18 Minutes

By THE BALANCE
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Vicarious trauma, often termed secondary trauma is defined as indirectly experiencing a traumatic incident through a first-hand account or description of the situation. Therapists and counselors as well as emergency crews, law enforcement officers, physicians, and judges, and lawyers may be vulnerable to vicarious trauma. Any individual who has a close connection with a trauma victim may be subjected to secondary traumatization.

In the course of their job, therapists as well as other caregivers regularly hear stories of horrible events. Hearing these stories can sometimes frustrate them, causing them to feel, on a lesser scale, the same emotions as the trauma victims in their care. The helper’s perspective is usually shifted as a result of vicarious trauma. Constant exposure to painful material, for example, may modify and/or impair the helper’s perceptions and beliefs.

What is Abandonment Trauma?

Burnout and compassion fatigue are related ideas that have some parallels to vicarious trauma, and a person may experience one or more of these states simultaneously. Compassion fatigue is physical and emotional exhaustion that occurs when people who serve others feel compassion for those they aid but do not have enough time to recover and look for themselves. It differs from vicarious trauma in that this is not always accompanied by trauma-related symptoms and does not always result in changes in one’s perspective.

Although burnout and vicarious trauma are often used indiscriminately, this condition does not always have a traumatic component. People might become burned out if they work in a toxic atmosphere or if they feel they are doing a monotonous or otherwise difficult job without adequate time for rest or proper self-care. All helping professions may be in danger, but those who deal with kids and victims of sexual harassment and abuse may be more vulnerable to vicarious trauma.

When we deal with large amounts of information, specifically information from individuals that arearemotionally charged, our minds, bodies, and spirits adjust to help us in coping with it. The way we cope may benefit in the short term, but it may have negative long-term consequences. While there are specific symptoms that you or someone you know will experience if they are suffering from vicarious trauma, still everyone deals with it differently. If you identify some of your personal experiences in the following list, keep in mind that there are solutions available.

Physical illness and exhaustion

  • Persistent exhaustion, even after rest
  • Regular Strain body
  • Wrist pain, neck or back discomfort, and headaches are all common symptoms.
  • Having trouble sleeping or sleeping too much
  • When you have time to rest, such as on vacation and you get sick.

Changes in emotions

  • Highly emotional content makes you vulnerable.
  • Becoming cut off from your feelings and/or your body
  • Feeling guilty because you have more opportunities or resources than the people you serve
  • You have the feeling that despite how much you offer, it will never be enough.
  • Having a sense of helplessness or hopelessness regarding the future
  • Anger, irritation, contempt, or skepticism

Changes in the patterns of thought

  • Find it hard to understand multiple viewpoints or various solutions for a single problem.
  • Leaping to conclusions, inflexible thinking, or a lack of ability to be careful and methodical
  • Other people’s suffering is minimized in relation to the most serious tragedies or situations.
  • Thoughts and pictures that are intrusive and related to the traumatic content you have seen or heard

Changes in behavior

  • Stagnation and absenteeism
  • Relationships, work, and/or obligations are avoided.
  • Afraid of engaging in activities that were formerly enjoyable or indifferent
  • Using escapist behaviors such as eating, drinking/using drugs, watching TV, or shopping

Changes in relationships

  • There is no distinction between professional and personal time.
  • Considering anyone who does not operate in your field to be less significant
  • Trouble relating to others’ daily lives without relating them to your own or those you help.
  • Inability to have a social life outside of work
  • Worried about the safety of individuals you care about, you become hyperaware.
  • Disconnect yourself altogether from others, or limit your interactions to people in your profession or who can empathize with your experiences.

According to the Association of American Medical Colleges, a professional nursing educator witnessing encounters between nurses and patients in emergency rooms sees that new nurses are “excited, enthusiastic, and engaged with patients.” Nurses with 20 to 30 years of experience, on the other hand, seem distant from their patients, as if they are “going through the motions” and “have built walls to avoid the hurt” of experiencing their pain and trauma. Because the experienced nurses haven’t lost their empathy or want to help others, the term “compassion fatigue” is inappropriate to use to describe their predicament.

Instead, they’re suffering from “professional emotional saturation,” a condition that combines secondary traumatic stress symptoms and burnout. Burnout is induced by long hours of work and having too much to work to accomplish daily goals. Nurses do not have sufficient time to engage with every patient, which contributes to burnout, in part since they are continuously inputting data into devices and computers. Secondary traumatic stress, on the other hand, is caused by witnessing and sharing the grief of a patient’s death and being swamped by unpleasant feelings. While all healthcare practitioners must experience some level of detachment in their work, secondary traumatic stress causes excessive detachment, which leads to skepticism, pessimism, and dissociation.

