Vicarious Trauma and the Value of Self-Care for Therapists
Vicarious Trauma is an ongoing topic in the world of therapy. It is something that can be difficult to recognize in oneself until it is having a negative impact. As therapists, we can never underestimate the importance of self-care and self-awareness on our ability to not only do our jobs, but to live our lives as we wish to. This article was found on the GoodTherapy.org website, written by Wendy Salazar, MFT.
Vicarious Trauma and the Value of Self-Care for Therapists
June 27, 2016 • By Wendy Salazar, MFT, GoodTherapy.org Topic Expert Contributor
People are drawn to the helping professions for many different reasons. They may feel a calling to assist in relieving others’ suffering and to help them heal from their emotional wounds. They may have been traumatized themselves and wish to share the coping skills they’ve learned with others going through similar issues. Or they may feel caring for others brings meaning and a sense of purpose to their lives.
Whatever their reasons for becoming a therapist or other helping professional, they often experience vicarious trauma through the stories told by the people they work with. This secondary trauma, also referred to as compassion fatigue, can seriously hinder their work if they remain unaware of its negative impact and/or do not practice sufficient self-care strategies.
Becoming aware of the signs of compassion fatigue is the first step in addressing the issue. The following are some red flags:
Preoccupation with the traumatic stories of the people they work with
Emotional symptoms of anger, grief, mood swings, anxiety, or depression
Physical issues related to stress, such as headaches, stomachaches, fatigue, or problems sleeping
Feeling burned out, powerless, hopeless, disillusioned, irritable, and/or angry toward “the system”
A tendency to self-isolate, be tardy, avoid certain people, or experience a lack of empathy and loss of motivation
Some of the professionals most likely to experience compassion fatigue include therapists, social workers, child welfare workers, emergency workers, police officers, firefighters, and ministers. However, anyone working with trauma survivors is susceptible to vicarious trauma. Helping professionals who have been subjected to trauma themselves also may be more at risk for developing compassion fatigue, especially if they have not worked through their issues.
Developing an adequate self-care strategy is key to preventing or overcoming vicarious trauma. Some of the techniques that can be used include:
Maintain a good work-life balance. This involves taking time off to recharge and avoiding working long hours and/or carrying too heavy of a caseload or workload.
Exercise to relieve stress. Developing a good workout routine is important to help increase feel-good endorphins and improve one’s outlook on life. Taking a yoga class, doing aerobic activity, or even just going for a walk can be invigorating and help change one’s perspective.
Start a meditation practice. Initially, try sitting quietly for just 10 minutes a day, then gradually increase the time to 20 minutes. Meditation has many benefits and can assist one with feeling more peaceful and grounded.
Develop a good social network. Having a good support system in place is important in order to be able to connect with others in a meaningful way.
Use humor to unwind. Humor is good medicine when it comes to relieving stress and improving one’s mood. Watch a comedy, play with a pet, read a funny book—whatever moves you and helps you relax.
Reconnect with Mother Nature. Being out in nature is therapeutic, whether you go for a hike in the woods, a walk on the beach, or just do a little gardening.
Get involved with activities outside of work. Take your mind off of work by taking a class or engaging in a creative endeavor such as drawing, painting, or writing.
Meet with a therapist to discuss concerns. Even individuals in the helping professions can benefit from meeting with a counselor, especially when they are experiencing compassion fatigue. A compassionate therapist can help put things in perspective and help identify additional coping skills.
Although all helping professionals are in danger of developing compassion fatigue, especially when working with individuals who have experienced traumatic events, having a self-care plan in place can help reduce the risks.
Salazar, Wendy. "Vicarious Trauma and the Value of Self-Care for Therapists." GoodTherapy.org. GoodTherapy.org, 27 June 2016. Web. 28 June 2016.
Content of this article can be found at the following link: http://www.goodtherapy.org/blog/vicarious-trauma-value-of-self-care-for-therapists-0627164
This article came from the GoodTherapy.org website, an excellent resource for articles covering a wide range of topics targeting both clients and therapists. This article focuses on the significance of childhood wounds in couples work, a factor that can be overlooked by couples therapists but is very important to recognize in many cases.
