OVERVIEW OF VICARIOUS TRAUMA

21/06/2024

Vicarious trauma is “compassion fatigue” when a person is exposed to the traumatic stories and experiences of others at work; witnessing the fear, pain, and horror that another person has experienced; or preoccupied with horrific stories told to the professional.

What Is Vicarious Trauma?

The concept of vicarious trauma was first mentioned in the 1980s. It is sometimes called “compassion fatigue,” “secondary traumatization", "secondary stress disorder", or "insidious trauma”. Vicarious trauma is the emotional residue when a person is exposed to the traumatic stories and experiences of others at work; witnessing the fear, pain, and horror that another person has experienced; or preoccupied with horrific stories told to the professional. In other words, vicarious traumatization refers to exposure to another person's trauma. It can have a significant impact on mental health and if not minimized or treated effectively, it can be a pathway to post-traumatic stress disorder (PTSD).

Who Is At Risk Of Being Affected By Vicarious Trauma?

Vicarious trauma is an occupational challenge for those working or volunteering in the fields of victim assistance, law enforcement, emergency medical services, fire services, and other allied professions, due to their frequent exposure to victims of trauma and violence. Work-related vicarious trauma can occur from experiences such as listening to individual clients recount their victimization; watching videos of children being exploited; reviewing case files; day after day hearing about or responding to the consequences of violence and other traumatic events; and responding to incidents of mass violence that result in multiple injuries and deaths.

Factors that can make individuals more susceptible to vicarious trauma include:

Previous traumatic experiences;
Social isolation, both in and out of work;
Tendency to avoid emotions, withdraw, or blame others in stressful situations;
Difficulty expressing emotions;
Lack of preparation, orientation, training, and supervision at work;
Be new and less experienced employees at work;
Frequent exposure to trauma in work tasks;
Lack of effective and supportive workflows for discussing trauma content at work.

Common Signs Of Vicarious Trauma

Individual Symptoms Of Vicarious Trauma

Side	Specific symptoms and signs
Behavioral	▪ Sleep disturbances ▪ Nightmares ▪ Appetite changes ▪ Hypervigilance ▪ Exaggerated startle response ▪ Losing things ▪ Clumsiness ▪ Self-harm behaviors ▪ Negative coping – smoking drinking, acting out
Physical	▪ Panic symptoms – sweating, rapid heart rate, difficulty breathing, dizziness ▪ Aches and pains ▪ Weakened immune system
Cognitive	▪ Minimization of vicarious trauma ▪ Lowered self-esteem and increased self-doubt ▪ Trouble concentrating ▪ Confusion/disorientation ▪ Perfectionism ▪ Racing thoughts ▪ Loss of interest in previously-enjoyed activities ▪ Lack of meaning in life ▪ Thoughts of harming yourself or others
Emotional	▪ Helplessness and powerlessness ▪ Survivor guilt ▪ Numbness ▪ Oversensitivity ▪ Emotional unpredictability ▪ Fear ▪ Anxiety ▪ Sadness and/or depression
Social	▪ Withdrawal and isolation ▪ Loneliness ▪ Irritability and intolerance ▪ Distrust ▪ Projection of blame and rage ▪ Decreased interest in intimacy ▪ Change in parenting style (overprotective)

Symptoms Of Vicarious Trauma At Work

Side	Specific symptoms and signs
Behavioral	▪ Frequent job changes ▪ Tardiness ▪ Free floating anger/irritability ▪ Absenteeism ▪ Irresponsibility ▪ Overwork ▪ Irritability ▪ Exhaustion ▪ Talking to oneself (critical symptom) ▪ Going out to avoid being alone ▪ Dropping out of community engagements ▪ Rejecting closeness
Interpersonal	▪ Staff conflict ▪ Blaming others ▪ Conflictual engagement ▪ Poor relationships ▪ Poor communication ▪ Impatience ▪ Avoidance of working with clients with trauma histories ▪ Lack of collaboration ▪ Withdrawal and isolation from colleagues ▪ Change in relationships with colleagues ▪ Difficulty having rewarding relationships
Personal values/beliefs	▪ Dissatisfaction ▪ Negative perception ▪ Loss of interest ▪ Apathy ▪ Blaming others ▪ Lack of appreciation ▪ Lack of interest and caring ▪ Detachment ▪ Hopelessness ▪ Low self-image ▪ Worried about not doing enough ▪ Questioning frame of reference – worldview, spirituality, identity ▪ Disruption in self-capacity ▪ Disruption in needs, beliefs, and relationships
Job performance	▪ Low motivation ▪ Increased errors ▪ Decreased quality ▪ Avoidance of job responsibilities ▪ Over-involvement in details/perfectionism ▪ Lack of flexibility

WARNING: The symptoms listed are for reference only. If you suspect that you have vicarious trauma, see a psychologist for an accurate diagnosis.

The Impact Of Vicarious Trauma On Mental Health

Vicarious trauma can develop into more pronounced mental health symptoms. If you are experiencing any of the problems below, visit a medical facility or see a psychologist for timely examination and diagnosis.

