Tuesday, April 24, 2007

The Canard of Interview Trauma

In his essay, "Oral History and IRBs," historian Taylor Atkins justifies IRB review of oral history in large part based on the alleged risk that interviewers will traumatize their narrators. He writes:

As unimpeachable as the OHA's own Professional Guidelines may be, I think it is arrogant to assume that oral historians have nothing to learn from other disciplines with regard to the ethical treatment of human subjects. If nothing else, they can become more sensitized to the possibilities for psychological or social harm that may result from oral history interviewing. Whenever our IRB reviews a protocol from the psychology department that involves questions about childhood abuse or some other trauma, we make sure that the investigator is either qualified to directly provide appropriate counseling or intervention, or provides a list of appropriate support services. How many oral historians have the expertise or qualifications to handle a situation in which an informant with PTSD experiences distress during an interview? How many would have a list of counseling services at hand in case it was necessary? How many even imagine such a scenario when they venture out with their tape recorders?

I would like to suggest that historians don't imagine such a scenario because it doesn't happen.

When I asked Atkins what made him think interviews could traumatize narrators, he replied,

when I was at the 2004 OHA meeting, I attended a panel on the Veterans' Oral History Project, at which the presenters very casually remarked that several veterans, being interviewed by small groups of fourth-graders, broke down into tears when talking about their battlefield experiences. My first thought was, "so how did a bunch of fourth-graders respond to that?" Breaking down crying is not always indicative of PTSD, but you surely understand that the possibility is there.

As Atkins concedes, crying is not trauma requiring "counseling or intervention" by a licensed therapist. Basic decencies—a pause in the recording and some words of sympathy—are enough. And while the possibility of real trauma exists, so does the possibility that a narrator will fall down the stairs trying to answer the interviewer's knock at the door. The question is whether the risk is great enough to justify the hassle of IRB review, and Atkins presents no evidence that it is. Historians have recorded oral history interviews for half a century, and he cannot point to one that has traumatized the narrator.

Having imagined a harm, Atkins also imagines a remedy: "a list of appropriate support services" to be tucked into the interviewer's bag, next to spare batteries for the recorder. Unsurprisingly, he has no evidence that such a list has ever helped anyone.

For researchers in parts of the world where such support services are common, carrying such a list isn't much of a burden. But the paperwork and training it takes to get to the point where the IRB will approve one's project is a real burden. And the requirement of a list could disrupt research in parts of the world where those services don't exist, or even for a researcher who travels around the United States to collect stories, and would have to carry lists for each area she visits.

Atkins is not alone in making such claims. Comparable fears appear in Lynn Amowitz, et al., "Prevalence of War-Related Sexual Violence and Other Human Rights Abuses among Internally Displaced Persons in Sierra Leone," JAMA 287 (2002), 513-521, and Pam Bell, "The Ethics of Conducting Psychiatric Research in War-Torn Contexts," in Marie Smyth and Gillian Robinson, Researching Violently Divided Societies (Tokyo: United Nations University Press, 2001). But neither Amowitz nor Bell cites any evidence to suggest that interview research traumatizes narrators. (If anything, Bell's piece indicates that narrators know how to protect themselves, for example, by choosing to be interviewed as a group rather than one-on-one.)

In contrast, the existing empirical evidence suggests that, if anything, conversation is therapeutic. In her essay, "Negotiating Institutional Review Boards," Linda Shopes cites three articles to make this point:

  • Kari Dyregrov, Atle Dyregov, and Magne Raundalen, "Refugee Families' Experience of Research Participation," Journal of Traumatic Stress 12:3 (2000), 413–26.
  • Elana Newman, Edward A. Walker, and Anne Gefland, "Assessing the Ethical Costs and Benefits of Trauma-Focused Research," General Hospital Psychiatry 21 (1999), 187–196.
  • Edward A. Walker, Elana Newman, Mary Koss, and David Bernstein, "Does the Study of Victimization Revictimize the Victims?" General Hospital Psychiatry 19 (1997), pp. 403–10.

To these I would add Elisabeth Jean Wood, "The Ethical Challenges of Field Research in Conflict Zones," Qualitative Sociology 29 (2006): 373-386. Wood writes:

While the discussion of this consent protocol initially caused some interviewees some confusion, once the idea had been conveyed that they could exercise control over the content of the interview and my use of it, participants demonstrated a clear understanding of its terms. In particular, many residents of my case study areas took skillful advantage of the different levels of confidentiality offered in the oral consent procedure. This probably reflected the fact that during the war residents of contested areas of the Salvadoran countryside daily weighed the potential consequences of everyday activities (whether or not to go to the field, to gather firewood, to attempt to go to the nearest market) and what to tell to whom. Moreover, I had an abiding impression that many of them deeply appreciated what they interpreted as a practice that recognized and respected their experience and expertise. Although for many telling their histories involved telling of violence suffered and grief endured, I did not observe significant re-traumatization as a result, as have researchers in some conflict settings (Bell, 2001). I believe the terms of the consent protocol may have helped prevent re-traumatization as it passed a degree of control and responsibility over interview content to the interviewee.

(It's worth repeating that Bell's article presents no observations of re-traumatization.)

Though I have not interviewed trauma survivors myself--at least, not about their trauma--I have no doubt that it is a tricky business. If anyone can show me that interviews can aggravate real trauma, I welcome correction. I would also welcome more scholarship on how interviewers can maximize the catharsis described by Wood.

Unfortunately, the arbitrary power enjoyed by IRBs relieves them of the responsibility or incentive to seek out such real solutions to real problems. Atkins and his colleagues can dream up phantom menaces and require burdensome, useless conditions based only on guesswork. Only the removal of their power is likely to force them to support their arguments with evidence.

Note: I thank Amelia Hoover for pointing me to the Wood and Amowitz articles.

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