PTSD, access to role-playing games, and the Luxton technique by P.H. Lee

This post was originally posted on G+ by P.H. Lee on August 28, 2017. It was a significant influence on updates to the Script Change RPG toolbox, and is an essential read in regards to addressing safety in the game community and at every game table. Lee has authorized me to post the text here in full since G+ is dying, which I greatly appreciate – it’s super valuable!


I have PTSD. About 6-7 years ago, more or less, various pan-RPG techniques to control triggering[1] content — The Veil and the X-Card, to name two of a vast diversity — became commonplace in the RPG circles that I played in. Around the same time, I stopped participating in role-playing games at meet-ups and conventions, or anywhere else that these techniques were promulgated. These three things (PTSD, X-Card, and my withdrawal from play) are related. I’m writing this essay to discuss the ways that these techniques cut off my access to role-playing games, and introduce know techniques that, I hope, will point to a way forward in terms of accessibility.

Conflicting Access Needs
Before I go further, I’d like to reference a term from the disability rights movement: conflicting access needs. Disabled people are extremely diverse and our disabilities are also extremely diverse. While an ideal world would have everyone’s access needs met at all times and in all circumstances, in many circumstances, with many disabilities, that is practically or fundamentally impossible.

An example, which I’m paraphrasing from Autistic blogger Mel Baggs: A group home for Autistic people have some occupants who constantly verbalize, and others who are hypersensitive to noise. The verbalizers have a reasonable access need to be allowed to verbalize. The hypersensitive have a reasonable access need for quiet. Both of these access needs are reasonable, but it is impossible to meet both of them in the same space.

For this essay, the point is that, while I’m describing ways that my (and others) access to role-playing games has been cut off, I want to acknowledge that the techniques in question were developed and promulgated — often by people with similar disabilities to mine — to meet a legitimate access need. That they cut off my (and others) access to role-playing games does not mean that they are inherently wrong, bad, or ableist.

I do not want this to turn into “X-Card (or The Veil, etc, etc) is bad” and, even more so, I do not want it to turn into “the people who propagate these techniques are bad.” That’s not my opinion and, also, it’s wrong. I am hoping that by writing this essay I can move the discussion of accessibility of RPGs for PTSD sufferers from “use this technique” to a conversation which can account for different players, different goals, different communities, and different access needs.

A Note on Personal Narrative

I’m going to use a personal narrative throughout this essay, because it is based on my own experiences of both role-playing games and PTSD. But I want to be clear: I am not speaking solely for myself in this. Simply from personal circumstances, I can attest that the problems I have are problems that are shared by a number of other people with triggered mental illnesses.

Likewise, there are people with triggered mental illnesses who have a very different experience — most importantly, there are people with triggered mental illnesses who find the X-Card, The Veil, etc. to be vital techniques for their access to role-playing games. I do not want to erase these people — they exist, and their experiences also matter.

Please do not take my use of personal narrative as evidence that I speak only for myself. I don’t. Likewise, please don’t take my speaking on this topic as someone with PTSD to assume that I speak for all people with triggered mental illness. I don’t.

The X-Card, the Veil, and all that

The X-Card, the Veil, and similar techniques have their roots in a section of Sex and Sorcery, a supplement for Sorcerer by Ron Edwards, where he (roughly paraphrasing) suggests a technique dealing with difficult sexual content in the game by “drawing a veil over it,” basically, describing it in loose terms and then moving on with play, rather than playing it out. This is included together with several other techniques, including actually playing it out and fading to black. From there, like many things from the Sorcerer supplements, it developed on the Forge forums as a more generalized technique that could be applicable to all games.

I first encountered The Veil as a universally applicable technique in the context of public play in the Pacific Northwest — I believe it comes out of the Go Play NW convention, but I could be mistaken. By the time it reached this form, it had mutated considerably — it was something that was invoked by a particular player, rather than a general technique for play, and it generally had the effect of erasing the content of play [2], rather than playing it out in a vague sense and then moving on. It became a widespread meta-technique[3], adopted at a lot of public play events.

Simultaneously [4], in the New York City play scene, John Stavropoulos developed the X-Card as a meta-technique. With the X-Card, the system is formalized. By “throwing the X-Card” (either a physical card marked with an X or just an invocation), a player stops play, and the offending material is erased, and play continues as if it had never happened.

The X-Card grew in popularity and was adopted throughout the indie-games public play culture. By the time that I had largely retreated from public play (~2013), it was fairly universal. Although I have not been in touch with public play culture since, it does not seem (from my outsider perspective) to have become any less widespread.

