Vicarious traumatization


Vicarious traumatization is a transformation in the self of a trauma worker or helper that results from empathic engagement with traumatized clients and their reports of traumatic experiences. It is a special form of countertransference stimulated by exposure to the client's traumatic material. Its hallmark is disrupted spirituality, or a disruption in the trauma workers' perceived meaning and hope. The term was coined specifically with reference to the experience of psychotherapists working with trauma survivor clients. Others, including Saakvitne, Gamble, Pearlman, and Lev have expanded its application to a wide range of persons who assist trauma survivors, including clergy, front-line social workers, justice system professionals, health care providers, humanitarian workers, journalists, and first responders.

Signs and symptoms

The symptoms of vicarious trauma align with the symptoms of primary, actual trauma. When helping professionals attempt to connect with their clients/victims emotionally, the symptoms of vicarious trauma can create emotional disturbance such as feelings of sadness, grief, irritability and mood swings. The signs and symptoms of vicarious trauma parallel those of direct trauma, although they tend to be less intense. Workers who have personal trauma histories may be more vulnerable to VT, although the research findings on this point are mixed. Common signs and symptoms include, but are not limited to, social withdrawal; mood swings; aggression; greater sensitivity to violence; somatic symptoms; sleep difficulties; intrusive imagery; cynicism; sexual difficulties; difficulty managing boundaries with clients; and core beliefs and resulting difficulty in relationships reflecting problems with security, trust, esteem, intimacy, and control.

Contributing factors

Vicarious trauma, conceptually based in constructivist self-development theory, arises from an interaction between individuals and their situations. This means that the individual helper's personal history, coping strategies, and support network, among other things, all interact with his or her situation, to give rise to individual expressions of vicarious trauma. This in turn implies the individual nature of responses or adaptations to VT as well as individual ways of coping with and transforming it.
Anything that interferes with the helper's ability to fulfill his/her responsibility to assist traumatized clients can contribute to vicarious trauma. Many human service workers report that administrative and bureaucratic factors that impediment to their effectiveness influence work satisfaction. Negative aspects of the organization as a whole, such as reorganization, downsizing in the name of change management and a lack of resources in the name of lean management, contribute to burned-out workers.
Vicarious trauma has also been attributed to the stigmatization of mental health care among service providers. Stigma leads to an inability to engage in self care and eventually the service provider may reach burnout, and become more likely to experience VT. The research has also begun to show that vicarious trauma is more prominent in those with a prior history of trauma and adversity.

Related concepts

While the term "vicarious trauma" has been used interchangeably with "compassion fatigue", "secondary traumatic stress disorder," "burnout," "countertransference," and "work-related stress," there are important differences. These include the following:
The posited mechanism for vicarious traumatization is empathy. Different forms of empathy may result in different effects on helpers. Batson and colleagues have conducted research that might inform trauma helpers about ways to manage empathic connection constructively. If helpers identify with their trauma survivor clients and immerse themselves in thinking about what it would be like if these events happened to them, they are likely to experience personal distress, feeling upset, worried, distressed. On the other hand, if helpers instead imagine what the client experienced, they may be more likely to feel compassion and moved to help.

Measurement

Over the years, people have measured VT in a wide variety of ways. Vicarious trauma is a multifaceted construct requiring a multifaceted assessment. More specifically, the aspects of VT that would need to be measured for a complete assessment include self capacities, ego resources, frame of reference, psychological needs, and trauma symptoms. Measuring of some of these elements of VT exist, including the following:
Vicarious traumatization is not the responsibility of clients or systems, although institutions that provide trauma-related services bear a responsibility to create policies and work settings that facilitate staff well-being. Each trauma worker is responsible for self-care, working reflectively, and engaging in regular, frequent, trauma-informed professional confidential consultation.
There are many ways of addressing vicarious traumatization. All involve awareness, balance, and connection. One set of approaches can be grouped together as coping strategies. These include, for example, self-care, rest, escape, and play. A second set of approaches can be grouped as transforming strategies. Transforming strategies aim to help workers create community and find meaning through the work. Within each category, strategies may be applied in one's personal life and professional life. Organizations that provide trauma services can also play a role in mitigating vicarious trauma.
Research shows that many simple things increase happiness and this aids to lessen the impact of vicarious traumatization. People who are more socially connected tend to be happier. People who consciously practice gratitude are also shown happier. Creative endeavours that are completely detached with work also increase happiness. Self-care practices like yoga, qigong, and sitting meditation are found to be helpful for those who practice. HBR in a case study regarding to traumatization stated that it is essential to create an organizational culture in which it is cool to be a social worker or a counselor, where these professionals are empowered to influence the workplace issues, the strategy of human services in both corporate and care services.