What Is Vicarious Trauma?
Vicarious trauma affects people in all sorts of caring professions, from humanitarian aid workers to healthcare professionals. The British Medical association describes it as ‘a process of change resulting from empathetic engagement with trauma survivors’. They go on to explain ‘it stems from engaging empathetically with survivors of traumatic incidents’.
In the same way someone who’s been through a traumatic event(s) is left with the fallout from that experience, professionals can be left with some of the fallout or residue of the traumatic information they’re exposed to through the course of their work. Sometimes the impact of this can be obvious. At other times it’s more subtle. A colleague of mine likens vicarious trauma to thin pieces of parmesan being shaved from a large block. Each time we are exposed to trauma, it shaves a tiny slither from the block. It’s barely noticeable, but over time all those little bits amount to quite a lot.
Signs and Symptoms to Look Out For
Vicarious trauma manifests in many ways. It’s a very individual experience, but here are some signs and symptoms to look out for:
· Changes to appetite
· Difficulty sleeping
· Fatigue
· Emotional problems and low mood
· Difficulty concentrating
· Problems in relationships
· Reduced empathy and compassion
· Drinking more or using more substances
· Self-harm or suicidal thoughts
Why Are Therapists at Risk?
As therapists, it’s our job to provide a safe space for people to talk about the difficult things they’ve experienced. They rely on us to help them work through these things and come up with reflections and solutions. To be effective, this requires a certain degree of empathy. We must sit with the difficult experiences and absorb some of the client’s pain. A lot of therapists hold their clients in mind outside sessions too. They might be thinking about how to help them next or processing information the client has shared. Although it’s vital to the work we do, forming these empathetic connections can make us susceptible to vicarious trauma.
In general, therapists are kind, caring, empathetic people. It’s often what draws us to the profession in the first place. Based on my own experience and from supervising other therapists, I know many of us are led to this job because of our own difficult experiences and trauma. Although I would hope most therapists will work through these things on their own therapy journeys, the ‘baggage’ we bring to the role can be another risk factor for vicarious trauma.
Ultimately, I believe it’s impossible to sit with other people’s pain and not be affected by it. It can be difficult to acknowledge this because as therapists we feel we should be immune. There’s also the misguided belief that it’s unprofessional to admit your work is impacting your own mental health. I would argue, if you’re not affected, you probably shouldn’t be in this job. A lot of what we hear is awful, painful, and horrific. It’s natural and human to be moved emotionally in some way by the experiences people have survived. This means we need to find ways to manage our exposure to trauma in a manner that keeps both us and our clients safe.
5 Ways to Guard Against Vicarious Trauma
1. Self-Awareness
Reducing the risk of vicarious trauma starts with acknowledging therapists are human beings too. We don’t need to be immune to trauma or unaffected by our work, but we do need to develop our own mechanisms for coping. This starts with self-awareness. Ignoring the ways we’re affected by the things our clients share is a recipe for disaster. Nobody can compartmentalise forever, and we cannot immunise ourselves against human suffering. To be honest, I don’t think I would want to see a therapist who was able to do that.
2. Self-Compassion
We can think about the work we do like cash flow. For every little bit of emotional energy that goes out we need something coming in. We must replenish what we give our clients because you cannot withdraw from an empty account.
For me, this starts with self-compassion. Showing myself compassionate helps me remain compassionate towards others. This includes basic things like getting a good night sleep (not always easy when you’ve got two small children!), preparing myself healthy meals ahead of a busy day, and making sure I’ve got a big bottle of water and lots of snacks. I also prioritise getting some fresh air, stretching my legs, moving my body, and listening to music in between appointments. These are all things that replenish me, helping me bring my healthy self to therapy sessions.
3. Support
Self-care is essential, but we all deserve community care too. When I’m struggling, I find it helpful to be authentic and honest with the people around me. Although I’m always mindful about what I share for obvious professional reasons, if I’ve had a tough day, telling people what I need and why can be very powerful.
4. Grounding
Although it’s important to process the material clients have shared and deal with any emotions rather than bottling them up, we also need to find ways to ground and centre ourselves. While I’m not suggesting everyone should get a dog, this is what works for me! There’s just something about being able to pick up my puppy, cuddle her and play with her and feel her little furry body next to mine. Find what works for you and make it a priority.
5. Supervision
Good supervision is key, especially when working with trauma. You need a supervisor you feel safe with and space to talk about the process and interpersonal dynamics of therapy, not just protocols. I’m lucky to have an amazing supervisor who is not only super knowledgeable, but also creates space for me to talk about things that have been difficult or challenging or that have some sort of resonance for me as a human being. She always helps me reflect and figure out how I’m going to manage these things moving forward.
About Shelley
I am a qualified, trauma informed Clinical Supervisor with experience supporting individuals, groups and trainees. I’m also an EMDR Consultant and Training Facilitator, a BABCP accredited CBT therapist and lecturer and a RN(MH). My supervision style is relaxed, supportive and focussed on providing a safe space to learn and share knowledge. Learn more about my services here and please get in touch to discuss working with me.
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