My Experience

My first reaction to The Veil as a meta-technique was simply “well, I don’t want to do that.” At the time, it was not generally regarded as a universal meta-rule, so that was the end of my encounter with it. However, as it grew in popularity, I began to be increasingly averse to it. I remember a particular event — I think it was at Indie Hurricane, although I could not guess at the year — where it was introduced as a generic rule for all pick-up games. I got a horrified, sinking feeling, my eyes started to flutter and my stomach twisted — familiar signs of a triggering [1] event. I cannot remember whether I then said to my players “I’d like not to use that for our game” or not — I cannot even remember if I ran my planned game or left the scene immediately. Poor memory often accompanies being exposed to triggers.

I tried playing a few games with the rule in place, thinking I could maybe get used to it. Even though, to my recollection, it was never invoked, those games left me an anxious wreck afterward.

I stopped going to convention events as often. I started going to local public play groups, but shortly thereafter the meta-rule spread there as well, and I stopped attending those as well.

I did not at the time understand why this was triggering to me. I’m not entirely sure I was conscious that I was being triggered — it seems obvious in retrospect but I think that at the time I was not able to recognize exactly what was going on.

I made several attempts to communicate my distress — I remember talking on separate occasions with John Stavropoulos and Avery Alder about it — but because I didn’t understand what was going on, I could not clearly explain my problems, let alone propose solutions. Obviously, my attempts at communication were unsuccessful [5].

The Veil was replaced by the X-Card, and the technique continued to spread. I continued to retreat from Indie RPG circles, although I continued to play with personal groups and in non Indie RPG spaces such as AmberCon NW.

As an aside, I should say that this inaccessibility was far from the sole reason I retreated from Indie RPG circles and that, also, I do not regret having done so. My retreat has allowed me to spend more time on fiction writing, on personal friends, and on campaign play of RPGs. All of these have benefitted me both personally and professionally.

The problem

Both the X-Card and The Veil (as practiced in the PNW at that time) have as their core concept that the correct default way to handle triggering material in a role-playing game is to excise the material from the fictional timeline and thereafter to continue play. This is a commonplace understanding of how triggers work — remove the trigger, problem now solved.

This is, for me, a disaster, because it replicates the environment of denial and powerlessness that caused my PTSD in the first place.

Fundamentally, any approach to triggering material that contains any element of “pretend it never happened” is emotionally disastrous for me, because it recapitulates the environment of denial and dismissal around my traumatic experiences. This is not limited to excising the material from play — it also includes attempts to dismiss, deny, or minimize it.

No technique that centers this approach can possibly be functional as an accommodation; furthermore, any game or community that uses a technique that centers this approach is necessarily inaccessible to me, because an environment that centers denial as a coping strategy for triggering material, is in and of itself, a traumatic trigger.

Centering status quo vs centering healing

Fundamentally, these meta-techniques center the status quo — the goal is to “deal with” the triggering event, or the triggered person, and then return to regular play as if the interruption had never happened. I submit that, due the nature of PTSD, this approach is fundamentally flawed.

Once I have been triggered, I am in a traumatic experience. No amount of care or concern or comfort or accommodation can untrigger me. The question is not “how do we return Lee to the status quo?” or “how can we stop Lee from having a traumatic experience?” because those goals are impossible. The question is “what kind of traumatic experience is Lee going to have?” It can either be a damaging experience — one that reinforces the trigger and my PTSD — or it can be a healing experience — one that lets me recontextualize the trigger and its part of the trauma into my normal psyche.

Denial and social pressure to “return to normal” are damaging experiences.

Acknowledgement, empowerment, and story-building are healing experiences.

I believe that, in principle, good techniques for dealing with PTSD in role-playing games will avoid damaging experiences and center healing experiences.

The Luxton Technique

I didn’t post about my problems with X-Card, The Veil, etc for a long time because, among other factors, I did not have a proposed solution or alternative technique. All I could do was say “I’d rather have nothing than this,” but “no technique” is not particularly good rallying cry and it was not really a meaningful solution, just an attempt to get back to the somewhat-more-accessible-but-not-great status quo.

Until last year, I truly believed that there was no technique that would improve access to RPGs for some PTSD sufferers without also excluding PTSD sufferers like myself. But, last year, I played in a role-playing game at AmberCon NW that was specifically focused on traumatic experience and, particularly, centering the trauma of the players in the story we made. In that game, we used a particular technique — which I’d like to call the Luxton Technique after the GM of the game — which I found to be empowering, healing, and accessible to me.

It’s difficult for me to summarize all the parts of this that worked, but, roughly, the Luxton Technique includes:

* An honest discussion of potential traumatic triggers prior to play, in a supportive environment, with the understanding that there is no possible way to identify or discuss every conceivable trigger or trauma, and with no social pressure to disclose particulars of individual trauma.

