TERRY GROSS, host:
My guest, Anthony Feinstein, is a psychiatrist who wrote a book about the psychological hazards of covering war called "Journalists Under Fire." He's treated war correspondents and created a website to help journalists in war zones diagnose and deal with their stress related problems. Dr. Feinstein is a professor of psychiatry at the University of Toronto.
Dr. Feinstein, welcome to FRESH AIR. A lot of soldiers when they come home don't like to talk about what they've seen in war and they don't want to dwell on those memories. When you're a journalist it's your job to remember. It's your job to get every detail that you can remember and report it, and then that report lives. That report, you know, lives in print or on the internet and video, whatever. And chances are, somebody's going to ask you about it too. I mean, you might even become famous for this report and end up being interviewed about what you've seen and the memories will come out again. So is it harder sometimes for journalists to deal with the memories that can cause post-traumatic stress because it's their job to report it?
Dr. ANTHONY FEINSTEIN (Author, "Journalists Under Fire"): I think it can. And I think you're touching on a really interesting point over here which is this: one of the symptoms of post-traumatic stress disorder is what we've termed avoidant behavior, that you want to stay away from reminders or recollections of the traumatic event. And this is where journalists who have this syndrome, who have PTSD, find themselves in a unique conundrum because their physiology is telling them to stay away from it, but they can't because they're journalists. They often have to go back to that particular scene and get the news, get the story.
And this puts them in a unique bind and I think it's a very difficult bind for journalists to reconcile because it is their professional demands. They want to be able to, you know, tell the story and keep the newsroom happy. But at the same time the physiology is giving them a warning sign that they should back off from this. This is very uncomfortable for them.
GROSS: I think it must be hard sometimes for war correspondents to know when is it time to come out, when have you taken too many risks, when are you just too worn out from the risk that you've exposed yourself to and the things that you've witnessed. And if you're a dedicated war correspondent, it must be very difficult to give that up for a lot of reasons as one, you're kind of working at the center of history and recording it.
And two, I think a lot of war correspondents become so committed to understanding and translating the war - or disaster, calamity - that they're witnessing and they don't want to leave the story because they come to care about it so deeply. Have you worked with correspondents in helping them to figure out when it's time to give it up?
Dr. FEINSTEIN: I found that the, you know, the journalists that I've worked with who are, for the most part, very experienced have figured this out themselves often. They know that they have a certain limit of time that they can spend in the frontlines and then they need to take a break from it. And so, they tend to follow that. Many of the journalists have said to me they, you know, spent about six weeks, two months and then they know that they need to take a break from it before they come back and continue the work.
So to many of them, they seemed to have sorted out their own way of dealing with this. I think what's often been much more difficult is for a journalist to decide to leave a particular conflict altogether and go and do something else. Because as you point out, their investment in the story is often extremely intense and they've - they may not necessarily have become emotionally involved in what they're doing, many of them don't, but they still are attached to the power of the event that they've been reporting. And it's very hard to walk away from that.
In addition, they have made often very intense friendships or established strong bonds with local journalists or fixers whom they often feel a moral responsibility for. So, situations that I've counted in Iraq for example as journalists - western journalists who have gone into work there. They've done some wonderful work, they've established excellent contacts with Iraqi fixers who help them, but then the journalists start feeling responsible for their fixers because they realize that if they leave the story, or they come back to home, this journalist might be unemployed, they may be in some financial difficulty.
And so they have this kind of obligation that they feel they need to fulfill to people who've helped them and allowed them to get the story and allowed them to do the work. And that can be very difficult because guilt then starts playing a prominent part in their decision-making process and that's not a healthy thing. You don't want your decisions to be driven primarily by guilt and so that's something that certainly crops up in the therapy that I do.
GROSS: I know you've spoken with some journalists who have a close friend, a colleague or somebody who they met in war zone who died. And sometimes they even feel partly responsible or guilty about the death. Is there a story about that - that you helped somebody through that you could tell us without necessarily mentioning the name of the person?
Dr. FEINSTEIN: I think from a clinical perspective, it's been my experience that this is the hardest thing to deal with, that from time to time I've had a journalist referred, who has lost the colleague in the field and the journalist holds himself responsible for the person's death. And then the guilt becomes extremely powerful and overwhelming. And as part of the guilt the journalist often wishes that it had been he or she who had died and not their friend - that speaks to the intensity of their guilt. And this becomes a very difficult clinical situation to deal with.
What I often do in situations like that is that I check for an underlying depression. And if that's present, I treat that. But then, what I have to do with the journalist is to correct the distortion that has crept into the person's thinking, in relation to their guilt and the blame. And that can be a very challenging task. I've found also that the presence of prominent guilt at the death of a colleague is the single biggest catalyst that triggers an often significant depressive disorder in journalists. So, it's a pressing clinical issue. I think the most dramatic account of - this was given to me by the Italian journalist Giuliana Sgrena. I don't know if you remember the episode. It took place in Iraq, back I believe in 2005.
