The Silent Struggles of Therapists: Part 2 – Vicarious Trauma

By Emily Heimberger, LPC-Associate
Supervised by Jennifer Buffalo, LPC-S, LMFT

What is vicarious trauma?

Vicarious trauma goes by many names: secondary trauma, insidious trauma, secondhand trauma, “the cost of caring,” and more. All refer to the trauma that can occur after exposure to someone else’s traumatic stories and experiences. This phenomenon is commonly observed among professionals who work closely with individuals who have experienced trauma, such as therapists, social workers, emergency responders, healthcare providers, journalists covering traumatic events, and others in helping professions.

What are the signs and symptoms?

Over time, exposure to someone else’s trauma can lead to symptoms similar to those endorsed by individuals who have directly experienced trauma. These may include:

  • Behavioral: Sleep disturbances, nightmares, appetite changes, hypervigilance, exaggerated startle response, losing things, clumsiness, self-harm behaviors, increased substance use
  • Physical: Sweating, rapid heart rate, difficulty breathing, dizziness, aches and pains, weakened immune system
  • Cognitive: Minimization of vicarious trauma, lowered self-esteem, trouble concentrating, confusion and disorientation, intrusive thoughts or images, thoughts of harming yourself or others
  • Emotional: Helplessness, sadness, or despair, survivor guilt, numbness or detachment, oversensitivity or overreactivity, fear, anxiety
  • Social: Withdrawal and isolation, loneliness, irritability and intolerance, distrust, projection of blame and rage, decreased interest in intimacy

This list is not exhaustive, and individuals experiencing distress should seek support from qualified mental health professionals for proper assessment, diagnosis, and treatment.

How to treat vicarious trauma?

Treating vicarious trauma requires a multifaceted approach that addresses individual, organizational, and systemic factors impacting the well-being of professionals who work with trauma survivors. Here are several approaches:

  • Maintain a healthy lifestyle by eating a balanced diet, staying active, and prioritizing rest.
  • Engage in activities that promote relaxation and stress reduction
  • Establish clear boundaries in both your professional and personal life.
  • Seize opportunities for professional growth and development.
  • Address systemic factors such as workload and exposure to challenging cases.
    Advocate for organizational policies that prioritize employee well-being, such as access to counseling services, debriefing sessions, and training on self-care techniques.
  • Attend regular supervision and peer support structures.
  • Take regular breaks, time off, and opportunities to recharge and rejuvenate outside of work.

Addressing vicarious trauma is an ongoing process, and what works for one individual may not work for another. It often requires a combination of strategies tailored to the individual’s needs and circumstances.

Therapists, it’s okay to seek help. Just because you didn’t experience the trauma yourself doesn’t diminish what you’re experiencing. Your experience is valid. You deserve to heal.

Resources

The Vicarious Traumatic Toolkit
Guidebook on Vicarious Trauma: Recommended Solutions for Anti-Violence Workers
Trauma Information Pages
Secondary Traumatization, Burnout, and Vicarious Traumatization: A Review of the Literature as it Relates to Therapists Who Treat Trauma
Resource Guide for Coping with Secondhand Trauma

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