In these modern times, trauma and post-traumatic stress disorder (PTSD) are firmly embedded in the popular lexicon. This doesn’t mean that the general public has a comprehensive understanding of it yet, but it does mean that people recognise that trauma can have lasting effects. However, what hasn’t come to the forefront of public perception as much is vicarious trauma.
You don’t have to have experienced a life-or-death struggle or serious abuse for trauma to leave an enduring imprint on you. It’s possible to absorb other people’s traumatic experiences, which can be just as disturbing as going through the original event.
Exploring Vicarious Trauma
Vicarious trauma, also known as insidious trauma or secondary traumatisation, happens when people who did not immediately witness the traumatic event still integrate certain aspects of it into their being. This is frequently mistaken for compassion fatigue or burnout as several symptoms are similar, such as lack of empathy or exhaustion.
Anyone is potentially at risk of vicarious trauma, although some occupations might increase the risks. These include:
- Law enforcement
- Counsellors/therapists
- Emergency service workers (including phone operators)
- Social workers
- Lawyers and other workers present during court cases
People who have a close relationship with a trauma survivor can also experience secondary traumatisation. This doesn’t have to be a romantic relationship; it could be a friend, colleague, or student.
It’s possible that people who work with trauma could set themselves up for lasting nervous system dysregulation because of the way they are expected to respond in a professional context.
In a previous blog, we covered what happens when we suppress our natural trauma response. Our nervous system governs our response to danger. Our intellectual selves, or human brains, don’t get a say in how our limbic system or mammalian brains respond to danger. All animals except humans will obey what their threat response tells them to do – fight, flight, or freeze. Once the threat is over, they’ll shake to release the pent-up energy.
However, in a professional context, therapists and others who work in this field have to conduct themselves in a certain way. Although they may have had a bodily response to something they hear, they have to appear neutral.
Humans can overpower their physical threat response with the most developed part of the brain – the neocortex. However, if the trauma response is not processed properly and the energy isn’t discharged, it remains dormant in the brain until it is triggered, setting the stage for traumatic events to have lasting consequences.
Signs of Vicarious Trauma
The mental and physical signs and symptoms of vicarious trauma can be almost identical to direct trauma. They can be emotional, behavioural, somatic, cognitive, and spiritual, and include:
- Nightmares
- Intrusive thoughts
- Loss of connection
- Suspicion of others[1]
- Depression
- Hyperarousal
- Overwhelming feelings of futility
- Shortness of breath[2]
- Heart palpitations
- Numbness
- Loss of hope
- Increased isolation
- Anxiety
Vicarious trauma is well-recognised in medical literature – the Diagnostic and Statistical Manual acknowledges that repeated exposure to aversive details of trauma is enough to cause PTSD.
PTSD and other trauma-related conditions present differently in everyone, and there is no exhaustive list of warning signs as our responses are always unique. If you’re concerned that you might be experiencing vicarious trauma, getting a professional diagnosis is always the best approach.
Preventing And Treating Vicarious Trauma
If you frequently encounter trauma in your employment, you need to be working reflectively, engaging in self-care, and receiving trauma-informed professional supervision.[3]
Just as there are many ways that vicarious trauma can present in us, there are many different ways of approaching it. If you’re working within an institute that provides some form of trauma-related service, they have a duty of care to create policies that facilitate well-being; however, reaching out for treatment for vicarious trauma lies solely with the individual.
Treatment for vicarious trauma is similar to that of direct trauma – we need to complete the unfinished reaction stored in our bodies and reframe how we see events in our past. Some effective modalities to support this are:
- Sensorimotor psychotherapy
- Somatic experiencing
- Lifespan integration
- Internal family systems (IFS)
It may also be helpful to engage in training around work-life balance, boundaries, and self-help to prevent future occurrences. Making sure that you get enough sleep, eat healthily, and socialise can all bolster our mental well-being and resilience too.
It’s important to remember that if you are experiencing vicarious trauma, it is not a reflection of your professional ability. Just because you work with trauma, you’re not expected to be immune to it. It’s normal to have an emotional response to certain things – it’s what makes us human. Getting treatment for vicarious trauma will enable you to do your job unencumbered by the past, make you more resilient, and support your work.
If you have a client or know of someone struggling to heal from vicarious trauma, reach out to us at Khiron Clinics. We believe that we can improve therapeutic outcomes and avoid misdiagnosis by providing an effective residential program and outpatient therapies addressing underlying psychological trauma. Allow us to help you find the path to realistic, long-lasting recovery. For more information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours).
Sources
[1] Melius, Ambryn D., “The Lived Experience of Vicarious Trauma for Providers: A Narrative Phenomenoleogical Study” (2013). Creative Arts Therapies Theses. Paper 46.
[2] Hochleutner, Katie, “Stuck in Somatic Countertransference: A Heuristic Study” (2018). Creative Arts Therapies Theses. 111. https://digitalcommons.colum.edu/theses_dmt/111
[3] Pearlman, Laurie A.; Saakvitne, Karen W. (1995). Trauma and the Therapist: Countertransference and Vicarious Traumatization in Psychotherapy with Incest Survivors. Norton
