When the Work Gets to You: Understanding and Healing Vicarious Trauma
Many of us in a helping profession—including therapists—get into this field because we want to help others. Whether focusing on physical well-being, emotional support, mental health guidance, or the plethora of other fields, the main goal is to help. And we do help! But this profoundly rewarding work often comes at a price.
This work requires us to make ourselves vulnerable to some of the worst experiences a human being can face:
· A doctor working with patients who have a terminal diagnosis.
· A first responder on the scene of a horrific traffic accident.
· A crisis response provider supporting a community after a shooting.
· A therapist working with clients with trauma histories or in current traumatic (possibly abusive) situations.
The Cliffs of Trauma
Trauma Stewardship by Laura van Dernoot Lipsky illustrates the nature of this exposure through the following passage:
“‘Are you sure all this trauma work hasn’t gotten to you?’ he asked.
We were visiting our relatives in the Caribbean. We had hiked to the top of some cliffs on a small island, and for a moment the entire family stood quietly together, marveling, looking out at the sea. It was an exquisite sight... As we reached the edge of the cliffs, my first thought was, ‘This is unbelievably beautiful.’ My second thought was, ‘I wonder how many people have killed themselves by jumping off these cliffs.’
Assuming that everyone around me would be having exactly the same thought, I posed my question out loud. My stepfather-in-law turned to me slowly and asked his question with such sincerity that I finally understood: My work had gotten to me.”
This experience is the very definition of vicarious trauma. Van Dernoot Lipsky’s reflections are in congruence with thoughts I have had throughout my almost 10-year career as a trauma therapist. While I can only speak from this perspective, I can confidently state I have been witness to some of the lowest, most vile acts human beings can inflict on one another. And this has taken its toll at times.
When Self-Care Isn’t Enough
In the course of one’s education in the therapy field, the importance of self-care is lauded. And it is important! But there are times when it can only go so far. I have learned what works for me in sessions to keep from taking the client’s “stuff” in. This process has been almost a decade in the making and is always evolving. But there have been, and will continue to be, times when I find my work ‘getting’ to me.
When our well-developed self-care strategies feel insufficient, we need objective tools to recognize the harm.
Identifying the Signs of Vicarious Trauma
According to the British Medical Association (BMA), signs that the work is getting to you can include:
· Lingering feelings of anger, rage, and sadness about a client’s victimization.
· Becoming overly involved emotionally with clients.
· Experiencing moral distress, bystander guilt, shame, or self-doubt (akin to imposter’s syndrome).
· Being preoccupied with thoughts of client situations when not at work.
· Over-identification with a client, like having horror or rescue fantasies.
· Feeling hopeless, pessimistic, or cynical.
· Finding yourself distancing, numbing, detaching, cutting patients off, or staying overly busy.
· An avoidance of listening to a client's story of traumatic experiences.
· Difficulty in maintaining professional boundaries, such as overextending yourself beyond your role.
It is also important to acknowledge that today’s geopolitical climate, the recent COVID-19 pandemic, and the state of the world in general have an impact on everyone, which can further exacerbate the symptoms of vicarious trauma.
Finding Resilience and Growth
I know this stuff is hard, and I know it is difficult to ask for help. But there is no shame, no judgement here.
If you find yourself experiencing these indicators, then that is a sign that your work is ‘getting’ to you. I provide a great service for working through this stuff in the form of intensive therapy using modalities like EMDR, ART, and parts work.
If you find yourself in or going into the realm of burnout, reach out. We can process out the stuck, negative stuff and grow new neural pathways for change, growth, and resilience.
Resources:
· Trauma Stewardship: https://www.penguinrandomhouse.ca/books/574932/trauma-stewardship-by-laura-van-dernoot-lipsky-with-connie-burk/9781576759448
· BMA Vicarious Trauma: Signs and Strategies for Coping: https://www.bma.org.uk/advice-and-support/your-wellbeing/vicarious-trauma/vicarious-trauma-signs-and-strategies-for-coping