Another example of the effect of vicarious trauma is described in Reflections on Nursing Leadership by a nurse with 20 + years of experience who left the field experiencing “turmoil, shame, and confusion.” She didn’t understand she was suffering from secondary traumatic stress until years later. She discovered that she had grown “hardened and cynical,” and that she felt “crippled when confronted again by suffering,” leading to “hopelessness, withdrawal, and lack of self-esteem.” “Going silent… diverting, shutting down, minimizing, or ignoring the experiences of patients” were among her coping techniques.

According to constructivist self-development theory, vicarious trauma is the result of an interaction between people and their environment.  This means that the individual helper’s past history (such as previous exposure to traumatic events), coping mechanisms, and support system, among other things, converse with his or her condition (which include work environment, nature of work, client base served, and so on) to produce individual manifestations of vicarious trauma. This suggests the unique nature of adaptations and responses to vicarious trauma, as well as unique coping and transformation strategies. Some have proposed that this traumatization develops when a person’s worldview or sense of safety is broken by witnessing and/or listening about their patients’ traumas. The clinician’s regular functioning may be disrupted as a result of their exposure to traumas, however inadvertently, lowering the efficiency of the clinicians.

Anything that makes it difficult for the helper to fulfill his or her role of assisting traumatized individuals might lead to vicarious trauma. Many social care workers say that bureaucratic and administrative barriers to their efficacy have an impact on their job fulfillment. Burning out of the employees is further exacerbated by negative aspects associated with the organization as a whole, such as reorganization, downsizing in the name of implementing change, and a shortage of resources in the guise of lean management.

The social stigma of mental health treatment among service providers has also been linked to vicarious trauma. Stigma makes it difficult to engage in self-care, and as a result, the caregiver may burn out and be more vulnerable to vicarious trauma. Vicarious trauma is more prevalent among those who have experienced trauma and suffering in the past, according to a study. According to another research, the defensive style of a mental health therapist may be a potential risk for vicarious traumatization. Vicarious traumatization is more common among mental health caregivers who use self-sacrificing coping methods.

Females are more prone than males to suffer from secondary traumatic stress, according to research, and counselors who do not work in private practice are more likely to suffer secondary traumatic stress. Secondary traumatic stress is reduced in those who have a stronger counselor professional identity (CPI). Previous service records, in particular, increased the risk of experiencing vicarious trauma in Emergency management personnel.

To help avoid burnout symptoms and vicarious trauma from worsening or occurring in the first place:

  • Make use of your team and supervisors for regular debriefings and other forms of assistance.
  • Check out if you have accessibility to an EAP (employee assistance program) that you can use in the event of a crisis.
  • Critical reflection is a beneficial prospect for prevention. This can be done one-on-one with a close person, boss, counselor, or another caregiver (often referred to as ‘supervision’); with coworkers; or on your own (for example, by writing in a diary).
  • Enjoy your yearly vacation and take scheduled breaks.
  • Examine your work environment for factors that promote wellbeings, such as plenty of space for you and your coworkers to eat lunch together, ‘chill-out’ areas, and enough of light/flowers/plants/color.
  • Be supportive and helpful to your coworkers, and remember to take time out to celebrate milestones and anniversaries.

A structured approach for the prevention of vicarious traumatization include:

The curriculum should include vicarious trauma education and training. By including burnout and vicarious trauma into the educational curriculum, resident skills training, apprenticeships, and teaching assistantships can take a primary prevention strategy. A program on trauma and PTSD would be incomplete without a discussion of vicarious trauma, and a forum on burnout would be incomplete without a discussion of vicarious trauma. FEMA and SAMHSA have acknowledged the need to understand better the damaging mental health impacts of disaster work by implementing programs to include vicarious trauma, secondary traumatic stress, and compassion fatigue training events and support programs prior to deployment. 

Screening and self-evaluation. Screening is a secondary prevention technique, and many organizations screen for work-related stress and, if necessary, provide wellness coaching, managing stress, and other similar programs. To track the rise of harmful mental health outcomes, forensic workers responding to major catastrophes are screened for stress-related disorders.  Similarly, providing vicarious trauma screening and self-assessment tools raises awareness of personal weaknesses and strengths while also establishing a baseline of symptoms that can be tracked over time.

