Dart Center & Frontline Club Look to Support Journalists

London’s new Frontline Club for journalists involved in the reporting of war, trauma and disaster has now formally opened its doors with a powerful discussion organised and sponsored by the Dart Centre on the role of trauma in journalism.

Former Reuters Global News Editor Stephen Jukes told some 40 news executives, reporters, psychiatrists and therapists of the news agency’s extensive trauma training project introduced during the Iraq War – and of his colleagues’ intense personal distress at the deaths of two Reuter cameramen in Baghdad.

The meeting was shown video excerpts from traumatic news of recent years, including the attack on the Palestine Hotel in Bahgdad in April – and as live pictures had come in of that attack, said Jukes, of the body of cameraman Taras Protsyuk and of wounded reporter Samia Nakhoul, it had deeply affected the Reuter newsroom.

“That newsroom,” he said, “a lot of hard-nosed hacks and a lot of us very cynical, I suspect, was reduced to an absolute mess and wreck that day, as we saw those pictures coming in. It affected all of us so many miles away because they were friends, we’d worked with them.”

Jukes spoke of the importance of having an international and toll-free helpline for journalists; of the central place of educating senior managers in trauma; of culture change which will in time see trauma support positioned alongside hostile environment training as journalistic second nature; and of the need perhaps to choose more carefully who gets sent to war zones.

The meeting, chaired by Dart Centre Europe Director Mark Brayne, also heard from trauma expert Gordon Turnbull, of the Ticehurst Priory Hospital near London, about the latest insights of brain science and the resilience of human response systems to trauma.

One of the United States’ best-known reporters from the Vietnam War, Jack Laurence, spoke of how thrilling but also damaging war reporting can be, and of how his own psychological well-being had been helped by three things in particular – reading self-help books, therapy, and the support and strength of his colleagues.

Speakers from London’s Metropolitan Police, and Britain’s Royal Marines and Armed Forces reported on how military and police cultures had had to change in recent years to acknowledge the experience of trauma – building especially on the “buddy-buddy” approach of destigmatising trauma within teams, and encouraging individuals to support each other.

Click here for a detailed transcript of the discussion, which also saw some of the following issues raised:

• The role of the Frontline Club: Founder and former freelance war cameraman Vaughan Smith looks forward to the Club being a centre of support and debate around the paramount issues of journalistic safety.
• John Owen, Chairman of the Frontline Forum, sees Frontline Club as a place to give a voice to journalists who have a conscience and are good at what they do.
• Mark Brayne views Dart Center Europe’s role as building community and changing culture – and going beyond PTSD to support emotionally healthy journalists and journalism.
• Bruce Shapiro, the Dart Centre’s US-based Field Director, sees the Frontline Club’s very existence as a statement against the kind of isolation and loss that too many in journalism suffer as a result of their work – and welcomes the progress made in the past year in British journalism in raising awareness of trauma and emotions.
• Stephen Jukes speakers of Reuters’ experience of trauma and its new programmes of training and support.
• Sarah Ward-Lilley of the BBC describes how the role trauma awareness and training played in the coverage of the Iraq War.
• Caroline Ellis describes in detail the Royal Marines’ programme of Trauma Risk Management – shortly to be introduced also in the American military and Britain’s Royal Navy.
• George Couch, a senior officer with London’s police liaison teams, describes how police culture in the British capital has had to change, from old macho approaches to a recognition of how trauma can hurt individuals.
• Gordon Turnbull, prominent trauma specialist, welcomes approaches to trauma which support survivors’ and witnesses’ natural resilience – now much better understood thanks to new brain science.
• Jack Laurence speaks powerfully of the thrill of war reporting and the longer-term damage it can leave behind – and of the value of peer support.
• Andy Kain, ex-SAS and one of Britain’s most experienced hostile environment training providers, underlines the similarity between media and military experiences of conflict, and the important of the buddy-buddy system.
• Ian Palmer, outgoing senior psychiatrist with Britain’s special services, stresses the need for caution: it’s not all about PTSD, and don’t expect everyone who needs to to be willing to take up the offer of support.

A Transcript of the Frontline Club Discussion

Mark Brayne: Good evening. I’m Mark Brayne, Director of the Dart Centre Europe for Journalism and Trauma, and tonight is an opportunity to talk about journalism and trauma and the emotional dimension to the craft. But it’s also about building community; and tonight is as much about networking and meeting each other as it is about saying things.

I’d like to ask Vaughan Smith to start the proceedings off. Vaughan is the founder and inspiration behind the Frontline Club.

Vaughan Smith: The history behind this Club is that I’ve been a news cameraman and also agent to other freelance cameramen and independent journalists in news gathering for about 15 years. We have closed our company, Frontline TV, because it’s quite a difficult business to run in the current climate, and we’ve therefore diverted our energies into this building. The real purpose is to create a room like this for the newsgathering industry and the wider media, and to directly support individuals who are going out and risking their lives for newsgathering.

We are taking membership from a wide group of people but essentially we do expect those people to be interested in foreign newsgathering. The principal is that by joining the Club, that will support this forum and make it secure. We want to use this room to promote a variety of journalism, whether by having screenings, as we have later on this week, or by photo-journalism and things like that.

I have dedicated the building to eight friends of mine, for whom I was technically agent, who risked and lost their lives in the gathering of news. For me that’s quite poignant and it focuses my mind on getting over the rather large hurdles in terms of the building.

I’d like to welcome you for what essentially is the first use of this forum. I’m delighted that it should be Mark and the Dart Centre Europe, because safety has been absolutely paramount in my mind. It seems to me to be THE industry problem and of course, post-traumatic stress is absolutely related to that. I do think hope that we can use this space to promote good practice. Practice that hopefully will help lives, and we intend to co-operate with anybody with that interest in mind.

So thank you very much and I’m going to hand over to John Owen who is Chairman of this Frontline Forum.

John Owen: A very warm welcome to you all. I must say it’s an emotional moment for me because I was the guy who used to run something called the Freedom Forum and we used to do gatherings like this, so it really is wonderful to see again this kind of gathering. Those are even the same chairs that used to be in the old forum, so there’s a certain amount of déjà-vue here.

First of all, I also, again, want to just note what a contribution Vaughan Smith has made to this community in doing this. Last night Canon David Meara gave a wonderful memorial message as we dedicated a plaque to Vaughan’s former colleagues who’ve been killed. There was a real poignancy in the room about what this place can be about.

It is more than just a place for people to gather and to be together; there is a special significance about this place. People are trying to do things that are in the best interests of the news industry and trying to prevent any more deaths of journalists around the world. We know that’s probably a futile thing but the important hope that we all have about this place is that it is a gathering not just for journalists, but for people interested in international journalism. And I know many of you in the room, as Mark has pointed out to me, are not actually practitioners but are interested in PTSD and also in working in support activities for journalism.

