Vicarious Trauma: It Seems to be Taking Over My Life!

Presentation by Greg Carlsson, L.M.F.T.Pasadena, California (626) 568-7991

gregcarlsson@sbcglobal.net

Activity Part 1

Mindful Breathing:

Mindfulness is “paying attention, in a particular way; on purpose, in the present

moment, and non judgmentally.”

Jon Kabat-Zinnn, Scientist, author and educator.

Objectives

1. Understand the working definitions of: Vicarious Trauma

Secondary TraumaCompassion FatigueBurn Out

2. Understand the ‘parallel trauma process’ between students and care providers.

3. Gain a better understanding of where trauma is held in our bodies.

4. Learn clinical tools to work through identified traumas.

To be trusted with another’s traumais not to be taken lightly.

Trauma may not be what we signed up for... but its part of the job. If we are to continue

with this work, we must embrace our reaction to trauma, learn from it and move

forward.

Trauma, Fatigue and Burnout.

Primary Trauma: A traumatic event that has happened to you.

Primary trauma can happen at work or stem from our past trauma history.

As helping professionals it’s important that we address our own trauma history. Research

shows that about 60% of helping professionals have a trauma history of their own.

Our own trauma history may play a role in why we become involved in a helping profession. If our own past trauma is not addresses, we may become more vulnerable while doing the work.

Adapted from The compassion fatigue workbook: creative tools for transforming compassion fatigue and vicarious traumatization, Francoise

Mathieu

Secondary Trauma: You are not at the event but learning about it at a later date.

Secondary exposure refers to not experiencing the trauma first hand but

hearing about it, reading a report describing it, or maybe seeing photos of the traumatic

event.

Both Primary and Secondary Trauma can cause Post Traumatic Stress Disorder (PTSD)

Adapted from The compassion fatigue workbook: creative tools for transforming compassion fatigue and vicarious traumatization,

Francoise Mathieu.

Symptoms might be characterized by:

NightmaresHaving intrusive thoughts about the

traumatic event.

Depression The lack interest in important areas of life.

Becoming immobilized in certain parts of your life.

.

Vicarious Trauma: The profound shift that you may experience in your world view when you work with

individuals who have experienced trauma

You may begin to see the word in a different way.

Vicarious Trauma also occurs when the stories we hear transform us in a way that also traumatizes us.

We find it difficult to rid ourselves of the stories we have been told. These images and experiences can stay with

us for a very long time.

It is not something that clients do to us; it is a human consequence of knowing, caring and facing the reality of

trauma.

Adapted from Saakvitne K.W., Perman, L.A., & Staff (1996) p. 25

.

Compassion Fatigue:

A general erosion of our empathy, hope and compassion for life may begin to surface.

A reduction in our ability to be genuinely compassionate may occur.

Who: Teachers, psychologists, nurses and other helping-professionals

Symptoms may include:

A profound emotional and physical exhaustion A bitterness towards work

Changes in our personal and professional lives. Becoming part of a toxic work environment.

Adapted from The compassion fatigue workbook: creative tools for transforming compassion fatigue and vicarious traumatization/

Francoise Mathieu.

Burnout :

Physical and emotional exhaustion that workers can experience when they have low

job satisfaction, feel powerless and overwhelmed at work.

Adapted from The compassion fatigue workbook: creative tools for transforming compassion fatigue and vicarious traumatization,

Francoise Mathieu.

Exhaustion, irritability, and anger, caused at work, may be transferred to your loved ones.

You may feel as though they should be as compassionate as you are! “Why donʼt they

see this work as important as I do.”

Your body may also take the impact.

Vicarious Trauma, Compassion Fatigue & Burn Out are not exclusive and can build on

each other.

We can begin to feel alienated at home and not feel supported by our families or

friends.

Risk Factors that can cause one to be more vulnerable to S.T., V.T.: 1. A history of childhood trauma

2. Difficult life circumstances

3. The use of vices may be used to escape the overwhelming sadness coming from the trauma; Food, Drugs, Excessive work Excessive alcohol Sex...

1. Think of a situation that might apply to one of the above areas.

2. Take three minutes, turn to your neighbor, and share your story. 3. Donʼt get too graphic.

4. While sharing, reflect on your feelings.

ActivityPart II

Your body can be a barometer.

Notice where in your body you hold the tension.

As you were sharing your story, did you feel parts of your body

tensing up?

ActivityPart III

Butterfly Hugs, Bilateral stimulation

& Mindful Breathing

1. Complete the “Mindful Breathing” again while adding the Butterfly Hugs.

2. Notice where you hold the tension.

3. When breathing out, focus on releasing the tension from your body.

4. Notice if you are holding on to the tension.

When hearing about stressful situations first hand,

do you notice your body becoming more tense?

Self Awareness - The relationship between physical and emotional health is paramount to understanding our relationship to trauma

and stress.

Self Awareness in the present

Self Awareness of the past

Self Awareness for the future.

