If you don’t know someone has a phobia or trauma, that’s one thing. But once you do, the social calculus changes. A friend does not intentionally expose a friend to something that may reasonably be expected to cause emotional pain, regardless of the context.
For years, one of my best friends and I had a running joke. At some point, he asked me to end it because it bothered his wife deeply. Because it bothered her, it had started bothering him. I honored his request. I didn’t continue the joke, even when it was just the two of us hanging out.
This isn’t pop psychology, it’s basic human empathy.
And I’m definitely not talking about using gaming as therapy, especially by amateurs. I’m talking about avoiding pushing a friend’s buttons instead of messing with them in order to run a game. Why make a buddy squirm for fun?
Look, if people have a phobia or whatever, that is something that can be dealt with on a case by case basis, from group to group and handled by the person suffering from the phobia and their therapist. However it isn't as simple as person has phobia so you need to establish a list of things they can't be exposed to. And I think the growing issue is you are taking something that is very personal, very individual, varies a lot by people and by play group, and issuing guidelines or rules for how people should handle it at the table. I don't think there is one true way here. But I do think many of the assumptions here are making the issue worse not better. Again, like I said, we should be compassionate to our friends, but let people negotiate these kinds of social concerns in a way that they are comfortable doing and that fits their group and their needs. Not every group is going to be able to accommodate these kinds of requests (especially if it is something important in the game that is being avoided).
If a person is having such issues with trauma or phobias, that this leads to problems at the table, or leads them to have an episode of some kind: that is something for them to deal with with professional help. I had very severe trauma at one point and I realized I needed to take a break from gaming and also would occasionally have to excuse myself from the table. I am not talking about telling people to toughen up if they are going through a serious mental health crisis or anything like that. But I am saying we have moved so far in the direction of structuring play and the hobby around mental health concerns, I think it isn't healthy for any one who is involved.
And yes if a friend in my group is like 'hey I have this extreme phobia and it bothers me a lot if X comes up in play', I am not going to make them uncomfortable, and I am very likely going to help however I can, but I also don't think the best solution can be reduced to having the group automatically avoid whatever it is that might bother someone in all cases, nor is it the best solution to begin with the assumption that you have people in your group with such extreme phobias that the mention of an element will trigger them. Everyone is different. I have a fear of heights. No amount of people falling off cliffs in an RPG is going to bother me. No movie with mountain climbing will bother me. But scaling a fairly small wall, would be crippling. I have a friend who is afraid of spiders. He gets a little jittery if you start talking about them, but he can handle them in a game. If he sees them in a movie he has a much harder time. We have been gaming together and seeing movies together forever. There isn't a formal procedure for us to follow around his fear of spiders. I don't think you can issue a single path on that (he and I are friends and know how to negotiate this stuff naturally in conversation). And we also know how to playfully bust each others chops about it too, which is okay.
Simply ask if anyone has any issues they’d rather avoid being included in the game. You could even make the query private.
And that could happen while you’re in the planning stages.
Think of it like the warning signs you see in certain amusement parks. Besides asking about your height or weight for basic safety precautions, some do ask about other health conditions:
This is the increasing norm in the hobby I am talking about. People have been having conversations before play since forever, and how a conversation might play out, when it is appropriate, etc, that will vary from group to group. But making the default that we begin with an assumption like this and warn people of every potential concern is bad for the hobby to embrace as something everyone is supposed to do. One, it doesn't even work. Triggers are often not merely as 1-1 or concrete as people think. Two, physical dangers are very different concerns from mental health issues and I think equating the two is a growing problem in the culture and the hobby (and not saying mental health is not serious but it isn't the same as a person with blood pressure who might die due to something like riding a roller coaster). You aren't actually making things better for people with mental health issues, you are making them seem like weak, fragile people who can't deal with goblins coming up in a game (and the kinds of assumptions operating in these discussions, in the promotion of safety tools, heavily exaggerate and distort what it is like to suffer form mental illness or from trauma-------we are treating people with mental illness like they don't have agency).
The other major problem here is you are going from something that is genuinely reasonable (being concerned about peoples mental health) and kind of pathologizing it at the table, but baking it in as an assumption (i.e. you start play by asking people what they would like to avoid). Again this goes back to my point about priming. Now you are effectively making adventures and settings by committee. Which some people like, but some people really hate because it takes away things like surprise. But you are also encouraging people to give you things they don't want to see at the table (and it is pretty clear in these conversations that a lot of the people who weigh in aren't really taking about true crippling phobias or trauma but are in fact exaggerating----this whole conversation encourages people to exaggerate is part of the issue).
That isn't to say someone who is experiencing a mental health crisis should be ignored, dismissed or any of that. It is to say, you are not a therapist, game designers are not therapists, the gaming group is not a therapy group. Individual groups should deal with this stuff in ways that make sense to them, not in ways that are dictated to them by a person or game designer who doesn't know them, doesn't know their friends, and isn't even technically qualified to dispense mental health advice.
