As UX writers, we are stewards of words, the gatekeepers to the digital world. We have the power to include or exclude, confuse or clarify, and represent or marginalize. I bet most of us have attended a workshop on accessibility and maybe even have a checklist we like to use for vetting our content.
Some of us go the extra mile: choosing disability-friendly fonts, verifying reading levels, and ensuring screen reader compatibility. But how often do we pause to consider whether our carefully crafted copy could unintentionally harm users with trauma?
Trauma has many definitions, but it is commonly understood as an emotional response to distressing events, often involving actual or perceived threats to safety. This can include direct threats to one’s life, such as physical assault, or threats to one’s sense of self and identity.
However, trauma is deeply personal, and individuals may react differently to similar experiences based on a variety of factors, including past experiences, resilience, and life stage.
This variability is, in part, due to how our nervous systems process and respond to perceived threats.
Trauma activates the autonomic nervous system (ANS), triggering the sympathetic (fight-or-flight) or parasympathetic (freeze or shutdown) responses. Typically, once a threat has passed, the parasympathetic nervous system helps the body return to a relaxed state.
However, in the early 1990s, Dr. Stephen Porges observed that some patients struggled to regain this state of calm. His research led to the discovery of a previously unrecognized third branch of the ANS: the ventral vagal complex.
His polyvagal theory explains how our nervous system adapts to danger, identifying three primary states:
The key takeaway? Appropriate social engagement at the right moment can help people avoid shutdown and remain engaged.
Image Credit: Alman, R. (2024). A Practical Guide to Trauma-Sensitive Research: Integrating Trauma-Informed Frameworks into the Qualitative Research Lifecycle. Routledge.
When we understand how trauma shapes the nervous system, we start to see its influence on user behavior, decision-making, and digital interactions. These survival-driven responses don’t just affect emotions—they shape how people navigate experiences, process information, and engage with our products.
According to the World Health Organization (WHO), approximately 70% of individuals worldwide will experience at least one traumatic event in their lifetime, with about 5.6% developing PTSD as a result. This equates to an estimated 3.9% of the global population having experienced PTSD at some point in their lives.
In the United States, the National Institute of Mental Health (NIMH) reports that approximately 3.6% of U.S. adults experienced PTSD in the past year, with a lifetime prevalence of 6.8%. Based on these statistics, we can infer that around 9 million Americans cope with active PTSD symptoms annually.
It’s also important to note that PTSD prevalence varies significantly based on geographic location, exposure to conflict, and economic hardship. Individuals living in war-affected regions or severe poverty may experience higher rates of trauma and PTSD yet have much lower access to identification and intervention.
The reality? A substantial portion of the global population has been or will be impacted by trauma. As a result, we must assume that on any given day, some of our users are bringing their lived experiences of trauma with them as they interact with our digital products.
Post-Traumatic Stress Disorder (PTSD) impacts the entire brain, altering both its structure and functionality. For those affected, PTSD can significantly influence how they interact with the world—both physically and digitally.
Image credit: NHS Lothian. (n.d.). VIDEO: How Does Trauma Affect the Brain? Wellbeing Lothian.
The chart below illustrates just a fraction of the neurological changes that can occur in individuals with PTSD. My goal in including it is to highlight why recovery isn’t as simple as “moving on” after a traumatic event or prolonged exposure to stress. PTSD fundamentally reshapes how the brain processes information, responds to stimuli, and engages with the world.
| Brain Region | Structural Changes | Functional Changes |
|---|---|---|
| Hippocampus | The chronic stress related to PTSD can cause this region of the brain to atrophy, leading to a decreased volume (size) and function. | The individual’s ability to form new memories and differentiate between past events and present experiences is impaired. |
| Prefrontal Cortex | In PTSD patients this region of the brain decreased in volume (size) becoming hypoactive. | The individual’s decision making, impulse control, and regulation of fear reactions is negatively altered. |
| Amygdala | In PTSD patients this region of the brain becomes hyperactive as the neurons undergo permanent changes to their excitability. | The individual experiences heightened fear and anxiety responses frequently leading to a constant state of hypervigilance. |
For UX professionals, these changes have critical implications. The cognitive and emotional shifts caused by PTSD influence how users navigate digital experiences, absorb content, and interact with designs.
