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Secondary trauma: a silent dilemma

Secondary trauma: a silent dilemma

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“Trauma fractures comprehension as a pebble shatters a windshield. The wound at the site of impact spreads across the field of vision, obscuring reality and challenging belief.”

– Jane Leavy

A few years ago, I was privileged to facilitate a vicarious trauma support group with first responders, including firefighters, paramedics, military members, police officers, etc., who were receiving treatment for substance use disorders.

These noble persons who repeatedly have put their lives on the line for others were experiencing trauma daily throughout years of service. I will never forget some of their profound statements:

• We see things people should never have to see.

• When I am out with my family, I rarely enjoy it because I am constantly watching out for danger.

• There are just some things that cannot be “unseen.”

More and more research is recognizing the need to address the impact of trauma on professionals and others who may become traumatized by situations they encounter on a day-to-day basis.

Vicarious traumatization, or secondary trauma, is the cumulative impact of witnessing or engaging in the traumatic experiences and terror of others.

It is nearly impossible to witness trauma on an ongoing basis and remain unchanged. Over time, trauma affects one’s identity, beliefs, relationships and psychological needs. This is because trauma always involves loss; and nothing seems normal afterward. People also tend to lose their innate sense of safety and control, and personal values and beliefs might become distorted.

It is essential to address experiences of secondary trauma that might lead to self-defeating behaviors such as substance dependence or mental illness.

Conversing with first responders is an intriguing discussion. Their stamina, passion and competency for the job is unwavering, but there also tends to be this “heavier, lonelier and even darker side” that burdens them.

One challenge in addressing secondary trauma in our communities and in the workplace is silence. A firefighter shared:

“I cannot go into the firehouse talking about my feelings and how the last run or several runs shook me up. I will be told to ‘toughen up; it’s part of the job,’ and may be looked down upon by my peers. I’m definitely not dealing with that!”

The dilemma then becomes to suffer in silence, which is maltreatment for those who put their lives on the line and take unimaginable risks every day.

So, what can we do to effectively address secondary trauma? To continue the silence will only lead to destructive behaviors, and, over time, those who suffer try to escape the tentacles of secondary trauma through addictions, substance use and even suicide. Others find themselves struggling with mental illness, especially major depression or even symptoms of PTSD (post traumatic stress disorder). Over time, someone struggling with secondary trauma might accept their behaviors as “normal” because they become accustomed to them.

Signs that someone might be struggling with secondary trauma include the inability to feel pleasure, shutting down, numbness, hardness, overly vigilant, anxiety, increased use of alcohol and/or drugs, rejecting physical/emotional closeness, cynicism, lack of interest in hobbies, dissatisfaction, hopelessness, negative perception, low self-image/low motivation or depersonalization.

Secondary trauma compromises one’s self-efficacy, and additional consequences of vicarious trauma include, but are not limited to:

• Resentment, trust issues, exhaustion.

• Struggling with self-esteem.

• Social withdrawal.

• Nightmares.

• Avoiding reminders or recall of the events.

• Errors in professional boundaries or judgment.

Understanding how secondary trauma develops is important, because it is not contingent upon one’s ego capacity or self-efficacy to handle difficult situations. Secondary trauma develops as a result of helping others. Secondary trauma is a natural human response of caring and knowing about the traumatic experiences of others.

Secondary trauma is cumulative. Over time, the impact of witnessing trauma is unavoidable, and addressing the effects through self-awareness, self-care, connection and balance is essential. In working through secondary trauma, the objective is to:

1. Become aware of the impact of traumatic experiences.

2. Acknowledge personal vulnerabilities.

3. Apply self-care processes to counter the negative effects of trauma.

Factors that might determine the extent of vicarious trauma that one experiences include lack of resources and/or support; personal traumatic experiences; current life struggles (e.g., finances, divorce); and poor coping skills.

You may ask, “How important is it to focus on vicarious trauma?” When a 911 call is received, first responders are there in minutes when the community needs help, even when it is a false alarm. But there is nothing false about vicarious trauma, and the impact and symptoms are undeniable. In time, vicarious trauma diminishes hope, idealism and optimism; and those who continuously encounter survivors of trauma cannot afford to give up on hope. We have both a professional and personal obligation to address vicarious trauma; and it will be a dilemma to continue the silence.

Meridith T. Graham, M.S., M.DIV, LMSW, is a behavioral health consultant at HopeHealth with experience in mental health issues, including depression, anxiety, grief, sexual trauma, vicarious trauma and other mood disorders. She is a licensed social worker in the states of South Carolina and Illinois.

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