We want you to be part of the Club. We want journalists to be talking to others outside of journalism. We hope you, too, will consider being members of this Club, so there can be this kind of dialogue between journalists who are practitioners, and others. Looking at who was in the room for the formal opening last night, it’s about the past, present and future of journalism.

We have wonderful practitioners from the past who celebrate the values that we still nurture, like Jack Laurence from CBS and ABC. He did some of the greatest reporting from Vietnam; I still can remember, minute by minute, his reports about Charlie Company going back to Vietnam. There never will, in my mind, be as great reports as those; we need his values and his inspiration for the present practitioners.

And like Brian Kelly who’s still a cameraman, who has been working for 20 to 30 years and has seen some very difficult things himself but is still travelling to tough places in the world, and who’s still one of the great craftsmen as a cameraman. He needs support from this kind of community; he needs to know that his values still matter.

And also I spotted in the room last night students I have at City University. They want role models. They want to believe that there still is a purpose in being a journalist, so they want to see others around them that they admire, who are practitioners. I think this place can give voice to journalists who have a conscience and are good at what they do.

Rodney Pinder, from the newly created International News Safety Institute INSI, is here with us tonight. He’s got a wonderful new book called Dying to Tell the Story, which is a tribute to the journalists killed in Iraq. You could buy that, it’s a very good Christmas present and it will help support safety training around the world.

We have people who run safety programmes like Andrew Kain, who’s here tonight from AKE. He has been involved for a long time in this business. So this is going to be a wonderful place for this kind of dialogue to happen.

Already, this place is being seized upon, I think, as an environment to try to have meetings, and there’s just a wonderful ambience about it already; you can tell that as you look at these pictures and feel the vibrations in this room. And already we have some good things happening. Tonight is the official launch, tomorrow night you’ll hear more about these magnificent photographs taken by Philip Jones-Griffith on Agent Orange collateral damage in Vietnam. And like the old Freedom Forum, these photographs will frame the discussions. How can you talk about trauma in this room without looking at what journalists do.

But, I now want to turn things over to Mark Brayne and Bruce Shapiro and I think it’s appropriate we start this series of forums with Mark Brayne. He’s been a long time champion of everything in this community having to do with journalists rights; the values of journalists. He was a great journalist himself with the BBC World Service; he’s one of the most thoughtful journalists I’ve ever been around. We’ve roamed around the Balkans together setting up programmes for local journalists with Andrew Kain and got to know each other very well and I have a huge admiration for him and the work he’s doing. So, welcome to you all and I hope you’ll be back and I hope you’ll join the Club and you’ll celebrate everything we’re trying to do here. Thank you very much.

MB: What can I say after that! That’s almost as fulsome a tribute as I read in my Stasi files in East Germany. When John invited me to Berlin for a commemoration of 10 years since The Wall came down, at the end of 1999, I used the occasion to see all my Stasi files that they made on me - all 2600 pages of them. They used to think I was a reasonably good journalist, but that was a bit over the top, John!

I’ll talk a little bit about Dart in Europe and where Dart Centre is going and how I look forward to this being a community; a growing community of people who are concerned about good journalism and emotionally healthy journalists, as far as that is possible. But before I do that, I’d like to ask Bruce, from the Dart Centre for Journalism and Trauma in the United States, to talk a little bit about the context.

Bruce Shapiro: It’s wonderful to be here. Mark and John both used the word community, and when you’re talking about trauma, when you’re talking about the after-effects of violence, and you’re talking about PTSD and isolation of the individual, loss of community is one of the main things that we fight. So, simply the existence of the Frontline Club is a statement against the kind of isolation and loss that too many in our community suffer from, from the work that we do.

For those of you who don’t know - and there may, in fact, be some of you though I know many people here, old friends and new friends - the Dart Centre for Journalism and Trauma is based in the US. It is an international network, more than a centre, a network of working journalists like myself, like others in this room; of therapists, of journalism educators and others concerned with violence and its aftermath and its impact on journalism.

The reason we’re all here in this room tonight is that we all care. We all care, first of all, about good reporting, effective reporting, reporting that is knowledgeable about the impact of trauma on the individuals and communities that we cover, whether it is a neighbourhood in London or a country in the Middle East. And concerned as well about the impact of trauma on us and our colleagues and friends who make the hard decision to bear witness to the worst things people do to one another.

So this is a celebration of community, a celebration as well of a group of people here who care. What we’re not going to do tonight, I can tell you, is give you long lectures about traumatic stress. Many of you in this room have had our basic rap several times over and many here know far more than we do.

What we are going to do, I think, is foster a conversation; the beginning of a conversation over where the Dart Centre in Europe has been, where it is going and what our community is doing and can do to make journalism more effective in reporting on traumatic stress and its meaning in our society; and what we can do as well about journalists affected by this.

I want to thank the Frontline Club and John Owen – I’m going to correct John on one small point. There has been some reporting that matches Jack Laurence’s reporting on Charlie Company. It’s his reporting on Iraq, which you could hear on National Public Radio. I didn’t want him to be interred just yet. He also has a book coming out on Iraq, which, if The Cat from Hue, his previous book, is any indication, will be something like a definitive war reporter’s book.

Anyway, this is a conversation, so I’m going to give it back to Mark to begin that, then we’ll see where we go.

Mark Brayne: What I’d like to do to start with, and I know that Jack Laurence is going to step outside for this, is show a 10-minute video which Reuters and we at the BBC worked together on producing. It’s a training video just to bring home the reality of what we’re dealing with. It’s a compilation of raw clips and reports on Iraq and other experiences of journalism-related trauma in the last few years.

We find each time we show this, in the BBC and in the context of Dart, that it reminds us that this is not theory. So anybody who is disturbed by violent images, please feel free to go and spend ten minutes downstairs.

[After showing of the video.] I hope that wasn’t inappropriately distressing for you, because one of the things that we’re aware of, of course, is that exposing people to traumatic images can trigger the natural human response to trauma, which is what we’re talking about; and we are after all talking about avoiding re-traumatising audiences – and colleagues – unnecessarily; but thank you for sticking with that.

I do want to say one or two things about the Dart process and what we’re hoping to achieve with this and also to open this up over the next 45 minutes or so to debate and discussion and the chance for one or two colleagues to tell us about what’s been going on in their neck of the woods.

We’ve got a very interesting mix of colleagues here tonight from journalism and psychotherapy, and from the support networks in Hostile Environment Training, and so on, so when we get going in the discussion, please introduce yourselves and explain a little bit about your context.

There’s been a lot of discussion in the last couple of years, as we have brought this agenda to Britain. At the BBC in particular in the last year, we’ve done a lot of work in raising awareness, in spreading the word that this matters to journalism and why this matters. How this can make for better journalism and healthier journalists. From News Exchange, Jim Gold at the back there has been working with John Owen over the last two years in Lubljana and in Budapest - extremely successfully - to bring the broadcast industry together under the umbrella of the EBU.

