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Major British news organisations such as the BBC and Reuters
are increasingly recognising the importance of providing support
and training for journalists and programme-makers who may be exposed
to trauma and traumatic stress in the course of their work.
The following notes have been pulled together on the basis of
a series of seminars on journalism and traumatic stress held recently
in London and in the US by the US and European branches of the
Dart centre for Journalism and Trauma.
They are not intended as a definitive guide to this very large
subject. However, we hope they will be helpful as a basic introduction
to some of the concepts - and why journalists should be aware
of them.
Dart Centre Europe is are interested in all feedback and ideas
on what else might be useful be provided in terms of written support
material. Please do contact us if you have any thoughts on what
else needs to be done or provided.
Trauma is part of the human condition, and has been documented
since early times.
Homer’s Iliad, the oldest text in Western literature, has
graphic accounts of the psychological trauma of war. Samuel Pepys
recorded his horror of the fire of London in his diaries. Trauma
experienced by World War One soldiers — understood at the
time as “shell shock” — has been well documented.
However, it’s only in recent years that the damaging effects
of trauma on the individual, both psychological and physiological,
have been properly understood.
Trauma is in fact much more prevalent than one might assume.
One generally accepted definition of trauma runs as …
“… any event that can be considered
outside an individual’s usual experience and which has the
potential to cause psychological harm.”
Post Traumatic Stress Disorder (PTSD) is a condition which can
set in after exposure to a traumatic event involving loss of life
or mortal danger, and formal diagnosis requires a particular cocktail
of debilitating symptoms that last for at least a month.
PTSD was formally defined by American psychiatrists after the
Vietnam war, to describe the experience of many army veterans.
But it’s not just conflict and war which can cause these
symptoms. Survivors of personal violence or car crashes, for example,
and victims of civilian disasters exhibit many of the same problems.
Journalists too will be affected by trauma work. Failure of self-care
is dangerous.
Trauma is a wound - different from a physical injury, but still
a piercing of the body’s defences. The word itself comes
from the Greek for wounding, and symptoms are the body’s
and psyche’s response to being wounded.
Wounds hurt and take time to heal. Journalists are no different
from other people in needing to let themselves feel the hurt,
to seek and accept help and to allow time and space for healing.
As defined in the principal textbook on Mental Disorders (DSM
IV), a event that can lead to post-traumatic disorders is one
which:
· involved actual or threatened death
or serious injury, or
· a threat to the physical integrity of
the individual or others
The individual will have experienced intense fear, helplessness
of horror — an aspect of trauma which is now known to have
significant implications for how that experience is stored in
the body’s and brain’s memory.
New research also suggests that PTSD-like symptoms can also take
hold after long exposure to other kinds of trauma, notably abuse,
whether physical, emotional or sexual.
It’s normal for people to experience distress after being
exposed to a shocking, highly stressful or harrowing event.
Most people recover reasonably well from traumatic experience.
But depending on their previous experience, their emotional coping
skills and the circumstances of the trauma itself, a significant
minority are at risk of their traumatic stress turning into a
disorder.
It’s also important for journalists to recognise —
although it’s not defined this way in DSM-IV - that traumatic
stress can accumulate over time, and that its impact on an individual
can be compounded by insensitive handling by editors and managers.
As with firefighters, soldiers or rescue workers, it is the journalist’s
profession at times to witness and experience traumatic suffering
and profound human distress. Such events might include the following
— not a comprehensive list …
· Armed Combat
· Natural disasters
· Plane/train/rail crashes
· Riots
· Detention and being held hostage
· Terrorist incidents
· Ordinary accidents (including especially
traffic accidents)
· Murder cases and trials
· Personal assault
Stories of trauma are the stuff of news — appealing probably
to those parts of humankind’s primitive brain which are
always on the lookout for danger.
But historically, journalism is perhaps the last profession to
take on board the need to understand the impact of trauma.
Journalists have inherited what might be called a macho culture,
with some of the following assumptions:
· We are not the story — so we
are not affected.
· We are trained to keep a distance
and only to report the facts, so are not touched.
· It’s weak/selfish/inappropriate
to feel emotions when the people we’re reporting have
suffered such pain and anguish.
· We’ll risk our careers if we
acknowledge any kind of weakness.
Journalists may want to believe they’re superhuman and
unaffected by trauma. However, current research shows —
not surprisingly — they are not.