Revisiting Childhood Wounds in the Context of Couples Work
January 23, 2015 • Contributed by Marian Stansbury, PhD, Imago Relationship Therapy Topic Expert Contributor
In November 2014, I wrote an article titled How Couples Therapy Can Help Heal Childhood Wounds. This article is a response to some of the comments that were made. Some agreed with the piece, while others challenged it, which I appreciate.
It takes two partners being in agreement to pursue healing in a relationship. One person commented that “… having someone with you who will fully participate in that recovery process with you could be amazing and what an experience to have the opportunity to do together!”
We don’t seem to have a choice about old, unresolved issues surfacing in a marriage, as that is the way we are wired. Whatever you have experienced is stored in your neural networks and will show up when activated, especially a hurt or wound. The good news is that it can be reprocessed. And the most effective way to reprocess the old material is through experience, not reasoning.
Whenever you find yourself upset at a 7-10 on a 0-10 scale, it is likely that something in the present triggered an old wound.
One person questioned if these things aren’t better hashed out alone. There is much that can be accomplished in individual therapy, and you may want to meet with a therapist alone in preparation for couples work. But there are many issues that show up only in a committed relationship. A marriage is different than a relationship with a therapist. It brings up different issues.
As an Imago relationship therapist since 1996, I have had many opportunities to witness that just what one partner needed to heal was exactly where the other would benefit from stretching and growing.
It isn’t reasonable to expect your partner to give you what you needed in childhood without identifying and asking for what you need. Our partners are not mind-readers. When you express your need and ask for what you want, it is a loving gesture when your partner cares enough to offer it for your joint benefit. Hopefully, you have a partner who values his or her growth as well.
Safety is a primary requisite for healing to happen. By having a loving partner with whom you feel safe, hopefully you will have the space you need to face any fear about visiting the old hurts. If safety is not present, healing and growth are not likely to occur. Speaking individually to your therapist so he or she can help you formulate how you will communicate your issues safely to your partner may be of benefit.
It is true that emotional needs from childhood that didn’t get met don’t go away just because you have reached adult age. The emotional brain learns through experience, not rational reasoning or time passing. It is through the experience of having the need fulfilled, regardless of your age, that emotional healing takes place.
You can grow and move past the old hurts that keep you emotionally stuck. It would be nice if you had all your personal issues worked out before you married, but that is not usually the case. It is in this intimate marital relationship that old patterns from our relationships with parents or childhood caretakers show up.
As a parent, you will tend to parent the way you were parented; that is what is familiar. Unless you make a conscious decision to do things differently, you are likely to repeat what was done with you with your children.
By parenting your children effectively, you can help heal your childhood wounds. As your children reach certain ages and developmental stages, it is not unusual for you to revisit memories of when you were that age. When you give your children what they need for their emotional growth, you also receive it.
It isn’t fair to ask your partner to bear the brunt of things you experienced as a child, but that’s what your partner will do until your issues are resolved. I don’t think in terms of what is fair; I think in terms of what is. What you haven’t worked trough emotionally will come up in your relationship. There seems to be no way around this except by going through the healing experience.
One commenter on the aforementioned article remarked how this process can “allow you to go back in time in a safe way.” I totally agree that it can be a “very enlightening experience.”
Stansbury, Marian. "Revisiting Childhood Wounds in the Context of Couples Work." GoodTherapy.org. GoodTherapy.org, 23 Jan. 2015. Web. 28 June 2016.
This article can be found by following this link: http://www.goodtherapy.org/blog/revisiting-childhood-wounds-in-the-context-of-couples-work-0123154:
This video was found on YouTube.com on June 29th, 2016. It was originally published February 28th, 2015 by Counselor Carl (http://serenityonlinetherapy.com). This video talks about different ways of dealing with Grief and Loss.
The following article was found on the Reader’s Digest website and is written by Brandon Specktor. It is an excellent article that addresses key phrases that escalate arguments and ways to change how people argue to be more productive.
6 Phrases Guaranteed to Make Any Argument Worse
You may think you're helping—but you're just screwing things up more.
BY BRANDON SPECKTOR
When you argue, you are at your most animal. Your brain literally enters fight-or-flight mode, your heart-rate escalates, and logic and reasoning physically shut down. It's little wonder you usually say a lot of bonehead things you end up regretting in the morning. Don't worry: We are all guilty of the same stupidity, and sometimes the key to a painless argument is what you don't say. For starters, here are six research-backed phrases proven to make any bad argument worse. Also: Here are wise quotes that can stop any argument in its tracks.