News safety was a key issue this year in Budapest, a couple of weeks ago, as it has been at the Newsworld conferences in earlier years. We’ve done some Dart seminars. A number of you have been at the various debates and discussions we’ve had about what it is that journalists need for their support.

It’s important to remember here that it’s not just PTSD that we’re talking about. It’s about stress and trauma and the emotional experience of being a journalist and reporting trauma appropriately. And needless to say, the Iraq war has brought this pretty vigorously to light. As we saw at the beginning in the video, the Iraq war has probably seen more journalistic deaths in a shorter space of time than any conflict that I’m aware of in history.

This has brought home the need to bring a better understanding of trauma into the journalistic community. To take the mythology out of it, to take the taboo out of it and to bridge the gap between journalists and their organisations, and counselling or psychiatry or whatever on the other side.

But it’s also about filling that gap between journalism and the journalistic organisation on the one side and the expert professions on the other that can feel a long way away. Journalists do not like going to see counsellors and understandably so. Counsellors and psychotherapists are important in the background. But for journalists it’s about shifting the culture, and that’s really what the Dart Centre is about. It’s about raising the journalistic game in organisations and among individuals to understand that this will help the journalism and help the journalists.

That’s what we want to do with the Dart Centre work in London, in partnership with the Frontline Club, in partnership with you all.

I don’t think any of you were at King’s College last Saturday, where The Times sponsored a day-long discussion about therapy culture. This was to launch a book by Frank Furedi, a sociologist from Kent University, which is a scathing critique of modern culture as being too soft, too pre-occupied with therapy ideas, where everything is turned into emotion. The government is paralysed, says Frank Furedi, because it’s too concerned about focus groups. Teachers can’t teach because they’re worried about their pupils’ emotions, and so on.

It’s a very, very harsh response to what I think is a legitimate awareness of the need for emotional intelligence and an emotional dimension to politics and to journalism and the human condition in the twenty-first century.

But it is a controversial issue we’re dealing with, and we need to strike a balance; to get journalists in on this debate; to get you all into this discussion in a way that won’t send journalists screaming for the exits.

There are relatively few jobbing hacks here tonight – we’re clearly got work to do as we stretch this awareness and get this debate going.

You may have seen the big double-page adverts over the weekend for the Discovery Channel on TV for a series called Reporters at War. Asking for example about what reporting war does to the reporter’s soul. Ten years ago, nobody was asking about the reporter’s soul.

The issues that I’d like to put into the round today are:

• What are the taboos that we need to challenge?
• In what way do we want or need to shift culture?
• The representation of trauma – it’s about good journalism in the representation of traumatic stories, as well as healthy journalists and prevention, as far as possible, of unnecessary post-traumatic stress responses.
• The families: this is something in Dart Europe we’ve been working with. Sue Brayne whom most of you know did a day’s workshop with wives of frontline journalists who often get sent away to war and leave behind a huge amount of distress. Many of you know that social support has been found to be critical in the working through of trauma; those with good social support are less likely to develop pathological post-traumatic stress responses. And the families at home are going through a difficult time – how can we support them, in order also, to support the journalist?
• Education and training: Jim Latham is at the back there from the Broadcast and Journalism Training Council; trainers from the BBC are with us; John Owen teaches at City University; NGOs also work in this field,

In short there’s a lot to be done, but I’ve said enough. I’d like to ask Stephen Jukes, who has done a tremendous amount of work at Reuters in this area to take us through what you did and the difference it made and the lessons that have been learned at Reuters in addressing this.

Stephen Jukes: Thank you. That film was very difficult, wasn’t it? And a lot of it you didn’t see on television, although some of it you saw live on television, especially September 11th. I can say that on the day that our cameraman Taras Protsyuk was killed at the Palestine Hotel we were receiving, in the Reuters newsroom, those pictures live, as rushes. We were just taking it in and we could see that Taras was almost certainly dead. You saw a woman being bundled into a car there at the Palestine Hotel, down below; that was a reporter of ours called Samia Nakhoul, a wonderful reporter. She underwent brain surgery that evening by an Iraqi neuro-surgeon who saved her life, before the city fell.

And that newsroom in Reuters - a lot of hard-nosed hacks and a lot of us very cynical, I suspect - was reduced to an absolute mess and wreck that day, as we saw those pictures coming in. There was just no doubt about that, it affected all of us so many miles away because they were friends, we’d worked with them.

Again, in August, I went to Hebron to the funeral of Mazen Dana, a Palestinian cameraman who was shot outside a prison on the western outskirts of Baghdad, and there we comforted his widow. The whole town of Hebron turned out to send him off; he was a hero in the Palestinian world. He has four children and the second eldest, who is 10, was taking a video of the funeral and you could see that he, too, was his Dad taking the video. It reduced all grown, cynical hacks there to absolute tears. I’ve never been through something like that. It was very, very difficult.

I was in Cardiff earlier today at a conference on asylum seekers, and I made some notes about what we did during the Iraq war at Reuters. The idea was just, very briefly to tell you, to see if we’re on the right track and whether there are lessons to be learned.

The first thing I would say was that Iraq was not normal, in that we had a long period of preparation. We all knew the war was going to happen at least six months beforehand, and so I think Reuters did get its act together. We went into a lot of training on chemical and biological warfare and then we also said, “We have to set up a programme for trauma and stress”.

This wasn’t itself new, but before we had always really faced crises, and got counselling in when we needed it, on an ad-hoc basis. We didn’t really have anything in place properly.

The watershed for us and for me personally, was the death of Reuters reporter Kurt Schork in Sierra Leone in 2000. You saw Kurt in that film as well. That really hit me. We lived in the same town in Washington; he reported to me and I was responsible for his assignments. That really shook me personally and I see my conversion there.

So this time we wanted to put in place a proper programme and so we concentrated on two areas. I’m not sure we got this right but that’s what we did.

The first area was the news executive, the news editors, the people who were doing the assignments. We instituted a programme first of all to train them in what PTSD is, what the issues are; how do you recognise symptoms and so on. But also, we ran a system of pre-assignment briefings and post-assignment briefings, which build in this issue when we’re talking to journalists who are going away.

And then the second group were those people who were actually in the field doing the real hack work - the reporting. We set up a global helpline for them, which has been used extensively, I can say. The first day I was inundated with calls that said it had to be a 1-800 number or a free phone number because people didn’t want to ring a number in London from Uzbekistan and find out that they then had to expense a bill of £40-50.

Also, it would appear on expenses as “phone bill for counselling’, which taught me very quickly that there is still a great stigma attached to this.

That system is now in place and I would say there are now four lessons, or questions.

Firstly, that this help line has to be available to people in all languages all over the world for us, because Reuters is an international organisation and actually only about 30 per cent of the people have English as their mother tongue.

Secondly, we need to be more selective, perhaps, as editors and assigning editors in who we send to war zones, because we’ve always said in the past, “Well, it’s your free choice”. Perhaps, on the other hand, we have sent people who, psychologically, mentally, from a point of view of experience, probably weren’t up to it, or needed more training and bringing on more.

