This summer saw some of the most brutal news stories of recent years.
The Syrian Civil War, the rise of Islamic State in Iraq, conflict in Gaza, civil unrest in Ukraine, the crash of Malaysian Airlines flight MH17 and the beheading of hostages by Islamic State militants all flooded newsrooms around the world with gruesome images of death and despair.
Filtering such images is a vital part of the news process, picture desks have forever been responsible for deciding what pictures or videos are fit for public consumption, and the issue of vicarious trauma among journalists has been the subject of recent debate.
But what constitutes 'trauma'?
"Trauma is a violation of the social contract," explains Bruce Shapiro, executive director of Columbia Journalism School's Dart Center for Journalists and Trauma.
"The images we see from Gaza aren't supposed to happen. The images we saw from Hurricane Katrina... are not supposed to happen. Children at Sandy Hook elementary school murdered by a young man with guns, it's not supposed to happen and it violates our sense of what's right."
Dr Anthony Feinstein, professor of psychiatry at the University of Toronto and associate scientist at the city's Sunnybrook Health Sciences Center, has spent the last 14 years investigating how journalists' work may affect their mental health.The overwhelming majority of journalists who do this work are psychologically okDr Anthony Feinstein, University of Toronto
In August, he published his first study into the issue of user-generated content (UGC) and vicarious trauma.
Three international news organisations provided Feinstein with the names and email addresses of 144 journalists working with UGC, of which 116 took part in the study.
They were asked about their work and rated the effects on scientifically robust scales of mental health.
"The overwhelming majority of journalists who do this work are psychologically ok," Feinstein told Journalism.co.uk.
"However there's always going to be a minority of journalists who, in response to this kind of work, may find it distressing."
Although journalists are likely to be affected by the nature of such images – they are human beings after all – these short-term effects rarely become long-term psychological problems.
The frequency of exposure to graphic images – how regularly a journalist works with them – was the stand out factor in contributing to emotional distress from Feinstein's study, but he said the "bigger issue" is of support and not allowing any initial shock or emotional distress to become deep-seated.
Throughout late August and September, Journalism.co.uk invited journalists to share their thoughts and experiences on working with traumatic UGC, and how news organisations or the industry on the whole should address the issue, in an online survey.
The survey asked respondents for their sex, age, years spent as a journalist, whether their workplace offered any support or positive reinforcement, the frequency and duration of time spent viewing graphic UGC, how it made them feel and what action they had taken.
Of the 62 journalists who finished the survey, 47 said they felt they had been affected in some way.
The most common effects were anxiety (20 per cent of respondents), sleeplessness (15 per cent) and irritability (12 per cent), although 28 per cent of respondents reported no or minimal effects from viewing graphic images.
The precise nature of the impact was not measured in the same scientific manner as Feinstein's study, and respondents were selected in a different manner, but it is clearly an important issue for news organisations in the 21st century.
A higher frequency or duration of exposure to graphic imagery increases possibility of vicarious trauma
Similar to Feinstein's study, responses showed a trend towards the frequency journalists view graphic images being a predictor of distress, but the duration of time also has an impact.
Figures relating to monthly exposure to graphic UGC may be distorted by the very low number of responses in this variable
Speaking of longer shifts, Feinstein said it may have a de-sensitising effect on journalists working with graphic images but that should not distract from other possible outcomes.
At Storyful, duty editor Joe Galvin regularly has to deal with such images and agreed that he can become inured to the effects but stressed the importance of giving the brain a break.
"You naturally learn to disengage and be impassive when you're on shift and working on this," he said, "but I think, especially if you're dealing with it on a very frequent basis, it's very important that you keep your work separate."
Researching stories or events on social media from home may be tempting, he said, but "the mind is the same as any other organ and it needs time to heal".
"I think it's a trap we all fall into from time to time, the job is engaging and something we're passionate about but we need to understand that we need to give ourselves a break and keep that work-life balance."
Shapiro agreed, no matter how important a story it may be.
"I'm an investigative reporter, a human rights reporter," he said, "I always worked by throwing myself at stories, getting my teeth into them and not letting go for weeks at a time.
"There are good reasons to do that but there are also very good reasons to pace yourself and understand that you have to be handling this in the long haul and that it can get toxic."
Older or more experienced journalists are less likely to be affected
There was a strong trend among respondents that showed age and experience play a role in whether or not journalists feel affected by the work.
Clare Wardle, founder of the EyeWitness Media Group and previously director of news services at Storyful, published a report on UGC and ethics through the Tow Center earlier this year.
When discussing her work at events and conferences she is regularly asked about vicarious trauma by audience members, and although it may have previously been an issue limited to those working on picture desks, it has become more widespread in newsrooms through social media.
"I think the difference is now you could be someone that is told 'can you look at social media today' and they're not necessarily used to it," she said.
"This isn't talked about a lot, and Anthony Feinstein was talking about doing more research on this, but often the people who work on social media desks are relatively young and often have never been out into the field."
The issue of age and experience in relation to verification, reviewing or filtering graphic images, was also raised by Shapiro, who likened the work to that of "criminal investigators, homicide detectives and psychologists".
"We understand that a correspondent who goes to Syria or Gaza is doing a kind of vital witnessing," he said.Having colleagues you can rely on... is crucial I thinkJoe Galvin, duty editor, Storyful
"People get OBEs for this. It's easy to see those folks as heroes.
"It may take some special planning to understand that the 22 year old sitting at their desk in London or New York or wherever they are, that 22 year old is putting a lot on the line in committing to viewing these images as well."
