Nuala Ellwood



‘When the history of journalism’s discovery of the importance of understanding trauma comes to be written, a place of honor will go to Dr Anthony Feinstein.’ DART Centre for Journalism and Trauma.

Dr Anthony Feinstein is a Professor of Psychiatry at the University of Toronto and the author of Journalists Under Fire: The Psychological Hazards of Covering War.

Feinstein’s study, exploring the link between war reporting and Post-traumatic Stress Disorder, was one of the first of its kind and found that 29% of war correspondents suffered from PTSD.

With the support of veteran journalist Chris Cramer, Dr Feinstein has set up a website that provides a self-assessment programme for front-line journalists who may be suffering the effects of PTSD. This website has proved to be an invaluable aid to many reporters who may otherwise not seek help.

Feinstein’s book, Journalists Under Fire: The Psychological Hazards of Covering War, has been an excellent resource for me as I set about getting under the skin of my protagonist, war reporter Elizabeth Rafter, so I was delighted to get the opportunity to talk to him and find out more about his ground-breaking research.

NC: What prompted you to investigate the effects of trauma on war reporters?

AF: In my clinical practice, back in 1999, I had a fascinating patient who turned out to be a war reporter. To better understand her condition I asked my research team to undertake a literature search on the topic of war, journalism and emotional distress and to our collective surprise, we found not a single publication on the topic. Intrigued by this, I wrote a grant application, sent it to the Freedom Forum in Washington and got my first study funded

NC: Many war journalists would balk at the idea of admitting they are suffering from stress and some may even fear that it would be detrimental to their career to do so. How difficult was it to get the journalists you interviewed to open up about what they had experienced
and how it had affected them?

AF: You are correct about some journalists having concerns that any admission of psychological distress might have negative career implications. That said, the overwhelming majority of journalists were very happy to talk to me. Of my initial sample of 170 journalists, 140 agreed to participate in the study which gave an acceptance rate of over 80% which is very high for the behavioral sciences. This suggested to me that the journalists were hungry to talk about their experiences and their emotions.

NC: Can Post-traumatic Stress Disorder lie dormant and emerge years later? For example, when the journalist has retired or moved from war to domestic reporting or during times of extreme stress such as death or divorce.

AF: Post-traumatic Stress Disorder can have a delayed onset. The American Psychiatric Association, in their classification of the disorder, defines the delayed onset as symptoms beginning six months or more after the traumatic event. On occasion, I have seen this delayed onset triggered by a stressful life event.

NC: Unlike the soldier, the doctor, the aid worker, who are actively engaged in the conflict or tending to the wounded and destitute, the war reporter, photographer or videographer is standing aside, recording what is happening but without being able to intervene. Did you find instances, through your research, of journalists experiencing guilt at not being able to help the victims of conflict beyond being a witness to their suffering and relaying that to the rest of the world. Do you think guilt is a factor in Post-traumatic Stress Disorder?

AF: The question of guilt and being a voyeur has come up frequently in my work with journalists. It arises for the exact reason that you mentioned in your question. For some journalists, they have difficulty managing what they see as an intrusion into the suffering of others. However, the journalists also note that without being there and witnessing a traumatic event or the aftermath of that event, they cannot really do justice to telling the story, but it certainly does place them in a bind and it is not infrequent that my therapy has to address this particular tension. Guilt is now recognized as a single symptom in the syndrome of PTSD. Guilt by itself is not PTSD and is more frequently associated with depression. Frequently, depression and PTSD occur together in the same individual and in this circumstance you often see prominent guilt.

NC: Can you tell me about the website you have set up to help journalists who may be suffering from trauma. How effective has this been in reaching out to people who may otherwise not ask for help? Would you say it is the first step towards seeking face-to-face therapy?

AF: I believe my website has been very effective in reaching a wide array of journalists. Whether the journalists actually act on the advice given to them by the website is not known to me, but I certainly hope that they do. However, in order for me to ensure that journalists do follow-up and get some help, or at least have access to help, I have restricted the use of the website in this regard.


NC: What happens when a journalist has received therapy and then decides to return to a conflict zone? Are there ways of preparing someone psychologically for this?

AF: I have provided therapy to many journalists who have successfully returned to conflict zones. I believe that an individual can emerge psychologically much stronger from therapy which leaves them in a better position to deal with stressors and dangers that lie in wait. That said, should an individual continue to show evidence of vulnerability and emotional distress despite therapy, it is my recommendation that he or she should consider some other aspect to journalism. However, this is very much a personal choice for the journalist and it is certainly not a decision that I can make for them.

NC: Did you find any gender differences in symptoms experienced by war reporters?

AF: In terms of the fascinating gender question, to my surprise I found no significant gender differences between men and women when it came to PTSD, depression or overall psychological distress. This result is fundamentally different from what you see in the general population where women are known to have twice the rate of depression and anxiety than men. Interestingly, our data with front-line journalists are not dissimilar to that seen in military personnel.

NC: How difficult is it for journalists to return to ‘ordinary’ life – for example, to spouses and families – after returning from a war zone? Do you think the disparity between the horrors they have witnessed while reporting conflict and the relative calm of day to day life at home can bring about/ exacerbate symptoms of Post-traumatic Stress Disorder?

AF: The question of returning to civil society and functioning well after a prolonged period in the war zone is a significant challenge for many journalists. Making a good adjustment to life back home is of course essential if relationships are to endure. When this transition cannot be made, marriages break up and friendships are often lost. In the process, this adds significantly to the distress of a journalist. This is a theme that crops up repeatedly in my therapy with journalists.

NC: What are the differences, psychologically, of reporting a natural disaster – where there is still a high volume of death and images of horror – and reporting from a war zone?

AF: It has been my experience that journalists can become very distressed with having to report this particular kind of traumatic event. I recently saw this first-hand with the earthquake in Haiti. That event was deeply disturbing to a number of journalists. That said, there is a fundamental difference between covering natural disasters and war. In the latter, there is a very real and significant threat directed towards the journalists whereas with disasters, this variable is usually absent. This suggests to me that war is a more hazardous work environment for journalists and as such one is likely to see more significant psychopathology as a result, but until such time as there is a direct comparison between these two particular kinds of stressors, I cannot definitely answer this question. But yes indeed, disasters can certainly trigger emotional distress in the fifth estate.

NC: How have news organizations reacted to your research? Have there been
changes in the provision of counsellors/ therapists for journalists returning from conflict?

AF: News organizations generally react very positively to my research. I believe that my early studies were responsible for a sea change in the attitude amongst many news organizations in that, for the very first time, they began offering confidential counselling to their front-line journalists. I have now been researching journalists for 15 years and so I see how the culture is changing and how organizations are certainly more open and supportive to their war journalists on this particular question. However, there are always individuals and in some cases organizations who disagree with this. These dinosaurs take what I believe is a punitive view which is that if journalists don’t have the “right stuff”, they should get out of the field and do something else. I believe this is fundamentally wrong. Great journalists can, on occasion, become very distressed by their work. They can benefit from therapy and in the process get back to doing their important and courageous work.

Dr Feinstein’s website offering help for journalists suffering from PTSD can be found here:

You can find out more about journalism and PTSD at the DART Centre for Journalism and Trauma:


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