Ah, vicarious trauma.
Those two words weren’t put together for a very, very long time. As a therapist, sometimes there’s pressure to leave work at the door and go about your day-to-day life unscathed by everything that you witness and experience. Well, that’s BS. Honestly, sometimes I’m left feeling hopeless, anxiety-ridden and just so, so sad.
How could you not experience an unpleasant emotion (or 12) after sitting with someone while they describe painful memories, thoughts and experiences? How does it not tug on your heart strings? I had a few moments while working at the trauma center when I felt myself mentally check out while someone was engaging in their trauma narrative. At first, I didn’t understand it. I felt like a failure and I automatically blamed myself. I questioned my ability to be a therapist who suffers from anxiety, panic and depression.
What I realized, after lots of soul searching and supervision, is that mentally checking out was my brain’s way of protecting itself. The stories I was hearing were filled with so much pain and betrayal and I wasn’t sure how to process all of it. I could physically feel their pain. I started to get dizzy and nauseous before and after each session. I was carrying everything that they said and everything that I felt around on my shoulders and wasn’t giving myself space to be hopeless, anxiety-ridden and sad.
Sitting with someone in the trenches isn’t easy and it can become increasingly difficult to pull yourself out once the session is over. When you’re stuck and unable to process, home doesn’t feel quite like home. Things that you love begin to fade into the background. I remember my bed becoming my best friend and for anyone who knows me, you know I’m not one to lounge and stay in bed for hours on end. I’m always on the go.
As I grow personally and professionally, I realize that I have specific things that trigger me and impact me more than others. I have a pretty good routine that I engage in before and after every trauma-filled session. I do my best to express myself by sharing my thoughts and feelings with people who I love and trust. I attend weekly individual and group supervision. I work for an organization that supports self-care and promotes mental health days when needed.
But, lately it’s been really hard. I’m finding it difficult to engage in my typical self-care activities. I’m feeling drained and unable to focus on my guided meditation, positive affirmations and deep breathing practices. I’m finding it difficult to keep up with this blog, which hurts to admit. My heart is aching and it’s tough to come out of.
I’ve been noticing that I’m extra sensitive when a client discusses a traumatic experience that involves substance use. My hands start sweating and my mind starts wandering. That’s my clue that I’m being triggered and that I need to check myself.
I recently experienced a death in my family that involves a long history of mental health and substance use. I keep hearing stories that are very similar to what my brother-in-law went through. I’m hearing stories that are traumatic in nature and now there’s an added layer of sadness that comes along with it. He went through so much and suffered for so long, just like my clients. He ran away from every trauma reminder that he faced. He would always tell me that it was easier to run and numb himself than face the people and the memories that hurt him so deeply.
So, when I hear something similar being said to me in session, I’m brought back to the exact moment he opened up to me for the first time. I’m reminded of the feelings that I felt and the thoughts that were crowding my mind.
Not only am I experiencing an added layer of pain, but I’m noticing my frustration with failing systems even more. Our justice system, or school system, our mental health system. I’m not saying all of it is bad. But, I know that a lot of systems failed my brother-in-law. The people who watched my brother-in-law slip through the cracks are the same people who watch my clients slip through the cracks. As you can see, this brings up a lot.
I could go on and on about him and what happened, but that’s not the point of this post. I just wanted to share this part of my life for two reasons:
Maybe it’ll help you feel less alone and instead, deeply understood.
We are all human first. We have our own painful memories to face just like our clients do. We will all reach a point when we are triggered and re-traumatized by something that someone says or does. I don’t have all the answers and I don’t have a list of coping strategies that are guaranteed to work. But, I know what keeps me going. I know what sets my soul on fire and I hold it really, really close to my heart. As always, thanks for reading and for providing me with a safe space. Engaging with you folks is part of my self-care now.
Wishing you all love and light.
Sometimes I wonder if I’m not a little bit of a masochist. But before I go on, I want to be very clear about a few things:
First and foremost, I do NOT blame my clients for the way I feel and how I am impacted by my work. I want to blame the people who hurt them. But I also know that even those people most likely learned how to hurt from someone else hurting them. I don’t know who to blame, and I give myself permission to be enraged anyway, by the perpetrators of violence who hurt the people I care for. Because in the moment, when I’m with my clients, I really don’t give a fuck where their perpetrator(s) learned how to hurt. All I know is that they hurt the person I’m with, and I see them hurting. And that’s not fucking okay.
None of it is.
So, like I said, I sometimes I wonder if I’m not a little bit of a masochist. Like Silas in The Da Vinci Code. I mean, only CRAZY people would choose to get into this field, am I right? We see so much horror and so much suffering, yet we choose to keep coming back. What makes it different though, is that I don’t come back time and time again for the suffering; I come back for the resiliency and commitment to justice. As I’m sure most of you do too.
I’d like to think that doing the right thing is showing up to right a wrong, even when it’s scary to do so. Not to mention wayyy complicated. And messy. And not at all what you thought it would be.
