Vicarious trauma, also known as insidious trauma or secondary traumatization, happens when people who did not immediately witness the traumatic event still integrate certain aspects of it into their being. This is frequently mistaken for compassion fatigue or burnout as several symptoms are similar, such as lack of empathy or exhaustion.

Anyone is potentially at risk of vicarious trauma, although some occupations might increase the risks. These include:

• Law enforcement
• Counsellors/therapists
• Emergency service workers (including phone operators)
• Social workers
• Lawyers and other workers present during court cases

People who have a close relationship with a trauma survivor can also experience secondary traumatization. This doesn’t have to be a romantic relationship; it could be a friend, colleague, or student.

It’s possible that people who work with trauma could set themselves up for lasting nervous system dysregulation because of the way they are expected to respond in a professional context.

Our nervous system governs our response to danger. Our intellectual selves, or human brains, don’t get a say in how our limbic system or mammalian brains respond to danger. All animals except humans will obey what their threat response tells them to do:  fight, flight, or freeze or fawn. Once the threat is over, they’ll shake to release the pent-up energy.

However, in a professional context, therapists and others who work in this field have to conduct themselves in a certain way. Although they may have had a bodily response to something they hear, they have to appear neutral.

Humans can overpower their physical threat response with the most developed part of the brain,  the neocortex.  However, if the trauma response is not processed properly and the energy isn’t discharged, it remains dormant in the brain until it is triggered, setting the stage for traumatic events to have lasting consequences.

Signs of Vicarious Trauma

The mental and physical signs and symptoms of vicarious trauma can be almost identical to direct trauma. They can be emotional, behavioral, somatic, cognitive, and spiritual, and include:

• Nightmares
• Intrusive thoughts
• Loss of connection
• Suspicion of others^[1]
• Depression
• Hyperarousal
• Overwhelming feelings of futility
• Shortness of breath^]
• Heart palpitations
• Numbness
• Loss of hope
• Increased isolation
• Anxiety

Vicarious trauma is well-recognized in medical literature – the Diagnostic and Statistical Manual acknowledges that repeated exposure to aversive details of trauma is enough to cause PTSD.

PTSD and other trauma-related conditions present differently in everyone, and there is no exhaustive list of warning signs as our responses are always unique. If you’re concerned that you might be experiencing vicarious trauma, getting a professional diagnosis is always the best approach.

Preventing And Treating Vicarious Trauma

If you frequently encounter trauma in your employment, you need to be working reflectively, engaging in self-care, and receiving trauma-informed professional supervision.^[3]

Just as there are many ways that vicarious trauma can present in us, there are many different ways of approaching it. If you’re working within an institute that provides some form of trauma-related service, they have a duty of care to create policies that facilitate well-being; however, reaching out for treatment for vicarious trauma lies solely with the individual.

Treatment for vicarious trauma is similar to that of direct trauma – we need to complete the unfinished reaction stored in our bodies and reframe how we see events in our past. Some effective modalities to support this are:

• Sensorimotor psychotherapy
• Somatic experiencing
• Lifespan integration
• Internal family systems (IFS)

It may also be helpful to engage in training around work-life balance, boundaries, and self-help to prevent future occurrences. Making sure that you get enough sleep, eat healthily, and socialize can all bolster our mental well-being and resilience too.

It’s important to remember that if you are experiencing vicarious trauma, it is not a reflection of your professional ability. Just because you work with trauma, you’re not expected to be immune to it. It’s normal to have an emotional response to certain things – it’s what makes us human. Getting treatment for vicarious trauma will enable you to do your job unencumbered by the past, make you more resilient, and support your work.