Trigger warnings don't help PTSD, but they do a lot to raise people's expectations

The Guardian

15-02-2025

If your Valentine disappointed you this weekend, spare a thought for the protagonist of The Years, the explosive West End play based on the writings of the French novelist and Nobel laureate Annie Ernaux. A teenager is thrilled to discover she has attracted the temporary attention of an older man at summer camp. After he painfully takes her virginity, she gradually realises that he has told half the resort. She finds the word 'whore' scribbled across her bathroom mirror. Still she yearns for the validation of his returning desire.
The play takes as its subject the full range of life experiences contingent on embodied womanhood. Like the Ernaux memoir from which it draws its name, its heroine tells her story in the plural 'we' and speaks for a generation of war-born French women. To the frustration of its artists, however, one of those experiences has captured all the headlines.
In a sequence set in the early 1960s a student obtains an illegal abortion. Trigger warnings plaster the walls, website and email communications of the Harold Pinter theatre. These warnings have failed to prevent a nightly sequence in which patrons faint in the aisles, the play is halted and unconscious theatregoers are carried from their seats. The Years deserves to be recognised as a rare achievement: a hit drama that captures a lifetime of female experiences. Instead, to casual observers, it has become 'the abortion play'.
Last month, when I interviewed its director, Eline Arbo, she lifted the lid on something few British directors are prepared to admit: trigger warnings may be doing more harm than good. Arbo is Norwegian, trained in the Netherlands and now runs the landmark Internationaal Theater Amsterdam: The Years was created for a Dutch cast and widely toured in the Netherlands. The first run used no trigger warnings. In each successive transfer, warnings have increased, as have the fainting fits, which seem to border on mass hysteria. 'My experience is that there's more reactions than if you don't have these,' Arbo told me. Arriving at current performances of the show, the audience 'are so aware of it that it enhances the feeling of uncomfortableness'.
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A wealth of academic studies support Arbo's case. Twelve of these studies were drawn together in a 2023 comparative analysis led by Victoria Bridgland of Flinders University, which concluded that 'warnings reliably increased anticipatory affect'. In other words, 'viewing a trigger warning appears to increase anticipatory anxiety prior to viewing content', measured by rapidly rising heart rates and aggravated medical distress. Bridgland and her colleagues do not endorse the conservative argument that these prevent students from learning: they conclude that 'trigger warnings do not seem to impair or enhance the comprehension of educational material'. If anything, they seem to attract readers, viewers and audiences – even those with trauma histories. We actively choose the thrill of forbidden fruit.
My differing visits to The Years bear this out. Last August, the English-language production premiered at the Almeida theatre in London; on press night, there were some warnings but no gory rumours in advance, and no hysteria. The scene draws its impact both from the language of its storytelling – performed as a monologue by Romola Garai – and an eventual gush of blood emerging from between her legs. If you menstruate, there is nothing new here. Some men, it seems, have had very sheltered lives.
The scene is affective, particularly in the final moments in which Garai describes the heartbroken and secretive disposal of the foetus. This material is drawn from Ernaux's short autofiction work The Happening, here incorporated by Arbo into a broader narrative drawn from Ernaux's The Years. One of the elements made more explicit in The Happening than the play is that months pass while its protagonist is forced to hunt for a provider of illegal abortion. The criminalisation of the procedure thus exacerbates the medical and moral consequences.
Yet, when I returned to the play, now transferred to the West End and the subject of such discussion, protest and press coverage, you could cut the audience's anticipatory anxiety with a knife. The sequence takes time to reach its emotive moments: Garai's character talks us through her first suspicions of pregnancy before we get anywhere near the word 'abortion'. The man sitting in front of me, however, had tensed his shoulders to his ears the moment Garai walked on stage. When her character mentioned she had skipped a period, his breathing was already shallow and broken. Before we had reached the sight of blood, he had keeled over. Soon, he was being evacuated limp and inert from the auditorium, his companion shouting for an ambulance. He was not the only one.
Fortunately, he didn't need that ambulance: a paramedic is on site at all performances, and he made a quick recovery. The production team are clearly concerned to protect audiences, staff and their own liabilities: I've never seen a front of house team so smoothly trained and the full company have received support from the mental health charity Applause for Thought. One wonders, however, if that concern for liability has driven the ever-escalating cascade of warnings I received before entrusting my psyche to the care of Arbo and her artists. As Arbo told me, speaking perhaps more generally of theatreland, official warnings are 'the theatre's way of giving an excuse for itself'. You can't go to the loo at the Harold Pinter without being reminded of them.
The problem is that trigger warnings are now a sacred cow in the arts. Arbo is a visitor here, but it is career suicide for a progressive director in London to question their value. It doesn't help that conservatives use the question as a wedge issue on which to pour scorn on 'snowflakes' and mock any call for empathy. No one, least of all Arbo, wants to retrigger trauma in the theatre.
But amid all this language of concern, we have forgotten that PTSD is rarely triggered by exposure to content that mirrors factual elements of our memories. The person in my life who has PTDS from combat experience can watch war movies without issue. His PTSD – debilitating, medically diagnosed and not something I would wish on anyone – is triggered only by a very specific taste in the mouth, which no one theatre director could possibly predict or warn for. Science tells us that trauma is real: its triggers are as varied as human experience.
There is no consensus on whether men or women are more likely to faint in The Years. What is clear is that the play offers us a rare chance to see women's lives and bodies on stage, with honesty. It deserves to make the trip to Broadway, where the horror of backstreet abortion is a revived reality – although I wonder what Americans will make of its European honesty about masturbation. Its slew of trigger warnings may help some people. But they have also served to sensationalise and disrupt the mundane reality of the women's stories at its heart.
Kate Maltby writes about theatre, politics and culture