And deliberately, as a top-down process, we said, “Right! Senior executives in the company need to set an example, or lead by example.” I’m now leaving Reuters, but beginning to see signs where people are coming to us and saying, “Well actually, I want that training. I want to be able to have that counselling”, in the same way as, today, no reporter would go to Gaza or anywhere without a flak jacket or without training. They will come to us and say, “I’m not going there; I don’t have the right kit”.

I hope that as time goes on people will come to us and say, “Look, I haven’t had my briefing, I don’t know what the whole plan is. I haven’t had the opportunity to talk to people”. So I think there is a shift of culture, but it’s going to be a long process.

So that really is where we are at the moment. It needs to be more than a one-off, attached to the Iraq war. It has to be a programme which is there, which is as second-nature as the security training which has now been in place for perhaps 10 years, and is just accepted. It’s just a normal way of doing business.

MB: Steve thanks very much. Sarah Ward-Lilley looks after BBC newsgathering correspondents and the newsgathering teams. She has been hugely supportive and instrumental in getting this programme going at the BBC.

Sarah Ward-Lilley: Thanks, Mark. I’m actually sitting with two of the colleagues who have helped make this happen at the BBC, Dipti Patel and Caroline Neil and a whole team of other people. Basically, at the BBC, we’ve been aware, in the background, of the need to address issues around stress and trauma for some time but were struggling for a while to work out how to do it.

We were aware of all sorts of things, going back years - you name it: Bosnia, Kosovo, the Omagh bombing, East Timor, endless instance in the Middle East, the first Iraq war, G8 riots - a lot of the things you saw on that tape have all made us realise that our colleagues have been seeing and witnessing some absolutely ghastly things.

But we were also aware that we’ve had a counselling system in place at the BBC, a help line, which is completely confidential and people, i.e. managers, don’t know who has taken it up. We know the numbers of people but we don’t know who, and we were very aware that in news, the take-up was quite low.

My instinct, as with some of my colleagues, was that this didn’t feel right. My colleagues who were going out to these things over and over again, could they really be as resilient as we thought they were? So we were trying to find a means to put systems in place so that we weren’t missing anybody and therefore relying on their families and social support systems instead of addressing the issues ourselves.

So, lots of problems in the way: trying to find out what system to put in place in what is, or has been, quite a macho culture; what system to get by in; to work out whether to do it top-down or bottom-up – just practical issues. 9-11 and what happened later in Afghanistan re-emphasised the need to do it.

And with Iraq looming ahead of us, with that sense of a looming spectre of WMD and so on, that really made us think, “Come on! We’ve got to get this sorted out. Because our own colleagues were taking the safety training even more seriously than they did already, insisting that they wouldn’t go anywhere without their kit and without their training. So there was a push in the right direction in terms of being prepared.

Mark Brayne, by then, was already a trained psychotherapist and we were able to draw on his support in a special project. He put us in touch with a team of people from the Royal Marines who have a very interesting and, what has seemed a very effective and practical support in looking after those who’ve gone through a traumatic experience.

We also tapped into various other set-ups. We were able to talk to the Metropolitan Police about how managers could break bad news. All sorts of different support systems became available to us.

So a big project of training managers was put in place, as Stephen was saying, to bring in adopters at all levels of the organisation. That would also help because the message would get out to the field that way – that it wasn’t just us saying, “Oh, yes, we must be nice to you”.

So it was a sort of scatter-gun approach dealing with lots of different levels in the BBC, lots of different departments in the BBC and trying to bring in as many support mechanisms as we could, because no single match will suit everybody. All you can do is put things that you think might be appropriate in place, encourage people to take them up and try and take the stigma away.

And what I would say is that we’re at the beginning of the journey. We had some very nasty incidents ourselves in Iraq in April; we lost some colleagues; we had some very serious injuries and what I’m very conscious of now is that it’s an ongoing story, an ongoing process there, plus in the midst of everything else you have what’s carrying on in the Middle East; you have all the carnage that colleagues will have witnessed on the streets of Istanbul as well. There are all the other news stories going on as well so we have to continue this process and continue to encourage our colleagues to take up the help that we’ve now made available to them.

MB: Sarah, you’ve usefully brought in the Royal Marines and the Metropolitan Police. Cameron March, who’s been the driving force in the Royal Marines behind this project, which they introduced seven years ago, is at the moment with his team in Istanbul, supporting the British Consulate and the Foreign Office teams after the bombing there with the trauma response programme that the Marines have developed. The FCO have taken it on board and we are in the process of looking at how it can be worked up for a journalistic use.

Caroline and David Ellis, you’re working with the Royal Marines in what they call ‘TRiM’ – Trauma Risk Management. Could you tell us a little bit about where you’ve got to?

Caroline Ellis: I’m from a psychology background and I’m a civilian, so I have not had much to do with the Royal Marines so far, but I am very interested in TRIM.

This is a programme that the Marines have introduced and stands for Trauma Risk Management. I think perhaps the best way that I can explain to you what goes on is to give you an overview of the philosophy behind what they actually do, within the Marines and the Royal Navy.

And that is, they are trying to implement within their organisation a very pro-active as opposed to re-active response to traumatic incidents. The way in which they do this is by using very straightforward written protocols and procedures that can be activated easily and efficiently. However, they are still flexible, because of the nature of the operations that go on within the military.

TRIM, the Trauma Risk Management programme, is a peer- delivered six stage model, which incorporates training in things such as effective, psychological site management, convening an appropriate trauma response meeting, assessing who is suitable for group intervention and who is suitable for individual intervention and carrying out risk assessment interviews. I would say that is the crux of TRIM.

What they do is identify, at a very early stage, people that are wobbly; people who are potentially going to need some help. To me that is the nature of the interviews that happen. These interviews are given by Trauma Risk Management practitioners. There are now over 400 Trauma Risk Management practitioners within the Royal Marines and the Royal Navy.

Within 72 hours, if not before, of individuals witnessing a particularly traumatic event, everyone involved in that event will receive a Risk Assessment interview. The interview is approximately one-and-a-half hours in length, on average; obviously, it varies according to the individuals and the specific trauma. The maximum group that this would take place in would be eight people, although I would say that the majority of assessments are done on an individual basis.

The interviews are constructed to incorporate and assess the level of trauma that the individuals have taken on. They do this by identifying 10 risk factors, including common things that we look at for PTSD such as excessive alcohol use; their social network; what the individual feels like; are they blaming themselves?

I would say the most important risk factor we do examine within this structured interview process is acute stress, and whether the individual in front of you is clearly suffering from acute stress. Are they claiming not to remember parts of the event, even though they were conscious throughout the whole trauma? Are they obviously nervy and shaking; distressed; not being able to control themselves emotionally? These are among the main predictors of someone who might go on to suffer from a post-traumatic stress illness.

