Journalism & Mental Health – secondary stress and burnout (Pt. 2)

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Whilst the first post in this series primarily looked at PTSD in conflict journalists, attention now turns to two widespread and more common mental health challenges; secondary stress and burnout.

Not all journalists report from conflict zones. Fewer still do so exclusively wearing Hollywood-esque battered chinos and artfully unbuttoned light blue cotton shirts (although there are compelling reasons behind a dress code of sorts I certain circumstances). Indeed, the term itself is not homogenous. On-air correspondents, fixers, camera crews, producers, photojournalists, print journalists and so forth all have subtly different roles.  What of the freelance opening alone compared to the employee of a large international broadcaster?  Consider the picture editor, sitting in relative comfort repeatedly reviewing footage deemed too graphic for public consumption compared to the cameraperson viewing and experiencing events on the ground via an viewfinder screen 10cm from one open eye. What about citizen journalists or bloggers, unaccredited and unattached to any recognised news organisation, yet on whom so much of the Western media’s coverage of Syria relied?

Journalists are not inherently a breed apart, despite the myths that some may propagate.  A facetious reader may find amusement in the assertion that in America, a country in which the Fourth Estate can be particularly self-referential and pompous, ‘a highly functioning super-ego is a crucial aspect of the mental make-up of a superior journalist’.​1​  As we have discussed, ultimately a journalist’s distinguishing feature is the higher than typical contact with potentially traumatic situations in the course of their work.  The COVID pandemic has brought mass casualty and trauma on a level, scale and duration to the front door of many who otherwise would not have experienced such events.  However, before the pandemic the vast majority of the profession were engaged in the daily hamster wheel of accidents, fires, murders, crime, interviews with victims of various trauma, political ineptitude and occasionally a bit of sport. As a fan of the Scottish rugby team, over the past decade the last category has proven to be equally depressing.  By one estimate, 86-100% of journalists have encountered potentially traumatic work-related experiences.​2​ 

Yet, there is little inherent in the role of a journalist that merits engaging in occupational exceptionalism.  Journalists are just people, who choose to bear witness, but many more professions engage with trauma either directly or indirectly. RM Remen’s oft-quoted aphoristic observation that those who are immersed in the trauma of others and envisage emerging unscathed is ‘as unrealistic as expecting to be able to walk through water without getting wet’, is as true for journalists as it is the caring professions.  This constant wash of distress undoubtedly carries a very real risk for two separate but linked phenomena – secondary or vicarious traumatisation, and burnout. 

No news is Good news

Frustratingly, there are far fewer studies of occupational stress amongst journalists than there are of PTSD. Just as some stories grab the headlines whilst others don’t, some disorders and topics get the funding. Whilst the nomenclature varies, several related terms are used (I will generously let you conduct your own background reading on who lays claim to what term). Vicarious trauma can be crudely characterised as traumatisation via the trauma of others, in which one’s own world views start to become impacted. Often used interchangeably, secondary traumatic stress (STS) was coined as a way of describing those who have been vicariously traumatised and are starting to display PTSD-type symptoms. Splitting hairs? Slightly. As one of the proponents of the term STS concedes, too often the hang-up can be over what to call it rather than how to treat it.​3​ Indeed, debate over what diagnoses are/n’t valid and what does/n’t fall under its umbrella, is a deep and wide rabbit hole down which we won’t venture in this post (although I may, should I feel cavalier brave enough, do so anon). With this in mind, it is worth noting that such occupational exposure has now been incorporated in to the diagnostic framework for PTSD and may in itself be counted as a primary trauma. Regardless, the general idea remains: the trauma itself is indirect and often repeated, and symptoms are no less valid of attention and intervention than the PTSD detailed in the previous blog post.

In a study of US local television journalists,​4​ 29.6% endorsed experiencing symptoms of STS whilst 41.4% experienced symptoms corresponding to the (also) related concept of compassion fatigue characterised by a loss of empathy, commonly found in the caring professions,​5​ and of increased academic interest across a diverse range of professions during the present pandemic. Importantly, remaining in the newsroom rather than being deployed to the field is no guarantee of immunity.  Journalists who repeatedly deal with graphic imagery (such as picture editors or those receiving newswire service material) show an elevated risk of adverse outcomes and symptoms including anxiety, depression, somatisation (where psychological distress manifests as physical symptoms)​6​ and re-experiencing/intrusion symptoms reflecting the viewed content, regardless of those symptoms ever passing the threshold to be considered part of a clinical diagnosis.​7​ In 2019, the awarding of AUS$180 000 in damages to an experienced Australian newspaper reporter for PTSD ruled to be as a result of a failure of her employer’s duty of care, serves as a striking confirmation that employers must address the risks not just to those in the field or operating in specific instances of extremis, but to all in their employ throughout the course of their professional work.

Burnout by contrast has less to do with the occupational content and is more related to organisational context.  Typified by emotional exhaustion, cynicism and depersonalisation, and feelings of reduced professional accomplishment, it is the result of chronic occupational stress​8​ rather than any trauma-related experience.  In the tradition of hair-splitting already discussed, whilst it is also not officially recognised as a medical disorder, the World Health Organisation do consider it an ‘occupational phenomenon’ likely to be a driver for an individual to seek medical help.

