How do you do this all day?

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One of the questions commonly asked to those who interact with people have had difficult experiences is referenced above: how do you do this all day? Taking this question a step further, one could ask the professional how do you deal with vicarious trauma all day? Before dealing with it, however, we must understand what vicarious trauma is and what the symptoms are.

Vicarious trauma impacts counselors, therapists, doctors, attorneys, and other people who are attempting to help survivors of trauma. Others refer to the term as “compassion fatigue” or “secondary trauma.” A person is susceptible to vicarious trauma where he or she is exposed to a client who has been exposed to graphic, traumatic experiences.

Basically, this could involve discussions with a client, or a number of clients, who are describing a painful experience. As one study described it here, secondary, or indirect, traumatic exposure is not limited to mental health providers. Anyone who repeatedly and empathically engages with traumatized individuals can be at risk for distress and impairment due to indirect exposure to others’ traumatic material.”

Although some attorneys may experience the feeling as intense anxiety or a strong desire to leave the room, this effect could also be vicarious trauma. In contrast to burnout, however, oftentimes vicarious trauma cannot be remedied merely by taking time off or moving on to a new job. One of the reasons for this, according to this study here, is because vicarious trauma results in a state of tension or preoccupation with clients ‘stories of trauma which leads to a strong need to avoid a client’s trauma history or perhaps experiencing persistent hyper-arousal.
The intensity of vicarious arousal is so strong that it often forces a person to reevaluate herself and her position in the world. Unfortunately, this evaluation is generally through a negative view of the present and future. Under the guise of “objectivity” or simply “describing the way things are,” one may begin to feel lost or even question whether life is a pointless exercise in futility. All of this may feel very “wrong” and scary, but, as research shows, these are the natural effects of experiencing vicarious trauma.

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Professionals experiencing vicarious trauma may experience painful images and emotions associated with their clients’ traumatic memories and may over time incorporate these memories into their own memory systems. The results of this dynamic, commonly experienced by those who have suffered vicarious trauma, according to research here, have a major impact in the person’s perception of safety, trust, esteem, intimacy, and control. The real life consequences may not just be limited to how the professional interacts with a client, but how the person manages personal relationships. The result is that one’s identity and external experience collide with each other, and if one does not have adequate coping skills, the identity will likely give way in a soul crushing experience.

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All of this is to say, that when a person suffers vicarious trauma, she is responding to experiences which are forcing her to question her beliefs and values. It comes as no surprise that under the weight of such pressure, a person will exhibit varying symptoms.
According to recent research on vicarious trauma, some of these symptoms, as noted in this study here, include: denial of clients’ trauma, over-identification with clients, no time and energy for oneself, feelings of great vulnerability, experiencing insignificant daily events as threatening, feelings of alienation, social withdrawal, disconnection from loved ones, loss of confidence that good is still possible in the world, generalized despair and hopelessness, loss of feeling secure, increased sensitivity to violence, cynicism, feeling disillusioned by humanity, disrupted frame of reference, changes in identity, world view, and spirituality, diminished self-capacities, impaired ego resources, and alterations in sensory experiences.

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It is critical for those who have experienced or are experiencing vicarious trauma to recognize the symptoms and seek professional help. Although getting a new job may be helpful, there are no quick fixes. Ultimately, it is imperative to develop coping skills and different ways of thinking which prevent the effects of vicarious trauma from taking firm hold. Commonly, some people will refer to developing coping skills as “self-care” which is simply another way of referring to developing skills to preserve one’s sense of self and identity.
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