Program: When doom scrolling leads to actual harm

Sana Qadar: Depending on the social media silo that you're in at the moment, your Insta or TikTok or Twitter might be business as usual. Holiday snaps, dance videos, an assortment of ads, the odd news story or it might be awash with content related to Israel in Gaza. And normally we, the audience watching news coverage of a war zone would get a more sanitised view of what's going on. The most graphic scenes would be blurred or would never make it to air. But social media isn't the news. It's people. And what people are filming and posting from Gaza in particular, feels unlike anything that's hit Instagram or TikTok or Twitter before. 

Social media video: If death had a smell I'm smelling it right now. 

Professor Kim Felmingham: You're seeing it from the perspective of the victims survivors here.

Dr Arash Javanbakht: So there is absolute vulnerability that is being seen. 

Professor Kim Felmingham: I think the other thing is the impact on children. 

Sana Qadar: On the one hand, these videos have given us a powerful view of what's happening on the ground, one we wouldn't otherwise get, as Israel has mostly banned foreign journalists from entering Gaza. But after eight months of daily videos and images showing the aftermath of bombings, chaos in hospitals, dead children, screaming children, you have to wonder about the cumulative effect of all of that. 

Dr Arash Javanbakht: We need to know. We should know. We must know. That is important. I'm not saying anybody should stop knowing about the world. We should know, but we should know what to know, how to know, and what's the use of it?

Sana Qadar: Like, at what point does wanting to stay informed and engaged with what's happening cross over into something closer to futile voyeurism, or something that can put you at risk of vicarious trauma, which can happen if you're exposed to traumatic stories or videos even though you weren't there. 

Professor Kim Felmingham: So the examples classically are watching videos of traumatic events, and it typically is cumulative. It's not just one time of watching those videos. 

Sana Qadar: To be clear, this isn't just a risk for people watching content from Gaza. There's been some incredibly harrowing videos released of the October 7th attacks as well, and watching those over and over would increase a person's risk, too. So today, the origins of vicarious trauma, how social media increases the risk, and how the current violence in the Middle East is magnifying all of that. 

Dr Arash Javanbakht: We feel heartless. We feel like I'm not doing enough if I'm not following this, but I want to break out some news. Me tormenting myself, I'm going through that video ten times is not going to help the person who suffered in that video, or the other people who are suffering compared to when I went through it one time. 

Sana Qadar: This is All in the Mind. I'm Sana Qadar. Long before the concept of vicarious trauma was ever applied to social media. It was noted first in people like therapists and social workers and first responders, people who see and hear awful things day in, day out. 

Professor Kim Felmingham: Yeah. Look, I think it really did start with frontline staff, first responders. You know, there's been a the actual concept of PTSD really didn't emerge until the 1980s from Vietnam veterans. You know, we always had other ideas or labels like war neurosis and things like that from First World War and Second World War. So the whole history of PTSD really came about from the military context. 

Sana Qadar: This is Professor Kim Felmingham. She's the chair of clinical psychology at the Melbourne School of Psychological Sciences at the University of Melbourne. 

Professor Kim Felmingham: I think then there was a gradually recognition and realisation that PTSD can emerge from sexual assault from a range of other experiences, childhood abuse. But I think it wasn't till later that people really started to recognise actually severe PTSD and trauma can also occur from the cumulative observation or exposure to traumatic experiences, even if someone's not directly the victim or experiencing that trauma themselves. 

Sana Qadar: So people like police officers turning up at violent crime scenes. 

Professor Kim Felmingham: Absolutely. Even, you know, and I think one particular set of police officers, people who are watching or exposed to images and videos of violence in particular, were flagged as people who can be developing vicarious trauma. 

Sana Qadar: And so what is vicarious trauma? Is it essentially PTSD? Just, you know, the fact that you weren't specifically involved in what happened? What is it? 

Professor Kim Felmingham: Vicarious trauma is probably a broader definition. It is having trauma reactions or trauma responses when you are witnessing something, a trauma, but not directly present. You know, increased stress, difficulty sleeping, increased irritability, negative cognitions about yourself and the world and others. So that can be a real damage to your ideas of trusting others or how safe the world can feel. If people are developing PTSD. It may also be that they're getting sort of intrusive images or memories or flashbacks of some of the images they have observed. So I think the reactions people have to that vicarious traumatisation can be quite variable and individual and vary in terms of severity, also the nature of it. 

Sana Qadar: And when did we first start to see or understand that media could cause vicarious trauma, like is 9/11 an early example the way that was covered? 

