Vicarious Traumatization

1. Vicarious Traumatization

2. Definition of Vicarious Traumatization • Secondary traumatization is the experience of trauma-related stress caused by working closely with trauma survivors. • Trauma may be defined as any experience that involves either (1) serious threat of harm to oneself or others, or (2) overwhelming negative emotions, such as fear, helplessness, grief, or rage. • The factors that contribute to secondary traumatization come from three main sources: • The work itself • The work environment • The worker

3. Three Key Elements of VT • Repeated exposure to clients clients’ traumatic experiences could cause a shift in the way that trauma counselors perceive themselves, others, and the world. • Cumulative effects of working with survivors of traumatic events, such as rape, incest, child abuse and/or domestic violence on the therapist. The effect on workers intensifies over time and with multiple clients. • VT is pervasive, affecting all areas of a therapist’s life, including emotions, relationships and world perceptions. Faulkner, H. (n. d.). Vicarious Traumatization. (Unpublished presentation). Alabama Pre/Post Adoption Connections. Birmingham, AL. http://www.childrensaid.org/includes/downloads/vicarioustraumatization.pdf

4. Factors From Work • The severity of the trauma, such as torture and other traumas of human design • Trauma survivors who have also participated in violence • Amount and intensity of exposure to trauma (e.g., jobs that involve counseling require more frequent, intense exposure) Northwood, A. (n. d.) Secondary Traumatization and Stress Management. Center for Victims of Torture. Minneapolis, MN. http://www.cvt.org/file.php?ID=5718

5. Work Environment • Inadequate job training • Inadequate resources and equipment • Inadequate job supervision • Work overload • Inadequate vacation and health benefits • Isolation from co-workers • Lack of choice and control on the job • Lack of administrative support for employees to address job stress Northwood, A. (n. d.) Secondary Traumatization and Stress Management. Center for Victims of Torture. Minneapolis, MN. http://www.cvt.org/file.php?ID=5718

6. Worker Effects: Personal • Current life stress • History of trauma • Individual and cultural coping styles, beliefs, values, histories, and personality characteristics Northwood, A. (n. d.) Secondary Traumatization and Stress Management. Center for Victims of Torture. Minneapolis, MN. http://www.cvt.org/file.php?ID=5718

7. Who Can Be Affected? • In reality, anyone. Context and perception is always key • Secondary witness to trauma • Any work that is done with traumatized persons: • Abused children, physically and sexually assaulted women, homeless men and women, new immigrants, persons with chronic mental illness and substance use, and those will life-threatening illnesses. • Listening to trauma narratives as well as witnessing the effects of trauma

8. Predictors of Vicarious Traumatization • History of Previous Trauma: Most especially those who have past history of trauma or abuse • Life Stress and Mental Health: The poorer the general mental health results in poorer psychological adjustment • Lack of social support: For all age groups, social resources mediate the effects of stressors • Age: The younger the worker, the greater the risk that it will affect them more • Gender: Unfortunately, women seem to be at greater risk. Lerias, D., & Byrne, M. K. (2003). Vicarious traumatization: Symptoms and predictors. Stress and Health, 19, 129-138.

9. Predictors of Vicarious Traumatization • Education and socioeconomic status: Lower educational attainment correlated with increased risk of severe cases • Coping styles: Negative coping styles put people at greater risk (increased concern for own safety, fearfulness, distrust others). Lerias, D., & Byrne, M. K. (2003). Vicarious traumatization: Symptoms and predictors. Stress and Health, 19, 129-138.

10. What happens? • Continued exposure to trauma can result in potentially permanent shifts in the provider’s cognitive schema (McCann & Pearlman, 1990). • What kind of cognitive changes? • Heightened feelings of vulnerability • Extreme sense of helplessness and or exaggerated sense of control • Chronic suspicion about the motives of others • Loss of a sense of personal control • Loss of sense of freedom • Chronic bitterness, cynicism and alienation. • This is not just countertransference. You don’t snap out of this state- its cumulative and permanent. The practitioner’s view of the world is affected: how they view themselves, the world, and the future. • Such significant listening and witnessing may, as Janoff-Bulman (1992) observed, "shatter assumptions" we hold about our identity as helpers, our world of the view and our spirituality.

11. Frightening Thought: Not Knowing You’ve Been Affected • Common early signs might be as simple as how other colleagues (or lay people) see you: • “You have become so cynical." • “You used to be so trusting." • “You always think the worse," • “What happened to you, you seem so worried?” • “You're so isolated, you only talk about work and the people at work." • Other behaviors: • Increased substance use • Chaotic relationships highlighted by pessimistic themes and suspiciousness (isolation, disconnection, and mistrust) • Caution: This is not just your garden variety countertransference or burnout. • The impact could be permanent (cognitive, behavioral, and overall personality changes (Pearlman & Saakvitne,1995).

12. Stress Management for Trauma Workers • Awareness: Identify and recognize the symptoms in yourself • Balance: Make sure that you have equilibrium in work, home, personal, and community. • Connection: Supportive relationships both with co-workers and people outside of work. Northwood, A. (n. d.) Secondary Traumatization and Stress Management. Center for Victims of Torture. Minneapolis, MN. http://www.cvt.org/file.php?ID=5718

13. What kind of interventions exist? • Professionally: Supervision or consultation • Therapy or support groups (stress reduction, meditation, spiritual renewal, etc.) • Personal life interventions: • Exercise • Time with family friends, and children • Journal keeping • Travel

14. References • Figley, C.(1995). Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. New York: Brunner/Mazel. • Janoff-Bulman, R. (1992). Shattered assumptions: Towards anew psychology of trauma. New York: Basic Books. • Faulkner, H. (n. d.). Vicarious Traumatization. (Unpublished presentation). Alabama Pre/Post Adoption Connections. Birmingham, AL. http://www.childrensaid.org/includes/downloads/vicarioustraumatization.pdf • Gabriel, M. A. (n. d.). Surviving Listening and Witnessing: Vicarious Traumatization in Social Workers Practitioners. http://www.naswnyc.org/p30.html • Lerias, D., & Byrne, M. K. (2003). Vicarious traumatization: Symptoms and predictors. Stress and Health, 19, 129-138. • McCann, I. & Pearlman, L. (1990). "Vicarious traumatization: A framework for understanding the psychological effects of working with victims." Journal of Traumatic Stress. 3,(1), 131-49. • Northwood, A. (n. d.) Secondary Traumatization and Stress Management. Center for Victims of Torture. Minneapolis, MN. http://www.cvt.org/file.php?ID=5718 • Pearlman, L, & Saakvitne, K. (1995). Trauma and the therapist: Countertransference and vicarious traumatization in psychotherapy with incest survivor. New York: Norton.