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Vicarious Trauma

9 Minutes

Edited & medically reviewed by THE BALANCE Team

Fact checked

CONTENTS

Healthcare professionals, first responders, and many other experts have cared for trauma survivors for years. As they effectively extend their health, support, and empathy to these survivors, many acquire secondhand trauma symptoms from them through a phenomenon now being recognized as vicarious trauma.

Vicarious trauma has recently emerged as a severe occupational challenge, especially for people volunteering or working in victim services, emergency medical services, law enforcement, and fire services, due to their constant exposure to trauma and violence survivors. Empathetic engagement with these survivors daily can take a toll on their mental health, hampering their professional and personal skills and abilities. It is, therefore, crucial to identify vicarious trauma as soon as it presents itself and learn how to deal with it effectively before the situation becomes critical.

Vicarious traumatization is a phenomenon by which people affiliated with fields where they frequently come in contact with the victims of trauma and violence end up negatively affecting their mental health. This work-related trauma exposure may occur for multiple reasons, such as by listening to individuals’ traumatic experiences, reviewing their case files, watching videos of exploited children, responding to mass violence incidents, or merely hearing about or responding to the aftermath of a traumatic event.

If you have been working with trauma or torture survivors, it is essential to familiarize yourself with some common symptoms of vicarious traumatization. These symptoms may include:

Experiencing lingering feelings of rage, depression, or anger about a patient’s victimization
Feeling shame or guilt
Having feelings of self-doubt
Becoming too emotionally invested in a patient
Over-identification with a trauma survivor, such as having rescue fantasies involving them
A state of hopelessness
Feeling cynical or pessimistic
Always being preoccupied with the thoughts of a patient, even when you are outside of work.
Facing difficulty in maintaining professional boundaries with patients or trying to do more than what is expected from your role to help them
Distancing yourself from patients, cutting them off, or refusing to listen to their traumatic experiences

Vicarious trauma is a multifactorial phenomenon that may occur for several reasons. However, the presence of the following risk factors significantly increases the chances of experiencing it.

Excessive Empathy

People who show a high level of interpersonal empathy or seem to care deeply about their love are more vulnerable to developing vicarious trauma at some point in life.

Age and Experience

People who are young and relatively inexperienced in their respective fields may expose themselves to more significant personal stress. This is because most of them have yet to develop mechanisms to cope with these new world views on their own and may end up developing vicarious trauma in learning.

Lack of Training

Knowing how to respond to and manage emotions can be difficult for a person with insufficient skills or training in their respective fields. As a result, they may develop strong negative feelings while dealing with trauma survivors who may quickly exacerbate vicarious trauma due to a lack of coping mechanisms. To minimize this risk, many organizations that constantly deal with trauma victims provide emotional containment training to help their employees handle themselves through crises.

Gender

Females are much more likely to develop vicarious trauma than males due to their natural inclination towards developing emotional bonds more quickly than their counterparts.

Personal History of Mental Health Problems or Violence

People with traumatic past life events or pre-existing mental health conditions, like depression or anxiety, are more vulnerable to vicarious trauma during a job requiring direct contact with trauma survivors. A personal history of trauma, such as child neglect and abuse, may place someone at greater risk as they struggle to adjust to the current traumatic events of other people. They may also face higher anxiety levels while dealing with these cases than those with sound mental health.

Individual Coping Styles

How an individual responds to stress also influences their sense of well-being. For example, someone with active coping styles who regularly seek emotional support is at low risk of vicarious trauma. In contrast, those who seek refuge in harmful coping mechanisms, such as avoidance, substance misuse, and disengagement, may considerably increase the risk.

Common Negative Reactions to Vicarious Trauma

Every person experiences the effects of vicarious trauma differently. However, some common adverse reactions that most of them are likely to exhibit include:

Difficulty in managing emotions
Sleep-related issues, such as insomnia or over-sleepiness
Feeling emotionally numb
Being easily distracted that causes increase the risk of accidents
Experiencing unusual physical problems, such as aches and pains, frequent illnesses, etc.
Feeling as if you have lost any meaning in life
Experiencing hopelessness about the future
Relationship issues, such as increased social isolation, frequent personal conflicts, and avoidance of intimacy
Increased irritability or aggressiveness
Frequent violent or angry outbursts
Excessively worrying about potential dangers in the world
Adopting destructive coping behaviors, such as substance abuse, over or undereating, and gambling
Losing interest in activities that you previously used to enjoy
Avoiding work and interactions with patients
Other symptoms, suggestive of posttraumatic stress disorder, such as flashbacks of any trauma you have heard about from a patient, getting nightmares, etc.