Self Awareness in the present:

Understanding how current tension in our lives effect our physical and emotional well

being.

Self Awareness of the past:

The influences that our past life experiences - good and bad have had on our current work

and life choices.

Self Awareness for the future:

Making changes now that will effect our future physical and emotional well being.

Activity Part IV

The Empty Container

For the time being, take the negative impact of the trauma or situation and “let it go” in to a container you have created in your mind.

1. Picture a strong container like a tupperware, treasure locker, ocean liner...

2. Practice opening it and closing it.

3. Feelings, thoughts or memories you don’t want to think about right now, flow from your

head into your container.

4. Take your time, this can take a while. When you have everything you want in the

container, close it up.

5. Notice how your body feels.

6. You decide when you want to open your container and take out one item at a time

7. Use this when ever you want to temporarily set something aside.

Be aware of your own process.

External: The way you interact with the rest of the world (Secondary Trauma, VicariousTrauma, Post Traumatic Stress Disorder).

Internal: The way your body holds the trauma e.g.

Tension in parts of your body. Unable to fall asleep at night. A lack of appetite. Bingeing on comfort foods.

Adapted from Trauma Stewardship: An everyday guide to caring for self while caring for others, Laura van Dernoot Lipsky with

Connie Burk

In both the personal and professional realm, it is about mindfulness, the ability to recognize and control your physical

symptoms of stress and anxiety, and your breathing.

The Parallel Process

When a trauma is shared by a group, each person has their own trauma history which may impact their reaction to the current

trauma.

Based on our trauma history, we may share similar or different reactions to the trauma

with the person we are helping.

This process may parallel your student’s process. Be aware of your reactions

internally and externally to the trauma.

With some trauma situations, you may not have the luxury of processing your own needs, if you are responsible for helping

others.

Use the breathing techniques taught earlier and utilize bilateral stimulation (the butterfly

hugs) to help calm yourself and focus on those you are helping.

Adapted from Compassion Fatigue, The Crucible of Transformation 2002 article, Eric Gentry:

Activity Part v

Peaceful Place, Person or Animal:

1, Pick a place where you feel calm and peaceful, like the mountains or the beach.

2. If you don’t have a real place you can make one up. If this seems to be difficult, try

imagining a favorite pet or a special person who brings you comfort.

3. Make sure you do not equate your place with anything bad.

4. Close your eyes and apply the butterfly hugs to the exercise.

As you tap, think about your place.

Next, decide on a word that reminds you of your special place. You can use your word to

“pull up” your special place.

What personal set of circumstances, helped develop the passion you hold for your work?

Once you understand and embrace your past, you can use it to strengthen your

current work situation.

Two key principles to help us addressV.T. and C.F.:

A non-anxious presence:

To be in a room with a child’s pain and suffering and be able to express empathy

and compassion without taking on the child’s suffering.

Self-validated caregiving:

The self-care that is guilt-free, self-care that is prioritized as a means of remaining

healthy in the line of work.

Ways to process your trauma history if it comes up:

1. Mindful Breathing.

2. Where am I holding the tension in my body. a. Breathing the tension out of my body.

3. Butterfly bugs

4. Debriefing: What do we say to whom, and when. Talking with a peer, (warnings of the content).

5. Asking permission to share, less is more. Do we really need to recap the

entire session or can we just say, “wow, that was really difficult for me to hear”.

1. Special music for the drive home or listening to a book on CD..

2. Stopping for coffee or tea before arriving home.

Taking a walk first.

3. Going to the gym first.

4. Stopping a block away - Mindful breathing, butterfly hugs, empty container.

Transition time from work to home. Letting go of the work day and

transitioning to your private time.

1. Take stock in your body, your home environment and work place.

Body Scan - Where is the tension?

2. Life /work balance. Work Hard... Play Harder.

Refueling during the day. Mini breaks: peaceful place, Mindful

Breathing, soothing music, soothing sounds, butterfly hugs.

Planning trips for vacation

Self Care: Four Steps to Wellness.

3. Resiliency through Relaxation Training - Walking, Yoga, meditation tapes,

4. Making a commitment to change.

5. You can hold yourself accountable to others.

6. Write down an area you would like to change and place it where you can see it each day.

7. Create a mantra that reminds you of the change.

Stop using rewards as a way to pay yourself back - In doing so, you may be setting up tension with yourself that may backfire –

If you want it and you know it’s healthy, then have it because you want it.

Recapping our strategies:

Mindful Breathing

Body Scan, where am I holding the tension

Peaceful place, person or animal

Empty Container

Butterfly Hugs

We need to develop a support system for ourselves.

We can not work in a caring profession in isolation.

We must develop and rely on systems and tools to support us if we plan to continue the

work for a long period of time.

Our capacity to help others and the environment is greatest when we are willing and even determined to be helped ourselves.

“Be the change you want to see in the world.”

- Gandhi.