There are several standardized measures that can be used to evaluate the indicators of vicarious trauma. The majority of these standardized measures were created to examine other work-related concepts and have not been psychometrically verified for vicarious trauma assessment. They have, however, been altered for research purposes and acknowledged as vicarious trauma screening methods. They aren’t intended to be used as diagnostic instruments. Instead, these tools can be used to track changes in symptom severity across time. Electronically accessible self-administered tools improve privacy and access while also encouraging staff participation.

Personal and professional support should be improved. Personal and professional social support is a protective measure that has been linked to a lower risk of vicarious trauma. It has been proven that consulting with peers and colleagues reduces a sense of loneliness and increases feelings of efficiency.  Managers and supervisors play a critical role in improving employee support. Managers can employ one-on-one monitoring to give support for difficult cases and manage caseloads, ensuring that each clinician has a balanced complexity and volume of trauma patients. A large caseload of trauma victims has been linked to an increased risk of vicarious trauma symptoms, according to research.  Supervisors can also help their employees design and implement self-care regimens. While the plurality of therapists and hospital personnel feel that self-care strategies can lower the risk of vicarious trauma, just a small percentage actually use them, according to a poll.

Encouraging a corporate culture that promotes resilience. The alignment of corporate ideals with an individual’s aims and values is the starting point for primary preventative techniques that promote resilience. These values help to establish a culture of honest and open communication, moral management, and evident leadership support. Integrating professional well-being into the goal and vision of the business, as well as accepting the value of personal, social, and work-life balance, is critical in driving strategies for promoting workplace resilience.

Intrusive thoughts is one characteristic that distinguishes a trauma response from other causes that can induce similar symptoms. It might be difficult to “un-see” distressing visuals if you have experienced vicarious trauma, whether you witnessed them in reality or on social media/news. Victims of vicarious trauma are more likely to be concerned about related issues. For example, regular media reporting of COVID-19 might increase anxiety about health-related difficulties, and numerous accounts of police violence can increase anxiety about personal security.

Here are some strategies for reducing the impact of vicarious trauma:

  • Take a rest from the social media and news for a full 24 hours. Make it a whole weekend if you can. (You shouldn’t worry about missing out on important information, you’ll hear it anyway afterward)
  • Stay grounded, pray or practice meditation.
  • Actively contribute to enhancing positive activities you do in your life that give you pleasure. Play a game of Frisbee in the backyard. Read a captivating book. Bring out old family films or photos. Make games.
  • Maintain relationships with people that make you feel cherished. The importance of human connection in trauma recovery cannot be overstated. While the pandemic makes it difficult (if not impossible) to see friends and family in person, stay in touch by phone, or best yet, video chat platforms or FaceTime that enable you to see their faces.
  • Self-care is extremely important. With COVID limiting our traditional “go-to” wellness solutions, you may have to think outside the box. Seek out a yoga studio that teaches classes outdoor. Look for a workout program that is available online. Make “solo time” for journaling at home.
  • Volunteering or taking part in advocacy events that take you outside of your comfort zone are both good options. It’s satisfying to aid others. Giving to a greater cause gives meaning and purpose to one’s life.
  • If you’re a parent, consider limiting your child’s exposure to traumatic media coverage. Keep the communication open by discussing what they’re seeing and hearing, as well as how they are feeling about it. To help children learn by example, model good coping techniques.

Employers of sexual assault specialists have a responsibility to help their employees reduce the impact or occurrence of vicarious trauma. It is reasonable to assume that vicarious trauma is an OH&S issue for sexual abuse organizations. Some employers require formal informed consent about the dangers of offering trauma therapy, and career development tools can be made available.

Workplaces can actively support sexual assault survivors. Some insights are given below:

  • Ensure appropriate and comfortable lunch and tea break amenities are separate from therapy spaces.
  • Offer non-counseling work opportunities (e.g. community education, resource development).
  • Decorate the office with soothing elements (for instance plants and framed pictures).
  • Share work success stories at group supervision or team meetings.
  • Create a culture of worker care.
  • Continuing professional development, education, and training are critical for mental health practitioners working in trauma fields to effectively cope with stressful work.

Caseload. When compared to mental health experts who work in broader or multidisciplinary domains, those who mainly work in the trauma sector are at a higher risk of vicarious trauma. Caseload management, such as reducing the number of patients per week and the number of ‘extremely traumatic’ cases, may help to mitigate the possible vicarious impacts of this profession. Caseload expectations must be reasonable. Allow workers to have some control over or participation in the allocation process, if possible.

