The Circulation of Trauma

Teaching a class on images of war has been an education for me. It is not my area of expertise, which perhaps made it all the more fascinating. I've had the opportunity to meet many wonderful guest speakers, think about things I don't normally think about, and make new connections when thinking about the subjects that I spend most of my time thinking about.

In our most recent class, we screened the powerful documentary Under Fire, which concerned post-traumatic stress disorder among war journalists. After the screening, we spoke with one of its producers, neuropsychiatrist Dr. Anthony Feinstein, and one of the journalists depicted in the film, Pulitzer Prize winner Paul Watson. Both were as candid and thoughtful as people who encounter trauma could be.

Watson's experiences as a war journalist are the stuff of classic tragedy. His telling of his experience being the photographer who helped change American military policy through his photos of dead American soldiers in Mogadishu in 1993 is the emotional climax of the documentary. It is also the basis of a series of poems, a play, and an opera that will be performed in 2014 in NYC. I've always felt a bit queasy about turning one person's suffering into another person's art/entertainment. Maybe it's the commodification that bugs me, the building of a career on the suffering of others. Even if the message affects others in some positive way, that other exploitative layer is there. Watson's pain also seems incredibly personal and private. In some respects, the troubles with the use of Watson's emotional and mental trauma for the purposes of art mirrors the trouble at the heart of his story: the depiction of death and suffering as a kind of desecration, no matter how noble the intentions. One idea I was left to mull over after that evening was how we can discuss trauma without it overwhelming us, or infecting us.

This relates to my musings on the circulation of ideas and stories about personal suffering online. When do our consumption of these ideas and stories and the conversations they give rise to provide us or the sufferer with solace? When do they prompt us to dwell on the suffering? When do they help us work through the suffering? These are "difficult" topics to think about, to speak about, to hear about. Watson had the feeling that there was something fundamentally wrong about recording and distributing these horrible images. Another part of him knew that they were important for the world to see.

Watson knew that some images he saw would overwhelm an audience. When he encountered piles of dead children, he didn't photograph them. He depicted the horror obliquely, showing the children's schoolbooks scattered on the ground. That ability to take in some overwhelming horror of real life and to retain it's essence through storytelling is, I'm understanding, an invaluable part of being a reporter, an artist, and maybe being a compassionate, honest human being.

The Werther Effect 2.0: Psychogenesis in the Internet Age

One of my favorite films from the last few years starts and concludes with an idea that, aptly, took root in my brain and has been something I think about long after I saw the film for the first time. It is articulated by the main character Dom Cobb: "An idea is like a virus, resilient, highly contagious. The smallest seed of an idea can grow. It can grow to define or destroy you." Soon after seeing this film, I learned about the Werther effect. 

The idea of the Werther Effect is simple and unnerving. When people are informed through news reports or fictional stories of the fact that other people have committed suicide, they are more likely to commit suicide themselves. The message (e.g., a news report of suicide or suicide statistics or a story about someone committing suicide) likely makes the message receiver believe that the act in question is something that people, perhaps people similar to him or her, do. That isn’t to say that it makes the act socially acceptable or condones the act. By conveying that it has happened and that someone else did it, the message makes the act salient to the receiver, introduces it as a possible course of action, and may imply that it is common. Some theorists say that it may just be a simple suggestion-imitation model of behavior. In either case, it is more likely that the message receiver will commit suicide than if they had not heard the message at all (see Etzersdorfer, Voracek,& Sonneck, 2004; Gould, 2001; Hittner, 2005; Phillips 1978, 1979; 1982; Wasserman, 1984 for details, Thorson & Oberg 2003 for a contrary view).

In the top-down world of mass media production, news editors have been encouraged to downplay suicides, making them less likely to inspire readers to commit suicide. But if we assume that the same relation holds between exposure to the message and suicide in the age when exposure is "viral" (i.e., spread through online social networks) and/or search-based (i.e., determined by in-the-moment interests), then how do you curb imitative suicide? The story of someone’s suicide might spread through a group of people who are already preoccupied with the idea or seek out this kind of information. It may spread through people who are trying to offer support. 

This might be part of a more general problem in the age of the internet (where messages reach people through social networks or based on their consistency with people’s pre-existing pre-occupations/preferences). There might be other kinds of behaviors (anorexia, cutting one’s self, abusing drugs) and even other ways of thinking (depressive thought patterns) that are similar to suicide in that they are capable of being directly influenced by messages (i.e., not entirely physiological in origin), they are generally considered to be undesirable (i.e., painful for the individual and community), and are stigmatized (that is, not talked about). This particular kind of stigmatization makes these behaviors and thought patterns different from acts of aggression toward others, which, as a culture, we seem to have no problem discussing. This stigmatization leads, in certain communities, to an attempt to overcome the stigma through communication, through sharing experiences with the behavior or thought pattern and through support, to let people know that they are not alone. This reaction to the silence of the stigma is unquestionably well intentioned and it may have positive effects, but the evidence of suicide contagion makes me wonder if there are unanticipated effects. It may make message receivers who do not yet exhibit the undesirable behavior or thought pattern (or who do exhibit it but to a lesser extent than the extreme examples they hear about) more aware of the negative behavior or thought pattern, believe that it is more common or that what they are experiencing is more serious or more intense than they would have otherwise thought, and believe that it is something that people like them do or, worse yet, something that people are (as in: a permanent, defining characteristic, e.g., a depressed person, an alcoholic, etc.). 

Possible stimuli that may lead to a negative behavior or thought pattern becoming more common include advertisements for drugs or programs treating depression, anxiety, and other psychological conditions; online support groups; social media messages (Facebook and Twitter posts) related to the topic; news stories encountered via major news sites (e.g., NYTimes) or circulated virally via social media (e.g., Twitter). Make no mistake: there is plenty of evidence to suggest that these tools are useful in combating the spread and intensity of suffering and so they should not be discarded unless there is evidence that they do more harm than good. Its unrealistic to think that they ALL do more harm than good, but the evidence of suicide contagion via mass media suggests that it is worth examining whether some of thee messages, under certain circumstances for certain people, may, in fact, backfire. Establishing whether or not any messages designed to curb suffering that is not physiological or physical in origin backfire is the first step. Then, it is essential to understand why this happens, when this happens, and be able to modify the messages so that it doesn't happen anymore: all possible given the wealth of data on Internet use.