Canadian psychiatrist Anthony Feinstein conducted a survey on
140 war correspondents, producers and camera operators, and found
that one in four had at some point experienced clinical symptoms
of PTSD.
These included social difficulties, depression, troubled relationships
(more than 50% of the group were single) and alcohol abuse. Many
also suffered flashbacks, nightmares, irritability, poor concentration
and hypervigilance.
Emergency services have introduced trauma training and support
their teams; police family liaison officers now have support networks,
and Britain’s Royal Marines have implemented what they call
a peer stress practitioner training in all their units.
In the United States, the Dart centre for Journalism and Trauma
(www.dartcentre.org) has done important work in recent years in
raising awareness of trauma among media organisations there, and
has much useful information on its website.
Dart are now sponsoring a sister operation in Europe (www.darteurope.org),
with support from the BBC and other media organisations. The BBC
is the first to implement formal trauma training programmes for
their journalistic staff.
Victims and survivors
People who’ve been exposed to trauma act in sometimes unexpected
ways — and it’s important for journalists to understand
what trauma can do to those whose stories they report.
Some victims and survivors become extremely talkative, desperate
to tell their story — something they may later regret when
they read it in the newspapers.
Others may appear to be coping stoically and well — and
journalists might be tempted to conclude that the community, or
family, or society, seems not to be affected.
However, remember that the wound of trauma can go very deep,
and parents who’ve lost a child in an earthquake or shooting,
for example, may function well for some time after the loss, but
fall apart when the media have moved on.
Some people who’ve experienced trauma shut down emotionally
- an important survival response which can be both frustrating
and confusing for reporters who want to know find out what happened
and how it’s affected people.
The key thing to remember when you’re working as a journalist
at the scene of conflict, of an accident or serious crime, is
that everyone who was there will at some level have been traumatised,
and that individual responses will differ.
Respect that, be aware of it, and use this constructively for
your journalism, and to tell the story fairly and well.
Trauma is central to the human condition — and even in
relatively stable Western societies, individuals can expect to
experience on average up to 20 traumatic events an average lifetime.
Understanding trauma, and how it impacts on individual and group
behaviour, is also therefore a key tool to explaining why conflict
happens — whether between nations, ethnic groups, communities,
families or individuals.
When trauma isn’t addressed within an individual, group
or society, it gets what’s termed acted out.
Look at Germany in the 1920s and 30s, when the unprocessed trauma
of defeat in World War One allowed the Nazi regime to manipulate
a whole nation to blame Jews for all their ills.
Look at the Middle East, where it might be argued that trauma
that reaches back much longer is being re-enacted daily in violence
between Israelis and Palestinians.
Look also at violence in local communities — where you
can make your own conclusions about how past trauma, individual
and collective, continues to impact on the present day.
At the moment, there’s very little coverage in most media
of the deeper pyschological drivers of conflict.
It’s hoped that these booklets and courses might provide
journalism with some new tools to understand and explain what
they’re reporting.
Stress in itself doesn’t need to be unhealthy. Indeed,
as humans we need an element of stress and pressure to function
at our best.
Adrenaline gets pumped into our systems, and we perform. But
when stress is overwhelming, the heavy, persistent and unprocessed
flows of adrenaline and other stress hormones can do deeper damage
to how we function.
Most people will experience distress after being involved in
or witnessing traumatic incidents. And it’s important to
bear in mind that most will find those symptoms getting better
after at most a few weeks.
However, sometimes, stress lays down longer-lasting damage, and
this can show itself as Post Traumatic Stress Disorder.
PTSD shows itself in three main clusters of symptoms:
1. Re-experiencing: The event is persistently relived as nightmares
and/or flashbacks (triggered by associated sights, sounds and
smells) as if it was the present. For instance, a car back firing
can have someone running for cover because they believe it to
be gunfire.
2. Avoidance/Numbing: A persistent avoidance of any situation
or stimuli reminiscent of the past trauma. There is also narrowing
and depletion of life: emotional numbing and detachment. Sometimes
the person is incapable of loving in the way they used to, or
he/she may be unable to maintain relationships.
3. Hyperarousal: Persistence symptoms of being on permanent
alert and in an agitated state — as if the threat could
return at any moment.
To qualify as PTSD, symptoms must have lasted for a least a month
and cause significant suffering or dysfunction.