Don't mention getting calm
According to parenting experts and hostage negotiators alike, the biggest mistake most people make in an argument is denying the other person’s feelings. Think for a moment if the words “calm down” have ever actually made you calmer. More than likely, they’ve only ever made you feel more annoyed—Why does this person think I’m overreacting? He doesn’t understand me at all! Telling a person to calm down assigns them a negative emotion (be it anger, anxiety, stubbornness, etc.) while denying their actual feelings. This seeming lack of empathy can be detrimental to reaching a mutual understanding, which is a far more important outcome than “winning” an argument. So instead of telling your companion how to feel, seek first to understand how they feel. Step one: listen. Here's what good listeners do in daily conversations.
Don't try to quiet their emotions
Always let the other person vent, no matter how long or loud that venting may be. “If the emotional level is high, your first task is to take some of the emotion out,” says Linda Hill, professor of business administration at Harvard Business School. “Hold back and let them say their piece. You don’t have to agree with it, but listen.” Often times, just talking honestly about a problem is enough to make a person feel better about it (hence, therapy). And as an argument participant, know that every word your companion says is a step toward mutual understanding. Just be careful how you approach it. Here's what happy couples do when they fight.
This stock phrase almost always comes across wrong; you may be trying to say, “your emotions are valid,” but the other person will more likely hear, “I get it—so stop talking.” Instead of merely saying you understand someone’s feelings, show them by doing what FBI negotiators do: paraphrase. “The idea is to really listen to what the other side is saying and feed it back to them,” says FBI hostage negotiator Chris Voss. “It’s kind of a discovery process for both sides. First of all, you’re trying to discover what’s important to them, and secondly, you’re trying to help them hear what they’re saying to find out if what they are saying makes sense.” If everyone’s on the same page, you can start moving toward reconciliation. But the worst thing you can say next is…
Don't tell someone how to feel
It may sound to you like you’re acknowledging the other person’s feelings, but by adding a “should” or “shouldn’t” you are condemning and judging them just as much. Psychologists call this subtractive empathy—a response that diminishes and distorts what the other person has just said, often making them feel worse. Instead of judging a feeling, try giving it a concrete name by saying something like, “You sound pretty hurt about [problem]. It doesn’t seem fair.” That’s what psychologists call additive empathy—it identifies a feeling, then adds a new layer of understanding that can lead to a potential solution. Think you have a solution? Be careful how you phrase it.
Don't tell someone what to do
When the fight-or-flight response is triggered, power becomes deceptively crucial to us. Telling someone what to do takes away their power; if they listen to your advice, they may feel less smart or less autonomous, and they will resent you for that. What’s more, insisting that an answer depends solely on the other person changing their behavior removes personal responsibility from the equation, and that’s no way to make friends or learn from your mistakes. The superior phrase: “What would you like me to do?” This handy question leaves the other person with their autonomy, and proves you’re willing to meet them halfway. It also moves your brains away from fight mode, and closer to the land of logical compromise.
Don't force a resolution
Never fret if you can’t settle an argument in one shot. According to relationship psychologist John Gottman, PhD, 69 percent of a couple’s problems are perpetual—they will never be resolved. “By fighting over [inherent] differences, all [couples] succeed in doing is wasting their time and harming their marriage,” Gottman says. While this may sound depressing to anyone new to a serious relationship, it’s meant to be liberating. Once you realize some arguments can never be won, it makes them that much easier to drop. You fight. You make up. You move on with life. Despite what your fight-or-flight brain chemistry is telling you, “winning” doesn’t matter; most of the time, it isn’t even possible. However, pay attention to these red-flag warning signs of a toxic relationship or signs of a toxic friendship.
Specktor, Brandon. "Phrases That Make Arguments and Fights Worse | Reader's Digest." Readers Digest. Trusted Media Brands, 2016. Web. 29 June 2016.
This article comes from the GoodTherapy.org website and focuses on Secondary Trauma. The GoodTherapy.org website has articles that cover a range of topics that can benefit both therapists and clients alike. It is an excellent resource for finding therapists near you through their therapist database as well.
