Trauma is an emotional, psychological, and physical response to a terrible and catastrophic event such as a terrorist attack, a major accident, assault, rape or a natural disaster like an earthquake.

Trauma is the response to a deeply distressing or disturbing event that overwhelms an individual’s ability to cope and causes pervasive distress and feelings of helplessness.

It diminishes your sense of self and your ability to feel a full range of emotions and experiences. Yet, being ‘traumatised’ has become a socially-misinformed term to mean anything that is upsetting or cringey to a person. 

Types of trauma

There are different types of trauma but they all share the same symptoms.

• Vicarious trauma is over-identifying with another person’s trauma.
• Posttraumatic stress disorder (PTSD) is the reaction after a traumatic event. Immediately or a long time later. It can become chronic and can lead to burnout, which is the reaction to chronic stress.
• Compassion fatigue is an inability to continue empathising.

More about vicarious trauma

Vicarious trauma results from repeated exposure to experiences and feelings of traumatic events experienced by others.

Trauma becomes contagious, you may suffer the same symptoms as the client through empathic engagement with the client’s material. Your sense of self and your inner experience is negatively transformed.

You are particularly vulnerable if you have experienced some kind of trauma in your own life (accident, loss of a family member, abuse, harmful incident). It can affect your personal and social life as well as your professional life.

Your core values and moral beliefs, your worldview and your sense of purpose may be violated. There may be a loss of idealism, an existential disjoint. How can you reconcile what you have witnessed and experienced with your personal sense of meaning in life.

Symptoms of vicarious trauma

The symptoms are similar to PTSD and burnout. They act as protective and defensive mechanisms of the brain, which has experienced shock and may go into a fight (adrenaline, cortisol, high alert), flight (avoidance, denial) or freeze (shut down, disassociation).

You may experience: 

• Physical, emotional and psychological exhaustion
• Numbness, withdrawal, disconnection, disassociation from feelings, avoidance, apathy.
• Confusion, anxiety, distress, fear, anger, sadness, depression, helplessness, and loss of hope. Loss of joy, feeling trapped, isolated. Inability to reach out and communicate. Catastrophising.
• Insomnia, headaches, stomach problems, bingeing or loss of appetite, use of alcohol or drugs, hyper-arousal, poor concentration, irritability, tearfulness, nightmares, flashbacks, mood swings, intrusive thoughts or feelings, memory lapses, panic attacks, re-experiencing graphic details of client’s trauma. Physical and mental illness. Self-destructive behaviour. Self-harm, depression, suicidal feelings.
• Guilt, shame, self-doubt, imposter syndrome, low self-image, deskilled, low motivation, difficulty in making decisions, powerlessness, feeling useless and disillusioned, cynicism.
• Relationships with family and friends may be affected.

None of these symptoms is unusual. They are normal reactions to abnormal events. You will not experience all of them.

Coping mechanisms

Vicarious trauma is the cost of caring, of bearing witness. You are bearing your client’s pain. Identify it, contain it, accept it and process it.

So, what can help?

• Take it one day at a time. Challenge irrational thoughts. Try to change a traumatic narrative into a positive narrative. Develop resilience.
• Recognise your symptoms. Don’t beat yourself up, let go. Practise self-care. Find your coping strategies.  Develop self-awareness and resilience. Remind yourself that you can be confident and capable, you are making a positive and valuable contribution to your work.
• Practise work-life balance. Personal/professional. Clarity about your role and boundaries. Do not give your personal mobile number or make work calls outside of working hours. Accept that you can’t run on empty. Look for the warning signs. Try not to over-identify, take some time and space if you feel overwhelmed.
• Control your eating and drinking. Keep to a healthy routine, and sleep.
• Do some self-soothing and nurturing activities, yoga, mindfulness, meditation, massage, swimming, exercise, and sport.
• Take refuge in nature and the arts. Find a creative activity, reading, drawing, cooking, gardening, listening to music, watching TV, singing, and dancing.
• Talk to colleagues, family members, friends, and those who share your values. Healing needs witnesses. Look for feelings of purpose and meaning. Nurture your spiritual side as well as your social side.
• Identify your triggers and avoid them if possible.
• Look for peer support and a mentor. Regular supervision.
• Seek therapy such as CBT and EMDR.
• Know when to step back. Take a break if necessary, time off, a spa day, a holiday, or a retreat.
• If you feel you are having a panic attack, focus on your breathing. Breathe in calmly, and breathe out stress. Feel the ground beneath your feet. Imagine your feet as 2 rectangles and press down on all four corners.

Examine your five senses, and identify what you can

• See. Focus on an object near you, and look at it in detail.
• Hear. Can you hear traffic? People? Birds? Your own breathing?
• Touch. How does the skin on your hand feel? The texture of what you are wearing?
• Smell. If you can’t smell anything, try the back of your hand.
• Taste. How does your mouth taste?

Alongside examining your sense and identifying what you can, it’s important to keep breathing.

Takeaway

Most of us have experienced a traumatic event in our lives. Try to identify what was helpful and what was not helpful. PTSD can last for a very long time.

If your feelings of trauma are ongoing and chronic you may not be in the right kind of work. You have not failed, you are in the wrong place and it’s fine to admit that.

Carol Martin-Sperry is a sex therapist and the author of three books about couples and sex. Carol is a fellow of the British Association for Counselling and Psychotherapy.