If symptoms last up to three months, it’s classed as ACUTE
PTSD. If they last three months or more, then it’s a case
of CHRONIC PTSD. And symptoms might take a while to show - sometimes
several years. If more than six months have passed since the traumatic
experience, then the psychiatrists talk of DELAYED ONSET PTSD.
For example, one picture editor found herself presented suddenly,
and unexpectedly, with disturbing PTSD-like symptoms after working
with images of the September 11, 2001, attacks on New York. These
had earlier trauma from an assignment in Bosnia 10 years previously.
SYMPTOMS CAN INCLUDE:
· Sleeping difficulties/nightmares Flashbacks/nightmares
· Exhaustion Aggressive behaviour/resentment,
anger
· Startled response/ hypervigilance
· Inability to maintain relationships
· Anxiety/fear/depression Social withdrawal
· Feeling of numbness Substance abuse
(drink, drugs, etc)
· Grief Cynicism
· Shame/loss of self respect
· Loss of sense of meaning and hope
· Fear Physical symptoms, body pain, headaches
· Anxiety/panic/irrational fears Self
harming
· Tearfulness Feeling “scattered”
Anniversaries can be a particularly difficult time. Watch out
for irritability, anxiety, increased nightmares, withdrawal and
the like as the date nears.
PTSD needs to be taken seriously. More British Falkland veterans,
carrying the impact of their experience in 1982, have now committed
suicide that were killed in action during that campaign.
WHO’S AT RISK?
Trauma is now known to have a ripple effect. Those most at risk
of developing PTSD are of course those immediately affected -
either personally or as witnesses.
However, anyone who reports or works on traumatic stories or
deals with traumatic images and text, or with traumatised individuals
is at risk.
Some of the categories who might be affected include (and this
is not a definitive or conclusive list…):
Those who collect the stories:
· Correspondents
· Camerapeople
· Producers
· Fixers
· Stringers
· Translators
· Logistical support
· Technicians, sound recordists, engineers
· Managers, editors and bureau chiefs
Direct personal contact:
· Line managers, assignment editors,
Foreign Traffic
Those who process material:
· Picture editors, producers,
BBC Monitoring
And don’t forget those at home:
· Spouses/partners/children
HOW TO TELL IF SOMEONE IS IN TROUBLE?
The following is a list of ways individuals may respond emotionally
to a traumatic event, and which can indicate whether a person
is suffering from an acute stress reaction. Generally six “yes”
responses indicate the presence of acute stress.
1. Upsetting thoughts or memories about the event that have come
into your mind against your will
2. Upsetting dreams about the event
3. Acting or feeling as though the event were happening again
4. Feeling upset by reminders of the event
5. Bodily reactions (such as fast heartbeat, stomach churning,
sweatiness, dizziness) when reminded of the event
6. Difficulty falling or staying asleep
7. Irritability or outbursts of anger
8. Difficulty concentrating
9. Heightened awareness of potential dangers to yourself and
others
10. Being jumpy or being startled at something unexpected
THOSE WHO MIGHT NEED TO BE PARTICULARLY CAREFUL
The following points emerged from discussions at recent Dart
Europe seminars, identifying those about whom particular care
needs to be taken.
· Young hungry journalists who want to
make their mark. Danger through lack of experience in the field.
May take unnecessary risks that endanger others as well as themselves.
· Journalists who work alone. Many journalists
(especially print and freelancers) work alone. Technology is replacing
human contact, and isolation can reinforce the risk of PTSD.
· Camera operators. Cameramen and women
who work with their own material after they have shot their pictures
seem to be less at risk than those who pass their footage over
to others to work on, without the opportunity to process what
they have seen.
· Those who cannot get out. Local journalists,
stringers, fixers, translators who are unable to leave the area.
· Those who have lower levels of self
awareness. This of course presents challenges to colleagues, who
may see trouble brewing but find it difficult to get their message
heard.
· Those without close family support.
There are many who defy the rule, but journalists tend not to
be very good at maintaining long-term partnerships. And those
who do have long-term partners or spouses tend to be male. It’s
particularly hard for women. So for both sexes, friendships with
other journalists tend to be especially important.
· Those who dissociate at the time are
more likely to develop PTSD. Individuals who found themselves
experiencing the event as if in a dream, or somehow removed (watching
it unfold, for example, as if in slow motion) seem statistically
to be more at risk of post-traumatic symptoms.
