Grief, Trauma, Exposure and the Internet

My colleague Dr. Elias Aboujaoude has made a name for himself as an interpreter of how social networking affects our emotions and identity. Stanford’s SCOPE blog recently interviewed him about the way that the Internet is changing how people grieve losses and traumas, such as the 9/11 atrocities.

Among his points is that because almost every significant event is recorded and turned into web images and videos, we are repeatedly exposed to traumatic, sad and fear-inducing events whether we wish to be or not. Elias notes that such exposure can be helpful in some cases but hazardous in others. My experience working with patients who have anxiety disorders leads me to think the critical variable is the amount of control experienced by the person who is being exposed to what upsets them.

The textbook therapeutic use of exposure under controlled conditions is the treatment of phobias. The patient is trained to relax with a series of muscular and mental exercises and then the feared stimulus (say, a spider) is gradually introduced over a series of sessions. At first the spider would be introduced just by talking about spiders and webs and the like, then by having a still photo of a spider, followed perhaps by a video of spiders, and then finally an actual spider. The patient retrains him or herself to maintain the relaxed state despite the exposure until the feared object is no longer scary. The patient knows when the sessions are going to happen and that the exposure will be graduated, which fosters the sense of control they need to master their emotional distress.

However, as we interact with the Internet and other media, feared or traumatic images can come at us unpredictably when we are not relaxed and when we feel no sense of control. This is certainly true of the 9/11 attacks as well as of many natural disasters, such as the Japanese earthquakes. Images come unbidden to our attention in mass-delivered emails, pop-up news stories on web sites, through Facebook and other social networking platforms as well as through the old standbys of television and the covers of the magazines arrayed before us at the supermarket checkout counter. At least some of the people who want to avoid traumatic memories of catastrophes must feel that it’s impossible to get away from vivid reminders of past horrors no matter where they go. And sadly enough, in the Internet age, those traumatized people are probably right.

Author: Keith Humphreys

Keith Humphreys is the Esther Ting Memorial Professor of Psychiatry at Stanford University and an Honorary Professor of Psychiatry at Kings College London. His research, teaching and writing have focused on addictive disorders, self-help organizations (e.g., breast cancer support groups, Alcoholics Anonymous), evaluation research methods, and public policy related to health care, mental illness, veterans, drugs, crime and correctional systems. Professor Humphreys' over 300 scholarly articles, monographs and books have been cited over thirteen thousand times by scientific colleagues. He is a regular contributor to Washington Post and has also written for the New York Times, Wall Street Journal, Washington Monthly, San Francisco Chronicle, The Guardian (UK), The Telegraph (UK), Times Higher Education (UK), Crossbow (UK) and other media outlets.

6 thoughts on “Grief, Trauma, Exposure and the Internet”

  1. Are the emotions felt by most Americans about 9/11 correctly described as grief? There were 2,977 victims. Their family members and close friends would at a generous estimate have amounted to ten times as many. Grief is the loss of someone you have been very close to and often (but not always) loved. For this group, the sudden death of their partner or parent or child or friend creates a ragged, painful hole. The operative word is close: few people really grieve for cousins or aunts or nephews or sometime lovers. That’s grief, and Aboujaoude’s argument makes sense for it. Repetition in the media of the images takes away from them one of the ways we manage grieving and allow the jagged hole to seal up. But for most Americans, it was always about people they didn’t know: a collective shock. Their mourning is stylised – I’m not belittling it, it’s needed and proper, just not the same thing. Where exactly is the trauma that repetition is supposed to prevent from healing?

  2. The rise and reliance of asynchronic communications does heighten neuroses as it directly challenges man’s linear abilities to create and sustain a consceptual continuity from one thing to the next, often producing a disorientation never before seen among humankind! Or something like that!

  3. James, Keith’s post didn’t seem to me to be focused on grief per se but on anxiety and traumatic memories. His initial phrase was “how people grieve losses and traumas.” Perhaps a better phrase would have been “recover from losses and traumas” or “deal with losses and traumas,” or “grieve losses and recover from/deal with traumas.” But the emphasis, I thought, was on trauma rather than mourning, and 9/11 was certainly traumatic for many people across the country, not to mention those in New York City and particularly in lower Manhattan. And of course those who escaped from the towers were seriously traumatized.

    Most people, especially those outside New York City, have by now largely or completely recovered from whatever trauma they experienced, such that images and reminders of 9/11 aren’t unduly upsetting. It’s those who still find them uncomfortably disturbing that Keith is talking about, suggesting that it’s more difficult for them to recover because they have no control over encountering reminders. Grief over personal loss is, as you point out, a relatively small subset of those people.

  4. Swift Loris: I fully accept your point about the thousands who escaped from the Twin Towers and those who were injured in the rescue or by falling debris. Their experience was certainly traumatic; and we can probably add the eyewitnesses in Lower Manhattan. As an order of magnitude, these additions should double my guess of the numbers personally and deeply affected. The family members of a survivor have presumably generally been in much better shape.
    I remain sceptical that the general national experience can be described as traumatic in the strong sense that’s needed for Dr. Aboujaoude’s argument. I’m not suggesting that endless repetition of Twin Towers videos is good there either; it’s desensitising and often manipulative.

  5. James, I don’t believe I suggested that continuing to find reminders of 9/11 “traumatic in the strong sense” was the “general national experience.” In fact, I think I said rather the opposite, that this wouldn’t be the case for most people.

    I have the impression that Dr. Aboujaoude and Keith are both concerned about the minority who, while not personally affected by losing a loved one or having been eyewitnesses to or rescued from or injured in the events, are having difficulty processing what happened and find reminders significantly upsetting. I can’t imagine how the existence of such a group would be even slightly controversial, nor do I understand why one would resist acknowledging that their inability to control their encounters with Internet reminders would be a problem for them that mental health professionals would be concerned about.

  6. Sometimes, when screening patients for PTSD, it is useful to ask, “How often do you watch the news on TV?” Often, patients with PTSD will say that they rarely or never watch the news, presumably because it reactivates past trauma.

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