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 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 article was found on the GoodTherapy.org website. This website is an excellent resource on a wide range of topics for both therapists and clients alike. This particular article focuses on personality characteristics that can impact the ability to effectively cope after experiencing a trauma.
7 Personality Characteristics That Help in Managing Trauma
June 22, 2016 • By Marjie L. Roddick, MA, NCC, LMHC, Posttraumatic Stress / Trauma Topic Expert Contributor
Psychological trauma, defined as the experience of an event in which a person feels their life is threatened or in danger, may be accompanied by a sense of helplessness, horror, or numbing as the internal alarm system becomes activated.
We react to trauma in a number of ways, and certain factors put us at risk for more severe psychological difficulties. Fortunately, there are qualities we can build on to help us manage our reactions to traumatic events.
There are four main types of reactions we may experience following a trauma: emotional, cognitive, physical, and interpersonal.
Emotional reactions include shock, fear, grief, anger, guilt, shame, helplessness, numbness, sadness, confusion, denial, abandonment, anxiety, and depression.
Cognitive reactions might include problems with concentration, indecisiveness, difficulty making decisions, and intrusive or unwanted memories. You may notice thoughts such as, “How could someone do this?” or, “It felt like time stood still.”
Physical reactions consist of bodily tension, feeling fatigued, insomnia, startling easily, racing heartbeat, nausea, change in appetite, chills, digestive problems, or profuse sweating.
Interpersonal reactions involve feeling a sense of distrust, experiencing a loss of intimacy, increased conflict with others, isolation from others, or problems at work or school.
Other reactions to trauma are less common and more severe, and may require professional intervention. These may include:
Emotional reactions that include intrusive or unwanted reexperiencing of the event after it has happened such as nightmares, flashbacks, and terrifying memories
Extreme emotional numbing that leads to a sense of emptiness
Potentially harmful attempts to avoid intrusive experiences through alcohol or substance use, lying, self-injury, or suicide attempts
Physical reactions that involve hyperarousal, panic, rage, extreme irritability, agitation, restlessness, or violence
Ongoing anxiety, uncontrollable worry, helplessness, or obsessive or compulsive behavior
Dissociation (or a sense of being separate from one’s body), having fragmented thoughts, lack of awareness of surroundings, or involuntarily spacing out
Not everyone will develop a mental health condition or posttraumatic stress (PTSD) following a traumatic event. There are certain risk factors that increase the chances of experiencing more severe reactions to trauma, including severe exposure to a disaster, low socioeconomic status, having a preexisting mental health condition, being part of an ethnic minority, lacking social support, and lacking social resources.
Although there are factors that increase the risk of severe trauma reactions, there are also at least seven personality characteristics, described below, that can help a person successfully cope with or manage trauma.
Locus of Control
Locus of control is the extent to which we believe or expect we can control the outcomes of events that affect us. Our locus of control may be internal or external. If we have an external locus of control, we believe our behavior is guided by fate, luck, or other external forces. If we have an internal locus of control, we believe our behavior is guided by our own decisions and efforts, and that outcomes are related to our actions.
Crises challenge our beliefs and expectations about the level of control we have in the situation. Attempting to assert some degree of control following a crisis can aid in more effective coping and can help create a greater sense of meaning and consistency. Some researchers have observed that an external locus of control is related to learned helplessness, a condition in which a person perceives no sense of control, expects that there can be no escape, and believes any attempt to escape will result in failure.
While an internal locus of control can have positive effects in moderation, those who attempt to unrealistically control events may need assistance adjusting their expectations about outcomes. For instance, someone with an unrealistic belief that they could have prevented a crisis on their own by doing A, B, or C may need help focusing on what they can realistically control.
Self-efficacy is our belief about how capable we are to handle situations. If we have high self-efficacy, we exert effort to overcome challenges. If our self-efficacy is low, we avoid actions we think will exceed what we’re capable of. Self-efficacy builds on itself as we add to our successes. It is thought that people who expect to successfully cope with their emotions and moods are more likely to be proactive in their healing and to seek out something positive in threatening situations.
Optimism is holding hope and expecting that good things will happen. Optimism is focused on a desired outcome and not on who is in control or how capable one is in reaching the outcome. Optimists emphasize the positive during difficult situations and have been found by some researchers to be less anxious, hostile, depressed, and self-conscious than those with pessimistic attitudes.
Hardiness as a personality characteristic describes someone who is curious, actively involved, believes they can influence outcomes, expects that life will present changes, and tends to believe that challenges are opportunities for development. People with hardiness have a willingness to learn something of value, and merge those lessons into their lives. Hardiness is also associated with active coping and decreased emotional distress.
People with resilience are those who are at risk for failure early on in life but who nonetheless become successful. Resilient people can take responsibility for their own part in a situation and let go of responsibility for the things they cannot change. Some qualities of resilient individuals include active problem solving, perceiving difficult experiences constructively, gaining positive attention from others, and an ability to continue finding meaning in their experience.
Sense of Coherence
People with a strong sense of coherence understand that stress is an inevitable part of life and recognize that dealing with it successfully can be beneficial. Having a sense of coherence means we seek to comprehend, manage, and find meaning in situations. When we attempt to comprehend the crisis situation, we try to make sense of what happened and explain how it occurred. To manage the situation, it can be helpful to utilize available resources. Meaningfulness indicates the situation is worthy of our time and investment. Having high meaningfulness motivates us to search for ways to comprehend the situation and seek out resources to aid in managing the incident.
The ability to creatively cope is related to one’s ability to let go of the usual ways of solving problems. People who can produce creative solutions are better able to cope with traumatic events in which there are limited opportunities to exert control. Creativity involves flexibility in dealing with one’s environment.
How we react to a traumatic event can be greatly influenced by a number of factors. There are several common ways we react to trauma, and some reactions are more severe than others. Numerous personality traits were identified here that can be learned or cultivated to deal more successfully with trauma and obtain what is increasingly being recognized as posttraumatic growth.
Roddick, Marjie L. "7 Personality Characteristics That Help in Managing Trauma." GoodTherapy.org Therapy Blog. GoodTherapy.org, 22 June 2016. Web. 28 June 2016.
This article can be found by clicking the following link: http://www.goodtherapy.org/blog/7-personality-characteristics-that-help-in-managing-trauma-0622165
This video was found on youTube.com. It was published by the Office for Victims of a Crime on February 27, 2013. Keep in mind when watching this video that trauma is experienced by children differently than adults and that trauma can be big, obvious issues and less obvious experiences that are experienced traumatically by the child.
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.