· Journalists who become obsessive or
missionary about their work can have particular difficulties.
They can become pressure cookers that will blow at some point.
They can also run the risk of endangering their colleagues.
· Traumatic events can trigger old patterns
and also sometimes childhood traumas which have not been acknowledged.
This can lead to accumulative traumatic stress and/or PTSD.
SO WHAT CAN I DO?
The single most important thing, if you or a colleague has had
a traumatic experience, is to recognise that something out of
the ordinary has happened, and that you or they might find yourselves
having an emotionally difficult time.
Awareness is the key.
And the good news is that even if knowledge about trauma won’t
always stop you feeling lousy and/or confused, it’s now
understood that a combination of knowledge and talking is the
best known way of stopping the symptoms getting stuck.
Britain’s Royal Marines have a useful procedure for dealing
with teams and individuals who’ve been through a traumatic
time. Applying this properly requires some training, but it’s
not rocket science.
No-one should be forced to re-experience the trauma. Latest research
suggests that compulsory debriefing, the fashion in the 1990s,
is at best not very much use, and at worst can actually do more
harm than good.
Research has repeatedly stressed the importance of team support
and a prompt response in mitigating the impact of traumatic experience.
If you or colleagues have been exposed to trauma, you’ll
need in your teams and with your editors/managers to decide how
serious it was, whether further action is needed and who, if anyone,
may need special attention.
The key is to set this process in train VERY SOON after a traumatic
event. You’ll need to sit down together and formally decide,
ideally within 24 hours, whether further action is needed and
who appears to be most at risk.
A first discussion - and follow up in a month.
Colleagues need team support during and immediately after the
traumatic event. However, bear in mind that for the first hours
and couple of days, emotions and adrenaline are running very high.
After three days or so, time should be found for a more measured
stand-back discussion.
The aim is to identify what are known to be particular risk factors
for possible later development of PTSD, and capture where an individual
is at this point.
These two discussions should be structured - designed emphatically
NOT to dig deep into the individual’s feelings, but (gently
and carefully) to generate answers to such questions as:
· Does the person feel that that they
were out of control during the event, or that their life was threatened?
· Do they blame others for what happened,
or feel ashamed of their behaviour?
· Are they still experiencing acute stress?
· Do they have any history of psychological
problems, or previous experience of trauma?
· Do they have adequate social support,
at work and at home, and are they drinking excessively to cope
with the trauma?
If it’s clear at the second discussion that they’re
finding it difficult to work through the experience, then that’s
a signal that the individual should be encouraged to seek further
help.
Remember:
AT ALL TIMES it’s important to emphasise that emotional
reactions to traumatic stress, however distressing, are ABSOLUTELY
NORMAL - the system’s attempt to get healthy again after
being wounded.
Just as you put plaster on a broken leg and the bones time to
knit, psychological wounds also need tender care and support.
Still hurting weeks later is NOT a sign of weakness. Different
people cope in different ways with trauma, and struggling to come
to terms with things that have happened can take longer with some
than with others.
Understanding, listening and support of the right kind legitimise
the feelings of someone who’s experienced a traumatic event
or serious traumatic stress.
It’s important to help an individual see their experience
in context, and know that it’s OK to feel its effects and
to ask for and accept help.
Editors and Managers:
Line managers of journalists and their teams being put in harm’s
way need to be particularly aware of trauma and its impact.
Again and again, reporters, camera operators, producers and technicians
speak of the importance of the desk’s understanding and
support in allowing them to cope with the traumatic things they’re
experiencing.
If you’re a manager or editor dealing with a colleague
who’s going through a traumatic experience, remember that
how you respond can have an impact on them out of all proportion
to what you might expect.
Their emotional defences are in effect down, and especially now,
they need to be handled with respect and care.
Telling a correspondent or producer who’ve just come out
of a firefight that their report is rubbish is just not good people-handling.
The Longer Term:
Most people get over a traumatic experience. Life in due course
returns to normal, and the emotive power of the traumatic memory
gradually reduces. Healing happens by turning the trauma into
an autobiographical memory.
Writing out one’s experience can help the processing of
trauma — apart, that is, from the journalistic telling of
the story.
With time, the trauma is put into its proper context of ‘then’
no longer being ‘now’. The grip of subconscious triggers
is loosened, and the person can incorporate the traumatic event
into their life experience and even learn from it.
