He said once the initial reluctance to seeking help is overcome, the healing process gets much easier.

“I don’t think trauma counseling is a very complicated business. The important message is that journalists need to own this for ourselves. And if we own it, and if we support each other, then you can ultimately push the psychiatric intervention slightly further down the line.”

The most effective treatment for PTSD remains old-fashioned talk therapy - either by re-living the trauma in safe settings to extinguish the gut-level fear reaction, or as cognitive-behavioral therapy, which aims to adjust emotions by changing old thought patterns.

“PTSD is not going to ruin your career,” said Friedman of the VA. “What will ruin it is not getting treatment. This has been a major paradigm shift in the military.”

Many high-quality studies have compared targeted talk therapy to supportive counseling alone, and guidelines uniformly recommend the former. One 2010 report that pooled earlier research, for instance, found therapists using so-called prolonged exposure treatment could expect their patients to do better than those who got plain counseling 86 percent of the time. And the effects lasted at least a year.

What is still a matter of research is how soldiers and journalists who’ve dealt successfully with PTSD will respond if they go back in, and whether pre-assignment training can fortify them in the first place. “We’re just dipping our toes into this whole are of resilience right now,” said Friedman.

AS AWARENESS GROWS, MORE DANGERS

When Loyn got back to London from Afghanistan, he met several traumatized colleagues who had just returned from a Balkan torn by the Bosnian war. It was clear to his managers at the BBC that something had to be done, and the result was one of the first support programs for journalists covering conflict zones.

Since then, several large news organizations have set up their own systems, including the CNN, the Australian Broadcasting Corporation and Reuters.

Kate Nowlan, the CEO of U.K.-based CiC, which has handled trauma support for Reuters since 2006, said she was initially met with some skepticism. But that has changed. Lately the company’s phones, manned by therapists and trauma experts, have been ringing off the hook.

And the calls don’t only come from journalists stationed in conflict zones. Sometimes it’s the local cop reporter on the line, or the photographer sent out to cover a fire and ending up with some lurid pictures stuck in her mind.

“People are aware of the effects of trauma,” Nowlan said. “You don’t have to hide it anymore.”

But awareness and decreasing stigmatization might not fully explain CiC’s busy lines. A more ominous possibility, backed by experts, is that reporting is also becoming a more dangerous line of work.

According to Elana Newman, a psychologist at the University of Tulsa, Oklahoma, and the Dart Center’s research director, war correspondents face growing threats of kidnapping, murder and death or injuries from IEDs or mortar attacks. (See linked factbox for more details.)

“I believe that as journalists are increasingly the targets of deliberate acts of violence in warzones,” she said, “the mental health consequences will become more dire for more journalists.”

And foreign correspondents aren’t the only ones paying the price. In fact, data from the Committee to Protect Journalists, a New York-based nonprofit, show nearly 90 percent of journalists who are killed for their stories are local reporters and photographers from countries like Iraq, Russia or Mexico.

“They don’t have PTSD because they are not ‘post,’” Newman said. “They are living it daily.”

###
By Frederik Joelving
NEW YORK