By Cynthia Hovis, MSW, LCSW
It has long been acknowledged that empathetic interpersonal skills are an asset in the medical field and helping roles in general. Among other things, it allows helpers to be more effective in their roles through more genuine connectivity with patients. These same empathy skills, however, increase the risk of experiencing personal symptoms of trauma exposure and chronic stress. The risk is increased with work experiences that include situations that are repeated or leave you feeling helpless to make a positive difference.
Vicarious trauma (VT) occurs when an individual who was not an immediate witness to the trauma absorbs and integrates disturbing aspects of the traumatic experience into his or her own functioning. Some precursors to vicarious trauma are compassion fatigue or burnout. Vicarious trauma often carries many of the same symptoms as first-hand trauma or post-traumatic stress disorder. These symptoms are usually grouped into three broad categories:
- Intrusions, such as flashbacks, nightmares, intrusive thoughts
- Avoidance of situations, people or places that bring on the intrusions
- Hypervigilance, sleeplessness and increased startle response (“jumpiness”)
Specific symptoms may include:
Behavioral symptoms
- Sleep disturbances/nightmares
- Negative coping -- smoking, drinking, acting out
- Appetite changes
- Hypervigilance
- Exaggerated startle response or “jumpiness”
- Losing things
- Clumsiness
- Self-harming behaviors
Physical symptoms
- Panic symptoms -- sweating, rapid heartbeat, difficulty breathing, dizziness
- Aches and pains
- Weakened immune system
Cognitive symptoms
- Lowered self-esteem and increased self-doubt
- Trouble concentrating
- Confusion/disorientation
- Perfectionism
- Racing thoughts
- Loss of interest in previously enjoyed activities
- Repetitive images of the trauma
- Lack of meaning in life
- Thoughts of harming yourself or others
Emotional symptoms
- Helplessness and powerlessness
- Survivor guilt
- Numbness
- Oversensitivity
- Emotional unpredictability
- Fear, anxiety, sadness or depression
Social symptoms
- Withdrawal and isolation
- Loneliness
- Irritability and intolerance
- Distrust
- Projection of blame and rage
- Decreased interest in intimacy
- Change in parenting style (becoming overprotective)
- Change in spiritual practices/beliefs
As with all risks in the health care profession, the answer to this potential problem can be found in awareness, education and open communication. Those at risk for VT must develop their own personal coping skills to deal with the stressors of life in general and the particular stressors of their jobs. The trick is to remember the things you instruct others to do for their well-being and apply those practices to your own life. Get proper nutrition, exercise, rest, recreation and develop professional and personal support networks.
Remember that you can contact BJC EAP at any time. It is not a flaw or a weakness to ask for help, it is the professionally responsible thing to do. To best care for others, we must first care for ourselves – mentally, physically and emotionally.
For more information on vicarious trauma, secondary trauma, burnout and compassion fatigue, visit these websites: