Vicarious Trauma

The term vicarious trauma, sometimes also called compassion fatigue, is the latest term that describes the phenomenon generally associated with the cost of caring for others Supporting Survivors of trauma can be stressful because of Survivors' resistance to change, their heightened states of pain, fear and terror to which professionals bear witness to, their ways of relating to helpers, and the nature of the work. The nature of the work is particularly stressful when it involves listening to detailed descriptions of very painful, often horrific events and it may also involve professionals re-enacting survivors' early experiences of trauma and betrayal with them. At times, hearing these stories may overwhelm professionals/helpers and lead them to experience, to a lesser extent, the same feelings faced by the trauma survivors who have shared with them. Vicarious trauma typically involves a shift in the world view of the helper. The helpers beliefs about the world may be altered and/or damaged by repeated exposure to traumatic material. The impact of listening to and thinking about the stories that you may hear, can continue well after the client has left the interaction. Other terms used for compassion fatigue are:

• secondary traumatic stress
• secondary victimization

It is believed that professionals such as counsellors working with trauma survivors experience vicarious trauma because of the work they do.

Vicarious trauma is the emotional residue of exposure that professionals have from working with people as they are hearing their trauma stories and become witnesses to the pain, fear, and terror that trauma survivors have endured. It's important not to confuse vicarious trauma with burnout or countertransference. Burnout is generally something that happens over time, and as it builds up a change, such as time off or a new and sometimes different job, can take care of burnout or improve it. These days, the term vicarious traumatisation is used to describe professionals' trauma reactions resulting from exposure to clients' traumatic experiences . Vicarious trauma, however, is a state of emotional stress, anxiety and tension and preoccupation of the stories/trauma experiences described by clients. Vicarious Trauma is unavoidable and is the natural consequence of being human, connecting to and caring about our clients as we see the effects of trauma on their lives. The effects of vicarious trauma might be experienced in several ways:

• avoid talking or thinking about what the trauma effected client(s) have been talking about, almost being numb to it
• be in a persistent arousal state

The single most important factor in the success or failure of working with trauma is about the attention paid to the experience and the needs of the helper. We cannot meet others needs when we are overriding our own. Counsellors and other professionals should be aware of the signs and symptoms of vicarious trauma and the potential emotional effects of working with trauma survivors. Vicarious Trauma can affect how a professional relates to their families, friends, and partners. Furthermore, the professional may experience changes in esteem for themselves and for others.

Signs and Symptoms of Vicarious Trauma

• having difficulty talking about their feelings
• free floating anger and/or irritation
• startle effect/being jumpy
• over-eating or under-eating
• difficulty falling asleep and/or staying asleep
• losing sleep over patients
• worried that they are not doing enough for their clients
• dreaming about their clients/their clients trauma experiences
• diminished joy toward things they once enjoyed
• feeling trapped by their work as a counsellor (crisis counsellor)
• diminished feelings of satisfaction and personal accomplishment
• dealing with intrusive thoughts of clients with especially severe trauma histories
• feelings of hopelessness associated with their work/clients
• blaming others

Vicarious trauma can impact a professionals performance and function, as well as result in errors in judgment and mistakes. Professionals may experience changes in their behaviour:

• frequent job changes
• tardiness
• free floating anger/irritability
• absenteeism
• irresponsibility
• overwork
• irritability
• exhaustion
• talking to oneself (a critical symptom)
• going out to avoid being alone
• dropping out of community affairs
• rejecting physical and emotional closeness

Or Interpersonal Impacts:

• staff conflict
• blaming others
• conflictual engagement
• poor relationships
• poor communication
• impatience
• avoidance of working with clients with trauma histories
• lack of collaboration
• withdrawal and isolation from colleagues
• change in relationship with colleagues
• difficulty having rewarding relationships

Or Affecting Personal values/beliefs:
• dissatisfaction
• negative perception
• loss of interest
• apathy
• blaming others
• lack of appreciation
• lack of interest and caring
• detachment
• hopelessness
• low self image
• worried about not doing enough
• questioning their frame of reference – identity, world view, and/or spirituality
• Disruption in self-capacity (ability to maintain positive sense of self, ability to modulate strong affect, and/or ability to maintain an inner sense of connection)
• Disruption in needs, beliefs and relationships (safety, trust, esteem, control, and intimacy)

And it could affect Job performance:
• low motivation
• increased errors
• decreased quality
• avoidance of job responsibilities
• over-involved in details/perfectionism
• lack of flexibility

Vicarious trauma can also impact a counsellors or other professionals personal life, such as relationships with family and friends, as well as the professionals, both emotional and physical.

There are ways to manage vicarious trauma:

1. Anticipating Vicarious Trauma and learning to protect yourself:

Protecting yourself includes arranging things ahead of time to antiipate the stress of your work and its impact on you. Strategies could include:

Awareness
Balance
Connection
A sense of balance is considered to be one of the key components to preserving a sense of identity and overall wellbeing. A healthy balance of work, rest, play, including socialisation with friends and family is important in decreasing the effects of VT. Furthermore, any activities which assist the individual's personal tolerance levels, for example; journal writing; personal counselling; emotional support from partners, will assist the individual to reconnect to emotions

2. Addressing signs of Vicarious Trauma

Addressing Vicarious Trauma includes those things you do for self-care. Strategies include:

Self-care
Self nurturing
Escape

3. Transforming the pain of Vicarious Trauma

Transforming VIcarious Trauma includes things you do to transform the negative impact of the work into a connection with some positive aspects of meaning and community. Strategies include:

Create meaning
Infuse meaning in current activities
Challenge negative beliefs
Participate in community building

People in helping professions can take specific steps to reduce the risk of vicarious traumatization. For counsellors and therapists, it is widely considered to be essential for those who are frequently exposed to traumatic material to receive appropriate training and supervision. Many mental health professionals also recommend connecting with other professionals who understand the experience of working with trauma.

One way helping professionals can reduce their risk of vicarious trauma is to ensure they are making enough time for self-care. When therapists and other people who are indirectly exposed to trauma dedicate time to self-care activities: journaling, taking time off from work, enjoying music, spending time with loved ones, pursuing hobbies, and so on, they may better able to address the experience of vicarious trauma.

Going to therapy can also be a form of self-care, as a therapy session allows time to focus on ones own thoughts and feelings and a safe place to examine them.

Maintaining a reasonable degree of balance, both in work and outside of work, may also be helpful. For example, therapists who frequently encounter trauma through their work may want to vary the kinds of work they do on a daily or weekly basis and avoid overworking themselves.

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