We must educate ourselves on trauma’s effects and integrate trauma-sensitive practices into our research, design, and copy. Our users deserve experiences that acknowledge their realities, not ones that unintentionally retraumatize or exclude them.
In June 2021, something happened that changed my life forever. The details aren’t the point—sharing them risks activating someone or causing secondary trauma.
What matters is that in the weeks following the event, I struggled to stay present. My focus was fleeting, my patience was thin, and no matter how hard I tried, I couldn’t shake the feeling that I couldn’t trust anyone. These symptoms, along with others that were equally unsettling, persisted. They interfered with my ability to show up in life the way I wanted to, and eventually, I was diagnosed with PTSD.
Naively, I assumed that once I had a diagnosis, I would be set on a clear path toward healing. That was not the case. Instead, I was presented with a buffet of treatment options—if I felt the PTSD was impacting my life significantly enough. Or, I could simply go on with my life and hope the symptoms faded over time.
During those months, I immersed myself in reading, research, and treatment options. I was singularly focused on one goal: getting back to who I was before. But the further I traveled down that road, the more I came to understand that my brain had been chemically and structurally altered. Healing was possible, but returning to my old self was not.
Image credit: Yale University. (2017, July 17). New PTSD study identifies potential path for treatment. Yale News. https://news.yale.edu/2017/07/17/new-ptsd-study-identifies-potential-path-treatment
About the image: This imaging reveals increased mGluR5 receptor availability in PTSD patients, demonstrating a biochemical link to heightened sensitivity to stress and fear in trauma survivors.
Accepting this – and getting to know the new version of myself – was a process. I had to understand my new patterns of thinking, rebuild my attention span, and learn to trust again.
As time passed, I found myself relying more on certain digital products. I was constantly writing on Grammarly, joining challenges on Fitbit, unwinding with Calm, and ordering coffee through the Starbucks app. I used to enjoy chatting at the counter, but now that felt different. At the same time, I became acutely aware that some digital products I once loved now felt unbearable to use. The mere thought of them made me wince.
I became curious. Why was I more attached than ever to some digital products, while others felt so wrong?
The more I read about trauma, the more I understood. It was simple, really. The products I gravitated toward gave me a sense of connectedness, agency, safety, and self. They were helping me. Conversely, I had to acknowledge that the products I was avoiding were causing harm.
So, I’ve made this my mission. I want to start important conversations about how we, as content designers and UX professionals, can take meaningful action. We have a responsibility to protect our users, build frameworks that prioritize their well-being, and design experiences that don’t just avoid harm—but actively help.
Thankfully, we’re not starting from scratch. Trauma-informed practices have been recognized since the 1990s as a crucial therapeutic approach. By 1998, the Substance Abuse and Mental Health Services Administration (SAMHSA) began developing frameworks for trauma-informed care. In 2014, those efforts culminated in the six core principles of trauma-informed care, which continue to guide us today.
The table below provides a closer look at how organizations have interpreted and implemented these six principles in practice.
