Understanding Vicarious Traumatization

Most anyone that works in a helping profession understands the term "burnout". It's something that we all must be aware of and pay attention to. Re-living traumatic events with our clients on a daily basis can be very overwhelming and starts to take it's toll on even the most seasoned therapists. I would like to share this article that I read on Vicarious Traumatization (also known as Compassion Fatigue) because I feel it does an excellent job in summarizing what Vicarious Traumatization is, signs to look out for, and how to cope.

Vicarious Traumatization of the Mental Health Professional
http://www.apa.org/apags/profdev/victrauma.html

Anne Ranee Farrar, MA
Seton Hall University

(This article was first published in the Winter 2002 issue of the APAGS Newsletter.)

Vicarious traumatization is also referred to as a secondary trauma. It can be experienced by a clinician who works with traumatized individuals, whether they work with victims of child maltreatment, domestic violence, victims of torture, or victims of large-scale disasters. Pearlman and Saakvitne (1995) emphasize the need for the therapist to be aware of vicarious traumatization and its impact on the therapist. "Vicarious traumatization is the process through which the therapist’s inner experience is negatively transformed through empathic engagement with clients’ trauma material" (p. 279). For example, a therapist may experience nightmares related to events in which they have heard graphic details. They may experience fear, may have concerns about their own safety, or they may feel compelled to question own their life experiences or their own vulnerabilities after hearing the stories of survivors.

Pearlman and Mac Ian (1995) reported that therapists who work with trauma victims and who have a personal trauma history show more negative effects from their work than those therapists without a personal trauma history. McCann and Pearlman (1990) suggested that vicarious traumatization among professionals working with victims result from the inability of the therapists to process the traumatic clinical material in which they hear. Brady, Guy, Poelstra, and Brokaw (1999) reported that vicarious traumatization has symptoms which are similar to Post Traumatic Stress Disorder (PTSD) and may disrupt the cognitive schemas reported by the therapist.

In a study of international relief and developmental personnel (Erisson, Vadne Kemp, Gorsuch, Hoke, & Foy, 2001) reported that 10% of returning staff who worked in the field with trauma survivors met full criteria for PTSD, reporting at least moderate symptoms such as re-experiencing the event, hyperarousal, as well as avoidance.

Friedman (1996) reported that therapist self-care is essential when working with patients who suffer from PTSD because this work can be functionally disruptive and psychologically destabilizing for the mental health professionals. Kinzel and Nanson (2000) found that educating and debriefing volunteers (mental health professionals) were two strategies, which they found to prevent the onset of compassion fatigue and also to reduce the resignation of the volunteers. They indicated that debriefing was found to help many of the volunteers cope and deal with processing the traumatic events which they heard.

For those who are volunteering their time it is important to take care of one’ self and to reduce stress. Mitchell and Everly (1998) indicate that stress management is "a personal process" (p. 23). They note that there is no one "right" answer to stress management but that the most important element is consistency and that it should become part of one’s lifestyle, not just some techniques which are utilized by a person when they feel stressed. Different methods of management techniques can be proper sleep and nutrition, progressive muscle relaxation, imagery, meditation, and physical exercise.

The question at all times remains, "How can we help someone else, if we first can’t help ourselves?" The only way for a mental health professional to help others is that they must first be as psychologically healthy as possible. We all have limits of what we can do. There is nothing wrong with taking time off to be alone, or spend time with family and/or friends, and to not volunteer. Follette, Polusny, and Millbeck (1994) report that peer support networks, employee assistance programs, and personal therapy represent some possible methods for reducing the negative impact of work related stressors.

The American Red Cross (2001) reported, "Most disaster workers are dedicated individuals who also tend to be perfectionists. Because of this, they are at risk of pushing themselves too hard and of not being satisfied with what they have accomplished" (p. 1). One of the most important recommendations the American Red Cross (2001) made is that as difficult as it might be when your shift is over "leave and take time to recharge" (p. 2).

If you are interested in learning more about Vicarious Trauma and what you can do to combat it, I have found an excellent article for additional reading. You can download it at the following link:

Preventing Vicarious Trauma: What Counselors Should Know When Working With Trauma Survivors