* When, in play, a player encounters triggering material, they can, if they choose, talk about that to the other players. When they do this, the other players listen.

* As part of talking about it — and possibly the only thing that they need say — the player is given absolute fiat power over that material, expressed as a want or a need. For instance “I’d like to play [character name] for this scene” or “I need this to have a happy ending” or “I want this character to not be hurt right now” or “I need this character to not get away with this” or “By the end of play, this should not be a secret” or “I need to stop play and get a drink of water” or “I don’t have a specific request, I just wanted you to know.”

* A player does not need to use their traumatic experience to justify any requests or demands. We just do it.

* A player does not need to be the one to speak first. We keep an eye on each other and we are watchful for people who seem withdrawn or unfocused or upset. If we are worried about someone, we ask.

* We play towards accommodating that player’s requests.

It’s hard to overstate how much the Luxton Technique (or, really, set of techniques) helped us approach extremely difficult, extremely person material, both for the trauma survivors at the table and for the non-survivors. Rather than having our traumatic experiences — already a disjoint with reality — cause a disjoint in play, we were able to integrate them into play and tell a story about or, at least, at an angle to, our traumatic experiences, real and pretend.

Healing and RPGs

I am well aware that it sounds both pretentious and terrifying to talk about RPG play as a process by which one might legitimately heal from trauma. But I’d like to elaborate on that a little, because I think it’s important.

Fundamentally, a traumatic experience is an experience that is at a disjoint with the narrative of one’s life. Having PTSD means that your trauma exists out of time, out of place, and always in the present tense. A big part of recovering from PTSD, inasmuch as it is possible, is not about excising the trauma or your continued experience of it. Rather, it’s about integrating the trauma into normal memory and a normal narrative of your life.

A big part of that is story-telling, because a story is about incorporating disparate elements into a coherent narrative. And, for me, a big part of that story-telling has been role-playing games. In this essay, I present the choice as a binary — either a game can harm, or it can heal. That’s a lot of pressure to put on something as casual as a role-playing game! But, also, story-telling helps, and the story itself doesn’t need to be traumatic. Any story-telling experience can contribute, constructively, to healing, because PTSD sufferers need to be able to tell our own stories to the world and, more importantly, to ourselves. As an accessible storytelling medium, RPGs can’t be beat. They have been, and continue to be, a great help to me. In introducing these techniques, I am hoping that they can continue to be a help to others as well.

This is not limited to “heavy intense” sorts of stories that directly reference trauma. Ordinary RPGs can be stories about friends sticking together, or triumphing over evil, or just being clever and solving traps and puzzles, all of which have the potential to be healing narratives. Don’t think that I’m limiting the healing potential of RPGs to “serious” games or “serious” stories. I’m not.

It’s a reasonable reaction to say “I don’t want to do anything that heavy in my RPG!” or “I can’t be responsible for this!” And, obviously, don’t play in circumstances that you’re uncomfortable. But RPGs, and the people I’ve played them with, have given me so much healing. It’s wrong for me to dismiss, deny, or belittle that simply because games are a recreational activity. I hope that, in looking at problems of accessibility of RPGs, we can look to their potential to heal as much, if not more, than their potential to harm.

My hope (edited addition)

My hope is that this essay will start / continue a conversation where we look critically at our tools and techniques for RPG play. I hope that we can get to a place, as a community, where we understand that they are not one-size-fits-all and that we are able to take a look at what that means in terms of accessibility. I’d like for us to be able to make better-informed choices about accessibility and our RPG play, and the trade-offs that entails.

[1] Because I have no alternative vocabulary, I’m going to use “triggering” in this essay to describe images, words, or ideas that trigger traumatic flashbacks, panic attacks, or other PTSD symptoms. I’m aware of the popular usage of “triggering” as a derisive term for an emotional reaction. I am not using it in that respect. Please, also, refrain from doing so in responses. Thanks.

[2] I’m not sure exactly when the pivot from “veil as not playing out blow-by-blow” to “veil as erasing the content from play” occurred. It might have been after this.

[3] I use the term “meta-technique” to mean “a role-playing game rule intended to be used with any game.” In some cases, it is “a role-playing game rule intended to be used with every game.”

[4] I am not sure about the historical relationship between the X-Card and the Veil. It’s possible that there was some inspiration. It’s also possible it was a parallel development.

[5] I do not want to cast any aspersions on John or Avery for our failure to communicate. Both of them listened as well as they could have to my concerns, even though I was unable to communicate them clearly. The failure was definitely on my end, and I want to thank both of them for their patience in waiting this long to hear my thoughts more clearly expressed.