| Principle | Description | Real-world examples |
|---|---|---|
| Safety | Creating physical and emotional environments that do not retraumatize. | - Maintain consistent routines - Establish clear boundaries - Explain policies clearly - Use calming colors, comfortable furniture and adequate lighting |
| Trustworthiness and transparency | Building genuine, reliable relationships through clear communication and consistency. | - Apply policies uniformly to all clients - Give detailed info about treatment, expectations, and outcomes - Make policies, rules, and expectations available and understandable Involve clients in discussion about their treatment - Offer honest feedback on progress |
| Peer support | Encouraging connections with others who have experienced trauma. | - Facilitate peer-led groups - Provide training to help peers support each other healthily - Organize activities to foster connection Include individuals with lived experience in the treatment team |
| Collaboration and mutuality | Reducing power imbalances in support structures by ensuring shared decision-making. | - Involve clients in goal setting - Encourage a team-based approach with staff and clients - Build an environment where input and perspectives are valued - Allow clients to give feedback freely |
| Empowerment, voice, and choice | Prioritizing agency and self-determination in healing processes. | - Personalize plans for clients - Offer skill-building programs - Have systems to allow clients input on their treatment - Encourage clients to express their needs and preferences |
| Cultural, historical, and gender issues | Recognizing the unique impacts of systemic and historical trauma in service environments. | - Educate staff on diverse cultures and their impact treatment - Be respectful and responsive to different cultural and gender identities - Acknowledge and include understanding of historical traumas - Provide services specific to the needs of different gender identities - Offer materials and services in the preferred languages of clients |
As trauma-informed design gained widespread recognition, other industries began adapting these principles to improve interactions with customers, clients, and users—in short, human beings in need of and deserving help.
One field that recognized the importance of this work early on was architecture. By the early 2000s, organizations like the Center for Health Design were already exploring how these ideas could be applied to physical spaces. Much of the early effort focused on creating environments that support healing and avoid re-traumatization, particularly in healthcare and therapeutic settings.
Since then, the movement has continued to expand:
2015: The framework of Dignity-Infused Design emerged, focusing on supportive spaces for vulnerable populations, such as shelters, correctional facilities, and places of worship.
2017: The Trauma-Informed Design Society (TIDS) was founded, broadening the scope of trauma-informed design to schools, public buildings, and city planning.
2020: The COVID-19 pandemic intensified the mental health crisis in the U.S., increasing public awareness of the need for trauma-sensitive public spaces.
2025: These concepts have now evolved into mainstream design practices, shaping how we create environments that foster well-being and psychological safety.
The Trauma-Informed Design Society (TIDS) has outlined six key principles for creating trauma-sensitive spaces:
Before moving on to what this means for content design (getting there, I promise!), I want to take a moment to show how these principles translate into physical space. Understanding the evolution of these ideas can help us see how they can make their final leap into the digital realm.
| Principle | Description | Real-World Examples |
|---|---|---|
| Safety and trustworthiness | Spaces should foster a sense of security and predictability. | - Ample natural light - Clear wayfinding - Controlled acoustics - Consistent design elements - Private spaces to retreat to |
| Choice and control | Users should have autonomy over their environment. | - Flexible seating - Reconfigurable layout - Communal and secluded areas - Individual temperature/lighting controls - Accessible and discoverable instructions for space use |
| Collaboration and mutuality | Spaces should foster a sense of connection and encourage community engagement. | - Shared collaborative spaces - Multi-use community hubs - Non-transactional social spaces - Open and inclusive circles for seating - Shared green spaces and walking paths |
| Empowerment and voice | Spaces should support self-expression and personal growth. | - Maker spaces - Self-service options - Visible meeting areas - Learning and reflection spaces - Positive language on signage |
| Cultural sensitivity | Spaces should reflect and respect diverse backgrounds, ensuring inclusivity. | - Disability accessible - Sensory inclusive - Multilingual signage - Inclusive imagery - All-gender restrooms - Varied seating arrangements - Dedicated cultural gathering spaces |
| Flexibility and adaptability | Spaces should be modular to fit different needs and emotional states. | - Temporary pop up structures - Reconfigurable walls - Elevated structures for disaster resilience - Universally accessible recreation areas |
So, that’s my case for trauma-informed content design. In today’s digital-first world, the same people who rely on trauma-informed care in physical spaces are also using our products. They deserve to be met with the same thoughtfulness and care.
That’s why I believe content designers should take an oath: primum non nocere.
Translated, that means “first, do no harm” – a phrase many of us associate with the Hippocratic Oath that doctors take before they begin practicing medicine. (Fun fact: It’s actually not part of the original oath, but that’s a topic for another day.)
