This huge panic came over me and all I could think was ‘Please let me get to my car, please…’. I started running; all the while visions of me being raped were going through my head. I heard someone call my name, and it was my co-worker running after me with my purse. The fear I felt that day scared me. I was never like that before.
Working with people who have experienced trauma is hard work. As with anything, there are the good aspects – strength and resilience building, personal growth, and being a witness to incredible progress and change – and the difficult aspects – knowing about human cruelty, suffering and vulnerability, and the devastating impact it has on the people we work with.
There has been many ways to identify what is commonly known as Vicarious Trauma. Historically, “the transformation that takes place within us as a result of exposure to the suffering of other living beings or the planet” (van Dernoot Lipsky, 2010) has been identified in various ways.
Occurs over a long period of time and is usually related to work place/environmental stressors (i.e., not having adequate resources to do your job, downsizing, increase in paperwork, the organization not acknowledging the impact of being exposed to trauma), rather than specifically related to working with clients who have experienced trauma.
Is outdated/inaccurate terminology that suggests having too much “compassion” can have negative impacts. What we know now is that working from a place of compassion for self and others can be a protective measure against Trauma Exposure Response.
Suggests it is something you “catch” from working with people who have been affected by trauma like the cold or flu.
The experience of bearing witness to atrocities that are committed human against human. It is the result of absorbing the sight, smell, sound, touch and feel of the stories told in detail by survivors who are searching for a way to release their own pain (Health Canada, 2001). In the case of service providers, Trauma Exposure Response is the impact of working directly with individuals who have experienced or been affected by trauma.
Just as being a primary victim of trauma transforms clients’ understanding of themselves and the world around them, so too does bearing witness to it, sometimes in very profound ways. Service providers become affected by the trauma experiences of their clients and are exposed to the terror, shame and sadness of their clients. Providers are vulnerable because of their empathic openness, which is a necessary and essential part of the helping process. However, service providers must be mindful of the balance between empathy and the impact of the exposure to the clients’ trauma.
Trauma Exposure Response can be seen as an occupational hazard that is almost unavoidable (a box with not “if” but “when” and “how” will be affected by our exposure to our clients trauma) when hearing about traumatic experiences. Just as PTSD is on a continuum, so is Trauma Exposure Response. The more traumatic material the provider is aware of, the more likely they are to develop a trauma exposure response, especially if their capacity to process the information is limited as a result of an overload of traumatic experience (either through their work or their own trauma history). The impact/effects and changes that result from exposure to trauma can be slight and perhaps barely noticeable, while others can be profound and life-changing. This is normal and is completely manageable with strong workplace and social supports.
These are some of the ways that working with people affected by trauma can impact service providers. A service provider may experience one or two or even many of the themes included in this list:
It is important and relevant to recognize that service providers will bring their own trauma histories to their work. What we know is that this increases the risk of further traumatization. It is imperative that service providers recognize and acknowledge how their own trauma histories can be a relevant factor when working with people who have also experienced trauma. As with PTSD, shame and secrecy can/will increase the suffering.
Preventing Trauma Exposure Response is very much dependent on the level of commitment an organization or system has made to being trauma informed. Being traumainformed means placing a high regard on creating a culture of safety and trust for staff and service providers, as well as clients, patients or residents.
A trauma-informed organization places a high regard on staff health and wellness and in helping staff to develop the same self-soothing, self-regulation, self-compassion and selfcare skills as is being offered the people to whom they are providing services. Adequate levels of supervision is essential, especially from supervisors who are knowledgeable about trauma.
Trauma Exposure Response is manageable if the provider recognizes its negative impact, and takes immediate steps to address it. It is important that providers have a clear distinction between work and personal life. Although empathy and genuine connection are critical in working with trauma survivors, providers need to be able to make a separation that allows them to nurture their mind, body, soul and spirit.
If providers are not connected to themselves, then they will not be as effective in connecting with clients. Clients require service providers who are balanced and well, and this wellbeing of staff is the responsibility of both the service provider and the agency for which they work.
Just as providers encourage their clients to find ways to become more centred and grounded, providers themselves need to practice this.
Healing from Trauma Exposure Response requires awareness. It is no different than what is recommended for those who have experienced primary trauma. Service providers also need to access self-compassion, know how to relax, to self-soothe, to experience joy, and be able to “take in the good” (Hansen, 2005),
Workplaces and organizations have a responsibility to create a psychologically safe workplace. This includes an environment that promotes trauma-informed principles such as safety and trustworthiness, not just for those receiving services, but also for those providing services. Trauma-informed workplaces place a high value on staff wellness, as well as open and respectful communication, and in so doing, makes an important contribution to addressing the impact and healing of Trauma Exposure Response. Ways they can accomplish this are:
Being attuned to one’s needs, limits, emotions and resources. Heed all levels of awareness and sources of information, cognitive, intuitive and somatic. Practice mindfulness and acceptance.
Maintaining balance among activities, especially work, play and rest. Inner balance allows attention to all aspects of oneself.
Connecting with yourself, to others and to something larger. Communication is part of connection and breaks the silence of unacknowledged pain. These connections offset isolation and increase validation and hope. (Health Canada, 2001)
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