Secondary Trauma: A Therapist’s Guide
August 14, 2013 • By Anastasia Pollock, LCMHC, Posttraumatic Stress Topic Expert Contributor
My mom has worked as a nurse for over 30 years. I remember she would sometimes come home from work and talk about how she had had a doctor or nurse as a patient that day. She would always say how health-care professionals were always the worst patients, usually because they would push themselves farther and faster than they should, which resulted in a longer recovery.
I think that as therapists, we are just as guilty of holding ourselves to a “higher standard.” I have seen colleagues and friends who are therapists give out excellent advice about the importance of seeking and accepting help and practicing good self-care, only to neglect themselves and fall into a cycle of depression, anxiety, and trauma symptoms, basically disregarding their own wise words.
I previously wrote an article about secondary trauma for loved ones of people who had experienced trauma. I felt it fitting to write another article for therapists, as I believe we have the potential to also experience secondary trauma. Figley (1995) defines secondary trauma as “the stress resulting from helping or wanting to help a traumatized or suffering person.”
Think about it: Most therapists see anywhere from 10 to 40 people per week. These people are coming to us for help with their problems, which could range from normal levels of stress to severe depression, anxiety, trauma, or other mental health difficulties. We listen and offer tools they can use to overcome their challenges. They leave the sessions armed with new skills to face their lives and challenges. And what are therapists doing between sessions? I can answer from my own experience: doing notes, writing up treatment plans and assessments, returning phone calls, following up with other professionals, preparing for the next session, etc. After work, many professionals have other commitments and obligations. Life can get very busy and chaotic, and many of us consistently put ourselves last.
Therapists are just as susceptible to secondary trauma as any other person. We are not superhuman, nor do we possess mental powers that make us resilient to depression, anxiety, trauma, and other mental health challenges. Sometimes as therapists we forget this and, therefore, neglect ourselves. One study found that therapists who treat people with trauma are susceptible to the effects of secondary trauma, particularly if they do not have the appropriate training, support, and self-care (Pearlman & Mac Ian, 1995). In my experience, this applies also to therapists who are treating other mental health issues.
So what do we do about it?
First, make self-care a priority. Pearlman and Mac Ian (1995) emphasize the importance of self-care in order to provide the best services possible while protecting the provider’s own well-being. In my experience, I am much more effective as a therapist when I am taking excellent care of myself and being aware of any secondary trauma I might be experiencing. The basics are important here: getting enough rest, eating healthy foods, getting exercise regularly, spending time engaging in leisure activities, and spending time with loved ones, to name just a few. It basically comes down to taking our own advice and implementing the self-care skills we so often suggest to people who seek our help.
Get support from fellow therapists through supervision or consultation. Even after the days of internship are done, we can all benefit from continued supervision and consultation. Pearlman and Mac Ian (1995) state of their study, “Therapists who work with trauma survivors need supportive, confidential, professional relationships within which they can process” the work they are doing. I have found it extremely helpful and stress relieving to consult with colleagues and to even ask for supervision at times. It can be extremely validating to learn that you are not the only therapist who sometimes struggles with secondary trauma, stress, and other emotional consequences common in the helping professions. Consultation and supervision can also help a therapist to work through challenging cases by giving a new perspective and new ideas for intervention.
Consider furthering your training. One of the most stressful situations a therapist can encounter is having a person come to you with an issue with which you are not familiar or do not feel competent treating. Of course it is good practice to acknowledge when you are not competent to treat a specific problem, and to make a referral to a colleague who might be more skilled in that area. However, sometimes furthering your education and skill set can help to reduce anxiety and stress when it comes to treating people with unfamiliar situations. Furthering your education and training can also help you to effectively treat issues with which you are familiar. The bottom line is that getting the proper training can reduce your susceptibility to secondary trauma (Pearlman and Mac Ian, 1995).
Consider finding your own therapist. Therapists are not an exception to the fact everyone encounters difficulties in life at times. It is extremely important that we are willing to acknowledge that we are human, and to address our own issues, whether they are from the past or present. Engaging in your own therapy will ensure that you are working through your own challenges, which will make you less susceptible to the effects of secondary trauma and more available to engage in meaningful and effective therapy with people.