Giuliana Sgrena is a journalist who works for Il Manifesto. And she's by nature a pacifist but had gone to you Iraq repeatedly to tell the story of the human cost of war. And while she was there, she was kidnapped. Held captive for a month, her video was posted. It was a very distressing sight to see her pleading for her release. It was a real concern that she would be killed by her captors. Eventually she was released. The Italian government sent a security man to broker her release, which he did. And en route to the airport, their car came under fire, mistakenly from American soldiers. And Giuliana Sgrena was injured but the security man shielded her from the incoming fire and he was killed.
And it was just this remarkable confluence of events that her moment of release and freedom had been blighted by this event that took the life of the man who had come to secure her freedom. And she described to me, very vividly, what it was like to feel this man literarily breathe his last on top of her and to feel his body go limp as he died. And these were the memories that she'd been left with in terms of her moment of freedom. And, you know, the guilt in response to something like that is extremely powerful.
GROSS: My guest is psychiatrist Anthony Feinstein. We'll talk more about his work with journalists who cover war after a break. This is FRESH AIR.
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GROSS: My guest is psychiatrist Anthony Feinstein. He wrote a book about the psychological hazards of reporting on war, and he's treated journalists who work in war zones. Is it still difficult for journalists to admit that they're having problems as a result of covering wars because they're afraid that their news organization will think that they just don't have the guts to do it anymore or that they had to be rotated out? You know, that they're not very good?
Dr. FEINSTEIN: I think the answer is yes. I think for some journalists it's very difficult to admit to that. There's no doubt that there's still a stigma surrounding issues of psychology and mental health, and some journalists are very uncomfortable with this notion, and there are going to be news managers who are not comfortable with it either. But there's something else that I've confronted in journalists, which I think is interesting, that the ones who have gone often done this remarkable work feel that in many ways the victims of war are the displaced people - those who've lost their homes, who've lost loved ones. And in relation to that degree of suffering, what right do they have these journalists to complain that they're feeling unwell.
And many of them use as a yardstick to judge their own complaints by. So, they feel almost guilty at times, ashamed that they could be having these kinds of feelings when their suffering in relation to what they've witnessed in war zones is so much less. And this is a message that I've heard time and time again from journalists who feel that it's a luxury for me to go and talk about my own distress when clearly what I've seen in other people is so much greater than what I've experienced. And of course this is a distortion. On one level they're correct, but it's a distortion in terms of their thinking. It shouldn't negate what they've been through.
If a journalist has been held captive, if they've been subject to a mock execution, if they've been beaten up, if they had a colleague killed -you can't dismiss those kinds of experiences as relatively inconsequential because, in comparison to what's going on in a war zone and the mass killing and they've around them, this doesn't rate. And that's a very dangerous distortion that creeps into some journalists' thinking and becomes a barrier in terms of their accepting help.
GROSS: Are any of your people - and by that I mean people who you've interviewed or who you have treated - in great jeopardy now either because they're in prison or kidnapped or…
Dr. FEINSTEIN: To be honest, I don't know. What's been an interesting development of the Web site that we established to help frontline journalists is that the reach of the Internet is so great. I now get correspondents from countries such as Somalia et cetera where journalists are in dire difficult. Now the exact nature of the stress that they're under is not known to me but these are journalists who are often reaching out in extremist. Those are very difficult situations to deal with because how do you provide assistance to someone who is in a society where, you know, medical services have collapsed et cetera. So, that becomes a challenge.
But I'm sure that there are journalists who have used the Web site, who send emails to me, who at this very moment are in considerable danger.
GROSS: You know, what I think about sometimes, like, it's one thing to cover a war and put your life at risk in order to cover it when you know that people are paying attention to what you write, and that they're paying attention to the war that you're covering. But some journalists are risking their lives to cover wars that aren't on the front pages -that are in places that, you know, people aren't paying that much attention to, and that must make it even harder.
Dr. FEINSTEIN: I think that's right. I mean, I've had journalists tell me that, time and time again, how difficult it is to go and witness something and report it, and to know that the photographs, or the stories, and not going to get much attention. I think what the very experienced journalists often do in a situation like that is that they start to record what they've seen with camera or with their words, because they want there to be a record, a historical record. It might not make the newspapers, it might not make the 9 o'clock news, but at least there will be a record of what's taken place over there. So, they're bearing witness.
And I think a number of journalists find that to be a very important motivating factor and one that, in some ways, offsets their irritability or their frustration that their story's not really going to make it into the consciousness of people back home.
GROSS: Dr. Feinstein, thank you so much for talking with us.
Dr. FEINSTEIN: Oh, it's my pleasure, thank you.
GROSS: Anthony Feinstein is the author of "Journalists Under Fire." He's a professor of psychiatry at the University of Toronto. You can download podcasts of our show on our Web site, fresh.npr.org. I'm Terry Gross.