A survey claiming that 11 per cent of Londoners were ‘substantially stressed’ by the bombings raises more questions than answers.
I have an interest to declare. My partner is one of those who lost a good friend in the terrorist bombings in London on 7 July 2005. Miriam Hyman was on the bus at Tavistock Square when the youngest of the suicide bombers, Hasib Hussain, detonated his device about an hour after the three other attacks on the London Underground.
Is my partner affected? Undoubtedly. Bereavement is painful, and it is felt individually in a way that few others can appreciate. Loss hurts. And loss of a young life brought about by such an ultimately pointless act as 7/7 can hurt even more (1).
So does my partner (a) feel upset when reminded of what happened; (b) have repeated thoughts about what happened; (c) have difficulty concentrating; (d) have trouble falling asleep; or (e) feel irritable or angry? Definitely. Yet now, answering ‘yes’ to having experienced any of these feelings in the aftermath of 7/7 indicates the presence of ‘substantial stress’, according to a team of researchers at King’s College and University College, London, in a survey conducted shortly after the 2005 attacks and now published in full.
Never mind the fact that most of us could answer ‘yes’ to at least (c), (d) and (e) every now and then – the conclusions of the research team, as presented in the British Journal of Psychiatry and reported in the Sun newspaper yesterday, are held to indicate that 11 per cent of the British population have suffered from persistent and substantial stress as a result of 7/7 (2).
The researchers first telephoned 1,010 Londoners 11 to 13 days after the 7/7 bombings and asked them about their feelings and thoughts; they then carried out a follow-up survey of 574 Londoners between seven and eight months after the bombings. In the first survey, they found that around a third of respondents were suffering from ‘substantial stress’ as a result of the bombings; by the time of the second survey, that had fallen to around 11 per cent of Londoners.
There seems to be a definitional problem in some of the language used. How upset does one need to be in order to be suffering from ‘substantial stress’? Using non-specific terms to explain an ill-defined concept like ‘stress’ is a formula that allows one to conclude pretty much anything, according to prevailing prejudices. The researchers themselves are not unaware of this problem. In their paper they argue: ‘It is reasonable to question whether our measure of substantial stress might have produced an artificially inflated prevalence estimate.’ (3) Tucked away in the ‘Limitations’ section of the paper, this caveat did not make the headlines.
If respondents answered yes to any of the questions (a) to (e) listed above, then they were judged to be suffering from ‘substantial stress’. Most said yes to the first question: ‘Do you feel upset when something reminds you of what happened?’ If you remove the yes responses to this question from the overall survey, then the percentage number of those who suffered from persistent and substantial stress falls from 11 per cent of the population to five per cent of the population.
It is somewhat surprising that the researchers, among the myriad questions they asked, did not enquire about the influence of media images and reporting of 7/7 on people’s views of the terrorist event. We are informed about the respondents’ age, gender, social class, working status, residential location, housing tenure, ethnicity, religion, income and parental status, but no mention is made of what media they follow and what kind of media images and claims they consumed post-7/7.
Those who have a link to individuals directly affected by the bombing will know that the constant reappearance of references to the attacks in the news, and particularly images of the blown-up bus (the other Underground incidents did not provide a similarly iconic image), often reminds them of what happened and leaves them feeling upset.
Feelings and perceptions are usually a poor guide for social research. For example, numerous surveys of both ordinary people and public figures in the US have consistently shown a high degree of expectation that there will be a terrorist attack in the coming months; such an attack has not come to pass. This shows that expectations can be wrong – and policy built on misplaced expectations can be disastrous.
As I have argued elsewhere, as more money has been spent on the ‘war on terror’, and as more measures are put in place to protect people from an allegedly big terrorist threat, the more people’s awareness about terrorism is raised and the more ‘stressed’ they seem to feel about it (4). Many in the British media and the authorities seem loathe to ‘let go’ of the 7/7 bombings, instead revisiting them as symbols of evil and as a justification for various legal measures. This institutionalisation of 7/7 and its effects no doubt has an impact on how people feel about the event. Could it be that society itself is prolonging the impact of terrorism on the population, by elevating terrorism to the main issue of the day and working from the presumption that it will have a long-lasting and damaging emotional impact on those who experience it?
At the same time, as the sociologist Frank Furedi has pointed out, people’s individual identities are increasingly fragile today. There is a widespread assumption that people are vulnerable and open to suffering from stress and other mental problems (5). It is notable, for instance, that those who took part in the 7/7 stress surveys were older and wealthier than non-respondents, and were less likely to have previously reported being stressed.
No doubt, some affected by 7/7 will have needed the support of psychiatrists to come to terms with their loss. But the growing presumption among professionals is that significant numbers of us have been affected somehow – a presumption which, sadly, this research will have done little to question. Ironically, those truly needing support may find it more difficult to receive it, given that we now have a situation where everyone involved in an incident is encouraged to seek counselling.
Professor Simon Wessely, a leading and insightful psychiatrist at King’s College London, tells people that whatever they do after an emergency, they should not give their name to the media. Otherwise they will never be able to ‘let go’ as the various anniversaries of the incident will bring a fresh round of calls to remember and reflect. Maybe we could add that nor should you give your name to ‘boffins’; certainly when research is carried out along these kinds of uncritical lines, the benefits are far from obvious.