We incorporate these 10 risk factors and we do this in what we call a BDA process – before, during and after. We take them through what happened before the event, during the event and after the event. This is a very factual interview; we do not delve into their emotions, we do not want to know how they’re feeling to a great extent. It’s a very factual process and is repeated again approximately 28 days after the first interview.

The scores are compared and we can very easily and quite precisely see the level of stress that an individual has taken on. From that, the main objective is whether we feel the person has indeed taken on a great amount of stress and is going to need some specialist help; and we can get them that help quickly.

As I say, I’m a civilian coming from a psychology background. The process is very simple, very straightforward and anyone who knows anything about post-traumatic stress will know that not everybody involved in an event will suffer from a post-traumatic stress illness. We know that a lot of them will be fine. We need to identify those that aren’t very early on, and get them some help. It’s not about putting a box of tissues in the middle of the room and not leaving until everyone’s been through it all. We know, as you said earlier Mark, that can actually re-traumatise the individuals; so we attempt to identify early and seek help. That’s basically the gist of Trauma Risk Management and the way they do it within the Royal Marines.

MB: Thanks Caroline. What Cameron would have added to what you’ve said is what he told us at the International Society for Traumatic Stress conference in Chicago a couple of weeks ago. Which is that most people cope pretty well and that the Marines’ experience, having had this in place, is that in a sense because it’s been culturally accepted, that people there are saying – as Stephen says – before they’re sent on assignment “Where’s my briefing? What I’m about to experience or what I’ve just experienced has a psychological dimension. Where’s the support?”

The Marines expect support because the culture has shifted. The Marines had 6000 military folk deployed in the Iraq war. Of those 6000 , we understand that just nine are psychologically wobbly. With six of them, it’s nothing really to do with the war, and of the three remaining, one is in a slightly bad way and the other two are getting better.

It’s a very small number, and the thing that really strikes me is that if we can create a culture in journalism where a lot of this is caught early, we can keep the levels of distress more manageable by making it OK. Of course, there are some who are going to get PTSD whether we like it or not, whatever we do in terms of training and support, culture change and so on.

The Royal Navy now and the American military are taking the Marines model on board; perhaps this is something that we can learn from for journalism. If the Marines are OK with getting emotional and wobbly, who are we as hardened hacks to say that we’re tougher than the Marines?

SW-L: Can I just add to that, that possibly the reason that it is so well accepted is that it’s very much peer-delivered and it’s not just senior officers within the military. Junior ranks are trained in TRIM and trauma risk assessment, so the chances are that one of these risk assessment interviews to determine how much stress has been taken on board is actually happening with one of your colleagues you know very well. So the chances are they’re going to know how you’re reacting anyway, without having to do this interview, even though it is a very structured process. It’s all the way through, and that seems to help a lot in changing the culture.

MB: The curious thing is that the number of formal risk assessments that are done with teams and individuals who’ve been through a nasty time is relatively small, in fact surprisingly small considering how many people have been through the training. And it almost seems that the training and the awareness is more important than the actual risk assessment after the event.

Joan Sewell, from the Metropolitan Police. Sarah mentioned the work you did with us before the war, which tragically we needed to use at the BBC. We need to see this also in the context of local journalism where young reporters have traditionally been sent to do the “death knock”, almost as a rite of passage, very early in their journalistic career. They have to go and tell Mrs Smith that her son has just been killed in a car accident and how does she feel?

The police have been through a similar transition away from this kind of approach, and have learned a lot. Perhaps you can just fill us in, Joan?

Joan Sewell: I’m a Metropolitan Police Officer and a family liaison co-ordinator. We have deployed Family Liaison Officers to New York, Bali and, more recently, Istanbul. We assist the families of the bereaved. We deliver death messages and we assist the families in viewing bodies and with repatriation.

We were instrumental in the training of the Rapid Deployment Teams with the Foreign Office who are working with our anti-terrorist branch at the moment in Istanbul. We have officers over there at the moment assisting the British families.

We thought we knew it all and in the past we got it severely wrong. The Macpherson report on the killing of Stephen Lawrence in 1993 was instrumental in our training, as police Family Liaison Officers learned how families should be treated appropriately and according to their diverse and cultural needs.

That is one thing we practice within the police service - to try and work with the communities, community advisors, community leaders, to address the needs of the families.

I’ll pass you on to George Couch, my boss, who can tell you about our risk assessment and the things we do before we deploy a Family Liaison Officer.

George Couch: Thanks Joan. I share the responsibility for all the Family Liaison Officers in London, of which we have about 800. We devised the training course aimed primarily at dealing with the needs of the community but also at dealing with the needs of the officers themselves.

It’s quite important, and I’d reinforce what the Royal Marines are doing, in that peer pressure plays a great role in how you deal with stress; but managers also have their own responsibilities and it’s something that the managers need to get to terms with in their head.

This is not going to be a short process for you. It’s taken the Metropolitan Police about five years to turn the culture round from a hard-bitten, cynical bunch of individuals dealing with murder and rape and everything else, to a group of individuals who now recognise that stress affects everybody. Peer pressure means that you can see in somebody else who you’re working with, that that person is actually suffering. What can I do? Where can I go?

We put the structures in so that Occupational Health is now there. We’ve allowed that managers can refer people to Occupational Health but more importantly, the individual can self-refer. What we ask is that the other officers come along and say, “Look, I think you’re suffering here. You’re not sleeping, you’re drinking too much, you’re being abusive in the office, and you’re clearly suffering. Go to Occupational Health.”

And we’ve found that the vast majority do and they don’t need session after session. Usually a one-hour download session is more than sufficient for most individuals to get it off their chest. And that can even be done in confidence, because they can self-refer in confidence or they can go through their line manager and say they want to go to Occupational Health. And it’s accepted now, by all officers, that this is a very valuable thing.

We do it in post-shooting incidents, where officers are involved in a shooting where we either shoot someone or were shot at. Immediately, within 12 hours there is a counselling service set up; there is a group de-brief and then if people want to go on an individual basis, they can.

On the managerial side of it, I think probably the risk assessment – and I’m not talking about the health and safety risk assessment that managers are supposed to be responsible for – but it’s the risk assessment of managers saying, “Okay, where am I going to send this reporter to? What am I going to send him into? When was the course they were last on?”

There’s not much point if they’ve been on a course five or six years ago; things have changed. But it’s also down to the individuals recognising the risk themselves.

If they are a reporter on the West Bank, or a cameraman with a camera on their shoulders, they’ve got to think, “What does this look like to somebody who might be in a tank on the other side? Am I putting myself in danger?” I noticed on the Borneo clip there, the reporter is right there when that man is being hacked to death. People get caught up in what’s going on around them and they’re reluctant to leave. Police officers are terrible for it; if something’s happening they’ll jump in and they’ll get involved and they’ll get hurt.

And likewise, the cameraman, the reporter should be thinking, “I need to get this story but can I do it from a different distance?” It’s thinking about the risk to them and that can only come about by managers reinforcing the training on a regular basis saying, “Have you thought about this?”

