Vicarious Trauma - Tools & Tips for Essential Workers

As the COVID-19 pandemic continues, essential workers are still bravely risking their own safety to provide much needed services for others. In the last two months, some might have started to notice adverse changes in their mental and physical wellbeing even if they are otherwise “physically healthy.” The essential workers I have encountered in my personal and professional lives have described observing dread and anxiety around going to work, feelings of hopelessness, apathy, fear, and panic, frequent crying spells, recurring nightmares, being “on edge” or tense, trouble accessing empathy, difficulty managing tasks at home, and a sense of being numb or detached. These symptoms in conjunction with other factors might indicate the presence of vicarious trauma. Some COVID-19 essential workers, such as medical and mental health professionals and first responders, may already be familiar with vicarious trauma in their lines of work, whereas others might be experiencing it for the first time.

What is vicarious trauma?

Vicarious trauma is a traumatic response to bearing witness to the distressing and sometimes horrific experiences of others. The impact is both mental and physical and occurs over time. While observing a single trauma of another person is likely to be deeply upsetting, it is the repeated exposure to these types of events or stories that leads to vicarious traumatization. Those experiencing vicarious trauma integrate aspects of others’ traumatic experiences into their own functioning as if the event happened to them directly. Just like primary trauma—the type of trauma that occurs directly to someone—vicarious trauma shifts our view of the world, our sense of safety, our level of trust, our beliefs about justice, and our understanding of ourselves and others.

Who is susceptible to vicarious trauma?

As human beings, we are all susceptible to vicarious trauma. However, some of us are more likely than others to experience it. The following factors increase our vulnerability:

• Previous trauma (including historical and intergenerational trauma)

• Current trauma (including social trauma and systematic oppression)

• Mental health or substance abuse issues

• High levels of empathy

• Financial struggles or unstable housing

• Physical health issues

• Relationship or family issues

• Caregiver strain

• Poor work/life balance

• Exposure to trauma or suffering through work

Depending on which and to what extent these different factors are impacting essential workers influences their likelihood of becoming traumatized.

How will I know if I am experiencing vicarious trauma?

If you are an essential worker right now and have had repeated exposure to traumatic or upsetting events, keep an eye out for the following warning signs in these four categories:

Emotional warning signs:

• Feelings of increased anger, sadness, fear, guilt, hopelessness, and helplessness

Cognitive warning signs:

• Negative thoughts about the world, the future, and your ability to help others; dissociating or checking out; shutting down

Physical warning signs:

• Chronic exhaustion, aches and pains, getting sick or run down more often than usual, feeling on edge or unable to relax

Behavioral warning signs:

• Isolating from others, avoiding work or other responsibilities, feeling unable to listen or empathize with others, losing your sense of humor, needing substances to cope

It is important to note that vicarious traumatization an involuntary response to an overwhelming situation. It is not a sign of weakness. While we are all potentially susceptible to vicarious trauma, there are ways we can work to build our emotional resilience. Emotional resilience is the ability to bounce back or recover after crises, stressful events, or traumatic experiences. Having a high level of emotional resilience doesn’t make us immune from experiencing distress after exposure to a trauma, but it can help us return to feeling more like our regular selves more quickly and without a shattered worldview.

Here are eight tools that can help you start to build your emotional resilience:

1. Become more aware

Awareness is the first step toward building emotional resilience and coping with vicarious trauma. If you aren’t aware of how you’re feeling, you won’t know when to intervene. Check in with yourself every day. How do you feel? What do you need? Who or what can help you? Understand your own triggers. Be aware of your warning signs.

2. Feel your feelings

As much as you can, try to avoid shutting down, going numb, or denying your emotions. Those methods may feel like a short-term solution but will lead to problems down the road as they build up inside. Laura van Dernoot Lipsky, the founder and director of the Trauma Stewardship Institute, says on this topic: “You don’t get to be selectively numb. So, if you’re going to numb out your sorrow, you’re also going to numb out any possible happiness you can have.” In order to really experience positive emotions, we have to feel the uncomfortable ones, too.

3. Set strong boundaries (professional, personal, and with technology!)

Whether it’s with family, friends, or colleagues, strong boundaries are important in decreasing the potential for additional stress and overwhelm. Where you’re able, say no to taking on additional tasks or responsibilities at times when you’re struggling. Take a lunch break every day at work. Ask for help from friends or family when you need it. Consciously decide when and where you will take in potentially triggering information from the news and social media. That might mean unfollowing certain profiles, turning off news alerts, or deleting apps from your phone if you are checking them too often.

4. Build and utilize your support network

Vicarious traumatization can lead to social isolation, so having supportive people in your life who can help you through difficult emotions is very important in building emotional resilience. Stay in contact with loved ones who know you best – they can offer feedback if you stop sounding or acting like yourself. While talking about your experiences can be incredibly beneficial, especially with others who “get it,” watch out for unhelpful venting. Do conversations become negative rather than supportive? Do you leave them feeling worse rather than better? If so, it might be time to set boundaries around how you and others discuss difficult topics.

5. Access professional resources when needed

Some topics are better to talk about with a professional than with friends, family or colleagues. Particular examples include if your own trauma history comes up in connection with the vicarious trauma, your mental health starts to be negative impacted, or you are concerned about your substance use as a coping mechanism. Professional help for is available now through Coronavirus Online Therapy.

6. Develop an internal locus of control

Research has shown that people who are more emotionally resilient have some sense of being in control over their lives. While we can’t control what happens to us, we can learn how to control how we respond, and doing so can improve our attitudes and decrease feelings of helplessness and hopelessness. When life starts to feel out of control, take time to reflect on all of the decisions you make in a day: What time did you decide get out of bed? What did you choose to wear today? What did you choose for breakfast? Whose texts did you decide to respond to first? Etc., etc. It may seem simple, but forcing your brain to pay attention to times you were able to make a choice can help shift neural patterns from responding to vicarious trauma to building emotional resilience.

7. Practice mindfulness

Because our brains our wired to pay more attention to negative stimuli than positive ones to help us survive, taking time to pause and notice all of the good around us can be very useful in building emotional resilience. Experiencing gratitude for what we have is important but can bring on feelings of guilt, and it’s important to be able to hold both emotions instead of allowing one to negate the other. If you’re feeling too overwhelmed to focus on positive thoughts--which certainly can happen with vicarious trauma--take time to pause and connect with your surroundings. When you look around you, what do you notice that is pleasing or comforting? It might be something in nature, a photo that sparks a happy memory, a color, or even a sound or smell. Take a minute to focus on this detail until you start to feel even slightly less overwhelmed.

8. Be kind to yourself

Lastly and most importantly, be kind to yourself. Eat well, sleep well, go outside, move your body, exercise. When you are strong and healthy, you will be less susceptible to vicarious trauma. Maintain your sense of humor. As much as you can, let go of negative self-talk or beating yourself up about how you’re feeling. Remember that vicarious trauma has nothing to do with “not being strong enough” is an involuntary response to an overwhelming situation, not a sign of weakness, and there is help out there.

Sources

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, DSM-5 (5th ed.). Washington, DC: American Psychiatric Publishing.

• Clements, et. al. (2018). Secondary Trauma in the Workplace: Tools for Awareness, Self-Care, and Organizational Response in Montana. https://traumahealing.org/wp-content/uploads/2018/10/Secondary-Trauma-Manual-.pdf

• van Dernoot Lipsky, L. (2009). Trauma stewardship: An everyday guide to caring for self while caring for others. Oakland, CA: Berrett-Koehler.