At first, this might sound a little extreme. But hear me out – because when you really think about it, we do have people’s lives in our hands. Even symbolically, taking this oath would remind us of our responsibility to serve our users with care.
Image credit: Midjourney by Megan Legawiec — “If content designers took the Hippocratic Oath.”
We need to rethink algorithms, redefine our goals, and let a genuine desire to meet people exactly where they are drive our work. This applies just as much to the words we write as it does to how we conduct research and everything in between.
At no point in our process should the bottom line or the urge to be clever cloud our judgment, especially when it comes to protecting other human beings.
And while this article focuses on the content we create, it’s worth noting that there are also guidelines for conducting trauma-sensitive research. These, too, are key to ensuring we build great products without harming the people along the way.
With all that said, we have to start somewhere.
| Principle | Description | Defining characteristics |
|---|---|---|
| Safety and predictability | Fostering a sense of security by eliminating aggressive language and unexpected disruptions while maintaining a consistent experience. | Consistent layouts: Maintain uniform design patterns across platforms to reduce cognitive load. Clear navigation: Ensure users can easily find information without unexpected detours. Content warnings: Provide alerts before presenting potentially distressing material. |
| Trust and transparency | Building user confidence through clear communication of policies, data usage, and expectations. | Plain language: Avoid jargon and use straightforward language. Accessible policies: Present terms of service and privacy policies in an easily understandable format. Feedback channels: Offer users avenues to ask questions or express concerns. |
| Choice and control | Empowering users by allowing them to customize their interactions and manage their preferences. | Personalization options: Enable users to adjust settings like notifications and content display. Opt-In features: Allow users to choose which communications they receive. Easy exits: Provide straightforward ways to leave or pause interactions. |
| Empowerment and agency | Supporting user autonomy and providing clear paths to rectify mistakes. | Undo options: Allow users to easily reverse actions. Non-punitive error messages: Use supportive language that guides users to correct issues without assigning blame. Resource availability: Provide access to help or tutorials for self-directed learning. |
| Collaboration and community | Providing safe, inclusive spaces and tools that foster user interaction. | Clear community standards: Establish guidelines for respectful interactions and ensure users understand expected behaviors and consequences. User reporting and safety controls: Allow users to flag harmful content or interactions and provide tools to manage their engagement, such as blocking or muting. Content that bridges digital and physical spaces: Create resources that help users navigate real-world interactions, like clear instructions for mobile ordering, appointment scheduling, or accessing in-person support discreetly. |
| Cultural and historical sensitivity | Ensuring content respects diverse identities and acknowledges varied experiences. | Inclusive imagery: Use visuals that represent a wide range of cultures and backgrounds. Localized content: Adapt language and examples to be relevant to different regions or communities. Avoid stereotypes: Avoid clichés or assumptions about any group. |
| Flexibility and adaptability | Designing content that accommodates various user needs and preferences. | Multiple formats: Offer content in text, audio, and video formats to cater to different learning styles. Adjustable settings: Allow users to modify font sizes, color schemes, or layouts to suit their comfort. Responsive design: Ensure content is accessible on various devices, from desktops to mobile phones. |
Trauma sensitizes the nervous system, making unexpected disruptions—such as jarring visuals or aggressive language (e.g., harsh commands, blame-based messaging, or fear-inducing warnings)—trigger a heightened fight-or-flight response. This can lead to stress and disengagement.
Consistent design, calming language, and predictable interactions help regulate the nervous system, fostering trust, enhancing well-being, and improving retention and engagement.
About the example content: Using gentle visuals, calming language, and clear, structured navigation helps prevent overwhelming or distressing interactions for users.
Trauma can make uncertainty and unclear communication feel overwhelming, leading to anxiety and disengagement. When users don’t know what to expect from policies, data usage, or system interactions, it can degrade their sense of control and safety.
