Understanding Secondary Trauma

We live in a broken world. If we exist long enough, we will be exposed to hard things—trauma, grief, injustice, physical illness, and human tragedy. We are designed to live in community, and we are designed to care about people. Our existence depends on it. From our earliest moments our survival is highly impacted by the care we receive.

Because on our communal nature and our care for others we are impacted by the world around us and those in it. Being impacted by the pain of others we are in community with is normal and appropriate—it means we are capable of empathy and compassion—the roots of connection. But what happens when the impact of others’ pain became too much to bear?

Secondary trauma, also known as vicarious trauma, compassion fatigue or “burn-out”, results when we are heavily impacted by exposure to the pain of others. Those in helping professions are especially vulnerable to secondary trauma because we frequently bear witness to human tragedy. While it is expected that we be affected, secondary trauma can be experienced much like post-traumatic stress (PTS)—resulting in intrusive thoughts and feelings, sleep disturbance, somatic complaints, and loss of meaning or worth. More commonly, secondary trauma is experienced as the loss of compassion, avoidance, or resentment.

Secondary trauma develops over time and like PTS is influenced by our previous experiences and the resources we have available. Two things that profoundly influence our vulnerability to secondary trauma are Spirituality and Responsibility. Simplified, spirituality is our sense of meaning, purpose, and hope. As long as we find meaning, purpose, and hope in our work we are able to endure tragic circumstances for long periods of time. Chronic exposure to others’ pain, however, can attack our spirituality, weakening our hope and sense of meaning. I might lose hope that things can improve, feel my work is pointless, or question my beliefs about humanity.

Those in helping professions—first-responders, ministers, counselors, teachers, social workers, to name a few—may set out to change the world, driven by great meaning and purpose. Our purpose often influences a great sense of responsibility. When we begin to assume responsibility for things that are not ours to hold this increases our vulnerability to secondary trauma. We have influence but we are not sovereign. Assuming too much responsibility in any situation will eventually leave us feeling powerless–we cannot sustain the work. To combat this powerlessness, we may begin blaming others for their pain, leading to resentment and loss of compassion.

So what now? How should we protect ourselves from secondary trauma and how do we respond when we are facing burn out?

Check your responsibility

We must first begin to identify what is and is not our responsibility. As a counselor, I am responsible for showing up authentically, being present in the pain of others, and using my skills to guide healing.  I am not responsible for the pain my clients experience and I am not responsible for fixing their situation or having all the right answers. I have always thought it was arrogant to believe that I can change anyone in one hour a week; I don’t have that kind of power. There is benefit to taking on too much. It can make us feel important and valued but it is ultimately a trap. I believe there is a Savior but I am not Him.

Maintain boundaries

Once I have identified my responsibility—my role in living out my purpose–I must put boundaries in place to protect this so that I can sustain my work. This might mean that I only see a certain number of clients a week or that I only am available on certain days. This also means that I am not going to carry the burden of my clients’ pain. I will sit with your pain and look it in the eye. I will feel with you but I will not take it home with me. This work is difficult to define (See my blog on boundaries). For me this connects back to responsibility—I have my work to do in this world and you have yours. In more complex cases, setting boundaries may bring issues of responsibility to the surface. If my boundaries trigger abandonment in another–who is responsible for this? While I can have compassion for the other, I am not responsible for his or her response to my boundaries. This work is hard!

Stay connected to meaning and truth

I have said this is previous blogs and I think it bears repeating: I could not do the work I do, immersing myself in the depth of human tragedy, hearing what abuses others have endured, if I believed that this world is all there is. What I believe may not be what you believe, but I have to stay connected spiritually in order to sustain my work. In this I find meaning and purpose. It would be too devastating otherwise.

Get support. This is stewardship.

I view the above tasks as stewardship. I must care for myself emotionally, physically, mentally, and spiritually in order to continue my work. I must seek support when needed. As someone in a helping profession it feels good to be the helper and it can feel shameful to ask for help. However, If I am unable to seek care without judgement then I am ultimately unable to give care without judgement. All humans need care and asking for help is an immensely valuable skill.

Responding to secondary trauma or burn-out is not always straightforward. If you are having difficulty deciding if this applies to you ask yourself the following questions:

• Do I resent those who need me or ask things of me?
• Am I avoiding things that once brought me joy?
• Do I say yes to things I don’t want to do because I feel obligated?
• Is my work life-stealing and joy-killing or is it life-giving?
• Am I able to ask for help when I need it?

This work is difficult, and it is lifetime work. We may find that our work and our career evolves with our resources. It may mean you re-evaluate your boundaries, seek professional help, or take up a hobby. There is no correct formula here. Stay curious. Take care of you.