The images are graphic, disturbing, and endless, said a former Facebook employee. Her job as a content moderator required that she review and remove disturbing posts. That work, she claimed in a lawsuit, caused her to suffer serious psychological trauma.
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In September 2018, she filed a complaint with the Superior Court of California.
“Every day, Facebook users post millions of videos, images, and livestream broadcasts of child sexual abuse, rape, torture, bestiality, beheadings, suicide, and murder,” reads the complaint. “By requiring its content moderators to work in dangerous conditions that cause debilitating physical and psychological harm, Facebook violates California law.”
In May, Facebook settled the case, agreeing to pay $52 million to content moderators to compensate them for the consequences their work had on their mental health. The settlement was the first to officially recognize the psychological toll of exposure to disturbing material resulting from online moderator jobs. It also highlights an emerging understanding of vicarious trauma.
Also known as secondary trauma, vicarious trauma can result from exposure to images, stories, or accounts that someone does not directly experience, said Françoise Mathieu, MEd, CCC, RP, a compassion fatigue specialist and executive director of TEND, a company in Kingston, Ont., that offers resources and training for people who work in high-stress, trauma-exposed workplaces.
Secondary trauma can affect people much as any other kind of intensely stressful experience. “What I can tell you as a specialist is that trauma is trauma,” Mathieu said. “Our brain doesn’t necessarily know the difference.”
The potential for vicarious trauma has long been recognized as a risk for journalists, health care providers, and anyone who watches television coverage of a disaster. Only recently, Mathieu said, have researchers started to investigate the psychological impact of jobs that require people to look at extreme, graphic, or disturbing images.
Physical fallout
In a 2017 study of digital forensic examiners, researchers found that examiners who worked on cases involving sexual crimes against children were at elevated risk of developing secondary trauma.
However, the exploratory study did not quantify the risks, and the study investigators concluded that more research is needed to understand how best to help people deal with PTSD resulting from working in the criminal justice system.
Content moderation requires sifting through upsetting images, and people can react in different ways to the task, says Anthony Ng, MD, a psychiatrist at Hartford (Conn.) Healthcare in Mansfield Center.
Dr. Ng says some individuals may become emotionally numb in order to protect themselves. Others might relate to what they are seeing, either because of their own life circumstances or because of experiences they have had in the past. For example, individuals might think: “I could see that kid being my son, I could see that woman who was assaulted as my wife who got beaten up”
that ramps up activity in an area of the brain called the locus coeruleus, Dr. Ng said.
Heart rate rises. Breathing rate goes up. Muscles become tense. If a threat occurs once and then dissipates, the body can often recover a state of calm. However, when that threat is part of the daily workday, it can cause chronic harm to mental and physical health. Unlike with direct, or primary, trauma, he adds, secondary trauma can take a while to become symptomatic.
“Your heart is not designed to be constantly pumping at a high rate,” Dr. Ng says. “We just can’t sustain that for long periods of time without starting to develop stress reactions.”