In 1992, the BBC broadcast Ghostwatch, one of the most controversial shows in television history and one that has had a curious and unexpected effect on the course of psychiatry.
The programme was introduced as a live report into a haunted house but in reality, it was fiction. This is now a common plot device, but the broadcast happened in 1992, years before even The Blair Witch Project used the documentary format to tell a fictional story and viewers were used to news-like programmes presenting news-like facts.
But despite some subtle nods to its fictional nature, the fact it was broadcast on Halloween and the ridiculous conclusion (the poltergeist eventually escapes from the house, takes control of the BBC and possesses presenter Michael Parkinson), many people believed the ‘documentary’ was real and that the programme was capturing these astounding events as they happened. You can watch it on YouTube and see how it was introduced.
Consequently, lots of people were genuinely frightened by the programme, including many children who were watching with their families. As a result, the BBC was flooded with calls and letters and were forced to start an investigation into the programme.
As the controversy raged on, an article appeared in the British Medical Journal, written by two doctors from Gulson Hospital in Coventry, reporting post-traumatic stress disorder (PTSD) in two children that was apparently caused by watching Ghostwatch.
Case 1
This boy had been frightened by Ghostwatch and had refused to watch the ending. He subsequently expressed fear of ghosts, witches, and the dark, constantly talking about them and seeking reassurance. He suffered panic attacks, refused to go upstairs alone, and slept with the bedroom light on. He had nightmares and daytime flashbacks and banged his head to remove thoughts of ghosts. He became increasingly clingy and was reluctant to go to school or to allow his mother to go out without him.
Although not without scepticism, several other cases were published as replies to these initial reports producing a small case series of PTSD caused by the TV show.
These minor cases drifted into the history of medicine until people started to debate what event should be considered a sufficiently traumatic event in order to diagnose PTSD.
At the moment, the current DSM-IV-TR diagnosis for PTSD says that “the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others” and that the person’s response involved “intense fear, helplessness, or horror”.
It’s the “confronted with” part that allows people who have seen distressing things on TV and reacted with “intense fear, helplessness, or horror” to be diagnosed with PTSD.
At the time Ghostwatch was broadcast the criteria required that “the person has experienced an event that is outside the range usual human experience and that would be markedly distressing to almost anyone” which could similarly be interpreted to allow TV programmes to cause the disorder.
The new proposed criteria for the DSM-5 wouldn’t allow television-triggered PTSD. In fact it specifically says that exposure to traumatic events “does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work related.”
Ghostwatch has played a part in changing how PTSD will be diagnosed. Although a major motivation was the wave of PTSD diagnoses after watching coverage of 9/11 on TV, the fictional ghost investigation is often cited in the medical literature as an example of how the existing criteria can lead to absurd consequences.
Although the programme is more famous for its effect on the history of media, it remains a minor but significant spectre in psychiatry’s past.
Link to GhostWatch entry on Wikipedia.
Mind Hacks 
While an interesting study, it hardly is the first broadcast that induced panic in the population. The honor belongs to Orson Wells’s War of the Worlds. The radio show was modeled after a live breaking news format. Grown men and women fled for their lives.
Interesting. I’ve never seen that program (though to be honest, the idea of Michael Parkinson being possessed seems rather amusing)
It’s also interesting that the proposed DSM-5 criteria makes an exception for work-related exposure via electronic media. Working in a newsroom, there are many highly upsetting things that one has no choice but to look at or listen to. I’m not aware of any diagnosed cases of work-related PTSD at my former job, but some incidents triggered widespread depression, anxiety and nightmares. Having to listen to the sounds of a fatal house fire over the police scanner as it happened was one of these. Despite the distance, the horror and helplessness we felt were very immediate.
Stay at home moms?
Volunteers?
School children watching a documentary?
What is the criteria for “work”?
This is silly (the DSM side). Psychology needs to start separating description from explanation. PTSD is a problem people have, it has symptoms. The idea that it cannot be caused by TV is an empirical question, something you would have to do research to determine. To declare it one way or the other as a simple matter of definition is to confuse the issue and to make scientific investigation impossible.
Blah.
James is right: broadcasts worthy of PTSD (according to the proposed DSM-5 changes) have been occurring for some time now.
When you look at the events that are regularly broadcast, both on television and online, there are going to be things that will traumatize some viewers, per the comment above mine.
Changes in the criteria for PTSD would likely make many media outlets second-guess broadcasting some things, correct? Then you start running into issues of companies not broadcasting certain content for fear of being targeted by at least someone. Can we accurately gauge what the consequences could look like?
Eric Charles: “Psychology needs to start separating description from explanation.”
Eric, you need to start separating psychology from psychiatry. The DSM is a project by psychiatrists, not psychologists. And, concerning the separation of description from explanation, note that the diagnostic criteria for PTSD (both the DSM IV-TR criteria and the proposed DSM-5 criteria) are descriptive, not explanatory. The first criterion is “exposure” to an event of a certain kind. Following that exposure, certain signs and symptoms occur. There is no mention of causation in the wording of the criteria.
Yes! You have me with the separation of psychology and psychiatry. On the other hand, so long as the psychologists treat the DSM as a reference, it is our problem as well. While I have not read a very wide range of clinical articles, those I have read classify participants with DSM criterion.
I will protest the other point. Careful avoidance of the specific word “cause” does not mean their definition is free of assertions of causation. They are clearly asserting a causal relationship.
Why would you have as part of your definition the existence of certain past events, if you did not think those past events caused the present events? Why would you talk about current stimuli “associated with” the past events? And why would you disallow alternative causal events (drugs, etc.)? You do all this because you are not merely asserting that the stress-disorder happens to be post-trauma, you are asserting that the stress-disorder is here because the trauma was before.
If you look at the change in “A” from DSM IV to (proposed) DSM V, all they have done is removed the possibility of the symptoms being caused by certain things. In essence they have declared that people cannot be traumatized by certain things. In doing this, they have muddled the potential causes of trauma with the problems trauma can cause.
It is a myth that watching events of 9/11 on TV caused PTSD. Myth perpetuated by bad research–
http://www.psychologytoday.com/blog/the-skeptical-sleuth/201109/september-11-2001-did-americans-suffer-virtual-trauma-television-co
I was affected by this show as child. Having gone to bed scared out of my wits at the age of 12 and never having seen the end to know it was fake, for years i thought it was real. I have had reoccurring nightmares since then i am 30 now and still get them, always starts the same in a room then banging starts on the pipes and the ghosts come. Recently I was forced to watch the show by some friends and it has helped to revisit it, but still at night if i hear a random banging the first thought that creeps into my head is Mr Pipes until i remind myself it was fake. Im sure there are a lot of kids out there who where affected by this and I imagine some a lot more than others.