And if, sometimes, when you get the rushes back into the office, the manager should be thinking, “That person’s far too close. I’ll mention it when they come back.” It doesn’t have to be an overly critical one but more importantly, peer pressure. Your colleagues, the people you actually work with, can have a greater impact than any schemes that are set up, than any managers have an input into. There’s nothing like the people you actually work with for giving you honest criticism and 99 per cent of the people actually take it.

MB: Thank you George. It’s so relevant for journalism. In my own experience it’s my old war stories of being drawn into firefights into Romania during the revolution there without any kind of awareness of the danger - just wanting to go back and not having a perspective on my own position – putting myself at risk.

Gordon Turnbull, from the Priory Ticehurst Hospital, you gave us some fascinating insights a couple of weeks ago into new understandings of the science of trauma; that trauma is treatable. Now that we can do brain scans, we know that trauma has a definable and visible impact on the brain, and that certain kinds of medication, certain kinds of therapy, actually work in reversing the impact of trauma.

Gordon Turnbull: Yes. Thank you Mark. The first thing I’d like to say, really, is to congratulate you on having this particular organisation kick-off, because it’s been a long time coming. I’ve personally been aware of the developments in media for quite some time now, certainly since Lockerbie, which was my baptism of fire. And Lockerbie changed people’s attitudes towards the media - the role of reporters at the scene of tragedies - because they were the people who maintained the communications on the ground that had all been taken out by one of the falling wings of the aircraft. And I think that from there, there seemed to be a turning point; the media have begun to be seen as people who could be helpful at the scene of a trauma, rather than perhaps the way that they’ve been seen in the past.

But a word of caution. Functional magnetic resonance imaging machines, FMRIs, have brought about a great leap in technology, and have allowed us to see many of the secrets – not all of them by any means, of course – but many of the secrets of the central nervous system and the part of the brain that we’re particularly interested in in trauma.

But we actually had an awareness of human nature before that, which was brought into prominence by great thinkers like Freud and Jung etc - the basis of many of the psychotherapies.

I would strongly recommend that somewhere in this room, perhaps on the mantelpiece, although I don’t see one, but on the wall you could hang a portrait of Napoleon Bonaparte. I’ll tell you why.

Napoleon Bonaparte once said that, “There’s nothing more stultifying to progressive human thought than a successful war”. What he was really saying, I think, was that we don’t like to think about trauma. We like to think about victory; we like to think about winning things; we like to sweep the horrors of war, if you like, under the carpet; we just don’t like to think about it.”

Here with Dart we have an example of an organisation which is bringing trauma right out into the open and it’s your job – and of course in my field it’s my job – to keep it right there where it is.

What we’ve just heard about the Royal Marines has actually been a great victory in a battle that was fought for the past 10 years, about the field of debriefing. I’m so pleased for that because I believe that acute intervention based on pro-activity rather than re-activity is essential, in my view, in the management of trauma reactions. We have to do that. I think that the Marines’ development has been a great one because of its acceptability within the establishment. So it is actually beating back denial, a little bit.

The development of the neuro-sciences has given us huge insights into the way the brain, the human brain, processes trauma. And there are one or two that I’d like to mention here because I think they too, push back the denial. The denial, of course, that PTSD is an actual condition is still something that exists and there was an article in a newspaper - a prominent British newspaper - only few weeks ago proclaiming that they believed that the Americans had got it all wrong by diagnosing so much PTSD following Vietnam.

So there is, still, a certain scepticism. But the biology is, I think, the key to getting rid of that once and for all. I really do believe that. We know for example that the brain processes traumatic memories and that it does so in a recognisable way.

The hippocampus perhaps, would be another little statuette that you should have on your mantelpiece alongside Napoleon; they would go well together. The hippocampus means sea horse in Greek and the hippocampus is a wonderful decoding device that is the organ in the brain which actually translates the new information that comes in, in one computer language as it were, in the right-hand side of the brain (in right-handers, that is) into a new computer language which is the only acceptable form for it to be laid down in the filing cabinet. The new information can’t get in; it has to be decoded and understood.

The thing about trauma is that trauma – traumatic stress – releases an extreme response from the adrenal glands, so that we get a huge outpouring of adrenaline and of cortisol – two major stress hormones that actually damage the hippocampus. This blows a fuse, which has been identified in the hippocampus, and up until two years ago this would have been seen as a great tragedy because until then, the brain was thought not to have the capacity to repair itself.

Now, with the benefit of neuro-sciences and the FMRI, we actually know that the brain is a much more plastic structure than we ever thought it was before. So it’s true to say that the brains that we are actually using tonight in this room are not the brains that we had yesterday and they certainly won’t be the brains that we have tomorrow.

So the fuse on the hippocampus blows but the brain can generate new stem cells. It grows new stem cells which will replace the fuse in the hippocampus so that it can be functioning perfectly normally afterwards. How long does that take? Well, we know it takes about a month. We know that there’s a natural process that goes on and that’s what I like so much about the Marines’ approach, that what it doesn’t try to do is to interfere with a natural process that is going along anyway.

Of course we didn’t know until two years ago what the natural process was. So it’s important that we don’t interfere with Mother Nature. But what’s good about the Marines’ approach is that it’s monitoring a process that is going along. And that when that process begins, the process of recovery of the hippocampus, it means the recovery of your normal thinking ability, which is really what we’re trying to achieve in trauma management.

The Marines’ process will monitor and detect, very early on, if there is a hitch; if there’s a problem in that natural process, which means that something else has to happen. That’s where, I suppose, people like me come in, because as psychiatrists we have an increasing understanding of this process and we can treat post-traumatic stress reactions very effectively.

I’d like to say one more thing if I may and that is, we’re learning more and more about resilience now and much less about vulnerability; the vulnerability has actually been a burden to psychiatry for a long, long time. It has been believed of course, that when people encounter difficulties in their lives that those difficulties will last afterwards and that they may have an exaggerated reaction later on if they are unfortunate enough to meet with another distressing circumstance.

We now know and understand that that isn’t true. That resilience is much, much more of an important process in human beings and that we actually learn from trauma.

That’s my main message really; that you can learn your way out of a trauma. It’s not exactly a nice training exercise to go through, but it is something that can lead to a very positive outcome and it should not, I think, be regarded as a mental illness.

MB: Gordon, that’s an important message because, certainly in my work with psychotherapy I’m very aware that trauma and distress can be turned into a profound experience of meaning. There’s plenty in literature and in human history to illustrate that, and we now know much more about the science behind it as well.

I’m aware that there is so much expertise and so much experience in this room we could talk all night and we’re probably approaching a point where people need to repair to the bar again. But I do want to turn to Jack Laurence.

Jack, you’ve had much experience of war, and you’ve told the story, as Bruce was saying, as well as any that I know. If anybody has not yet had the opportunity to read The Cat from Hue as a description of war as seen from a journalist’s perspective, it is the most extraordinary piece of literature, as well as an extraordinary insight into the reporting experience of war.

