When caring becomes to much - Vicarious Trauma

Susan Stubbings
7 days ago
5 min read

Updated: 2 days ago

As a trauma therapist I’ve worked with presentations of Post Traumatic (PTSD) and Complex Post Traumatic (C-PTSD) many times.

Although I've dropped the ‘disorder’ word because in my way of being people are not 'disordered', which means according to the Cambridge Dictionary, "not normal, in a way that is unhealthy! However our nervous systems are reacting normally as would be expected in the fullness of being human, in response to the environments, situations and events that give rise to the aftereffects of being part of or witnessing traumatic events. For example, sexual abuse, neglect, RTA, DV any event that may have been threatening or in fear of your life.

One of the other presentations I’ve also find myself working with is the phenomenon of vicarious trauma, experienced by practitioners supporting others.

This is an important concepts for practitioners to understand if they are going to ensure they are not going to fall prey and be at an implicit mercy, because it doesn't have any.

As practitioners we need to be mindfully aware, skilled and knowledgeable to be able to spot symptoms if it starts happening to you.

Anyone engaging in caring work can be exposed to the phenomenon of vicarious trauma and we need to be aware of the possibility especially if we are working with clients presenting trauma and the many intense emotions evoked.

These days with media coverage many others not just counselling practitioners can fall prey to Vicarious Trauma because of the reporting of traumatic events. The Manchester bombing for example and more recently the Liverpool attack and the stabbing of young people which seems to becoming more common place in society.

These can also be a trigger for our own unprocessed wounds from the past.

But can our already strained nervous systems take on board such news without absorbing part of it as our own?

Over time if not addressed vicarious trauma can change a person's worldview, perceptions of their world, personal identity and sense of safety and this can have lasting impact. It is imperative as practitioners we understand this phenomenon.

So What is Vicarious Traumatization?

Vicarious traumatization is secondary trauma, also known as compassion fatigue or burnout. Vicarious trauma is indirect trauma which can happen when we as supporters are continually exposed to traumatic experiences of others and we can begin to absorb the emotions of others. We begin to feel like we are drowning in the mire of emotions of our work

Its not to be thoughts of as a failure or a weakness on a practitioners part, it is through repeatedly witnessing distress, stress and the sorrow of others. It refers to the emotional, psychological and spiritual impact upon practitioners who are continually hearing and witnessing the distress of others.

In our role as counsellors and therapists we hear the pain and suffering of our clients on a daily and hourly basis and of course this is part of our role, and we want to listen deeply to others this is the why we became therapists in the first place, to make a difference.

Over time If we absorbed this pain and suffering it can affect our own well-being and can lead to us beginning to mirror clients experiences and symptoms, for example:

Reduction of interest in your work, family, friends or activities you once enjoyed
Nervous system hyperarousal – shallow breathing, palpitations, tight chest
Experiencing more intense emotions than usual
Flashbacks, panic attacks, intrusive thoughts, detached or numbing out
Withdrawing because we are becoming hypervigilant

We may also over time suffer with accumulative symptoms :

Sleep disturbances, loss of appetite,
Low mood, disturbed concentration
Negative coping behaviours (drinking more alcohol)
Feel like we are not getting anything right
Anxiety, depression, deep sadness or survivors guilt
Distrust, irritability, anger or even rage
Loss of job satisfaction
Empathic exhaustion & compassion fatigue
Being to close to clients overly emotionally involved
Feeling bystander guilt, overwhelming feelings of self-doubt
Boundaries becoming blurred or slipping into rescuer mode
Burnout exhaustion or stress from difficult roles.
Derealisation, detachment, high levels of anxiety
Pessimistic feelings, loss of hope or preoccupied with clients between sessions

These symptoms may not be noticeable at first and others around you may notice them before you do, its easy to dismiss what others say when we are being affected by vicarious trauma symptoms. Whilst burnout may be transient vicarious trauma may not be as easy to overcome.

This is when mindful self-awareness, self-care and being fully present with self in the practise of reflexivity within our supporting sessions is crucial to be able to empower our own understanding.

This needs to be on-going on a daily basis not just when the trauma symptoms have set in because then it may be too late it makes it more difficult to resolve.

On-going support with peers, within supervision and on-going CPD can all help us to be ‘intune’ with our clients without absorbing intense emotions and the wearing down of empathy.

Which contributes to and can become empathetic bonding rather than true empathy that is walking in another's shoes without losing the 'as if' factor and compassion fatigue that erodes empathy.

At first you may not notice there are any changes happening in your inner world and others may notice first that you are becoming irritable, sad or angry more readily or more frequently. Listen to them and act.

How to manage Vicarious Trauma:

Take a break from working - give yourself time to rest and digest, aid recovery
Practice self-care – back to basics get enough sleep, eat a healthy diet and gentle exercise like walking, swimming
Reset your boundaries establishing clear parameters to protect yourself.
Stress reducing strategies e.g. mindful breathing, body scan, guided imagery
Building self-compassion into your daily life can support alleviation of symptoms but also can balance compassion fatigue and ward off vicarious trauma.
Take small manageable steps to regulate your nervous system
Connect with others and seek personal therapy to understand what happened to you, to support you to self soothe and take care of yourself, vicarious trauma helps us forget how to undertake the basic needs we have daily.

Final thoughts

Prevention is better than cure it has been said, and it is no different with counsellors engaging daily in emotionally charged environments.

Keeping mindful to the possibility of burnout and vicarious trauma as practitioners is to understand the impact and depth of your role. To be aware and increase self-observation, recognise and track any signs of stress, pressure or anxieties and empower actions before you get to burnout and/or vicarious trauma. Taking care of yourself emotionally by engaging in self-compassion, having other interests outside the counselling arena, being socially engaged, checking in on yourself asking yourself "how am I doing". Connecting with others on a regular basis and maintaining a work-life balance is important to your overall health and well-being.

Carrying out daily practices of self-compassion and taking self-care seriously as in putting yourself first and building support networks and setting clear boundaries is a must.

If we want to continue to be healthy whilst also supporting and making a difference to others.

Keeping your eye on the ball of work-life balance, ensuring you are having a lunch break, not filling every waking minute with the business of work.

Empower yourself in daily practices before you start experiencing the symptoms of vicarious trauma or burnout will enable you to continue make a difference to yourself equally as to the people you serve.

Don't be worried about asking for help with daily tasks or contacting a counsellor yourself to enlist personal support. Asking for help and support is a skill in itself, be mindful and skilful, taking care of yourself is equally important as taking care of others.