Flashbacks: reliving aspects of a traumatic event or feeling as if the event is happening now, which can happen even if you can remember specific details of it.
Panic attacks: a type of fear response, they are an exaggeration of the body's response to danger, stress, or excitement.
Dissociation: a way the mind copes with overwhelming stress. You may feel numb, distant, detached from your body, or as if the world around you isn't real.
Hyperarousal: feeling very anxious, on edge, and unable to relax. You may be constantly on the lookout for threats or danger.
Sleep problems: you may have it hard to fall or stay asleep, feel unsafe at night, or feel anxious or afraid of having nightmares.
Low self-esteem: vicarious trauma can affect how you value and perceive yourself.
Grief: experiencing a loss that can cause psychological trauma; this can also lead to other types of loss. You may feel that the trauma has caused you to miss out on some things in life, which leads to a feeling of loss.
Self-harm: hurting yourself as a way of trying to cope with trauma.
Suicidal feelings: include preoccupation with ending your life, thinking about suicide methods, or planning to take your own life.
Alcohol and substance abuse: one way you can try to cope with painful emotions or memories.

Measures To Minimize The Risk Of Vicarious Trauma

Self-care

Prioritizing your general health during times of heightened stress is important: you should ensure you rest, stay hydrated, and eat properly. You will be more productive and able to help others if you know how to take good care of yourself.

Prepare yourself: If you are about to engage in a trauma-related work task, you should mentally prepare yourself for what you are about to be exposed to and remind yourself of the purpose of your work.
Healthy lifestyle: It is important to remember to eat well, stay hydrated, and ensure regular physical activity.
Make sure you “switch off”: Allowing yourself to disconnect, mute notifications, or delete certain apps can help you better rest, recalibrate, and then get back to work better.

Sleep well: Create a habit of staying away from electronic devices, and try to avoid viewing disturbing images close to bedtime.
Find something meaningful to you outside of work: It's healthy to have a pastime that takes you away from your professional life: this could be meditation, mindfulness, exercise or sports, being in nature, creative practice (writing and art), or something else.
Share: Talk to people you trust who recognize what you're going through, it could be your direct manager at work, a colleague, a relative or a friend.

Adjusting The Way You Work

Limit exposure: Vicarious trauma often occurs through repeated or continuous exposure to graphic images. Therefore, minimize the exposure time, size, and sound of images/videos. If possible, try to avoid scrolling back and forth to review the document.
Proactively schedule breaks: Try to change your work environment and stay away from material, both mentally and physically.
Separate your personal and work lives: If you work from home, try to set aside a specific place for viewing work documents, especially when there's a chance that the material you're exposed to could make you anxious.
Create a buffer between work and home lives: Create a “ritual” that marks the end of the work day – such as making a cup of tea, changing into some clothes or simply turning off your laptop and taking a break.

How To Help A Loved One Experiencing Vicarious Trauma?

Suggestions For Family Members

As mentioned above, people who work in victim services and first responders are often affected by work-related trauma exposure and are at increased risk of vicarious trauma. Support and help from family can be very important.

Here are some suggestions for family members:

Share concerns and develop support strategies with your loved one.
Do your best not to take your loved one's reaction as a personal attack; remind yourself that what your loved one may be experiencing is related to the job, not you.
Maintain a stable daily routine.
Stay connected with family and friends.
Discuss your loved one's work requirements and their impact on other family members.
Seek professional support when needed.

Suggestions For Colleagues

If you believe your colleague may be struggling with vicarious trauma, consider:

Reaching out and talking to them personally about the impact of their work.
Helping them establish a consistent transition from work to home to create important boundaries and safe spaces outside of work.
Encouraging them to take care of their basic needs - sleep, healthy eating, hygiene, and exercise.
Supporting connections with family, friends, and co-workers.
Referring them to organizational supports such as peer support groups, employee assistance programs, etc.
Encourage them to share their experience with their supervisor.

Suggestions For Supervisors

Some suggestions for supervisors of employees experiencing vicarious injuries include:

Discussing vicarious trauma as part of supervision.
Allowing employees to have flexible work schedules, recognizing the need for and protecting time off, while preserving their ability to withdraw or quarantine.
Creating time and space in the workplace for employees to reflect through reading, writing, prayer, and meditation, among other activities.
Referring to therapeutic and professional support as needed.

If you feel you are having symptoms of vicarious trauma, go to a medical facility for a timely examination and diagnosis, or contact the Vietnam - France Psychology Institute via Hotline: 0979.158.463 for specific advice. Early intervention is key to improving health and quality of life.

References:

[1] What is Vicarious Trauma?. https://ovc.ojp.gov/program/vtt/what-is-vicarious-trauma

[2] Vicarious Trauma. https://www.mind.org.uk/media/4tybnie0/headlines-guide-to-vicarious-trauma.pdf

[3] Fact Sheet: Vicarious Trauma. https://www.cdcr.ca.gov/bph/wp-content/uploads/sites/161/2021/10/Trauma-Fact-Sheets-October-2021.pdf

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