A social identity explanation is used to offer insight into who is and who is not affected by trauma, using two examples from data collected after an earthquake in Nepal in 2015 and during the COVID-19 pandemic in 2020. Traumatic experience is not equally distributed across any population, and the likelihood of experiencing an extreme event is affected by group membership and particularly the status of different groups. Attributes of groups and the resources that they offer to members can be important in driving risk and resilience. The chapter offers evidence that trauma and social identities are inherently linked, and that changes in our social identity resources have substantial consequences for health and wellbeing. Derived from this approach, we can recognise those people who are likely to have short-term versus long-term impacts as a consequence of traumatic experiences. Finally, the chapter discusses how this work can inform policy and practice.

The London Nightingale was designed to be the largest field hospital in UK peacetime history. It was built in a matter of weeks on the site of an existing exhibition centre, with a final capacity planned for 4,000 intubated patients who had COVID-19, and 16,000 clinical staff. Supporting the mental health of its staff was a key element from its inception, with a specialist team engaged to create and implement an evidence-based, tiered, occupational health model. The emphasis was on minimising distress and moral injury, and maximising post-traumatic growth through a rapid, de-medicalised, forward psychiatry model that encouraged return to work where possible. The London Nightingale was fortunately never required at anything near its capacity, but the mental health team was operational throughout its life, and openly disseminated its standard operating policy and learning to other UK hospitals, many of which used it as a template to design their own.

One of the most powerful ways to counter the isolation that often accompanies social media use – whether that use is professional or personal – is to foster community. That community can take various forms. For researchers and online investigators, it may mean working collaboratively or celebrating the cultures of those you are researching. For everyday users of social media, community may mean reaching out to others to talk about what you’re observing or to share your thoughts and feelings online. However, not all attempts to develop a sense of community are equally beneficial: According to recent research, for example, venting can have positive or negative effects, depending on how the user engages. In this chapter, the authors discuss what is known about effective ways to combat the isolation that can be endemic to online engagement, and how to proactively foster community in online and offline spaces to minimize the risk of psychological harm and maximize psychosocial well-being.

While people have similar biological responses when viewing graphic online imagery, our unique identities mediate that affect. This chapter explains how reactions to disturbing images can vary significantly from person to person, and how important it is to understand what makes each of us – and each other – more or less vulnerable to potential psychological harm when engaging online. The chapter explores how we can better protect our kids and communities by becoming more aware of the potential impact of social media content on ourselves and on other people, and the steps we can take to lessen the risk of harm.

In this chapter, we offer a number of recommendations for those who are in a position to do something technically, structurally, and legally or otherwise to minimize the risk of psychological harm that comes with the public’s use of social media and other online sites, especially their engagement with graphic or other upsetting digital material. We outline the policy implications of what we’ve learned from more than three years of desk research and original interviews that we have conducted with dozens of people, ranging from technologists to psychologists to content moderators to human rights investigators and beyond. We first spotlight the competing interests that underscore social media companies and governments’ policy deliberations with regard to content moderation. Next, we lay out our suggestions for companies, governments, and individuals with regard to how to improve the experiences of both content moderators and everyday social media users. We close with suggestions for creating a more “pro-social” online environment, one that not only better mitigates the risks of psychological harm but potentially encourages greater connection, resulting in wellness and even flourishing.

In the concluding chapter of Graphic, the authors recount the story of a pivotal trip they took to San Miguel de Allende, Mexico, where they absorbed the stories and insights of a diverse cohort of women who had gathered to discuss the concept of resilience. Through a World Cafe–style event, where the women discussed their perspectives on both trauma and healing, the authors gathered several insights that can be used to help foster positive experiences in peoples’ engagement with social media and other online spaces. This final part of the book underscores key themes from earlier chapters, including the power of humor, community, and connection to minimize psychological harm when engaging with graphic material online and, ultimately, to maximize well-being.

While graphic online content may be upsetting, people who regularly work with such content – like journalists, content moderators at social media companies, and human rights investigators – have developed various strategies for minimizing the risk of psychosocial harm when engaging with such material. Many of these strategies can be adapted by the general public to limit the risk of harm and maximize the potential for positive outcomes from their online engagement. Such strategies include tactics aimed at increasing our control over when and how users view graphic online material, varying how users engage with upsetting media, treating such content like “toxic waste” and limiting exposure of the user, their loved ones, and their households, and striking the balance between looking at and engaging with such content, and knowing when it may be better to look away.

Too often, people mindlessly scroll through their social media feeds and other online spaces to catch up on the activities of their friends and family or simply to pass the time. However, this behavior can leave them vulnerable to the more insidious aspects of online engagement, especially if they come across graphic online content – whether intentionally or without warning. In this chapter, the authors of Graphic discuss how bringing greater intentionality to one’s online engagement can serve as a protective force. They summarize the most recent research and insights from their interviews with diverse experts to illustrate tactics for deriving greater meaning from time spent online and ultimately how to use that engagement to not only protect oneself from psychological harm but also to potentially even flourish.

This chapter from Graphic discusses humans’ biological and psychological responses to viewing the suffering of others, including through graphic videos and photographs found online. The authors discuss the sometimes-negative effects of such images on human rights workers and journalists – including the risk of secondary or vicarious trauma – referencing the most recent research as to what happens in the body when people view and process upsetting images.

Viktor Frankl, a psychiatrist who was a survivor of the Holocaust, has much to teach us about resilience. One key lesson from his work is that having a sense of meaning and purpose can fuel persistance and survival in some of life's most difficult situations. In this chapter you will learn about post-traumatic growth, the experience of positive life changes after a stressful or traumatic event. You will see ways that individuals have used their emotional suffering to help others, including having a clear and impactful “survivor mission.” Meaning and purpose can be given, but it can also be made. We will teach you four areas where you can make meaning in your lives.

Creativity is connected to healing in many different ways. Creative people are more likely to experience post-traumatic growth or beneficial psychological changes that come in the aftermath of trauma. Creative activities can also help maintain emotional equilibrium. The cognitive reappraisal of seemingly negative events is associated with divergent thinking. Notably, the act of drawing, writing, or making music simply for the pleasure of the act can improve one’s mood by helping reduce sadness, anxiety, and anger. Even passively engaging in the arts can improve one’s mood and stave off potential cognitive decline.

The authors critique trauma and illness models of the effects of adversity, and go on to consider alternative societal and political understandings.They then review biological insights from attachment theory and affective neuroscience. An analogy with grief leads to consideration of post-traumatic growth, and adversity activated development.

A review of symptoms resulting from adversity then leads to consideration of the factors that help people rebuild their lives after major adversity, such as safety and security, interpersonal bonds, and networks.A positive sense of one’s identity and role, and feeling that life is just and meaningful, also helps.Effects of the asylum process often counter these factors.

People’s problems often have to be categorised as ‘health’ issues in order to access care. Positive and negative effects of this are reviewed.