And it is interesting, Jack, that you chose to leave the room at that time when we showing the video, having just been back to Iraq. Where do we take this? And what difference can we make to people like you, who are perhaps starting in their career, and what can we give them at an earlier point in their career that could really support them through that career?

Jack Laurence: Thanks, Mark. Having worked for American television networks for 30 years and hating to have to stand up in front of a camera with a microphone in my hand, really I was genuinely so embarrassed every time I had to do it, I’m a little embarrassed tonight and I wasn’t prepared to speak to you until the last moment when I was asked.

I started in my early twenties as a journalist. Because I was single and because there was a war on, I was asked to go the Dominican Republic in 1965 by my employers at CBS Radio News, and found that when I got there, there were American paratroopers and Marines putting down a local revolution in the capital, Santa Domingo. And as a young man with no military experience I just put myself in the hands of these paratroopers and they were delighted to have a reporter with them.

Remember this was 1965, the Vietnam war had not really escalated yet, it was April or so and I found that if I just did what the soldiers told me to do, I could get a great story. It was easy and it was very dramatic. There were very few American casualties. There were a lot of Dominican casualties and you could go down at 11 o’clock in the morning and cover the rebel leader and his news conference in English, be out of there by lunchtime and go cover the battle that afternoon. So you could literally cover both sides the same day, day after day, until the war was over and the rebels were crushed and America won yet another war.

The experience to a young reporter is thrilling. You must all know that, but even if you haven’t been in a war I can tell you, several things happen in one’s own psyche to enhance the experience.

You get great praise from your colleagues and your superiors. I was, a couple of months later, sent to Vietnam as the radio reporter for CBS News on the strength of the work I had done in Santa Domingo earlier in the year. So your job chances are improved by covering a war.

I can’t think of another story that’s more dramatic to tell, with all of the elements of tragedy in it – the traditional, classical elements of tragedy in it – than a war. So for a journalist the attractions are very, very powerful.

Even though it’s not your intention to become a war correspondent, the more often you do it the more it becomes self-supporting. And even though you are traumatised by some of the experiences that you have in the war – that is, when I say trauma I mean not in the professional sense, I mean scared out of your wits; you’re so frightened you’re paralysed, thinking you’re about to die at any moment. That must make a lasting impression on your brain.

I was struck by a number of things that were said here today, particularly about the Detective Inspector’s admonition to young cameramen, and women too, to “think about what it looks like to someone with a gun in his hand down the road, when you point a camera at him”.

In 1973 in October in the Golan Heights, my cameraman, an Englishman named David Green and I and our soundman were standing near our car between the Israeli lines and the Syrian lines. We were trying to find a story that day and it was perfectly quiet, early in the morning around eight o’clock, no soldiers around and David had the camera on his shoulder and we heard this clank, clank, clanking sound of a tank coming over the rise a couple of hundred yards toward the front.

We assumed it was an Israeli tank and when it came into view we realised our mistake; it wasn’t, it was a Syrian tank. As soon as the driver spotted us, he turned, swung round and pointed straight at us. David had the camera and we just froze. We knew that in the next instant the tank shell was going to fire and we’d be blown away and that would be the end of us and the story. And it just kept coming closer and closer and closer and David discreetly took the camera off his shoulder, nobody moved too fast.

I started to wave, like that, “Hey, I’m a civilian. No guns here!” And when they were about 50 yards away, the hatch opened up and an Israeli soldier popped out and waved back. They’d just captured the tank and they were bringing it back!

Well, that’s another kind of being scared out of your wits and having the impression painted on your memory. That same cameraman, the year before, had been in Londonderry with me on Bloody Sunday. I was not with him at the moment but he was in-between the paratroopers and the Irish kids running around in the streets, and David came in really traumatised.

One of the things that had happened to him was that he was pointing his camera down the street, in this ghetto, and he saw, through his lens as he was rolling the film, a British paratrooper swing his rifle around at David and go down on one knee into the firing position. And David, being a man of very quick reflexes, ducked around the corner like that, as the bullet went by him. When a bullet comes that close you can hear it. It buzzes. You can hear it going by. That traumatised him and certainly gave him the impression that the soldiers were shooting at anything that looked like it might have a rifle.

I’ll just add one thing. I’ve had to deal all my adult life with wars and the effects of those wars on my well-being - my psychological well-being. Three things have helped me: reading a lot of self-help works, therapy, and the support and strength of my colleagues. It’s not by accident that journalists are known for their tolerance to alcohol and that any honest account of a journalistic experience in a war zone will talk about the scene in the bar at the hotel after the stories have all been filed.

I think it’s a kind of group therapy that’s just naturally developed over the years; that journalists know how to take care of one another and in the war zone. The drinking at the bar at one o’clock in the morning is a kind of natural way of reliving what happened to each of us in that day’s experience or in that week’s experience or in previous experiences and the story telling that goes on is a kind of therapy.

I would just make one suggestion to the broadcasting and journalist news organisations that are represented here. The Royal Marines and Scotland Yard seem to have a fully developed programme for recognising their people who may be in distress. And as I covered wars in my career, we had nothing like that at CBS News, or at ABC News. What we did was had a kind of Buddy system – when you saw one of your colleagues going off the rails either drinking too much or isolating, because that’s your natural tendency, to retreat to somewhere by yourself, where you can deal with the fear, alone.

The effect of all those traumas on oneself is to be frightened of almost everything – even life itself. And when that becomes too great, the consequences can be extreme.
I can’t tell you how many of my colleagues from Vietnam have killed themselves; either jumped out of windows or drowned or, quite literally, committed suicide. It’s a significant number of people, just from memory.

If news organisations can develop a way to help to identify people who are in trouble, especially right after a war, who are isolating or drinking too much or are tranquillising themselves into a stupor, obviously they need help. And the best kind of help in my experience has been a phone call, an invitation, a friend that comes around the house unexpectedly and just checks up on you – or you doing that for someone else – it works both ways. If it weren’t for the fact that I’ve been fortunate enough to have friends, particularly the cameramen, who were helpful in that way, I’m not sure I’d be here talking to you tonight, honestly.

There needs to be a support system, there need to be warning signs that are seen and recognised and acted on, in the journalistic community just as it’s done so well in the police and in the military. Thanks.

MB: Jack, thank you very much indeed. Andy Kain, of AKE.

Andy Kain: I’ll just add a few reflections from someone who came from the military Special Forces and made a transition on reflection rather than as a result of peer pressure to accept that stress is a factor. Coming from a culture where denial was the norm. That said, I think to some extent we can go too far. The military had systems in place that actually dealt with stress whether it was intentional or not.

For example, in the Second World War, on the front line – the average was three months on the front line – they knew they had to change troops over because they reduced in effectiveness. We had systems such as rest and recuperation where people came out of the fields; they had three or four days to make a transition back to normal life.

