Laura van Dernoot Lipsky remembers the moment she was close to a psychotic break.
In a 2015 TEDx talk titled “Beyond the Cliff,” the veteran social worker and founder of The Trauma Stewardship Institute recounted a vacation where she was standing on the edge of a very tall cliff, thinking, “I wonder how many people have killed themselves by jumping off of these cliffs.”
“Where would the helicopter land? Is there a Level 1 trauma center in the Caribbean? Do they fly you to Miami?” she asked out loud, forgetting the people around her. After a long silence, a family member approached and asked, “Are you sure all this trauma work hasn’t gotten to you?”
In that moment, she realized the emotional toll of her work was causing secondhand trauma.
“Over time, what you’re exposed to affects your entire world view,” she said.
What Is Secondhand Trauma?
According to the American Counseling Association (ACA), secondhand, or vicarious, trauma is a condition that affects many people who interact with those who have experienced a traumatic event (PDF, 102KB). When those in helping professions hear clients talk about what they experienced and see their physical reaction to the experiences, they may also begin to feel the effects of trauma. In some cases, the condition can be a cumulative effect from hearing multiple accounts in their daily work, Dernoot Lipsky noted in her talk.
Secondhand trauma, also referred to as trauma exposure response, secondhand stress and secondary traumatic stress, may manifest in a number of symptoms ranging in level of severity, from headaches, stress eating or loss of appetite to chronic exhaustion and paranoia, the ACA reports. Social Workers, first responders, physicians, nurses, rape counselors, school counselors, coroners, lawyers, and teachers are among the professionals who may be at risk for secondhand trauma. But anybody can feel the effects of this form of trauma if they are repeatedly exposed to traumatic stories and images in the news or on social media, for example.
What Are the Signs of Secondhand Trauma or Trauma Exposure Response?
Secondhand trauma or trauma exposure response has multiple symptoms, although individuals may not exhibit all of them.
Lipsky’s book, “Trauma Stewardship: An Everyday Guide to Caring for Self While Caring for Others,” identifies 16 signs of trauma exposure response:
- Hopelessness and helplessness
- A sense that one can never do enough
- Diminished creativity
- Inability to embrace creativity
- Chronic exhaustion/Physical ailments
- Inability to listen/Deliberate avoidance
- Dissociative moments
- Sense of persecution
- Anger and cynicism
- Numbing/Inability to empathize
How Can Secondhand Trauma Impact the Work of Professionals?
Unchecked, secondhand trauma can be debilitating, like the emotional numbing associated with compassion fatigue. When those in helping professions see a great demand for their services, they may ignore signs of their own trauma to serve others.
“It’s important for you to attend to it because if you ignore the impact of trauma, it continues to affect you and it starts to affect your work with clients or whoever you help, whoever you work with,” Maryland social worker Laurie Reagan, LCSW-C, said on her podcast, “Therapy Chat,” in an episode on vicarious trauma and secondary traumatic stress.
Secondhand trauma “can lead to burnout, and burnout is a career-ender,” Reagan added. “And that’s tragic because we need people who care about helping.”
The effects of secondhand trauma on workers can impede the work of organizations and agencies that provide necessary care leading to increased absenteeism, impaired judgment, low productivity, poor work quality, high staff turnover and greater staff friction, according to the Department of Health and Human Services’ Administration for Children and Families’ guide to secondary traumatic stress.
How to Prevent Secondhand Trauma
Mindful intention is a useful method to address secondary traumatic stress, Reagan said in her podcast, as is taking the time to pause and think about purpose in what you do.
While secondhand trauma may seem inevitable, there are steps to take to prevent and cope with its effects. SocialWorkLicenseMap.com summarized recommendations by Reagan, the DHHS Administration for Children and Families guide and “Secondary Traumatic Stress: A Fact Sheet for Organizations Employing Community Violence Workers (PDF, 191KB),” by The National Child Traumatic Stress Network.
What can you do?
Walk more, hit the gym or join a dance class.
Rest and relax
Get enough sleep, use mindful intention and meditate.
Spend time in nature
Find places to appreciate the outdoors and maintain perspective.
Connect with others and ask for help
Talk about your feelings with people you trust, such as loved ones, friends, and support groups, or see a mental health professional.
Use your creative expression
Paint, cook, start a journal or do woodworking.
Assertiveness yourself and manage your time
Learn to say “no” and set limits.
Celebrate your work
Identify how you have helped others and be proud of positive outcomes you facilitated.
Plan for coping
Identify the skills and strategies that work best for you when signs of secondhand trauma appear.
What can organizations do?
Promote self-care and prioritize staff care
Let employees use sick leave for mental health days and to exercise, engage in team sports, etc.
Divide responsibilities and ensure diverse workloads
Reduce intensity and duration of exposure to most disturbing encounters with trauma.
Offer professional training and encourage staff development
Promote trust and appreciation for employees’ work.
Create opportunities for staff to connect with the community outside work
Build organizational relationships with clients and communities.
Ensure a safe work environment and provide equipment for workers to be safe
Assure employees that their employer cares about them.
