Understanding the impact of working with trauma survivors

Amber Foster, LCSW-S
May 1
5 min read

Working with trauma survivors is both a rewarding and inspiring endeavor. This work instills a sense of purpose and provides the opportunity to offer hope and healing to individuals in distress. However, professionals in this field are also human and may experience challenges. The risks associated with this work include vicarious trauma, burnout, and compassion fatigue. It is crucial to recognize these risks in order to develop effective prevention and self-care strategies.

A closer look at vicarious trauma, burnout, and compassion fatigue

Vicarious Trauma:

Vicarious trauma is acknowledged as a professional challenge for individuals in victim services, law enforcement, emergency medical services, fire services, and similar fields. This arises from their continuous exposure to those who have endured trauma and violence, potentially altering the worldview of those in victim services.

Symptoms may include:

Intrusive thoughts related to clients' experiences
Nightmares
Absenteeism
Social withdrawal
Avoidance of clients' traumatic disclosures, resulting in diminished clinical service quality
Adoption of negative coping mechanisms, both personally and professionally
Increased alertness regarding personal and loved ones' safety
Avoidance of physical intimacy
Growing pessimism about the world
Loss of motivation at work
Detachment from spiritual beliefs
Reduced career longevity
Medical conditions related to stress

Burnout:

Burnout is a state of physical, emotional, and mental exhaustion resulting from prolonged involvement in emotionally demanding environments, such as challenging workplaces.

The three dimensions of burnout include:

Emotional exhaustion: Feeling fatigued at work, potentially leading to absenteeism.
Depersonalization or cynicism: Developing indifferent or hostile attitudes towards others, whether clients or colleagues.
Decreased effectiveness: Perceiving a lack of achievement at work, which can result in diminished motivation and performance.

Symptoms may include:

Exhaustion
Isolation
Escape fantasies
Irritability
Frequent illnesses

Compassion Fatigue:

Compassion fatigue is characterized by physical, emotional, and spiritual depletion associated with caring for individuals in significant emotional and physical distress. It is also referred to as secondary traumatic stress.

Symptoms may include:

Feelings of failure
Frustration or anger
Hopelessness
Feeling disconnected from others
Depression
Anxiety
Using alcohol or other substances as coping mechanisms
Secondary traumatic stress, a component of compassion fatigue, includes:
Hypervigilance
Being easily startled
Anticipating catastrophic or traumatic events
Racing heart, shortness of breath, and increased tension headaches
Intrusive thoughts about clients' traumatic experiences
Feeling as if others' traumatic experiences are one's own

"We can do good work with others and keep ourselves well and healthy. We can take care of ourselves first so we can then take care of others. Even Mother Teresa recognized the potential drain of helping and made it mandatory for her nuns to take extended periods of time off to heal from the effects of their caregiving. While extended sabbaticals aren’t something most of us can enjoy, we can make self-care a priority.”

–Overcoming Compassion Fatigue, p. 118

The Significance of Self-Care

What is self-care?

Engaging in self-care practices is essential for maintaining a healthy mind, body, and soul. When working with trauma survivors and frequently encountering tragic stories, it can be easy to perceive our own issues as insignificant or to view the world as inherently negative. Such thought patterns may lead to compassion fatigue and burnout. Excessive stress related to work can impact our personal lives. It is important to acknowledge that taking a break is acceptable, seeking support is valid, and slowing down is permissible.

Self-care can vary from the simplicity of pausing to acknowledge your feelings to the indulgence of a weekend retreat at a spa. Many of us may not realize that we already have self-care tools and coping strategies; it is crucial to be intentional in utilizing them.

Types of Self Care

Getting enough sleep
Having a balanced diet
Engaging in physical activity
Keeping up with medication and/or vitamins
Having a healthy support system
Engaging in healthy coping skills
Keeping up with medical appointments
Engaging in psychotherapy
Setting and maintaining healthy boundaries
Nourishing your spirituality

The ABC's of self-care

Awareness: How frequently do you consciously assess the state of your mind and body? Are you operating on autopilot, merely going through daily routines? This is a common experience. As we become busy, fatigued, and overwhelmed, we tend to disengage. As a result, we may encounter symptoms of burnout or compassion fatigue that appear unexpectedly. Awareness involves intentionally slowing down and evaluating your personal state. At the end of your workday, take a moment to pause and reflect: What challenges did you face? What successes did you achieve? What do you need to relax this evening? Pay attention to your sleep quality, your eating habits and spiritual well-being. Having self awareness requires practice, as we often fall into habitual routines, whether beneficial or not. It's perfectly fine to start small. Choose one aspect of your life to focus on and enhance your awareness from there.

Balance: Achieving balance is within your reach, and it will uniquely suit each individual. By increasing your self-awareness, you'll confidently pinpoint areas you wish to transform. When considering balance, focus on the four domains of your life: intellectual, spiritual, emotional, and physical. How are these areas currently? Is there an opportunity to reduce your time at the office? Can you incorporate some movement into your day with a light stretch at your desk? Perhaps diving into a self-help book or journaling about your spirituality is exactly what you need right now. Take the time to reflect on how you want to create more balance in your life.

Connection: We are wired for connection. As Dr. Bruce Perry has said, "your connectedness to other people is so key to buffering any current stressors and to healing from past trauma". How are you engaging with others? It's important to note that merely observing the lives of friends and family on social media does not constitute true connection. Consider the quality of your relationships. How is your sense of connection being nurtured? If you currently feel disconnected from others, it might be beneficial to arrange a lunch with a friend or family member. Additionally, consider exploring community groups, whether at the gym, church, or a book club, to try something new.

Your well-being matters.

Recognizing the risk factors of working with trauma survivors and the importance of self-care is vital for sustaining a long career. Dedicating yourself to helping others through their most challenging times is both a privilege and an honor, showcasing your admirable character. Prioritizing your own well-being is essential to effectively support others.

Understanding the impact of working with trauma survivors

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