The Effects of Drastic Image and Video Exposure and How to Avoid the Unnecessary Trauma - an Interview with Professor Mooli Lahad

Professor Mooli Lahad: My career started when there were only newspapers, radio, then television. Now it’s social media and the Internet. We did very interesting research on the difference between reading about an incident and seeing it: seeing images causes much more distress and reactions on various levels. The images stayed with the viewer, penetrating the brain and staying there like a photo. In times of crisis, these images surface again and again. Of course nothing is only bad or dangerous - there are „side streets.” But, on the whole, if we're talking about mental health, definitely images are not just images - they come with a commentary.

We are using harsh words such as dramatic, disastrous, horrendous - this terminology makes the images even worse. Also, the images are often shown repeatedly because the media only have one piece of news and they keep showing the same content over and over. All of that has a negative effect on the brain in general. Information is not edited or censored - it is just constantly coming at us. We already know, for a long time time now, that such images have a negative effect on children. Not only do the images make children feel afraid, but they also give children permission to be aggressive. On the one hand, such images make us fearful and anxious. On the other hand, they make us desensitized to human suffering. The more you see such content, the more you feel but you’ve already seen it so you are not affected by it.

Interestingly, one of the outcomes of watching any image is that the brain gets used to it. from the perspective of the viewer, there is no difference between a Hollywood film and a video that was filmed on the street because for the mind both are just images. The images need to be interpreted in order for the mind to grasp what is reality and what is not. Images activate the areas in the brain that are less controlled by our prefrontal cortex, so that they stimulate a sense of emergency, a sense of fear, excitement, drama and that’s why we are ”hooked” on them. At the same time, they’re impact is not positive.

Beata Zwierzyńska: As you mentioned, there are no gatekeepers nowadays, especially on social media. I was wondering whether you could elaborate on how body and mind are stimulated by different images. Any specific reactions, warning signs for those who watch and those who witness and share?

Prof. Mooli Lahad: Let’s talk about viewers, rather than about those who make the content. When we see images, the areas of our brain that are activated are called the visual thalamus and the visual cortex. These are much deeper parts of the brain that can be interpreted and controlled by the prefrontal cortex. At the same time, because the major sense used for absorbing information by the human are the eyes or the visual apparatus, it can also bypass that. As we are confronted with images, we think that we see the image itself, but, in fact, we see pixels which are colors, shades, movements. All that may be even more impactful on the medium brain or even the reptilian brain that is activated as if - and this is important - as if the event is happening to the viewer now. In order not to feel that, either we have to be repeatedly exposed to content as is practiced in desensitization through therapy, but this time the result is a negative kind of desensitization, or we have to become, what we call in PTSD, “numb,” which means “I don't feel anything anymore either in order to protect myself or as a result of the frequent recurrence of images.”

That makes people less sensitive to suffering, so that they become numb when they are themselves subject to an event. This is the case of firefighters or police people - the first responders are not functioning on neutral basis because all the images they have collected throughout their life and all the images they've seen while in action, may surface out of the blue and it can be confusing what is going on outside and what is going on inside. Similarly, in the case of therapists, the news or videos from the scene taken by people who took their cameras make therapists more vulnerable because the therapist is not only listening to what the client is saying, but suddenly, their own film screen in the brain starts showing them what happened. Sometimes the therapist has been exposed to these images but the victim was not - because the victim was injured or was shocked and they didn't see everything. Those who are bombarded by films of events made by bystanders seemed to be worse affected. What happens is that you come to help but suddenly all the images that you've collected throughout your experiences and the last exposure to the images of the event surface and this is very difficult to differentiate. We call this secondary victimization or compassion fatigue. It’s not really the same, but it's basically the impact of being in close proximity to someone who has been affected by an event.

As for what happened to those who were taking the videos or the bystanders who made the videos, we did a very interesting study a while ago on the filming crews of various news channels. The most vulnerable ones are the photographers because, in the lens, they only see the horrendous images. When they're in the action, they distance themselves from what they see happening in the lens, but the brain absorbs all those images so once the event ends or when they go back to the studio, all these images surface and many of them have severe symptoms either of acute stress disorder or sometimes PTSD, which can lead them to heavy drinking. When we wanted to do some prevention work with them, we met them in the bars. After the events they go to the bars to reduce their anxiety. We sit with him there and slowly help them share what happened to them, we invite them to join a support group. But I believe non-professionals who collect and produce such images are similarly affected. Basically because of the excitement at the moment, they are not aware of the negative impact on their well-being and, unfortunately, some of them may develop full PTSD. As we know from the DSM-V, being an observer in the event is also a high risk position.

Beata Zwierzyńska: That sounds really serious. Let's talk about the solutions as well. Should we be worried if we experience recurring negative images or re-live events as if we actually were witnessing the tragedy? When and where should we get help?

Prof. Mooli Lahad: I want to stress that reporting on the kinds of dramatic events we’re talking about is important. Otherwise atrocities may take place without anyone knowing about it or it may take years for the information to reach the light of day, for instance, the Holocaust or the Armenian massacre. Broadcasting news to the world can raise awareness among bystanders or the general public, and arouse sensitivity with regard to the victims and encourage condemnation of the perpetrators. For this reason, we shouldn't completely disregard the need for broadcasting difficult news - there is a need for it, and public opinion nowadays can be very effective in shifting the consequences of such events. We’re living in the era of films, videos and streaming, so we all get less affected by drastic events in the sense that we are less involved emotionally.