That has been my experience being in the trauma field. And I’ve said it since the beginning: I’m a lifer, and I’m never going back. This is where I’m meant to be, and this is what I was called to do. It called to me, and I answered, ever since I was a little kid.
I remember being really young, like seven or eight, and reading reports and memoirs about girls who were raped. I remember feeling sick to my stomach, but not stopping. I had to keep reading. I was morbidly hypnotized by the notion that this was actually going on and curious about how it started even happening to begin with.
I’ve always been drawn to those who suffer. It started with animals. Since I was maybe five or so, I would draw intense pencil drawings of wild animals yearning to be free and escaping their torturous lives. I read as many Zoobooks and library books on animals as I could get a hold of, and these were what informed my awareness of their plight. Looking back, I can see that I was already a vegan and advocate at a young age.
I’ve been actively in the trauma field as a practitioner since my senior year of college when I interned as a case manager in a domestic violence program. I still remember a case involving child pornography that didn’t get picked up by DCFS, no matter how many times I called them, and that was the most traumatizing part of all in that time of my life; the inaction. The injustice. The systemic let-down and failure to protect and serve victims.
I felt sad and confused. And also incredibly GUILTY. Because I had to report it as a mandated reporter, I ethically also had to tell my client, even though nothing resulted in it. My client was distraught. And that’s when I felt ashamed. Ashamed that I shared the same professional title of the people who denied our (yes, our) report of abuse: social worker.
I have since then learned more, and now know better, that this is not my fault, but, at the time, it felt so awful. And it still does when situations like that one happen, but not because I feel guilty; because I feel enraged at the victim-blaming and oppressive features of our justice system that keep people in power in the safe zone. And anger, to me anyway, always feels better than sadness. With anger, I can act. With sadness, I am paralyzed. But, without getting too ahead of myself, I also know now that there are other ways to cope. But I’ll get to that later.
In grad school, I interned as a therapist at a rape crisis center. It would have been helpful if my grad program had talked about vicarious trauma. Because it was during this time that I developed PTSD.
Something clicked during that time of hearing so many horrific stories that hadn’t before: that these things could happen to anyone. That strangers could break into your house without you knowing it and hide in your closet. And then come out while you’re sleeping and rape you in the middle of the night when no one else is around to hear or see you.
I became hypervigilent. I began checking my closet at night and double/triple-checking to make sure my windows were locked. It feels so wrong to say, but I had been “lucky” to not have had those experiences personally. It had never been something I’d had to worry about before. And being exposed to purposefully human-caused atrocities, specifically intimate ones like sexual violence, made it so so real.
I’ve always been a protector. Whether it was at home or as a defense on the soccer field. It’s in my blood. I always make sure I walk on the side next to the street and keep the person I’m with on the inside. It’s just in my nature, and these experiences in being immersed in sexual trauma exacerbated them.
Not to mention that I have OCD, specifically the symptom with intrusive thoughts of disturbing things. Add images of rape and torture into the mix, and I was flooded. I was drowning.
It didn’t help that my school put me on a performance contract because I started to suffer academically. Yes, a contract. I even took the chance in being vulnerable and sharing with my field liaison (field seminar professor) that I didn’t feel okay mental-health wise and I needed help. Instead, she put me on a contract, which stated that if I didn’t increase my productivity as well as attend mandated therapy (no resources were given by the way), I would be kicked out of the program.
To say that I felt betrayed, weak, and invisible doesn’t even convey what message that sent to me. It wasn’t until I got a new supervisor at my internship that I finally learned about vicarious trauma. I specifically remember the conversation. I asked her, “I keep seeing floating penises everywhere. What does it mean?” Her response was, “That’s something survivors of sexual abuse experience.” And it all clicked into place.
That’s how powerful not talking about this is, but more importantly, how powerful NOT SUPPORTING people in our field is. And it can lead to much, much worse things. People who were survivors of trauma (whether primary or vicarious) who die by suicide don’t die from suicide; they die from PTSD. That should be the stated cause of death.
We have to talk about this and not shun it away when people have the courage to even subtly or vaguely HINT at it, let alone say it in it’s full disclosure. We can’t be afraid of it. People freak the fuck out, only thinking of themselves from a liability standpoint. How fucked up is that?
Since becoming a supervisor six years ago, I’ve been able to move through my own healing. I give my interns and staff the space to process and identify their experiences in a safe, supportive space. I not only give them permission to be vulnerable and honest, but also normalize it. And help them cope, guiding them through this field we both love and hate so much.
I still see clients and still do trauma psychotherapy, as well as have a management position. People who stop working with clients seem to get out of touch and lose their understanding for what this feels like. Like many, I don’t want sympathy. I want empathy and solutions. And that’s 100% legitimate.
Being exposed to people’s suffering can be so painful. Images of the aftermath of being physically hurt aside, is the overwhelming feeling of HELPLESSNESS. I feel this the most with victims of active domestic violence and people who are homeless. Which are most of my clients now.
