Covering Trauma: Starting a Conversation About PTSD

(Reporting on Health contributor Angilee Shah originally wrote the following column about PTSD among journalists covering traumatic events in 2011. In light of the bombings at the Boston Marathon on Monday, we're reposting it below.)

Last month, Reuters reported on post traumatic stress disorder among journalists. The focus of the feature was war correspondents, but if you're covering health, you might be seeing tragedies in hospitals and communities regularly as well:

Kate Nowlan, the CEO of U.K.-based CiC, which has handled trauma support for Reuters since 2006, said she was initially met with some skepticism. But that has changed. Lately the company's phones, manned by therapists and trauma experts, have been ringing off the hook.

And the calls don't only come from journalists stationed in conflict zones. Sometimes it's the local cop reporter on the line, or the photographer sent out to cover a fire and ending up with some lurid pictures stuck in her mind.

The main lesson here is that journalists should become informed and be open to talking about how their work affects them. This week at Career GPS, we get that conversation going. 

Dr. Vincent Covello, director of the Center for Risk Communication in New York, says that, during traumatic events, we often forget a reporter can be a victim as well. Reporters, he says, can experience the same type of emotions as others involved in the story, even though we often purport to maintain a healthy distance from our subjects.

"Reporters may experience the same type of denial that fire fighters do - that they can't be harmed by what they're witnessing," says Covello. "You're expected to be above and beyond what you're doing."

Fire fighters have a buddy system and Covello reccomends the same for journalists. It is a simple concept: Someone whom you trust is assigned to watch out for the signs of mental health problems. "It's critical to have an intervention before things get really serious," Covello says.

First things first: Know the signs of PTSD. The Dart Center for Journalism and Trauma is an excellent resource for more information. Start with PTSD 101 for a good introduction to the problem and ways to identify it in yourself and your colleagues. Dr. Frank M. Ochberg identifies the three main symptoms:

• recurring intrusive recollections
• emotional numbing and constriction of life activity
• a physiological shift in the fear threshold, affecting sleep, concentration, and sense of security

Covello contributed to a 2005 U.S. Department of Health and Human Services guide for media covering terrorism and public health emergencies (PDF). It's a hefty document, but one full of information relevant to journalists covering health topics that involve traumatic situations. In particular, pay attention to section 9 on self care, says Covello. It includes tips to help you prepare to cover stories by protecting yourself physically and mentally. A section about emotional care begins on page 162 while the appendix has a comprehensive but one-page "self-monitoring checklist" to help you, your friends or colleagues identify potential mental health issues.

In the "Features for Journalists" section of the Dart website, you'll also find tips on ways to care for yourself when covering trauma and tough health topics. One 2004 post, for example, recaps a panel discussion about covering mental illness:

The fourth member of the panel, psychiatrist and author Jonathan Shay, focused on the issue of psychological self care for journalists. 

“Anybody who has a constant diet of exposure to severely traumatized people will become injured themselves if they do not have a community context within which they can metabolize this," Shay said. "If you hear trauma narratives, for instance, from prostituted children, from targets of incest, from grandparents of murdered grandchildren, this makes you a witness to atrocity - just simply hearing this narrative from this trauma survivor.”

How do you maintain your mental health while covering difficult subjects? What resources do you use? Share in the comments.