If you're talking about someone who has as a result of their work has been repeatedly exposed to horrendous, tragic, terrible images, signs that they need professional help include: symptoms of post-traumatic stress, such as avoidance, problems falling asleep, changes in appetite or mood, feeling numb or hyper vigilant and angry, sudden bursts of anger, and on top of it, the person has flashbacks (all those memories that come when the person is not on the site of the event and is just sitting in a café), they. In the case of news teams, at least people work as a team and in such cases I would work with the team on how to support each other, how to take care of each other, how to take shifts so that it’s not always the same person going to the scene, so that everyone has a chance to rest and have a change of exposure or control of exposure. When there witness a very difficult situation, it’s important that someone is present in the studio, who can attend to their basic needs of rest, food, drinks, but also, if needed, a meeting where they can share what has happened and think how they will do the job next time in a way that protects them better.

Also, one of the things that we teach or advise media crews is that they should take long-shots rather than going straight into the scene. We advise this for two reasons. One is that the closer you are to the scene, the more you are exposed to not just the images but also the smells and sounds, which can get stuck in your head. A second reason is for the benefit of the victims, to protect their dignity and privacy. In such situations, it’s easy to get excited, have that rush of adrenaline, and run to take photos, but we forget that the person who is affected has a family of their own life. Suddenly, we are exposing them while they are in a very sensitive situation and this will stay forever online so this is also something we should take into account.

There are methods to prepare and develop professional skills and means of protecting oneself, but the general public, unfortunately, can't be stopped from taking images. It’s a task for general education to teach youngsters who use phones for all sorts of activities about how to establish boundaries that will protect them from being affected. I would also support parents reducing the time their kids are exposed to horrendous images. I wouldn't stop the television because it's impossible as the parents want to know what's happening. But I would definitely avoid showing these images again and again. If the child has seen these images, I would sit with them and ask what's going on for them so that as to at least know if the child has been affected. There is a very interesting study that was done in Chile during 9/11, which showed that kids in Chile, who saw the Twin Towers falling, also had PTSD symptoms. Child exposure to images may affect own mental health too.

Beata Zwierzyńska: I was also thinking about the surrounding images and videos, especially in connection to refugees who want to know what's happening at home, or refugee children who get addicted to playing computer games. I mention games because they seem to be so impactful on the brain. Is there any advice you could give to people who are refugees or to people who engage with technology in this way? What are the do’s and don’t’s?

Prof. Mooli Lahad: First of all, refugees are an at-risk group because of the distance from their homes, especially if their loved ones stayed behind. They are worried not only about whether they will be granted the refugee status, but also about the well-being or what is happening with their loved ones, the neighborhood, the city. And I can see their need to get information. As I said before, and I know that seeing is not the same as hearing, it is better if refugees can get their news by listening to the radio, talking over the phone, or reading the news, rather than seeing the images that are presented in news sources with video content. If getting news through non-visual sources is not possible, it’s best to moderate the amount of exposure to the images. But they do need to know what's going on. Nowadays when information comes in within seconds of the incident actually happening, people need to remember one important thing: that the camera only captures only what the camera sees, but that's not the whole story - that’s very important to emphasize. The camera focuses on the dramatic things, but it’s important to realize that the situation is not only dire and that there are also people who function and cope. If I can suggest, instead of looking at images, talk on the phone, listen to the radio or read the news on the Internet. Of all these options, remember that reading is the least impactful on the brain. Every once in a while, you can look at the images but try to monitor the amount of exposure because it’s not good for your brain and mind.

On the question of children’s exposure to games - many of the games are very aggressive, cruel, conflictual, you have to kill in order to move on, etc. On the positive side, research shows that children who play games have good eye-hand coordination. The bad news, however, is that the games affect behavior and personality, frequent exposure to games does bring up more aggressive behavior both on-line and off-line. Children can become overwhelmed by adrenaline and dopamine while they are playing. This kind of excitement cannot be reduced quickly, and sometimes it's also about exposing them to aggression as a way to solve problems. At the same time, games offer a way to elicit aggression and frustration in a more acceptable way. I'm not suggesting to stop playing games completely, but to moderate the amount of time that children look at the screen, it’s great if children can try to control it by themselves but sometimes they will need the help of adult members of the family. We know also that exposure to the blue screen affect the brain’s ability to relax and does not allow for a very important hormone of sleep - to accumulate melatonin. The problem is that these games are produced on the principle that they engage you more and more. By boosting more adrenaline and dopamine, the players may lose sleeping hours. This can turn into a vicious circle. I'm not against games per se because I believe that, if at all possible, we shouldn’t ignore what’s happening. Some people can play games moderately. If a technology like computer games is there, let's learn how to make the best out of it or at least how to accommodate it in a way that won't harm our well-being.

Beata Zwierzyńska: Thank you very much Professor Lahad.

Prof. Mooli Lahad: Thank you very much and God bless. Let’s hope for peace and quiet in our countries.

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