Question
What is vicarious trauma?
Answer
When we work with families who have experienced trauma, we may be deeply affected by their pain, anxiety, and other strong feelings. The result may be vicarious trauma. Vicarious trauma is a natural reaction. It is our emotional reaction to the helplessness, fear, and hopelessness that other people who have experienced trauma often feel. Vicarious trauma can leave us with similar feelings that can weigh us down and make it difficult for us to relax or experience joy.
I would like to share a story about a time when I experienced vicarious trauma. I am now a trauma specialist, and my expertise is trauma, but this happened when I was an intern at a trauma center. The trauma center was busy day and night, and I had a caseload of about ten clients. These cases were all children and adults who had experienced significant trauma. It started to affect me to the point I was having a tough time concentrating. I had a hard time falling asleep without having nightmares. I had a hard time processing everything in my day-to-day routine and doing my work because I couldn't concentrate. Everything was really hard. I was experiencing vicarious trauma from the clients I had worked with. I was feeling extremely overwhelmed.
One day I was walking down the hallway, and the program director saw me walking and immediately stopped me. She said, "Nadia, what's wrong?" I told her nothing was wrong, and she told me to come to her office. When we got there, she said, "What's wrong? You don't seem like yourself. You're usually bouncing off the walls and happy-go-lucky, but now you're walking with your head down. What's going on?" I replied, "I don't know. I just feel weird. I just feel really weird." She said, "Oh, okay. I see what's happening." She didn't explain to me what was happening. She told me, "I want you to pick up your belongings and leave." I said, "What do you mean leave?" She said, "I don't want you to be here for the next two weeks." I was concerned about my hours, and she said to forget about the hours and go enjoy myself. She said, "Don't think about this place. Don't do any work around this place, nothing. I want you to just get out of here and do something you enjoy. Then when you come back, we will talk more about what I see is happening."
I was very confused, and she told me, "Nadia, please, don't try to figure this out. I know how you are. You're just going to go home and research it. Please, Nadia, go home and do things you enjoy." She was trying to get me to experience joy again, relax, and not think about all the cases I was carrying. I was still protesting and saying no, and she said, "Nadia, I don't want to hear it. Just go." I picked up my belongings and left. I didn't go back for two weeks as she had told me. When I returned, I met with her again, and she explained what was happening, which was vicarious trauma. I asked her, "Why didn't you tell me this before." She told me, "Because I know how you are. You were going to go home and do research on vicarious trauma. That's something I was trying to prevent you from doing. I didn't want you to continue to be so into it, so I told you to go home and completely relax."
The other thing that she mentioned to me is to have sound boundaries. This occurs when you do your best at work and try your best to help people. You do everything you can for people, whether nonclinical staff, clinical staff, teachers, psychologists, etc. Have set boundaries. If you don't, feelings start creeping into your life. Before you know it, you start feeling those same feelings that your clients are feeling. It doesn't necessarily mean it's the same thing, but you start feeling like that. There's also secondary trauma, where you start experiencing the same thing the clients are feeling with flashbacks, but your flashbacks will be different. They will likely be about when the client told you the story of how X, Y, and Z happened.
Remember, vicarious trauma includes feelings of helplessness, fear, and hopelessness. As I said, I wasn't able to concentrate. I wasn't able to write a sentence. It was so off-putting how I was feeling. The director and I talked about things I could do to help myself. I'll talk about that towards the end of part 3. The bottom line is that vicarious trauma is serious. It's very real, especially if you're just starting. Hearing many of these difficult stories is heartbreaking, to the point where I would think, wow, how can people do this to another human being? I would stay stuck on that. Please be aware of these things. If you start feeling like that, talk to your supervisor and always try to do something you enjoy. If you're feeling helpless, afraid, or hopeless, remember those are signs of vicarious trauma.
This Ask the Expert is an edited excerpt from the course, Collective Trauma and Building a Trauma-Informed Culture, presented by Nadia Tourinho, MSW, LICSW, LCSW-C.