Professor Kim Felmingham: Yeah, absolutely. I think that was really which kicked us off. A lot of this research was 9/11. And I think the difference there was it was the level of media is saturation. 

News anchor: The twin towers of the World Trade Centre have collapsed after being hit by two American airliners hijacked earlier. 

Professor Kim Felmingham: You know, really what we were running, there was a 24 hour news cycle of September 11th, you know, and you just could not really escape the footage. And it was going over and over again. And look, this was even really before social media kicked off. But I think that was an example of just how shattering that was. I think to the Western world. 

News anchor: Officials have raised the prospect of a huge death toll, with the mayor of New York, Rudy Giuliani, saying the number will be more than most people can bear. 

Professor Kim Felmingham: And some people really described it was almost like being addicted, getting sucked into just constantly watching, you know, not just the actual video footage, but also discussions about why this occurred and hearing survivors stories, all just to continually reinforcing and, you know, really playing these events on a loop, the people. 

News anchor The Twin towers of the World Trade Centre have collapsed. (Audio on loop) they have collapsed, collapsed, collapsed...

Sana Qadar: And then now with social media, a lot of what people are seeing are incredibly traumatic images, especially at the moment with respect to Israel and Gaza. All of the images and videos and stories are distressing, whether they have to do with the hostages or people in Gaza. Do you have any thoughts on the way the violence is playing out on social media at the moment, the impact that can have? 

Professor Kim Felmingham: Yeah. Look, I think that it's really significant. And the concerning thing is it's really unregulated. You know, there's much more challenge in being able to regulate that content. It's not an easy area to be working with, but it can do really significant damage. So the research that's now coming out is it's not just a oh yeah I'm looking at these images and that's not going to have much effect on me, it's fairly mild. Actually, as the images become more graphic and more violent and there's greater saturation, the greater the impact that this actually can have on people. 

Sana Qadar: But there is also the sense that images have power and the power to create change. You think of like the Vietnamese napalm girl. I asked Professor Kim Felmingham: about that as well. 

Professor Kim Felmingham: Really, really difficult because there's some things that are so incredibly powerful about social media. And I absolutely agree with the power of imagery to create change. I'm not advocating for removing all the images. I think they're important. It's how you are engaging. 

Sana Qadar: Yeah. It's interesting you talked about the cumulative effect of seeing these images and like the fact that they're on a loop. I mean, that's basically describing social media right now. And it's not like there haven't been traumatic events before that haven't played out on social media, like there's been coverage of mass shootings on social media. There's been coverage of like the bushfires here in Australia, even something like the Bondi knife attack. I guess what's interesting to me, what makes, this current situation different, is that it feels like there hasn't been anything so violent in such a sustained way that is so visible on social media, like there are obviously other conflicts happening in the world, but we've never seen so much video directly from people caught up in the carnage. What do you make of that? 

Professor Kim Felmingham: I think that's exactly yeah. And I think it is that immediacy of the horror. It's also that you're seeing it from the perspective of the victims survivors here. So that also I think can really impact. I think the other thing is the impact on children. So, you know, we really know, from many first responders, police, paramedics, if a child is involved in a traumatic incident that they might have attended or they were watching video footage of, it can really compound and increase the risk of developing PTSD and developing really difficult symptoms. And so just the number of children, the extent of the destruction, the extent to the helplessness that people are experiencing and that horror, I think, really is kicking this one, particularly with Gaza, really increasing the risks for people. 

Dr Arash Javanbakht: One thing I can think of is that, as you mentioned, there's a lot more data and images available. We didn't have much news and images available and videos available, let's say, from Yemen or Syria, right. A lot of people in America didn't hear about Yemen. But things were happening and people were dying there. 

Sana Qadar: This is Dr ArashJavanbakht. He's a psychiatrist who specialises in the research and treatment of trauma and adversity. 

Dr Arash Javanbakht: I work with refugees, first responders, survivors of torture, all sorts of civilians exposed to horrible, traumatic experiences. 

Sana Qadar: He's also an associate professor at Wayne State University in Detroit, and he's the author of Afraid: Understanding The Purpose of Fear and Harnessing the Power of Anxiety. And so on this question of whether the way Gaza is being covered on social media is different and more likely to lead to vicarious trauma compared to the way other events like bushfires or other conflicts have been covered, here's what else he had to say. 

