An interpreter expresses in English the story of an immigrant seeking asylum, including descriptions of political persecution and violence. A historian conducts in-depth research into atrocities committed against an ethnic group. A jury is shown horrific images of a crime scene during a criminal trial. In all these situations, traumatic events are described, activating the imagination and empathy of the professionals involved – and, a growing body of evidence suggests, possibly causing vicarious trauma.
Posttraumatic stress disorder was first identified in Vietnam veterans by psychiatrist Chaim Shatan, who warned that the mental health professionals treating them could also be affected by the transference of traumatic symptoms. In 1995, clinical psychologists Karen Saakvitne and Laurie Anne Pearlman gave a name to this disorder: ‘vicarious trauma’.
It is also known as ‘secondary traumatic stress disorder’, which the US Department of Health and Human Services defines as ‘a natural but disruptive by-product of working with traumatized clients. It is a set of observable reactions to working with people who have been traumatised and mirrors the symptoms of post-traumatic stress disorder.’
Vicarious trauma has been frequently discussed in connection with professions such as psychologists, social workers, and first responders. But people in other jobs can also be subject to vicarious trauma and may not have professional training to help them deal with it.
Professions at risk for vicarious trauma
- Interpreters. Interpreters express the words of another person in a different language. Particularly in courtroom settings, they may need to relate traumatic experiences in great detail. According to Melinda González-Hibner, a Spanish-English interpreter and board member of the American Translators Association, the nature of their profession may put them especially at risk. ‘When interpreting, we speak in the first person, and some studies show that there can be a neurolinguistic impact from that.’ González-Hibner says that the ATA and other professional organisations hold trainings to make interpreters aware of the risk of vicarious trauma, which is not only difficult on a personal level, but can also affect their work: ‘an emotional response can be an impediment to performance. It may put the interpreter in a position where they can no longer be objective and neutral, in addition to the obvious possible effect on comprehension, recall and verbal fluency.’
- Teachers. Teaching is also a profession where there can be significant exposure to the trauma of others. Dr Richard Shadick, Teach for America’s national mental health consultant, warns that ‘being exposed to traumatic situations from multiple students can lead teachers to feel very overwhelmed and develop some of the same symptoms as their students.’ A 2012 study conducted by the University of Montana concluded that there is an increased risk of secondary traumatic stress (STS) in school personnel. After questioning over 300 staff members in six schools in the northwest US using standard surveys, the researchers found that approximately 75% of the sample showed symptoms of STS.
- Historians. Even if they took place in the past, traumatic stories can still be powerful today. Journalist and historian James Robins has written about historians traumatized by their research into genocide and ethnic violence, saying that it ‘remains unstudied and is not widely known’. He describes his own mental anguish during the five years it took to write his book on the Armenian Genocide. He interviewed other historians and documented ‘a reservoir of pain that reveals itself through symptoms familiar to anyone diagnosed with posttraumatic stress disorder: insomnia, rapid weight gain or loss, abuse of booze or pills, unexplainable anger or fear, paralysing anxieties.’
Jurors. Leaving professional activities aside, anyone called to serve on a jury may be exposed to narratives and images of traumatic events. The danger of this exposure has been recognised by the province of Ontario, Canada, which started a juror support programme to provide professional counselling to anyone who has completed jury duty on a criminal trial, civil trial, or a coroner’s inquest. However, this systematic approach is exceptional. Legal writer Joe Forward describes efforts by individual judges in Wisconsin and other US states to inform jurors of the risk of vicarious trauma, but wonders whether courts should do more to help jurors cope. This raises an important question: what is the best way of dealing with vicarious trauma?
Recognising and handling vicarious trauma
Awareness of the risk of vicarious trauma is the first step in addressing it, and many organizations have assessments or checklists to help identify symptoms. The Secondary Traumatic Stress Consortium, The Joyful Heart Foundation, Alameda County Behavioral Health Care Services, and the Department of Psychiatry and Behavioral Sciences at the University of Texas are some organisations that offer online assessment tools.
If vicarious trauma is identified, what next? The National Child Traumatic Stress Network suggests that, ‘although evidence regarding the effectiveness of interventions in secondary traumatic stress is limited, cognitive-behavioural strategies and mindfulness-based methods are emerging as best practices.’
TEND Academy, a site devoted to education and resources for those in the helping professions, offers resources and webinars for people struggling with vicarious trauma. According to González-Hibner of the American Translators Association, some concrete steps that are recommended include ‘sharing your feelings, talking about your experience, being aware of the emotional impact of your work. Having a centring practice, whether artistic, physical, spiritual, or religious, definitely helps.’
In addition to individual efforts, organisations must also be aware of the risk of vicarious trauma and take steps to avoid it. In an article in the Psychiatric Times, Dr Gertie Quitangon describes a ‘supportive organisational culture’ as key to building resilience. Organisations with ‘a culture of strong communication and visible leadership support’ combined with ‘the value of personal, family, and work-life balance’ are best equipped to help employees weather the storm of vicarious trauma.
Organisations can also help employees deal with this issue by encouraging them to share experiences with peers and colleagues. Dr Quitangon adds that ‘social support, both personal and professional, is a protective factor and has been associated with a decreased risk of vicarious trauma.’ Not only will practising self-care and reaching out to others help prevent or reduce vicarious trauma, but these are also terrific strategies for dealing with any personal or professional challenges.