Transparent communication, clear expectations, and ethical design help build trust, reduce cognitive load, and empower users to make informed decisions with confidence.
About the example content: Clear security alerts with specific details build trust and reduce user anxiety. Straightforward language and actionable information empower users to control their privacy and make informed decisions.
Trauma can make feelings of helplessness deeply distressing, leading to frustration or disengagement. When users can’t customize their experience, undo actions, or opt out of certain interactions, it can reinforce a sense of powerlessness.
Providing clear options, flexible settings, and intuitive controls empowers users to navigate digital spaces on their own terms, fostering a sense of security and agency.
About the example content: Giving users control over their experience builds a sense of safety and agency. Features like content filtering and blocking, quick exit, quiet mode, and adjustable notifications empower users to manage their environment, avoid distressing content, and navigate digital spaces with confidence.
Trauma can lead to social withdrawal and isolation, making in-person interactions challenging. Digital tools that offer structured, low-risk engagement opportunities can help trauma survivors connect without overwhelming anxiety.
Features like mobile ordering, contactless payments, and real-time updates reduce the unpredictability of face-to-face interactions, providing privacy, predictability, and a greater sense of control.
About the example content: Creating safe and collaborative digital spaces fosters trust, empowerment, and a sense of community. Features that allow users to control interactions, report issues anonymously, and manage visibility settings help trauma survivors engage on their own terms.
Trauma can make users feel powerless, but well-designed digital tools can restore a sense of control and confidence.
Features like clear undo options, customizable settings, and intuitive self-service tools allow users to engage without fear of making irreversible mistakes. Digital products can also help users build autonomy in the physical world—resources like guided workflows, decision-making support, and step-by-step navigation empower trauma survivors to take action with clarity and reassurance.
About the example content: Empowering users with clear, actionable choices reduces uncertainty and fosters a sense of control. Features like straightforward call-to-action buttons, real-time availability updates, and transparent next steps help users make informed decisions with confidence. By minimizing ambiguity and guiding users through their options, these designs support autonomy and reduce stress, especially in high-stakes or time-sensitive situations.
Trauma is often shaped by cultural and historical contexts, and digital experiences that overlook these factors can alienate or retraumatize users.
Thoughtful design acknowledges diverse lived experiences, avoids harmful stereotypes, and provides inclusive representation. Using language, imagery, and content that respect different identities and histories fosters trust, making digital spaces feel safer and more welcoming.
About the example content: A lack of representation in digital tools can reinforce systemic biases and make users feel invisible. Features like diverse emojis, inclusive imagery, and culturally aware content proactively prevent retraumatization and social exclusion. By acknowledging varied lived experiences and historical contexts, these designs foster belonging, respect, and psychological safety, ensuring all users feel seen and valued in digital spaces.
Trauma can affect cognitive processing, emotional regulation, and energy levels, making rigid digital experiences overwhelming or inaccessible.
Thoughtful design prioritizes user choice, adjustable settings, and multiple ways to engage, ensuring content meets diverse needs. Features like customizable notifications, alternative content formats, and progressive disclosure allow users to interact at their own pace, fostering a sense of control and reducing cognitive strain.
About the example content: Giving users control over autoplay, screen brightness, reminders, and content opt-outs helps reduce overwhelm and support well-being. These features foster agency, minimize stress, and create a safer, more inclusive experience—especially for trauma survivors.
Trauma-informed design is not about turning every digital space into a healing sanctuary – it’s about ensuring that no user is unnecessarily put in a position of distress. While people don’t visit YouTube, Airbnb, or Spotify expecting emotional support, they also shouldn’t encounter experiences that amplify stress or discomfort.
As content designers, we already prioritize accessibility and inclusion; trauma-informed design is a natural extension of that work. By considering how language, structure, and interactions impact users, we can create digital experiences that are not only functional but also supportive, empowering, and mindful of the diverse realities our users navigate every day. Trauma is a fact of life, and as UX professionals, it’s our responsibility to acknowledge its presence in the experiences we create.
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