Dr Arash Javanbakht: The other aspect is when the atrocities, or when the trauma, or when the damage is done by humans is more traumatic. Actually, our own research shows that traumas that are perpetrated by humans lead to a much higher level of negative impact on PTSD, which is compared to, let's say, of the wildfires that you mentioned. I think the other aspect that is here, like painful, is the helplessness that is there, meaning that in most other stories of this kind of human conflict, you see that there is some sort of protection, right? When it comes to Ukraine, there's some air defences, some do have an army. There's something there, right, that is protecting these people. When it comes to some other kind of like the internal conflicts feel like, okay, these two parts of this country, there's some cognitive interpretation that helps people reduce to a level of thing. But now here people are basically looking at, well, that civilian doesn't have anything. So there is absolute vulnerability that is being seen that I think which has which is where I'm this is where I'm hypothesising, which has that advanced and higher negative impact. 

Sana Qadar: So there's all this graphic imagery that's out there. But I also wanted to ask Dr Arash Javanbakht: whether the absence of images could be damaging as well, in the sense that we don't know how the hostages are faring. We've seen some videos and images since October 7th, but not a whole lot overall. And not knowing, not seeing what's happening, that's its own version of terrifying. But can it cause vicarious trauma as well? 

Dr Arash Javanbakht: I would say no because and and my reason is that trauma is basically when something horrible was experienced, whether that was experienced through a story or seen or heard. Right. So if I don't see something, I think what you're alluding to is the kind of a sense of suspense and not knowing what is happening to those people you care about. That suspense and that waiting, and you don't even know if they're alive or not, right? You don't know in what condition there. That can have, continuous, ongoing chronic exposure to stress. And in that sense, it can be trim or turning up on people. So okay, we can we can loosen up a little bit, like not having to stick with the terminology of the trauma. And now we are talking about chronic stress. We are talking about adversity. Right. And actual in line of expanding this view of the adversity trauma as chronic stress, this kind of feeling of suspense and not knowing about something horrible that might or might have not, or will happen to someone, also leads to that kind of chronic state of anxiety and then can lead to basically burnout, emotional burnout. 

Sana Qadar: Coming back to the images that we actually are seeing that are available. The other thing I found especially jarring in this current moment is that not only are people seeing horrific imagery of suffering, but then that's juxtaposed by images of normal life. So you can, like, literally go from a headless child to a person's holiday snaps to an ad for something random back to, you know, screaming for children. Do you have any sense of whether that contrast and how people are consuming these images is worsening the potential for trauma? 

Professor Kim Felmingham: Yeah. Look, I think it would be. Absolutely. And, you know, there's some actual theoretical models that underpin some of our treatments for PTSD, which exactly speak to this. We've got this idea of a just world scenario. So many of our belief systems are all centred on that. There's justice in the world that things are predictable, and we that thing gives you a sense of safety. So what can really enhance horror is when you're seeing those juxtapositions of some people are going about their daily life and two streets away. There's this absolute carnage in horror. So I think that really enhances the sense of injustice and the shattering of belief systems. So we know that how people respond to trauma, and this is particularly about whether they develop PTSD or not in their risk, is often tied to what the meanings of the trauma are for people. So people who experience helplessness or being, you know, having no sense of agency or control or having their form of belief systems shattered, much more at risk of developing PTSD. And I think that also goes for people who are witnessing these events. 

Sana Qadar: I asked Dr Javanbakht this question as well, and he reckons there's a different aspect of how these images are being consumed that can have a bigger impact. 

Dr Arash Javanbakht: I think the the uninvited aspect, unpredictable aspect has a negative impact because you can be that you can be taken off guard because like a lot of times you can prepare yourself to go to something. When I'm in the clinic and I'm about to interview a survivor of torture. I'm ready mentally for this, right? But, teenager laying in their bed, scrolling down, it's midnight, and all of a sudden in this scene, that horrific image is totally unprepared. And actually, when the negative emotions are triggered, the brain goes to that state, it goes to fight and flight mode. It goes to threat detection mode. So you look for more and of course, social media algorithms. Not that there is a malicious intention that if you follow something, look at something, pay more attention to some posts or something that will show more what is relevant to this, right? And people, a lot of people just basically just keep scrolling and going to that. And actually we had a conversation with another reporter yesterday about it. What is the reason that we keep doing this and doing this and basically going kind of a disaster voyeurism. 

Sana Qadar: Yeah. Because at some point it's not uninvited. You know, people are seeking this out there and they and they keep pressing on these clicking on these kind of images.

