There are terrible stories that leave a deep emotional mark on those who know them, causing a vicarious trauma. Such was the case of Peter Connelly, a child of just 17 months who died in 2007, in London, after suffering more than 50 injuries in a period of just eight months caused in his family environment.
The injuries were so profound that the professionals who were in charge of the case experienced a mental shock, reporting also a strong sense of guilt and a sense of worthlessness, as revealed later by psychologists from the University of Sheffield.
However, it is not necessary to be in contact with such extreme cases to experience a vicarious trauma. Empathy, that capacity that unites and allows us to put ourselves in the place of the other, can play tricks on us when we carry the pain and suffering of the others, especially if we know that we cannot do anything to alleviate it. Then, the discomfort of the other becomes our way of the cross and we develop a psychological trauma.
What is a vicarious trauma?
Vicarious trauma is a concept coined by McCann and Pearlman in 1990 to refer to indirect exposure to a traumatic event that ends up generating harmful effects on the person. In fact, Psychology recognizes that it is possible to experience post-traumatic stress from “repeated exposure to aversive details” about a particularly painful event.
Also known as secondary trauma or indirect trauma, it can manifest itself on both a psychological and physical level, often causing a change in a person’s perception of themselves, the world, and the others.
Although we are all susceptible to developing a vicarious trauma, people who tend to be more exposed to pain and suffering from their work, such as psychologists, health personnel, social workers, lawyers and police and rescue agents, are at greater risk. However, anyone in a meaningful relationship with a trauma survivor may experience a vicarious trauma.
The path that leads to indirect trauma
Sometimes the path to vicarious trauma is straightforward and fast. We can participate in a traumatic experience so terrible that it leaves us in a state of shock. Other times the path is progressive, we travel it over time, and it is even possible that there is not a single traumatic story but several life stories that intertwine in our minds.
However, regardless of the stories that have generated the trauma, we all tend to follow the same “emotional path.” Generally, it all starts with experiencing great empathy for the victim. That empathy does not mean simply understanding their experiences but putting ourselves in their shoes and experiencing feelings similar to those of the trauma survivor.
As a result, we often end up establishing an emotional bond with the victim. We are committed to him to the point that we feel responsible for his well-being. This deep emotional bond prevents us from establishing the necessary psychological distance to protect our emotional balance.
On the other hand, it is common for the experiences lived by the victim to become a focal point of anguish. They can reactivate again and again and even enter our dreams, as if we had experienced the trauma ourselves. It is also common for us to react with great anger, we develop the feeling that life has not been fair, which ends up changing our perception of the world. We will begin to think that the world is a hostile, insecure and chaotic place.
At this point we will be plunged into a downward spiral, we cannot think rationally but we are dragged by the traumatic experience. We will develop Hyper-Empathy Sindrome, a kind of compassion fatigue due to the emotional burden that we carry and that usually occurs when we do not dedicate enough time to ourselves, but we immerse ourselves fully in the care and support of the traumatized person, which ends up emotionally overwhelming us, leaving us without resources for our own emotional healing.
In the end, this experience also changes our perception of ourselves. We begin to think that we are leaves moved by the wind, we develop a locus of control external, our perception of self-efficacy decreases, and our learned helplessness increases.
In these cases, when we interact with the victims and their life stories, all our resources are altered, especially those related to meeting our needs for security, trust, esteem, privacy and control, which are the ones that have a most significant impact on our lives and on the emotional well-being.
Symptoms of vicarious trauma, sinking under the weight of suffering
Indirect trauma can have a significant impact on the mental health of those who suffer it since it not only generates a true emotional cataclysm, but often shakes the beliefs and convictions on which we had built our worldview. Although each person responds to vicarious trauma in different ways and some are more affected than others, the most common symptoms are:
• Emotional symptoms. People with vicarious trauma may experience long-lasting feelings of pain, anxiety, or sadness. Some can become very irritable, have sudden mood swings, or get upset frequently over inconsequential things. They will also begin to feel insecure and likely to lose hope and the meaning of life. They may even feel guilty and believe that they are not worthy of love or think that their life is useless.
• Cognitive symptoms. Indirect trauma often causes difficulties in concentrating, which end up manifesting as memory problems and small distractions. What happens is that the mind is completely focused on traumatic events, it suffers from intrusive thoughts, so that there is a considerable decrease in cognitive performance that ends up being appreciated in other spheres of life, especially at work. That will make any task daunting, which adds more stress.
• Behavioral symptoms. Indirect trauma can turn a kind and optimistic person into a cynical and pessimistic one. The person is also likely to isolate himself and experience a sense of disconnection with the others and the world. In some cases, he may turn to food, alcohol, or drugs to cope with an unbearable situation and avoid things that reactivate memories of the traumatic experience. Sleeping problems are also common.
• Physiological symptoms. The vicarious trauma is not limited to the psychological plane, but usually causes a physiological activation that ends up taking its toll. The somatization of that stress and emotional distress can cause different reactions, from anxiety dizziness to skin rashes, heartburn, ulcers or stress-induced muscle tension.
Is it possible to avoid the vicarious trauma?
We cannot help but feel empathy, especially when we see a person suffering or know his or her terrible story. However, there is an empathic concern that allows us to help the other while maintaining our emotional balance and there is an empathy that only generates distress and drags us to the bottom of the abyss. It is important to learn to differentiate them and not to cross the fine line that separates them.
Keeping an eye on our emotional reactions and thoughts will help us to realize that we are getting too involved, to the point of hurting ourselves. Applying self-care strategies is a way to recharge our “emotional battery”. That means enjoying our free time and creating moments just to relax.
A study developed at Boise State University revealed that the main risk factors for developing vicarious trauma are the stress to which the victim is subjected, but also the inability to recognize our experiences of secondary traumatic stress and an unhealthy work culture, in the case of individuals serving as survivor support staff.
In fact, for people who are exposed to these situations through work, it is essential that they maintain a reasonable balance between work and their personal life. A study carried out at Monash University revealed that having social support is particularly important to avoid vicarious trauma since it is often the people around us who notice the first signs of suffering and excessive involvement and alert us to them.
In any case, we must bear in mind that when we face traumas that other people have experienced and we help victims, there is not only the possibility of developing an indirect trauma, but also of developing vicarious resilience. Traumas are transformative, there is no doubt, but their impact does not always have to be exclusively negative. Stories of resilience and positive growth emanating from traumatic events can become a source of indirect motivation.
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McCann, I. L. & Pearlman, L. A. (1990) Vicarious traumatization: A framework for understanding the psychological effects of working with victims. Journal of Traumatic Stress; 3: 131–149.