Provide counseling resources
Encourage employees to get help and acknowledge mental and emotional needs.
Where to Find Help for Secondhand Trauma
Organizations and Support Groups
- The American Institute of Stress
- Compassion Fatigue Awareness Project
- Families Thrive
- Self-Care for Advocates Facebook support group
- The Trauma Stewardship Institute
Toolkits, Fact Sheets and Brochures
- “Compassion Fatigue and Self-Care (PDF, 1.4MB),” SAMHSA and Health Resources and Services Administration: Signs of compassion fatigue and self-care tips.
- “Coping with a Disaster or Traumatic Event,” Emergency and preparedness response, CDC: Links to information on how responders can practice self-care and how to help children cope during and after a disaster.
- “Exposure to Stress: Occupational Hazards in Hospitals (PDF, 215KB),” National Institute for Occupational Safety and Health and CDC: Identifies sources of occupational stress and adverse effects and recommends work practices to reduce occupational stress.
- “Provider Self-Care Toolkit,” National Center for PTSD, Department of Veterans Affairs: Education and resources to help mental health care providers with burnout and secondary traumatic stress.
- “Secondary Traumatic Stress: A Fact Sheet for Organizations Employing Community Violence Workers (PDF, 191KB),” The National Child Traumatic Stress Network: Provides advice for workers and organizations that encounter violence.
- Self-Care Starter Kit,University of Buffalo School of Social Work: Provides resources for students in training and professional social workers.
- “Spotlight on Secondary Trauma and Professionals’ Well-Being,” Children’s Bureau Express, Vol. 17, No. 5, Administration for Children and Families: Focuses on secondary traumatic stress for workers, supervisors and organizations.
- “Tips for Disaster Responders: Understanding Compassion Fatigue (PDF, 1.2MB),” SAMHSA: Highlights signs of burnout and tips for coping while in a disaster zone.
- “Understanding Secondary Trauma: A Guide for Lawyers Working with Child Victims,” American Bar Association: Provides information on signs and symptoms for those working with the court system.
- “The Vicarious Trauma Toolkit,” Office of Justice Programs, Department of justice: Provides tools and resources for first responders, those in the fields of victim services and other allied professionals.
- “Vicarious Trauma in the Struggle for Immigrant Justice,” American Friends Service Committee: Offers a guide for those working with immigrants.
- “Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized,” edited by Charles R. Figley
- “Overcoming Secondary Stress in Medical and Nursing Practice: A Guide to Professional Resilience and Personal Well-Being,” by Robert J. Wicks
- “Reducing Compassion Fatigue, Secondary Traumatic Stress and Burnout: A Trauma-Sensitive Workbook,” by William Steele
- “To Weep for a Stranger: Compassion Fatigue in Caregiving,” by Patricia Smith
- “Trauma Stewardship: An Everyday Guide to Caring for Self While Caring for Others,” by Laura van Dernoot Lipsky with Connie Burk
- “Victim Advocate’s Guide to Wellness: Six Dimensions of Vicarious Trauma-Free Life,” by Olga Phoenix
Podcasts and Videos
- Child Welfare Information Gateway podcast, Episode 4: “Secondary Traumatic Stress” External link
- The Compassion Fatigue podcast series
- Coroner Talk podcast: “Secondary Traumatic Stress–Getting Through What You Can’t Get Over”
- Noggin Notes podcast: “Surviving the Storm: Vicarious Trauma”
- Therapy Chat podcast, Episode 24: “Vicarious Trauma and Secondary Traumatic Stress”
- Therapy Reimagined podcast: “Managing Vicarious Trauma”
- Ted Talk: “How Can We Support the Emotional Well-Being of Teachers?”
- TEDx Talks: “Drowning in Empathy: The Cost of Vicarious Trauma”
Social worker Stephen Cummings writes in The New Social Worker that these apps encourage meditation:
- Calm: Helps reduce anxiety, build self-esteem and experience the other benefits of meditation.
- Headspace: Provides meditations to help with concentration, mood, stress and anxiety.
- Insight Timer: Provides guided meditation without a subscription fee.
David Rebedew, MD, wrote in The American Academy of Physicians journal FPM that these exercise apps support a more active lifestyle among patients:
- C25K (Couch to 5K): A free program to help inactive patients raise their cardiovascular stamina by running or walking.
- Charity Miles: Offers walking incentive by converting miles walked into money for the user’s charity of choice.
- Zombies, Run!: Combines role-playing game with a story to motivate users to run more and faster.
Fact sheets and websites
- “Exercise for Stress and Anxiety” web page, Anxiety and Depression Association of America: Suggests how to start an exercise routine and exercise in cold weather.
- “Self-Care: Including Yourself in Compassion” fact sheet (PDF, 122 KB), World Trade Center Health Program: Explains how different activities and regular practices improve wellness.
- “Taking Care of Your Emotional Health,” CDC: Lists signs of distress and how to cope during a disaster.
- Your Healthiest Self: Wellness Toolkits, National Institutes of Health: Helps identify ways to improve well-being in multiple areas, including mental health.