Self-Study Unit 4: The First 24 Hours

The first 24 hours after a traumatic event can be a time of extremely high psychological stress for everyone involved — victims, their families, rescue personnel, medical staff and others. Often left out of this picture of sufferers, however, are the journalists who give witness to tragic situations so that others who are not on the scene have a sense of what happened and what impact it has had (and will continue to have) on the community. It has been said that journalists are the "eyes and ears" of society. To play that role can take a toll on a person's physical and psychological health. There is considerable anecdotal evidence and a growing amount of empirical research that suggest journalists are vulnerable to stress disorders like other first-responders to emergency situations.

If their jobs involve covering traumatic stories over a long period of time, journalists need to be aware of the potential for burnout, secondary traumatic stress, compassion stress, compassion fatigue and vicarious traumatization. (See Module 1, Part 3, "Why Do Journalists Need to Know About Traumatic Stress?" for a more detailed discussion of these effects.)

Reporting in conflict zones requires an online curriculum module all its own, but clearly these situations have an ongoing level of high stress that deserves special attention. The reflective writings of journalists who have been war correspondents or who have been assigned to areas where the threat of conflict is always present have been instructive. The short- and long-term effects on journalists of witnessing (and sometimes experiencing) this level of violence have not been well studied, but inroads are being made. More about covering violence in conflict zones should be forthcoming in future modules.

As for journalists responding to stress within the first 24 hours, there are some helpful points that can be offered here from the stress management/reduction literature and from journalists who have covered traumatic events in the past. These suggestions are not meant to be a substitute for professional clinical treatment but serve more as an informal discussion of what can be done to recognize and manage or reduce stress symptoms before they become detrimental to one's mental and physical health.

Psychological stress is not always harmful. Sometimes it can even save your life, or enhance or improve your performance. Robert M. Sapolsky, author of Why Zebras Don't Get Ulcers (1998), has written an extensive book on stress and the stress-response. He writes that when emergencies arise, the body's stress-response rapidly mobilizes energy and decreases many of the body's energy-expending functions (e.g., digestion, growth, reproduction) so that the body can concentrate on survival. Pain may be blunted but your sense become sharper. These are responses that help both humans and animals go into "fight or flight" mode. The stress-response, in the short-term, is a way that the body reacts to a perceived threat or danger.

However, Sapolsky warns, the stress-response can also be damaging when the stressor is long-term or chronic. You may go into a state of exhaustion, feel fatigued and succumb to diseases related to high levels of chronic stress. "Stress increases your risk of getting diseases that make you sick," Sapolsky writes, "or if you have such a disease, stress increases the risk of your defenses being overwhelmed by the disease" (16). Obviously, then, prolonged or chronic stress should be avoided.

During the first 24 hours after covering a traumatic event, journalists may need to take time to self-assess the level of stress they are under. It is easy to ignore signs of stress when one is overwhelmed by a crisis and the demands of newsgathering. Taking "time outs" to gather a different kind of information - specifically, biofeedback from one's own body - is an important part of self-care.

Experts on stress have identified some common symptoms of stress that journalists should be able to recognize if they take time to "listen" to their bodies. The International Critical Incident Stress Foundation provides a list of signs and symptoms on its web site in an attempt to prevent and mitigate disabling stress through a number of interventions. The web site can be accessed at: http://www.icisf.org

The signs and symptoms of stress are grouped by categories. They are as follows:

* Any of these symptoms may indicate the need for medical evaluation. When in doubt, contact a physician.

Mitigating Stress
The International Critical Incident Stress Foundation also recommends ways of mitigating the stress symptoms listed above:

· Within the first 24-48 hours, periods of appropriate physical exercise, alternated with relaxation will alleviate some of the physical reactions.

· Structure your time - keep busy.

· You're normal and having normal reactions - don't label yourself crazy.

· Talk to people - talk is the most healing medicine.

· Be aware of numbing the pain with overuse of drugs or alcohol; you don't need to complicate this with a substance abuse problem.

· Reach out - people do care.

· Maintain as normal a schedule as possible.

· Spend time with others.

· Help your co-workers as much as possible by sharing feelings and checking out how they are doing.

· Give yourself permission to feel rotten and share your feelings with others.

· Keep a journal; write your way through those sleepless hours.

· Do things that feel good to you.

· Realize those around you are also under stress.

· Don't make any big life changes.

· Do make as many daily decisions as possible which will give you a feeling of control over your life, i.e., if someone asks you what you want to eat - answer them even if you're not sure.

· Get plenty of rest.

· Recurring thoughts, dreams or flashbacks are normal - don't try to fight them - they'll decrease over time and become less painful.

· Eat well-balanced and regular meals (even if you don't feel like it).