Dr Arash Javanbakht: Yes. And so, so first I want to make sure I am relaying the message that I'm not encouraging people to be ignorant. We need to know. We should know. We must know. That is important. I'm not saying anybody should stop knowing about the world. We should know what to know, how to know, and what's the use of it. So I have a couple of theories about why this happens that we keep going and going and going. Number one is that emotions, whether positive or negative, they are stimulating to the brain. Yeah, like cocaine, like smoking like and any of those kinds do kind of awakening to the brain. So emotions drag us to things. And then as I said, emotions redirect our attention when I see the negativity in my mind goes to kind of a threat detection mode and constantly wants to look at anything that relates to the negativity. The other reason I think this behaviour has is that we feel at some level guilty. Yeah, we feel heartless. We feel like I'm not doing enough if I'm not following this, but I want to break out some news, me tormenting myself, I'm going through that video ten times is not going to help the person who suffered in that video, or the other people who are suffering compared to when I went through it one time. So this is there's this feeling that I'm not doing anything and I'm not doing enough. 

Sana Qadar: Yeah, I'm interested in this because, yeah, there's this conflict. I think that a lot of people are feeling where they want to bear witness, they want to be informed, but at what point does that cross over into sort of self punishment or voyeurism, like, you know, where it's no longer helpful. How can people assess when what they're doing on social is no longer helping anyone? 

Dr Arash Javanbakht: Absolutely. I tell everybody now is that if someone else is deprived of joy, is not around anymore to enjoy, or is not allowed to endure and suffering, my duty for being able to enjoy life doubles, because now I have to enjoy it for both of us. Adding one other humans to the suffering pool is not going to help anybody. So again, I think having a conscious approach, this quest of wanting to know is what is, what am I gaining here and what is the world gaining? Another example I as I mentioned, I always work with patients with the worst horrible traumatic exposures. I don't go to the all the details of the worst thing that happens of the bloody details. I just ask enough for me as much as I need to know. I avoid that voyeurism because the other person will suffer and I will suffer. I know enough to be able to help them. Now I know enough to what? That's the question all the listeners have to ask themselves when I'm viewing these things. What's the purpose? I want to know. Or I want to get angry because emotions have energy. If I just let them be, those negative energies and negative emotions are going to eat me up, are going to hurt and damage other people, as you see these days. On to social media, people are ripping each other apart without any benefit to any side. Nobody change their mind by being yelled at and screamed at and stuff. 

Sana Qadar: Yeah, yeah. 

Dr Arash Javanbakht: So if I have a strong emotion, I can turn to activism. I can basically utilise it for good. Now I can do donate. I can do volunteer work. Now, I have transformed this negative emotion into something useful for the world. 

Sana Qadar: This speaks to the other problem with doomscrolling and consuming too much negative content online. Dr Javanbakht says it can leave you desensitised. 

Dr Arash Javanbakht: Now the first person who died, the second person and the fifth person, now person number 1000 is just, that's just a statistics. And it loses its basically human, empathetic aspect of the impression. 

Sana Qadar: Yeah, I can see how on one hand, that's kind of an emotional coping mechanism to be desensitised. But yeah. What is the emotional danger of being desensitised? 

Dr Arash Javanbakht: You said that very well could be a defence, so the stress might still be there, but on the surface I don't feel it. The other part is basically people lose some of their humanity, lose some of their empathy, which is not a good thing. People don't care anymore. People don't get affected. And then if it is happening somewhere that you can do something useful, you will start doing things right. It's kind of a learned, learned helplessness aspect comes to this, that then people stop doing what they need to do to change the environment, change the situation. 

Sana Qadar: This is All in the Mind. I'm Sana Qadar. Today, social media and vicarious trauma. 

Sana Qadar: Can you touch on something earlier that made me think about silos? You said how it feels like some people are going about normal life while horrible things are happening two streets away, so to speak, and we're all sort of in silos at the moment. There's the silos of each side where, you know, people might only be seeing the pain of one group of people and perhaps not exposed to the pain of the other group. But then there's also the silos of normality versus horror. So for a lot of people, Instagram or whatever is kind of business as usual, while others are seeing this deluge of traumatic content, whether it's coming out of Gaza or whether it's about, you know, the hostages and anti-Semitic attacks. And that, I think, can make people feel more alone. I want your thoughts on this. Can it make people feel more alone or more crazy in their pain in a way, because maybe others in their workplace or friends are like, what are you so worked up about? Or they don't even know that you're worked up to begin with? 

