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Trauma, Healing and Gaming Part 2: Triggers and Trigger Warnings

Liana Kerzner | 13 May 2015 15:00
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Trauma, Gaming and Healing Part 2: Triggers and Trigger Warnings

In part one of this series, I provided a general overview of PTSD and some gamers who have it, as well as a summary of some of the successes and challenges the video game community is facing in being inclusive to gamers with PTSD. Now I'd like to dig into the gaming community debate surrounding "trigger warnings". I'm going to stay away from the explosively controversial university campus trigger warning debate and focus on the issue of triggers and video games. The Escapist is a video game culture site. Hooray for staying on topic! Furthermore, the goal here is not to make a definitive judgement on trigger warnings. My goal is to weigh the pros and cons and offer some analysis and suggestions while attempting to remain objective. There are no easy answers here.

Trigger warnings sit at an intersection point between feminist activism and mental health accessibility principles. A "trigger" is a sensory input that triggers a flashback or anxiety attack in a person with PTSD. Decorated Iraq veteran Michael Stevens provides this example of a trigger episode.

battlefield 4 helicopter

"You'll be in a car on a long, empty stretch of highway, and suddenly there are no trees, no buildings, only desert for as far as you can see. You blink and you're back to reality."

Trigger warnings are a form of content advisory that gives readers or viewers advanced warning that a piece of media contains known common triggers. Some believe that trigger warnings serve to warn trauma survivors away from potentially triggering material, but according to pro-trigger warning advocate Philip Wythe, that's not accurate. "I think the warning lets gamers with these triggers 'plan' for experiences." They explain. (Wythe prefers a gender neutral pronoun.) "That is, instead of playing a game in public, I'll play at home. That way if I have an anxiety attack, well, I'm at home and a little more comfortable -- less likely to feel socially anxious about it."

Knowing what to label as a trigger can be difficult. It's most commonly done for depictions of sexual assault, but every website or other organization decides for themselves what to label. Conversely, combat-related PTS triggers like the sound of helicopters, gunfire, or fireworks are in numerous games, but they're rarely prefaced by warnings. "Under certain circumstances, the audio engine in Battlefield with a nice headset can get my blood pressure up a bit, but I enjoy it. It's not something I 'fear'." Explains decorated Iraq veteran with PTSD Michael Stevens. "A game like DayZ or H1Z1 with an ability to create tense confrontations between players can have a similar effect, but I revel in that stuff. I think a lot of veterans do. As far as the mere discussion of video games acting as a 'trigger', no, that's absurd."

Speaking about military experiences and reintegration issues can, however, lead to a displaced feeling. Mike, a Canadian Forces veteran, needed to recenter himself after I interviewed him. This involved having a "quiet" moment and listening to a specific very loud song. He apologized if he "appeared rude" - he didn't - but a short time later he was back to discussing the awesomeness of South Park: The Stick of Truth. People with PTSD who are receiving the proper treatment can manage their symptoms with a minimum of disruption.

Outlast Screen

I myself have been triggered by games, including the game Outlast. I love horror games, but I had to stop playing Outlast a few times because my heart was racing unpleasantly, my chest hurt, and I was having trouble breathing. These weren't normal responses for me, but since I had to review the game and didn't want to admit to the anxiety attacks, I pushed through by watching Let's Plays before navigating through levels myself. In doing so, I discovered PewDiePie. YOLO!

I ended up quite enjoying Outlast. Trigger episodes do not mean that companies should stop making scary or intense video games. Should there be greater sensitivity in marketing these games, however? That's a different question.

In a trade show setting, I thought Bethesda struck a good balance last year with their E3 demo stations for The Evil Within. The gameplay was extremely gory -- full of body horror, dismembered limbs, screaming, jump scares, and even a guy ripping open his own scalp. But in order to get into the room with those demo stations you had to sit through a presentation about the game, and this presentation was full of clear content warnings. If you didn't want to partake, you could skip it. I fell in love with the game - like I said, I love horror games -- but other people passed. That's the way things should work.

Some people, however, don't believe in making any such allowances for sensitive souls. Some of that is just a lack of empathy, but not all of it. In researching this article, I came across four primary reasons that conscientious people opposed trigger warnings.

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