If you feel like you have developed vicarious trauma due to the nature of your job, remind yourself that you are not alone. There are multiple ways to manage the condition you are suffering from and learn how to prevent vicarious trauma in the future. These strategies include some simple steps, such as keeping track of your compassion fatigue or burnout levels, monitoring yourself daily, and learning to take a step back when things get too much to handle.

Some other essential strategies to remember include:

Take Time for Yourself

While your job holds high importance and value in life, it is equally important to put yourself first now and then. When things start to feel burdening and your emotional health hits a low, take a day off to do something you love. Consider taking a trip to a hill station, going out for a hike, planning a meet-up with a friend, or simply sitting down in your house and relaxing with a good book and your favorite meal.

Be Balanced

Try your best to balance your physical, emotional, and mental health well. When one of these aspects is off, it can make you highly vulnerable to vicarious trauma. Try to eat healthily every day, take time out to exercise and meditate, get enough rest every night and do whatever else you enjoy to feel balanced and well-rounded.

Separate Yourself

As you are fulfilling your duties that require facing different traumatic situations, it is vital to separate yourself from whatever is going on. Do not let the surrounding trauma dwell on your personality, opinions, and personal values, and remind yourself that while you are here to help other trauma survivors, their pain is not yours to feel.

Limit yourself

Whenever you leave for work every day, remind yourself of the boundaries you set with your clients and try not to break them. You may consider limiting the number of trauma cases you handle on a given day to ensure that you do not spend your entire working day filled with gloom and sadness, as it may harm your cognitive state directly or indirectly.

If self-care tips have not proven useful and you feel like the effects of secondhand trauma are spreading to all aspects of your life, it is time to consider professional treatment. Professional treatment for vicarious trauma takes place under the supervision of an expert and entails different therapies such as:

Cognitive Reframing

Cognitive reframing is an element of a popular behavioral therapy called cognitive behavioral therapy, which identifies and changes unhealthy patterns of behavior and thinking. It works by targeting any troubling thoughts that a person may have developed in their mind due to consistent interactions with trauma survivors and replacing them with healthier ones that do not overgeneralize things. For example, a first responder dealing with frequent automobile incidents and car crashes may develop a notion that driving is entirely unsafe and refrain from doing it. Cognitive reframing helps such people through logical reasoning, for example, through statistics suggesting how an average person is twice as likely to die from poisoning than in a car crash.

Mindfulness Interventions

Mindfulness interventions, such as meditation and yoga, have also been researched as one of the best ways to help people overcome the effects and impacts of vicarious trauma. Participants who participated in these research studies reported improvements in their physical and cognitive symptoms related to vicarious trauma, such as insomnia and self-criticism, once they started following mindfulness interventions. However, more research is needed to make any claims in this aspect.

Psychoeducation

Psychoeducation is an important element in many interventions directed at managing vicarious trauma. This approach helps the victims learn how to:

Recognize the symptoms of vicarious trauma
Reduce the levels of stress and increase mindfulness
Develop a personalized self-care plan

Depending on individual client needs, psychoeducation interventions may include up to 12 sessions and other treatment methods, like stress reduction workshops and group therapy. So far, research has proven that attending these sessions can reduce various symptoms of vicarious trauma, including anxiety, compassion fatigue, and burnout.

FAQs

Who is at risk of developing vicarious trauma?

Anyone who works with trauma and violence survivors is at risk of acquiring adverse effects. However, these normally include the following:
Doctors, nurses, and other medical health professionals
People working in law enforcement
People delivering emergency medical services, such as paramedics
People engaged in fire services
People engaged in delivering victim services

What are some common vicarious trauma examples?

Vicarious trauma is quite evident in nurses, some of which choose to leave their profession after years of service due to the feelings of confusion, shame, or turmoil that they are suffering from. What they do not know is these feelings mainly stem from secondhand traumatic stress that causes them to become cynical and hardened and makes them feel crippled when confronted by suffering time and again. While a small number of them can get over these feelings, others may resort to harmful coping mechanisms, like going silent, shutting down, ignoring the experiences of patients, etc.

Is it possible to prevent vicarious trauma?

Yes, with timely efforts, it is possible to prevent vicarious trauma. However, this requires collaborative efforts from the organization and employees in the form of psychoeducational classes, emotion containment classes, training for developing healthy coping mechanisms, and the establishment of proper support systems to lean on during burnout.

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