:51] Yeah, yeah.
[34:51] I was just curious about that.
[34:52] Yeah.
[34:53] So I do know that that research was with people with PTSD.
[34:56] Oh, okay.
[34:57] Right.
[34:57] Okay.
[34:58] And they forged a hit anyway.
[34:59] Yep.
[34:59] Wow.
[35:00] That's fascinating.
[35:01] Yeah.
[35:01] So, I mean, this kind of brings into question, you know, quite a number of things.
[35:06] And for me, like in treating trauma, I think that there are really at different stages of trauma, there are really important times when we do take action to take really good care of ourselves.
[35:20] And like I know in particular in working with grief that, you know, particularly in the earlier stages of grief, that there might be some really wise decisions to make about not exposing yourself to certain situations.
[35:36] You know, for example, if, you know, if you've lost someone, you know,
[35:40] And let's just say, you know, you've lost a child and you worked at a school.
[35:45] So at that time, it would be very overwhelming and very distressing to continue to work at school because you're exposed to children all the time.
[35:52] Yeah.
[35:53] Yeah.
[35:54] Now, you know, of course, that would make so much sense and it would probably be a very appropriate and caring act to take yourself out of that environment.
[36:01] But where avoidance comes in is that if that then means that you can't go anywhere, you
[36:08] without being exposed to this huge pain and grief, then that's a really hard thing.
[36:16] And so we want to be able to work with the discomfort that, you know, over time obviously, not straight away, but to be able to work with the discomfort that does arise when we do get triggered.
[36:29] Yeah.
[36:30] Yeah.
[36:31] And that is, I mean, obviously something that we want to do, you know, in an ideal world therapeutically or with the support of, you know, someone around us.
[36:40] But I guess the kind of my message there for me is, you know, in the longer term, how helpful is the avoidance to the sense of vitality and richness and well-being in your life?
[36:52] If it was up to you, would you, like if someone said, Dr. Eamon, did you make a call, all podcasts, all TV shows, trigger warnings or not?
[37:02] From everything you've just said.
[37:03] This is asking him to cancel herself, I think.
[37:07] No, I'd definitely keep them in.
[37:09] I mean, this is the real difficulty is that, like I think –
[37:15] Yeah.
[37:15] Like I think that it comes from my point of view and from working with you guys and I know how much like we all care about the people that are listening, that the act of the trigger warning is an act of care and compassion.
[37:31] But my question is how, you know, like how much further do we go with that?
[37:37] Do we need a trigger warning for every possible moment of discomfort that can arise?
[37:42] Because it's really speaking to our general sense that we cannot tolerate discomfort.
[37:48] Yeah, I totally know what you mean.
[37:50] I feel like this conversation and people understanding the purpose of them, but then also the benefits of pushing forward.
[37:59] I think that that...
[38:02] It kind of means that if they hear this and they understand what you're saying, then yes, maybe in five years, ten years, we do end up with a trigger warning for absolutely every possible scenario, but it kind of doesn't matter because they don't actually do anything anyway.
[38:17] But if people understand how they should be approaching them and why it's beneficial, then that's what's important.
[38:27] Mm-hmm.
[38:27] And I feel like that really important thing you established at the start, the difference between PTSD and experiencing unpleasant memories is such a crucial thing for people to be aware of.
[38:44] This sounds like a strange digression, but it feels like in an ideal world, in a dream world, that it does not exist.
[38:51] Everyone would have a psychologist that they go to and you would be able to work through this stuff
[38:58] and be exposed to it and go through the processes you need to and trigger warnings wouldn't need to exist.
[39:06] And we're not there at the moment.
[39:08] So it's like it feels like a Band-Aid solution that isn't maybe the best solution but one that is doing a bit, maybe not doing anything, but it feels like a Band-Aid solution until we get to a place where people have more access to professionals to work through their trauma.
[39:24] Mm-hmm.
[39:25] Yeah, I wonder if we just need to rename them, to like rename it to like trigger invitation.
[39:32] There's a true invitation here.
[39:34] Come inside if you want to do a little bit of healing.
[39:37] I like that.
[39:39] Yeah.
[39:40] I assume there's incredible utility for people who aren't classically or technically triggered in the trauma response to, like I feel like experience for me personally, and this is a personal thing to me, but experiencing trauma,
[40:00] difficult emotions through art music discussion is something that helps me so much to grow as a person and to like how it feels like it's preparing me for when I'll have to deal with stuff in real life so to speak so I yeah I
[40:25] It would concern me if I started to avoid all that kind of stuff because I feel like I would lose tools to deal with it myself when difficult things come along.
