War and peace

As GPs, we can give people permission to reduce their viewing of news reports to a once-daily dose.

In the past few weeks, many patients linger a little longer in the consulting room, reluctant to leave without mentioning the latest source of suffering – the war in Ukraine. While this is a challenging topic for everyone, in the context of the consultation, I find it particularly so. Unlike the pandemic, when GPs had continuous access to evidence-based guidelines for prevention and treatment of what was then a frightening, life-threatening infection, there are no guidelines or protocols for the management of the fear, hopelessness, pessimism, and overwhelming empathy that some people are experiencing as they watch this war unfold. 

Reactions to this humanitarian crisis are mixed. Some people watch every news report on multiple channels afraid that if they tune out, they will miss something important. This engagement, they say, helps them feel calmer and less disorientated, less likely to be taken by surprise with unexpected developments. Others compulsively watch TikTok and YouTube videos, re-play Instagram stories, share #ukrainewar posts on Facebook and Twitter. All day, images of women and children huddling in shelters, bombed cities, and displaced families run through their heads like a carousel of slides that they cannot stop. Such exposure fuels a cycle of anxiety that feels as threatening to them as if they were in the direct line of fire. Others mention the war in passing, only just to say that they have stopped watching any news, cannot take any more, feel powerless, impotent, and frightened. They are creating the psychological equivalent of a bunker where they hope to bury themselves until the crisis passes, when they can emerge and re-engage with the world. 

Are any of these responses healthy or helpful and if not, how are we to feel and behave when faced with suffering on such a large scale? Dr Ryan Niemiec, a leading psychologist and researcher in the field of character strengths and wellbeing, suggests some helpful strategies for dealing with the outrage, fear, confusion, and helplessness evoked by catastrophic events that are beyond our control. 

While we all want peace, only international negotiators have the power to influence world affairs. The rest of us must watch and wait. But, while waiting, we can choose to take positive action to help those less fortunate. Many people will choose to donate money to a reputable agency, offer their expertise to volunteer organisations that are supporting war victims, or even open their homes to refugees. These acts of generosity are beneficial both for the receiver and the giver. No act of kindness is too small or insignificant. Taking positive action boosts our wellbeing by restoring a sense of purpose. Practising generosity combats feelings of negativity and helplessness. The Buddhist monk Thich Nhat Hanh said, “It takes time to practice generosity, but being generous is the best use of our time.” 

No act of kindness is too small or insignificant 

Another recommended strategy is to acknowledge and name the feelings we are experiencing. Acknowledging that when any part of humanity suffers, we all suffer; that vicarious suffering is still suffering, reminds us to consider our own wellbeing and to be kind to ourselves as well as to others. We can pay attention to our own health and, as GPs, remind others to do the same, by making sure they eat well, get adequate sleep, spend time outdoors when possible, and take time to cultivate inner peace and calm. Focusing on peace in our immediate environment may be the only contribution we can make to world peace, but it is still an important and significant contribution. 

As GPs, we can also give people permission to reduce their viewing of news reports to a once-daily dose. Roxane Cohen Silver, a professor of psychological science with a special interest in media coverage and trauma wrote recently that people who watched more than six hours of daily coverage of the 2013 Boston Marathon bombings experienced higher acute stress than those at the finish line when the bombs went off. Viewing traditional news channels rather than social media platforms can also reduce vicarious suffering. Traditional news channels are curated and will often omit graphic images or issue a trigger warning. YouTube, Facebook, and TikTok present videos of raw personal stories of extreme human suffering. And there is a possibility that some of these videos may not be real. Reading rather than viewing is a less traumatic way of keeping informed, allowing us to take in information at our own pace. 

While there is no comparison between living through a war and watching it unfold on screens, news reports do impact the mental health of those not directly affected by the violence. There are no guidelines or protocols to help us through, but it appears that acknowledging feelings, taking positive action, and avoiding compulsive viewing of distressing news coverage will be beneficial for some.