Positive reinforcement in the newsroom decreases the possibility of vicarious trauma
"Newsroom leaders who communicate a robust sense of mission tend to have more resilient teams," Shapiro said.
"There's a psychiatrist at Yale University who has studied highly resilient people, people who have been through extraordinarily difficult circumstances and survived very well – journalists, combat veterans, survivors of torture, people who have done well in the face of horror – and something they all have in common is a clear, strong sense of mission."
In the survey, 53 per cent of respondents said they received regular positive reinforcement from managers or editors about their work. Of those, 65 per cent said they had been affected by the images, compared to 90 per cent of those who did not receive positive reinforcement
Shapiro said there are parallels in the armed forces and emergency services, that "good management, responsible management, responsive and educated management helps people cope".
"If people are immersing themselves in toxic imagery form Gaza and the newsroom itself seems to be a place where you can't trust people it profoundly underscores the steady drip, drip, drip of poison that these images represent," he said.
If such newsroom leaders – both those in managerial positions and senior or respected journalists – contribute to a negative, "hostile or unpredictable" atmosphere in the newsroom it "reinforces the sense of a broken [social] contract".
At Storyful, where a large part of the job can be verifying UGC from conflict zones for news outlets, Galvin said trust is vital.Social connection for people exposed to trauma is the single best predictor of resilienceBruce Shapiro, executive director, The Dart Center
"We trust each other and we've worked together for quite a long time and you build up trust with your colleagues," he said.
"We're all in the same position too, there's an understanding that what we look at and what we're seeing, we've all been there.
"So there's an understanding that we need to support each other. Even if it's not explicitly said it's implicit in the work that we do and I would say it is absolutely essential to have that.
"Having colleagues you can rely on – whether it's colleagues you can pass a video on to if you're not ready to look yourself or simply to offer some solace if you're finding things particularly difficult – is crucial I think."
Social engagement is the best way of coping
Discussing the work, the images, or the effects of viewing was the most popular action taken by respondents to the survey if they felt they had been affected.
"The single most important thing we know from every study that has ever been done on effective treatments and programmes, is peer support," said Shapiro.
"Social connection for people exposed to trauma is the single best predictor of resilience. Social isolation is the single best predictor of difficulty."
Whether in or out of work, assembling a "peer-support squad" to be open with and talk about the work with on a regular basis is something all journalists working with UGC should do, he said.
"If you find yourself really not concentrating, not sleeping, getting angry, having difficulties a month or more after the event, then you want to talk about counselling," he continued.
"That's the period when clinicians seem to think professional help is warranted, is when these things begin to really take root and keep going.
"But peer support is by far the most important single tool in pushing back against vicarious or direct trauma and finally, of course, destigmatising it."
The "macho culture" in some newsrooms of not discussing the imagery or problems that my arise from it can block this kind of social interaction, said Wardle, but some news organisations are actively involved in setting up peer support programs.
"ABC in Australia has a peer program for journalists." she said, "who have either been in the field or are suffering from watching these kind of images. It's very much about peer-to-peer support so everybody knows who they can go and talk to within the newsroom if they're struggling."
German broadcaster ARD have lunches that journalists are required to attend to talk about potential symptoms of vicarious trauma, she added, and news organisations should be looking to provide more than just a phone number for for counselling.
Feinstein agreed, adding: "Journalists need to understand, and organisations need to understand that this kind of work can be emotionally upsetting for a small group of journalists.
"Just because you're not actually sitting in a combat zone doesn't necessarily mean you are going to be immune to the effects.
"And if you are exposed to this frequently, multiple times during the day, over the course of a week, a few months, many months, then it's possible that a small group of journalists are being affected by it."
"I do it so my mom doesn't have to" – quotes from respondents
Journalism.co.uk's survey into the effects of viewing graphic UGC was strictly anonymous, but many respondents left additional comments that give more insight into the issue than statistics can. Here are a few choice examples.
Question: Do you feel you have been affected by viewing traumatic UGC? If so, how?
"It's not easy work, and it's certainly not something I look forward to, but it is an important part of the job. I have a strong stomach, but traumatic imagery certainly is disturbing. But when I sleep, I sleep."
"I am already prone to sleeplessness and depression. The imagery has intensified this and contributed to some social withdrawal, at times."
"There can be a drop drip effect – not just in viewing this content but dealing with the human stories around this content. Definitely irritability – sense of helplessness. All this stuff going on and there's nothing you can do about it. Noticed this particularly with Palestine. Social withdrawal perhaps in the sense that you just don't feel like small talk. And actually I don't have to deal with the really gruesome stuff."
"After a while you kind of get used to [it]. But it does give you the impression that you stop being a sensitive human being sometimes."
Question: What actions have you taken if you feel you have been affected by viewing traumatic UGC?
"I spoke to someone who has experienced the same in the job, they were much more experienced than me and I was not close to them either, so I felt I could speak freely without worrying about being judged."
"Lots and lots of yoga and meditation techniques. I did not seek counselling, [and] although my team was very supportive I ended up just quitting my job."
"I talk to colleagues if I need to – or I tell the next person up the chain that I've had enough or don't want to watch any more. I've avoided watching this latest batch of video on James Foley because I know I can't use it so I don't need to come into contact with it – it's just too horrible."
"I'm a military combat veteran, so I take the same approach I took when faced with trauma in person: talk about it when appropriate with colleagues, then move on."
"I think there's probably a counselling service in most news organisations but think that regular screening is a must. Constantly dealing with the stories and images on the news agenda right now can have a negative impact. But often people don't realise they're being affected so should have regular, professional check ups."
"I do it so my mom doesn't have to."
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