Vicarious trauma: the enormous cost of taking on the pain of others

There are terrible stories that leave a deep emotional mark on those who know them, causing vicarious trauma or indirect trauma. Such was the case with Peter Connelly, a 17-month-old boy who died in 2007, in London, after suffering more than 50 injuries in a period of only eight months from his family environment.

The injuries were so severe that the professionals responsible for the case suffered a profound psychological shock, developed a strong sense of guilt and a feeling of worthlessness, as revealed by psychologists at the University of Sheffield.

However, it is not necessary to be in contact with extreme cases to experience vicarious trauma. Empathy, that ability that unites us and allows us to put ourselves in the other's shoes, can play tricks on us when we take on the pain and suffering of others, especially if we know we can do nothing to relieve them. Then, the discomfort of the other becomes our via crucis and we develop a psychological trauma .

What is vicarious trauma?

Vicarious trauma is a concept coined by McCann and Pearlman in 1990 to refer to indirect exposure to a traumatic event that ends up generating harmful effects on the person. Indeed, psychology recognizes that it is possible to experience post-traumatic stress from "repeated exposure to aversive details" of a particularly painful event.

Also known as secondary trauma or indirect trauma, it can manifest itself on both a psychological and physical level, often causing a change in the perception of oneself, the world, and others.

Although we are all susceptible to developing indirect trauma, people who tend to be more exposed to pain and suffering from their jobs, such as psychologists, health care personnel, social workers, lawyers, police officers, and emergency care professionals, are more vulnerable. risk of developing this problem. But anyone in a significant relationship with a trauma survivor can suffer vicarious trauma.

The path leading to indirect trauma

Sometimes the path to vicarious trauma is quick and easy. We may have exposed ourselves to a traumatic experience so terrible that it leaves us in a state of shock. Other times the path is progressive, we follow it over time, and it is also possible that there is not a single traumatic story but several life stories that intertwine in our mind.

Regardless of the stories that generated the trauma, we all tend to follow the same "emotional path". In general, it all starts with experiencing strong empathy for the victim. That empathy doesn't just mean understanding her experiences but putting yourself in her shoes and having feelings similar to hers.

As a result, we often end up establishing an emotional bond with the victim. We compromise with her to the point that we feel responsible for her well-being. This deep emotional bond prevents us from establishing the psychological distance necessary to protect our emotional balance.

On the other hand, it is common for the victim's experiences to become a focal point of distress. They can reactivate multiple times and even enter our dreams, as if we have experienced the trauma ourselves. It is also common for us to react with strong anger, develop a feeling that life has been unfair, and end up changing our perception of the world. We begin to think that the world is a hostile, insecure and chaotic place.

At this point we plunge into a downward spiral, we cannot think rationally but we are carried away by the traumatic experience. We will thus develop the empathy syndrome , a kind of compassion fatigue due to the emotional load we carry and which usually occurs when we do not dedicate enough time to ourselves, but immerse ourselves completely in the care and support of the traumatized person, which ends to overwhelm us emotionally, leaving us without resources for our emotional healing.

Eventually, this experience also changes our perception of ourselves. We begin to think that we are leaves blowing in the wind, we develop an external locus of control, our perception of self-efficacy decreases and our learned helplessness increases.

In these cases, when we interact with victims and their life stories, all our resources are altered, especially those related to the satisfaction of our needs for security, trust, esteem, privacy and control, which are the ones that have the greatest impact. significant in our life and emotional well-being.

Symptoms of vicarious trauma, sinking under the weight of suffering

Indirect trauma can have a significant impact on the mental health of those who suffer it as it not only generates a real emotional cataclysm, but also shakes the beliefs on which we had built our worldview. Although each person responds to vicarious trauma in different ways and some are more affected than others, the most common symptoms are:

• Emotional symptoms. People with indirect trauma may experience lasting feelings of pain, anxiety, or sadness. Some people can become very irritable, have sudden mood swings, or frequently get angry about irrelevant things. They will also start to feel insecure and are likely to lose hope and meaning in life. They may even feel guilty and believe they are not worthy of love or think their life is useless.

• Cognitive symptoms. Indirect trauma often causes difficulty concentrating, which ends up manifesting itself in the form of memory problems and small distractions. It happens that the mind is completely focused on traumatic events, it suffers from intrusive thoughts, for which a significant decrease in cognitive performance is experienced that is noted in other areas of life, especially at work. This will make any task daunting by adding further psychological stress.

• Behavioral symptoms. Indirect trauma can turn a kind and optimistic person into a cynical and pessimistic person . The person is also likely to isolate and experience the feeling of disconnection from others and the world in general. In some cases, she may overindulge on food, alcohol, or drugs to deal with an unbearable situation and avoid things that reactivate memories of the traumatic experience. Sleep disturbances are common.

• Physiological symptoms. Vicarious trauma is not limited to the psychological level, but usually causes a physiological activation which ends by presenting the account. The somatization of stress and emotional distress can cause different reactions, from tension-type headaches to skin rashes, heartburn, ulcers, or muscle tension from stress .

Is it possible to avoid vicarious trauma?

We cannot avoid feeling empathy, especially when we see a person in pain or know his terrible story. But there is an empathic concern that allows us to help each other by maintaining our emotional balance and there is an empathy that only generates anguish and drags us to the bottom of the abyss. It is important to learn to differentiate them and not cross the fine line that separates them.

Paying attention to our emotional reactions and thoughts will help us realize that we are too involved, to the point of hurting ourselves. Worrying about ourselves is a way to recharge our "emotional battery". This means enjoying our free time and creating moments just to relax.

A study developed at Boise State University revealed that the main risk factors for the development of vicarious trauma are the stress to which the victim is subjected, but also the inability to recognize our experiences of secondary traumatic stress and a culture of the unhealthy work, in the case of people who serve as support personnel to survivors.

Indeed, people who are exposed to these situations for work must maintain a reasonable balance between work and personal life. A study conducted at Monash University revealed that relying on social support is particularly important in avoiding indirect trauma, because it is the people around us who notice the first signs of suffering and over-involvement and warn us.

In any case, we must keep in mind that when we face trauma experienced by others and help the victims, there is not only the possibility that we develop indirect trauma, but also vicarious resilience. Traumas are transformative, no doubt, but their impact is not always and only negative. Stories of resilience and positive growth resulting from traumatic events can be a source of indirect motivation.

Sources:

Begic, s. et. Al. (2019) Risk and protective factors for secondary traumatic stress and burnout among home visitors. Journal of Human Behavior in the Social Environment ; 29 (1): 137-159.

Newell, JM et. Al. (2016) Clinician Responses to Client Traumas: A Chronological Review of Constructs and Terminology. Traumatic Violence Abuse ; 17 (3): 306-313.

Horwath, J. & Tidbury, W. (2009) Training the workforce following a serious case review: lessons learned from a death by fabricated and induced illness. Child Abuse Review ; 18 (3): 181-194.

Dunkley, J. & Whelan, TA (2006) Vicarious traumatisation: Current status and future directions. British Journal of Guidance & Counseling ; 34 (1): 107-116.

McCann, IL & Pearlman, LA (1990) Vicarious traumatization: A framework for understanding the psychological effects of working with victims. Journal of Traumatic Stress ; 3: 131–149.