The one thing in my personal experience in reflecting on times when we may have been stressed was, we got through it by mainly lots of training and realistic training. And I think there’s an element today in the military, where a lot of people join the military and they’re joining for the adverts which show adventure training and all that type of thing, and they don’t actually come to terms with what they might be asked to do in the future. Whereas we spent lots of time actually thinking through the consequences of what we would be doing and what we would actually experience.

You would also have a difference if you gain experience through little drips. I was lucky enough to gain my experience through little drips, whereas in the Falklands you had young soldiers who were seventeen who made the transition from training on the training ground on Salisbury Plain with blank ammunition, to the real hard-arsed conflict in the Falklands. Lots of them really suffered because it was such a traumatic shift.

And in the 10 years we’ve been working with journalists, we’ve seen that. There are journalists out there who do not get any help or support, and I agree entirely with what you’re saying – the buddy-buddy system. The similarity between the media and the Special Forces is astonishing, believe it or not, in that you are working at the extremes of your own personal scope with very few resources in very tight communities.

We had very much the same - drinking at the bar, talking through the stories, swinging the lampshades. All those are mechanisms to deal with what’s going on.

But there’s no hard answer to it. There are people who suffer when most of us can get through it by that sort of community spirit, but it’s getting through the stigma people still have, that there is something wrong. Anything you experience in life is going to change you. If you see some horrible event or a part of it, it’s going to affect you; it’s going to change you. I believe that’s normal and most of us come through it.

I’d like just to pass you to a friend - I call him a friend because he’s a psychiatrist and I don’t want him to start analysing me. Ian Palmer who’s Professor of Psychiatry, retiring from the army.

Ian Palmer: Thank you. I’ll keep it short. I’m Ian Palmer and I was the SAS doctor for four years so I was deployed with the SAS on operations; also to Rwanda and Bosnia. I’d like to point out a few things that have come out tonight. Most people do not get PTSD. PTSD is only one mental health outcome, and for this organisation to be focused on PTSD, this is wrong.

I’d also point out the work in the Marines which shows that it’s a minority of people who have PTSD or problems and it’s the same with the British Army. I’d also point out that PTSD is NOT a psychotic illness, and therefore is multi-factorial in its origins and genesis, and is an interaction between the individual, the event, the environment in which that event occurs and afterwards and more importantly - and perhaps what’s come out for me in this discussion is - the culture.

I have to talk about soldiers who are cultured into a way of thinking, of living and being and that is similar to journalists but it’s not quite the same because you have to give up your autonomy in the Armed Forces.

So whatever happens in the Royal Marines is very important and very interesting, although I must say is unproven yet; it may not be transferable to other cultures. I would also point out that whatever occurs in the armed forces is part of a complete medical and psychological service; it is not a stand-alone.

I’d also point out that it is not the events that are the problems, it is the meaning of the event for the individual. This is certainly important in working with journalists with whom I’ve worked, many times, because these issues are quite complex. One of my fears is that PTSD may be misdiagnosed, erroneously diagnosed, and the treatment may, in fact, worsen the individual’s conditions.

There are no journalists here tonight who are working war journalists, as you said yourself; I think this is extremely interesting because it ties in with Gordon’s view about resilience. Perhaps these individuals are resilient. Perhaps there is a time in our life cycle when we can do all these things but later on, we have to reflect on these things and change.

I’ve mentioned issues of culture; I think it’s important in the British Army, which has twice as many people as the Navy and the Air Force, that they have been providing an education for many years and the facility for people to come and receive help. In fact, it is now far, fantastically easier in the armed forces to get psychological help than anywhere else in the country. The NHS has let down soldiers and sailors and airmen – the Armed Forces have not.

However, the majority of people will not seek help because of stigma. Now stigma is fine and we can sit here and talk about stigma. But the realities of ambition, of personality disorders and all sorts of things, interfere with us and how we perceive ourselves and how we seek help. So it’s very complicated. Provide the service by all means, but don’t necessarily expect people to pick it up. It may be the people who need it most who will not pick it up. I fear that, without risk, you may not get your story.

MB: Rodney Pinder, you’re from the new International News Safety Institute.

Rodney Pinder: I’d like to recommend again the book that John Owen mentioned at the beginning of our meeting, Dying to Tell the Story, which is not just about journalists who were killed in Iraq. There’s a very illuminating account by Dr Anthony Feinstein, one of the foremost experts on trauma and journalism. He’s written an illuminating article based on a survey of journalists who have been in conflict. It’s a useful book, not only for journalists but also for others who are interested in this field.

MB: Thank you Rodney. Quick final thoughts from me before I ask Bruce Shapiro to sum up.

We had hoped to have here tonight the Vicar of Soham, who is very supportive of what we’re doing - Tim Alban-Jones, the Anglican Minister of Soham. He was struck by how surprised journalists covering the murder of the two young girls in Soham last year were, and how affected they were, by what they were reporting. It was not unexpected to him that people would be affected by what they were doing but he was surprised that journalists were surprised. He sent me a note for not being here and I’ll just read out what he said.

“The modern trend to parachute teams of expert counsellors in is perhaps a recognition that trauma affects communities and people. It’s interesting to note from my limited experience in Soham that counselling has not been required; at least not yet. The various professional support networks that have been established have all had to be scaled down. I take this as a positive sign that the informal networks of support, family, friends and neighbours etc, can do the job far more effectively. Journalists, by the nature of their work, are often away from their personal support networks, hence, perhaps, the stampede to the bar when the deadlines have been met. May God bless you in your work.”

One absolutely final thought. Anthony Feinstein, the Canadian psychiatrist who got a lot of this out into the open with the first formal official survey of post-traumatic stress reactions among journalists, has done a second, follow up survey, the basic results of which are on the Dart web site.

The interesting thing is that it seems as if the Iraq war has been, so far, less disturbing for journalists, for people he’s spoken to, because at the time he was doing the speaking with them it was less personally threatening. He’s working on that and he thinks there may be more to investigate; but he’s produced a really striking book.

Bruce, over to you to sum up.

BS: Two quick points. One is that there are a lot of people in this room who have seen one another over the course of the last year, and I feel that I need to say as someone who has been kind of distant but coming in periodically and checking in, that the progress of this discussion over the last year and of the practice within Reuters and the BBC and amid all the people here has been just extraordinary.

It may feel like some of the same people having the same conversation, but it’s not. The circle’s much bigger and now hundreds of journalists have been trained at BBC and at Reuters and elsewhere, and this is a forward-moving conversation. This has been a revolutionary year in a lot of ways and I think that needs to be said.

A good American journalist and now historian named Gary Wills wrote once that the real story, the story that you want, is what happens after the camera leaves the room. And looking at the pictures on the wall here and talking amongst ourselves here, it’s very clear to me that whether we’re talking about news coverage of trauma or we’re talking about what we need to do, the story is when the cameras leave the room and how to make that the continuing subject of our discussion. I just hope that everything we do tonight and over the course of the coming months with Dart in Europe and Frontline Club and everything else, will continue that conversation.