Its cumulative nature means it can remain at subclinical levels for considerable periods of time, has been found to be more common than STS or compassion fatigue and as such represents a significant challenge in the workplace.  In the same sample of local television journalists described previously, 54.3% reported having experienced burnout symptoms, with 18.6% of the cohort experiencing symptoms frequently.  In addition, MacDonald et al.’s systematic review found moderate to high levels on all three dimensions of burnout across print and broadcast journalists with young age, low experience, poor work-life balance and perceived lack of organisational support all emerging as a significant risk factors.​9​

Complaints about employment conditions in journalism are far from a modern phenomenon. Fedler’s examination of accounts by American journalists from 1850-1950, found nine factors blamed for workplace stress: reputation and consequences; a need to sacrifice/compromise their ideals; the gruelling physical and mental demands; long and irregular hours; poverty and low pay; intense competition for jobs and stories; job insecurity; witnessing trauma; and treatment by editors.​10​ In short, far more organisational factors than occupational content. The same review categorised the four most common consequences as: becoming hard or detached; substance misuse; breakdown; and leaving the profession. Sounds familiar, eh?

Not only are these occupational factors identified as causes of burnout and stress, they are also implicated in the severity of mental illness, regardless of whether they were responsible in the first place. The most frequently endorsed occupational stressors (inconsistent leadership style, conflicts with supervisors, and organisational policy changes) have all been found to be positively associated with increased PTSD symptom severity,​2​ as has a perceived lack of support from superiors and peers.​11–13​

Whilst PTSD is comparatively rare, both in terms of the journalistic and general populations, vicarious trauma and especially burnout are most certainly not. In this respect, they represent a far more pernicious and dangerous threat to the mental health and general wellbeing of those working in the sector. Whilst the nature of what journalists are exposed is often outside the control those in positions of responsibility, the newsroom environment itself most certainly is not. Journalism and the wider media is a thrilling, rewarding and ultimately privileged profession in which to work. It is a field that continues to evolve and much is (rightly) made of making newsrooms and production teams reflect the audiences and general population. Journalists are not a breed apart, they are and should be ‘ordinary’ people. There is nothing inevitable about the enduring nature of Fedler’s nine sources of stress. The fact so many are recognisable today shows that structural changes are not just a question of adaptation and representation, but also one of a duty of care to the ordinary people who find themselves in the extraordinary position of serving as witnesses to history not mater how seemingly local and comparatively small.

Yet, one of Fedler’s nine factors is perhaps most intriguing, controversial and problematic of all, namely stress arising from an individual sacrificing or compromising their ideals. Today, researchers and clinicians refer to the outcome of a conflict between personal and professional as moral injury and it is to this the third part of this series will turn…

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For information and help:
Samaritans (call 116 123) and Shout (text 85258) – round the clock support via phone, email and text (UK)
Our Frontline – 24/7 emotional support for COVID 19 essential and frontline workers (UK)
Dart Centre – resources on reporting on, dealing with and self-care on trauma (Worldwide)
newsbreak – peer support for journalists (UK)
Film & TV Charity – 24 hour support on a range of issues for anyone in the media (UK)

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    Himmelstein H, Faithorn EP. Eyewitness to Disaster: how journalists cope with the psychological stress inherent in reporting traumatic events. Journalism Studies [Internet]. 2002 Jan;537–55. Available from: http://dx.doi.org/10.1080/1461670022000019173
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    Smith RJ, Drevo S, Newman E. Covering traumatic news stories: Factors associated with post-traumatic stress disorder among journalists. Stress and Health [Internet]. 2017 Aug 22;218–26. Available from: http://dx.doi.org/10.1002/smi.2775
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    Stamm B. Work-related secondary traumatic stress. PTSD Research Quarterly. 1997;8:1–6.
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    Dworznik G. Personal and Organizational Predictors of Compassion Fatigue Symptoms in Local Television Journalists. Journalism Practice [Internet]. 2017 Jun 30;640–56. Available from: http://dx.doi.org/10.1080/17512786.2017.1338532
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    Feinstein A, Audet B, Waknine E. Witnessing images of extreme violence: a psychological study of journalists in the newsroom. JRSM Open [Internet]. 2014 Aug 1;205427041453332. Available from: http://dx.doi.org/10.1177/2054270414533323
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    Weidmann A, Papsdorf J. Witnessing Trauma in the Newsroom. Journal of Nervous & Mental Disease [Internet]. 2010 Apr;264–71. Available from: http://dx.doi.org/10.1097/NMD.0b013e3181d612bf
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    Schaufeli WB, Leiter MP, Maslach C. Burnout: 35 years of research and practice. Career Dev Int [Internet]. 2009 Jun 19;204–20. Available from: http://dx.doi.org/10.1108/13620430910966406
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    MacDonald JB, Saliba AJ, Hodgins G, Ovington LA. Burnout in journalists: A systematic literature review. Burnout Research [Internet]. 2016 Jun;34–44. Available from: http://dx.doi.org/10.1016/j.burn.2016.03.001
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    Fedler F. Insiders’ Stories: Coping with Newsroom Stress: An Historical Perspective. American Journalism [Internet]. 2004 Jul;77–106. Available from: http://dx.doi.org/10.1080/08821127.2004.10677596
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    Hatanaka M, Matsui Y, Ando K, Inoue K, Fukuoka Y, Koshiro E, et al. Traumatic stress in Japanese broadcast journalists. J Traum Stress [Internet]. 2010 Jan 26;173–7. Available from: http://dx.doi.org/10.1002/jts.20496
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    Weidmann A, Fehm L, Fydrich T. Covering the tsunami disaster: subsequent post-traumatic and depressive symptoms and associated social factors. Stress and Health [Internet]. 2008;129–35. Available from: http://dx.doi.org/10.1002/smi.1168
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    Newman E, Simpson R, Handschuh D. Trauma exposure and post‐traumatic stress disorder among photojournalists. Visual Communication Quarterly [Internet]. 2003 Jan;4–13. Available from: http://dx.doi.org/10.1080/15551390309363497

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