Professor Kim Felmingham: Absolutely. You know, I think we absolutely know that the level of support you have around you. And when we talk about support, it's not just, you know, people around you, hugging you, giving you a cup of tea. It's actually meaningful support, validation, recognition of your fears and concerns as being real and justified. And you know, if you don't, if you have others in your environment that are downplaying the the horror, not really validating your fears or concerns or share, they've got a different algorithm. They're saying a different belief system that can be very invalidating for you. And that invalidation, again, can really compound trauma. 

Sana Qadar: So for people listening who have been very much on social media, seeing more images than maybe was useful for them, how can people identify if they are experiencing vicarious trauma, which they look out for? 

Dr Arash Javanbakht: So symptoms of anxiety, depression, stress related. Right. It could be I am not in a good mood. I mean, part is also - Let us also separate what is normal from what is abnormal. It is okay. It is normal as a human to feel terrible about these things. But we don't, I don't I'm not suggesting people should be like it senseless robots. You will feel bad, but when it starts to impact our functioning and stress us too much. Basically the most important criteria in psychiatry are dysfunction and significant distress. if I'm starting to not be able to function at work, function in my interpersonal relationships, that is, that is a basically a red flag. If I'm starting to be to distress constantly thinking about it, I am feeling depressed beyond some sadness that comes and goes when I have the exposure. I'm starting to have nightmares. So these are other signs that show basically something needs to be done about this exposure. 

Sana Qadar: And do we have any sense of whether the way Israel-Gaza is playing out on social media is leading to an increase in vicarious trauma, or is it, you know, just too early to say. 

Professor Kim Felmingham: Look, I think, you know, we don't well, obviously we don't have any research on this for, for now. But I think certainly with the level of the saturation, the level of the violence that's being displayed, it is really likely going to be and I think the level of vitriol in the debate. Yeah, too. I don't think we should ignore that. I think all of that likely is going to be leading to vicarious trauma for some people. And I feel like, you know, the other thing is, if you've been through these types of events before or, you know, you've been a supporter for people in Gaza and it's never been recognised, or you've been a survivor of the Holocaust or your family was really impacted on that. Yeah. All of that's going to compound your distress on both sides. 

Sana Qadar: But the good news here, if there's any to be had, is that most people who go through a traumatic event or experience it second hand won't actually be traumatised. In the end, they will be distressed, they will be upset, but they won't necessarily be traumatised in the clinical sense. 

Professor Kim Felmingham: I mean, even with September 11th, you know, people who were watching it on that 24 seven loop, it was only about 30 to 40% of people who reported fairly high levels of distress. So that wasn't PTSD, and then only about 10% who went on to develop PTSD from that. So the majority of people will be okay. But I think the messaging is, you know, 24/7 saturation of really graphic images and violence isn't helpful for anyone. 

Sana Qadar: How are you handling your own social media consumption at this moment in time? 

Dr Arash Javanbakht: I compare that with my chronic exposure in my clinic, because I sit down and hear the details of the worst things that happen to, survivor of torture or refugee or human trafficking. My first responders. So with the social media, what I do is limit. Of course, sometimes it's just another human. Part of me wants to know more and sees and hears. Oh, I heard this horrible thing. Let me go see what this is. But then I stopped there when I heard. When I saw I stop there. That I don't have masochism. To want to keep hurting myself. 

Sana Qadar: And then there's another strategy that Dr Javanbakht borrows from his work with his patients when they tell him the horrible experiences they've been through. He looks for meaning and purpose. 

Dr Arash Javanbakht: So these things sometimes hurt me a lot when it happens in the clinic. And sometimes I have been at the point that I thought, how long more can I do this? Can I listen to this horrible story? And then that moment, that thing which galvanised me, which was a very strong shield, protected me, was remembering why I do this and remembering that this person sitting in front of me totally shattered. In a few months, as a result of what we are doing is going to be feeling much better. And I have found that a very protective factor for myself. So the meaning. And now how could that extend to a life of someone who has exposure through the media is, yeah, what am I going to do with this? How can I turn this negative energy to something impactful, something meaningful I can do for someone who is suffering? Then I can transform it, and I can utilise it in a good way, which I believe will be very protective. 

Sana Qadar: That is Dr Arash Javanbakht. He's a psychiatrist specialising in trauma. And he's the author of Afraid: Understanding the Purpose of Fear and Harnessing the Power of Anxiety. You also heard from trauma expert Professor Kim Felmingham. She's the chair of clinical psychology at the University of Melbourne. That's it for all in the mind this week, thanks to producer Rose Kerr and sound engineer Simon Brathwaite. I'm Sana Qadar. Thank you for listening. I'll catch you next time.