If you or colleagues have been through a traumatic experience,
these are some of the simple ideas suggested by counsellors:
Do:
· Keep life as normal as possible
· Talk about the incident and your feelings
· Try relaxation exercises
· Eat and exercise regularly
· Go back to the location of the incident,
where possible
· Go back to work
· Speak to a doctor
Don’t:
· Isolate yourself
· Bottle up your emotions
· Drink alcohol in excess
· Get overtired
· Miss meals
· Take holidays/breaks on your own
Colleagues can also support each other:
· Take time to let someone who’s
been through a bad time tell their story.
· Ask them open questions — and
don’t interrupt or come back with your own experiences.
· Don’t tell them you know how
they feel — you can’t.
· Don’t belittle their experience
or imply that they need to pull themselves together.
Journalists are a self selecting group, resilient and dedicated
to their mission. Trauma is part and parcel of the journalist’s
job - especially, but not only, at the front line.
ACTIVE LISTENING
Listen to each other. Take time to do so - and if you’ve
had a bad time, seek out someone who will give you that time.
BEARING WITNESS
Research now shows for example that those police who
arrive first at site of disasters are most at risk of developing
PTSD, because their job is to report back to headquarters rather
than actively help victims. This parallels the work of journalists.
Journalists bear witness to the worst human beings can do to
each other, and their feeling of helplessness compounds the traumatic
experience. One foreign correspondent said that once he started
stopping to help, he feared he wouldn’t be able to stop
stopping.
FINDING MEANING
Healing happens when people see their experiences in
the context of meaning which can be personal, professional or
both.
HOT SPOTS
Unresolved trauma from an individual’s own past
can create emotional ‘hot spots’. Be aware of the
type of story that triggers strong emotional reactions. For instance,
a journalist who has suffered childhood abuse may either be obsessive
about reporting on child abuse or do everything to avoid it.
JOURNALISTS ARE NOT SUPERHUMAN
Minimising traumatic situations and feelings that arise
is unhealthy. Everyone’s reaction to a traumatic event is
individual. Some cope comfortably. Others do not. It is important
that each individual can be acknowledged in his or her personal
experience.
KNOWING WHEN TO STOP AND SWITCH OFF
Britain’s Royal Marines have a phrase for a key
part of self care: ‘Three hots and a cot’. In other
words, eat well three times a day, and get enough sleep.
You need to make sure that as far as events will allow, especially
when you’re working in the field or with others who are,
that everyone has enough food and sleep as well as ‘down
time’. You may not feel like taking time out - to sleep,
rest, or eat. Force yourself - and your colleagues - to do so.
MANAGEMENT SUPPORT
Journalists will call their managers to say they are
concerned over a colleague, but will rarely call to say they have
a problem themselves. Managers are getting training in trauma
too, and the days are gone when admitting to its impact will be
seen as weakness.
MUTUAL SUPPORT
Following a traumatic event, especially in the field,
there can be a period where those involved may be irritable, bad
tempered and not so good at their job. Allow each other, and your
teams, space.
PEER MENTORING
Talk with those who have either shared the same experience,
or who have been through similar experiences.
RESOLUTION AND CLOSURE
Unresolved traumatic memories can keep working away in
the unconscious. Find ways to close the circle - by talking, by
making sense of it, by accepting that it happened.
Some journalists have found benefit from revisiting relevant
sites at a later date. This can helps to explain the sequence
of events which may not have been clear at the time.
STATING WHAT YOU NEED
After a traumatic event, individuals or teams may want
to stay together for an extra day or two to process together informally
what they have experienced.
If this is appropriate for you, it’s important to ask for
this time extension as part of finding resolution on the experience.
WORK OBSESSION
Families suffer when journalists are obsessed with their
work. One television journalist commented: ‘The intensity
of my job means that sometimes I literally forget I have a family.
The family is not really interesting, in fact nothing is really
interesting apart from the story I am doing’.
An editor who hit midlife crisis woke up to an uncomfortable
realisation: ‘ I completely missed out on my thirties, let
alone relationships, because of my fixation on work’.
Z. BE HONEST - TRAUMA IS EXCITING AND REWARDING:
While it’s important to know the damage that trauma
can do, it’s also a fact that journalistic success is often
measured in terms of covering trauma. Documentaries about violence
win awards and trauma often leads the news. The closer the journalist/cameraman
gets, the warmer the accolades. As in all things therefore, balance
is the key.
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