Triggering Language in the Patient Experience

“Triggered” might just be the word of the year. It’s showing up in political discussions, on college campuses, in relation to gender equality, rape culture, military history, suicidal fears, domestic abuse, racial slurs, sexual abuse, and the list goes on. But triggers have another meaning in healthcare, and it’s relevant for those working in patient experience.

What are Triggers, Colloquially?

Generally speaking, there seem to be two concerns about triggers:

  1. People defending the right to free speech without worrying about who they might “trigger”
  2. People requesting a safe space where they will experience no “triggers”

These responses seem to assume that triggers are static things that people are impacted by, or that they make up. But a trigger isn’t always a word or phrase that defies political correctness. It’s not always a joke in poor taste, or something said to shock. For content strategists working in healthcare, triggers are associations that impact patients’ ability to care for themselves.

What are Triggers, in Healthcare?

In a 2016 Slate article, Katy Waldman explains what a trigger is, according to healthcare professionals:

“In psychological parlance, a trigger can be any stimulus that transports a PTSD sufferer back to the original scene of her trauma. It might be visual (a red baseball cap like the one an old abuser wore, a gait or facial expression) or aural (a whistle or slamming door). Some people are triggered by the smell of cigarette smoke or traces of a specific perfume. Others react to spoken or written language: words that switch on the brain’s stress circuits, bathing synapses in adrenaline and elevating heart rate and blood pressure.”

– Katy Waldman, “The Trapdoor of Trigger Words

She goes on to explain that for anyone who feels triggered by a term, that feeling isn’t necessarily a bad thing. In fact, people with PTSD spend time recognizing and processing triggers. However, without a mental health professional handy, a trigger can feel overwhelming and can cause significant pain and suffering.

Content Strategy for Patient Experience

During a recent conversation, a mental health professional told me she wished healthcare apps were more careful about how they spoke. “They can be very triggering,” she said. For a minute I glossed over the statement, but then I realized she wasn’t saying “triggering” to mean “makes them unhappy.” She meant triggering in the clinical sense: if we aren’t careful about how we phrase things, we can make healthcare apps unusable.

Imagine a diabetic who is predisposed to avoid taking medication begins using our app, which is designed to increase medication adherence. The language in the app gives her flashbacks to going into diabetic shock, and so she avoids using the application, negating any benefit.

These are the decisions we need to make. We need to care about our target audience, learn their needs, and understand their constraints – including their triggers.

How to Remove Triggers in Healthcare Writing

It’s not easy, but it’s doable.

User research. Talk to the target audience. Ask them about their fears, their loves, their concerns, and their interests. Find out the worst case scenarios, and the stress cases, as Sara Wachter Boettcher calls them.

Create a vocabulary. I’m likely preaching to the choir, but it’s absolutely necessary to write with a voice, and a considered vocabulary. It’s not enough to write in a “friendly” way. An app needs to have a purpose, and needs to have an appropriate personality through which to convey that purpose.

Test, test, test. Every interface requires testing – and so does the content. Try out three different ways of saying the same thing, and ask participants how they felt before and after the interaction. Encourage them to converse with the app, and see how they respond to the language being used.

We can’t stop clinical triggers. But when we work in healthcare patient experience our audiences deserve our best efforts to avoid them.

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