Supervision. Workers in the sexual assault profession, whether in an organization or in private practice, must have frequent access to individual monitoring. Many agencies offer this internally (for example, Senior Counsellors typically play a vital role in this), as well as assisting workers in obtaining external monitoring. There is a strong case to be made for keeping a clear distinction between clinical supervision and line management that focuses on operational supervision (though some argue against separating the two supervisory functions completely).

Workers should be able to communicate the effects of their work on themselves without any concern of being stigmatized or having their competence called into question. Concerns concerning worker or client safety should be brought up, discussed, and addressed during supervision (addressing clearly inappropriate, unethical, or harmful conduct). Developing supervision agreements that clearly state out the goal of supervision, individual and organizational responsibilities, and worker confidentiality limitations is a good practice.

A supervisor’s (operational and clinical) responsibility includes being aware of indicators of potential exhaustion and vicarious trauma, as well as checking in with practitioners when issues arise. Clinical supervisors have a responsibility to give knowledge and assistance to improve self-care and resilience, as well as to actively work to resolve challenges as they arise, including referral to a qualified health professional if necessary. In their practice, private practitioners are at great risk of getting isolated. Regardless of how much experience one has in the field, maintaining regular clinical supervision is critical.

Coping strategies. Vicarious trauma can be reduced by balancing work, play, and relaxation.  The ideal balance would include socializing with friends and family, creative interests, and physical activity. Participation in these activities may help maintain a feeling of self. Rest and recreation are crucial in reducing the consequences of vicarious trauma since they are restorative. Also, vicarious trauma can affect trust, so a strong social support network can help prevent or mitigate its effects. A natural reconnection to emotions occurs when one engages in activities that build personal tolerance (e.g. writing, therapy, meditation, and emotional support from others).

Spirituality. Vicarious trauma can cause a loss of meaning and affect how people think about themselves, others, and the world. A lack of meaning can lead to feelings of cynicism, numbness, hopelessness, and outrage, along with sorrow, confusion, and despair. Reconnecting with your professional and personal ethics, beliefs, and values is an important part of feeling sustained at work. Involvement in community activism around important issues could be achieved through supervision conversations that include ethical, purpose, and intention questions.

Leaves. There are many reasons why workers don’t take regular breaks. This is understandable considering the desire to help others that drives many in this field. This commitment can easily turn into an unreasonable sense of obligation, causing workers to worry about being selfish or abandoning clients if they take vacations.

Humor. According to Charles Figley, a worker’s sense of humor is one of their best tools when repeatedly exposed to trauma stories. Because humor is so subjective, it is impossible to suggest or prescribe ways to maintain it. It could be as simple as watching a funny movie instead of a serious documentary or spending time with someone who makes you laugh.

Focus on health. Everyday activities that support and enhance our personal well-being benefit us all, just like our clients. Prioritizing personal and relational well-being helps us live a rich, fully engaged life. In this context, self-care is not proposed as a way to shield us from the trauma and horror of childhood sexual abuse (that’s impossible and inappropriate). Being emotionally present, working with others, and expressing empathy without being thrown off course or swept away are all benefits of self-care and wellbeing. Above all, remember that you are not alone. Everyone is affected by the present situation to varying degrees. Reaching out to a therapist who specializes in trauma treatment can be highly beneficial if your symptoms become too difficult to handle on your own.

Stepping back and putting oneself out of the shoes of the trauma victim is the first step toward treating Vicarious Trauma. You must accept the fact that you are not alone in your suffering. Often, addressing Vicarious Trauma entails relearning how to care for yourself, both physically and mentally:

  • Keep hold of yourself. Make sure you get adequate sleep, eat well, and exercise on a regular basis.
  • Being conscious and aware. Spend time doing things that make you happy, practicing yoga or mindfulness, and consider the choice of therapy for healing trauma.
  • Enable yourself to interact with others. Get out and connect with your loved ones, friends, and relatives. Socializing is essential for mental nourishment.

Remember that addressing your Vicarious Trauma may necessitate some well-earned vacation time. So don’t be afraid to go ahead and do it!

Vicarious Trauma Treatment Options

  1. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is a type of cognitive-behavioral therapy that focuses on trauma. Through a therapeutic plan, TF-CBT responds to the person’s specific demands. This treatment approach will focus on skewed thought patterns, as well as negative responses and behaviors. They will also assist in identifying other symptoms related to Vicarious Trauma.
  2. EMDR (Eye Movement Desensitization and Reprocessing) is a popular and effective treatment for trauma. It is a powerful method for reducing negative emotions, memories, and physiological sensations linked to your personal experiences. EMDR works by having you “desensitize” to the traumatic incident through a sequence of guided eye movements as well as other exercises.

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