In conclusion, I believe one of the most important things we can do for people who see us is to take excellent care of ourselves. If we neglect our needs and ourselves, we are not able to give all we have to others. We can set a great example of self-care and avoid being susceptible to secondary trauma if we are just willing to follow our own good advice.
Pollock, Anastasia. "Secondary Trauma: A Therapist's Guide." GoodTherapy.org. GoodTherapy.org, 24 Aug. 2013. Web. 28 June 2016.
This article can be accessed at the following link: http://www.goodtherapy.org/blog/secondary-trauma-therapists-guide-0814135
This video was found on YouTube.com on June 29th, 2016. It was published on August 19th, 2014 by ASAPScience. This video talks briefly about what depression actually is and how it works within the body.
The following article was found on GoodTherapy.org and focuses on co-parenting effectively. Divorce affects more than fifty percent of marriages in the United States and many of these relationships involve children, making co-parenting especially relevant in therapy and day to day life. The following article was written by Andra Brosh, PhD and is an excellent article for co-parenting when parents cannot stand one another.
Five Tips for Co-Parenting When You Can’t Stand Your Ex
April 17, 2013 • By Andra Brosh, PhD, Divorce / Divorce Adjustment Topic Expert Contributor
The process of divorce is hard enough, but when you have to co-parent with an ex who has become the bane of your existence, things can get worse. Some parents become better at being caregivers after divorce because they find their own voice and style outside the relationship. Others transform into an unrecognizable version of themselves, making parenting a horribly intolerable experience. Either way, when you can’t stand the person you are parenting with, life can become a drag, and the battle becomes exhausting.
If you are struggling to co-parent with an ex you despise, here are five tips to help you manage the experience:
Reduce your ex-pectations: Expecting your ex to be the kind of parent you need him or her to be creates frustration and disappointment. While some exes flourish as parents after divorce, others become ornery and annoying. The rule of thumb is to expect no more than the ex was doing in the marriage, and brace for less now that he or she has other priorities. Even if you think he or she should be doing a better job, remember that it’s not up to you to police your ex’s parenting.
Try not to be a hater: Hate is a very strong word, but when it comes to an ex, there may not be a lot of other words (that we can use here, anyway) to describe the level of negative feelings you might have. However, to hate causes YOU stress and makes it hard to parent effectively. Get some professional help to move from hate to tolerance to see if that makes co-parenting any easier.
Look through your child’s eyes: You are most likely making your children the priority when it comes to co-parenting, but sometimes the mind can become clouded with negativity. Empathy is a great stress reducer, and it can really help to shift a detrimental perspective. Try to see your ex through your children’s eyes, a view that is most likely idealized and positive. Children will do anything to maintain an attachment to a parent, even in the face of horrible behavior. You can learn from their innocence.
Let go of control: Co-parenting with an ex is one big lesson in letting go. You may not approve of your ex’s parenting style or what he or she does with the kids during their time, but this is mostly out of your control. If your ex is stonewalling you and refusing to share information about your child’s well-being, you need to manage that anxiety. Your ability to relinquish your illusory power will not only reduce your frustration and stress, it will open space for you to enjoy your time alone. You cannot change your ex with your will and desire to be right. You can only model with the hope of being a positive influence.
Value your influence: Having your kids half the time (or sometimes less) may invoke a feeling of powerlessness with regard to your parental influence. All parents worry about scarring their children emotionally, and divorced parents may fear that the parenting going on in the other home may damage their little ones. If you are a parent who dreads letting your kids go with your ex, or who is concerned about your lack of authority, try to remember that whatever you are doing will be enough. If there is another (or new) partner involved, stay grounded in the fact you are the primary parent and no one can replace you.
Your children love you, are attached to you, and need you to be strong and centered as the “good enough” parent that you are.
Brosh, Andra. "5 Tips for Co-Parenting When You Can't Stand Your Ex." GoodTherapy.org. GoodTherapy.org, 17 Apr. 2013. Web. 28 June 2016.
This article can be found by following this link: http://www.goodtherapy.org/blog/co-parenting-tips-when-you-cant-stand-your-ex-0417134
I write articles based on my experience as a therapist or a training or conference attendee. Many of these articles are written by others who are experts in their field and I share their information as resources for others.