[40:35] Yeah, like are we going to put trigger warnings on songs?
[40:38] Yeah.
[40:39] Songs have some really traumatic stuff in there because it's artists talking about their life.
[40:44] It really highlights to me, you know, again our...
[40:47] Sorry, I'll just look down the barrel of the camera after I said that, like I'd said something really good.
[40:51] And we'll go to a break.
[40:57] There is a really beautiful quote by Susan David, who's a psychologist.
[41:01] She has a great TED talk, actually.
[41:03] And her quote is that discomfort is the price of admission to a meaningful life.
[41:08] Oh, that's so good.
[41:09] Bingo.
[41:10] She should look down the barrel of the camera after that.
[41:13] And I think this to me, this really highlights this difference between trauma and discomfort because, you know, it's almost like let's go to the place of discomfort.
[41:24] If we can hold and stay with that discomfort, if that discomfort is on track to my valued direction, then that's actually okay.
[41:34] Yeah.
[41:36] And so, you know, we do want to be exposing ourselves to uncomfortable thoughts, feelings and sensations because that allows us to kind of achieve what it is that we want to achieve.
[41:49] So I guess, you know, in distinguishing, I think it's important to distinguish a traumatic re-experiencing flashback or dissociation or a panic attack that occurs in the context of significant grief or significant trauma.
[42:04] Yeah.
[42:05] versus is this actually activating uncomfortable memories for me or is this activating a difficult experience for me?
[42:14] Can I stay with that instead and work through that so I keep heading in the direction that I want to in my life?
[42:24] When we first had kids and we started going to the park a lot,
[42:29] When I was at the park with Benji and he was playing there, when big groups of boys turned up, I'd get incredibly anxious and I'd go and stand next to him and I would always try and take him away.
[42:39] In fact, quite a few times I did when there were boys being really rowdy.
[42:42] I'd just grab him and he would be confused.
[42:45] And I would also be confused.
[42:46] I didn't know why I was doing it, but I just kept taking him away, even if they were completely harmless.
[42:50] Yeah.
[42:51] And I told mum that and she said, when you were three years old, you used to insist on going, when we left the house, you'd wear a handbag because I did.
[42:59] So I'd take one of mum's old handbags and apparently used to walk around because they were so big I'd have one arm up in the air so they wouldn't fall off my shoulder.
[43:06] So probably walked everywhere with one of them in the air carrying a handbag around.
[43:09] Then we went to her friend's house, mum's friend's house one day, and we got there and there were a heap of boys playing out in the back.
[43:14] And I said to mum, I'm going to play with the boys still with my handbag on my shoulder and I'm up in the air.
[43:19] And mum said, well, how about you give me a handbag?
[43:21] And I said, no, I want to show them my handbag.
[43:22] And she said, I think maybe you just leave the handbag with me.
[43:24] And I just went, no, no, I'm going to show them.
[43:27] So I went out the back and apparently the story goes that they took it off me and beat the shit out of me with my own handbag.
[43:32] Yeah.
[43:33] I've never heard this before.
[43:34] Yeah.
[43:34] So apparently I have no memory of it.
[43:36] How old were you?
[43:37] Three.
[43:37] Yeah.
[43:38] Mum said I came in screaming and crying and apparently all the boys had had a go at hitting me with my own handbag.
[43:43] How old were the other boys?
[43:44] Five or six.
[43:45] Oh, God.
[43:46] Yeah.
[43:46] And so mum said, so that makes sense to me that you get incredibly anxious around five or six-year-old boys when your three-year-old son is at the park.
[43:54] Oh.
[43:54] And I was thinking, gosh, that's a different conversation because it sidetracks you, but I don't have a memory of it, but obviously it was there somewhere in my head.
[44:03] So I'd stored the, I don't know if trauma, maybe it was traumatic, I'm sure it probably was at age three.
[44:08] I'd stored the trauma somewhere and then I didn't have the...
[44:11] Anyway, that's a separate topic.
[44:12] What I wanted to say was to back up everything you've just said, you don't have a choice with three kids out of the six.
[44:20] You go to the park a lot.
[44:21] And so the more I went to the park, the more I exposed myself to lots of five and six-year-old boys being rowdy
[44:27] the more I became okay with it.
[44:29] The more and more I was just to the point where now I notice it but I don't have this instinct to go and protect my kids or make sure nothing bad is going to happen to them.
[44:38] I sort of sit there with it and that's because I've exposed myself to – it sounds a weird thing to say but I'm exposed.
[44:44] That's terrible.
[44:45] Don't finish that sentence.
[44:49] Wow.
[44:50] Trigger warning.
[44:59] Jeez.
[45:01] This was the final episode of The Imperfects.
[45:04] You spent the next five years in jail.
[45:06] No, I...
[45:09] I didn't expose myself to – no, how do I get out of this?
[45:14] To me, that was like the vision of like when a ball comes at you and you can see the ball coming right at your face.
[45:19] It's like, no, no, no, no, no.
[45:22] So just so the ball doesn't hit us all in the face, I would stay at the park and the more and more these boys were turning up, I didn't leave and I got used to it.
[45:32] And the more and more I got used to it,
[45:34] the more I didn't have this response of anxiety and I need to protect my kids because something bad's going to happen.
[45:39] Yeah.
[45:40] I can't believe that.
[45:41] Wow.
[45:41] Thank goodness.
[45:42] No, that is exactly it because the alternative would have been for you to stop going to the park and the question then is what's the cost of that?
[45:52] Yeah.
[45:55] So it might have kept you safe for a moment.
[45:57] So you might feel less anxiety or less discomfort, but there is a big cost of that.
[46:03] Yeah, a meaningful life.
[46:05] And Benji misses out on socialisation and a meaningful life.
[46:09] Huge flow effect.
[46:10] Yeah.
[46:11] And that might seem like a really simple, like it's quite a simple example, but you can see how this plays out.
[46:17] Sorry.
[46:20] It's just a terrible...
[46:23] Sorry.
[46:24] But when we started this app, I did not expect that to be the thing that cancelled us.
[46:27] Hey, not us, mate.
[46:31] Yeah, sorry.
[46:31] Em, you're full-time.
[46:37] Sorry, I'm sorry.
[46:37] I had a minute right then.
[46:39] No, I guess I just wanted to really, like, in terms of the things that the session is...
[46:45] Session, this is not a session.
[46:46] Session.
[46:48] Is really having a look at what's the cost of avoidance and in instances where we have capacity to stay with that discomfort in a supportive way, you know, how helpful is that and does that keep us on track to where we want to be going in our life?
[47:06] And sometimes, again, this is my fear, is that if we start putting trigger warnings on every moment where there is the possible experience of discomfort, it actually starts to rob us of a capacity to develop skills to tolerate distress.
[47:20] Mm-hmm.
[47:20] Right.
[47:21] I love it so much.
[47:22] Yeah, me too.
[47:23] So I want to be clear, I'm not advocating we need to drop trigger warnings and there'll be plenty of people that find them very helpful and necessary.
[47:30] I don't want to discount or minimise that.
[47:33] But just to really question like more broadly, how does avoidance show up for you in your life and is this actually helpful in the longer term to like where you want to be?
[47:44] It's so good.
[47:45] I love this episode.
[47:46] And the way you've tackled it.
[47:48] Because to me it feels like just being more aware of the history of them, their utility, what they're there for, and the research just makes it feel like empowering to me as an individual to choose to engage or not.
[48:05] It's just more information.
[48:07] And I think it's so well put about what is the end goal for your life.
[48:15] Brilliant.
[48:16] Dr. M, thank you so much once again.
[48:18] It's a pleasure.
[48:19] That was unreal.
[48:20] Can we have a round of applause sound effect?
[48:22] I think we need my Frames episodes.
[48:23] We do.
[48:25] Yeah, we do.
[48:25] There is somewhere in there.
[48:27] Just don't hit.
[48:28] Yeah.
[48:34] We shipped that crowd in quickly.
[48:36] Very, very apt.
[48:37] It'll fade it off very quickly as well.
[48:40] Dr. M, thank you so much.
[48:41] Thanks, guys.
[48:41] Great to see you.
[48:42] Thank you.
[48:42] Thanks, Sam.
[48:45] The Imperfects is hosted and produced by Hugh Van Kylenberg, Ryan Shelton and Josh Van Kylenberg.
[48:50] Our executive producer is Bridget North East.
[48:52] This episode was filmed by Andy Poole and edited by Jamison Moore.

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