Homelessness is not only painful because of the extreme vulnerability these people are in, but also because of the systemic barriers in them accessing care and basic human rights. It feels like a fight sometimes and not a process to help someone get housed. And there’s something very wrong with that.
I won’t even go into the stigma and ignorance surrounding homelessness and people who have untreated mental illnesses. It would just be too much for right now. But it’s certainly something I take pleasure in educating people on.
What happens a lot in the homeless field, in particular, is death. I’m not gonna sugar-coat it. If you aren’t already familiar with The ACES Study, I encourage you to look it up (bottom line: trauma can kill). Death of clients happens frequently in my field. I lead a death debrief just two weeks ago. Talk about guilt and sitting with that.
The truth is that there is more we don’t have control over than we do. And we really feel the weight of that during moments like these that literally took someone’s breath away.
Similarly, working with clients who are so stuck in the cycle of domestic violence, as well as their own historically un-nurtured complex trauma histories, is what has been most recently challenging for me.
I’m a trauma specialist. I get the dynamics, I understand where the cognition come from, unhealthy and damaging as they can be. Doesn’t make it any easier. Even as a supervisor and licensed clinician, I’ll still be the first to say that it fuckin sucks to see. And I tell my staff the same thing.
Alongside just processing what this feels like, I also try to emphasize what we do have control over. Even if it’s just showing this person what respect and nurturing look like; what a secure attachment style looks like. Corrective experiences, to me, are what are most healing.
Because only a healing relationship can heal a relational trauma. You can do as much CBT as you see fit, but what it really comes down to is THE RELATIONSHIP.
That’s the basis of this whole thing.
That being said, here are some things and thoughts that help me when I’m feeling overpowered by adversity:
1. Corrective experiences are real and powerful. They will literally build new neural pathways and allow someone to experience safety for the first time.
2. I have limits. Even though I will do whatever it takes to help someone, I accept that I don’t have control over everything.
3. I can only do my best. I can’t do everything, but I will do my best in the capacity I have.
4. Vent. Vent. Vent. Debrief with your colleagues, even if you’re not searching for a solution. The validation you’ll get is relieving in and of itself.
5. Give yourself permission to take breaks. It’s not selfish to walk down to the coffeeshop, buy a pastry and chai latte, and scroll through celebrity gossip websites for 15 minutes.
6. It’s healthy to engage in totally shallow, bubbly stuff. I love Say Yes to the Dress. And Ryan’s Roses. And online shopping. And I don’t care! It’s a stress reliever to not be SO INVOLVED and GO DEEP all the time.
7. Escapism isn’t a bad thing. Read that sci fi/fantasy novel, watch that rom com movie. More often than not, it actually allows us to process our own stuff in an indirect, non-threatening way.
8. Get perspective back with the natural world. Sometimes I need to feel physically small to reign in my overwhelming emotions. And nothing else seems to do this like hiking in my mountains, looking up at the stars at night, or imagining orbiting over Earth. Everything that seems so loud suddenly becomes quiet.
9. Create and protect your soul-time. Whatever and wherever that may be, and it can be fluid. For me, it’s sitting on my balcony and just drinking in all of my senses: the green of the trees, the chirping of birds, the snugness of my round plush chair, the taste of cinnamon in the warm coffee mug that’s in between my hands. It’s sacred. And so needed.
10. Spend time with innocents. For some, it’s kids, for others like me, it’s animals. They reinstall a sense of wonder, joy, and tenderness that often gets lost in this work. Snuggles and evenings with my kitty are the best. It never ceases to amaze me that a creature so beautiful, wild, and precious allows me in.
11. Hugs from people I trust and love. One of my love languages is touch. And in a field where touch has been twisted into an evil, traumatizing thing, I need to reclaim that by holding and being held by people I have a loving relationship with.
12. Asking for support. Whenever I’m having a bad or off day, I ask for what I need. This can be a heart-to-heart with a friend, a verbal pukage to my supervisor, a fun date night, a day off, etc. As long as I do what I need, not avoid what I’m scared of.
13. I’m doing more than I think, and I’m helping more than I give myself credit for. It’s not elitist. It’s being loving to myself.
14. Be kind. I love that country song “Humble and Kind” because it’s so true. There are a shit ton of bad people in this world, but they also get more air-time. The people who do good to others and lead meaningful lives are too busy being in the moment to get the spotlight. Don’t lose your kindness toward others just because of the shitheads in the world. They don’t deserve you, but the good people do.
15. Get rid of the judgy. Embrace morbid humor and realize that sometimes we have to laugh to keep from crying. There’s a difference between humor and bitterness. And we need the former to survive this chaos.
16. Know the difference between alone time and isolation. Alone time regenerates your energy. Isolation keeps you from gaining any energy at all.
17. Treat yourself well, don’t compare, and don’t shame. Let yourself enjoy the roof over your head and the things you have; your clients would want you to, just as they would.
18. Join or be part of a cause that takes action. Whether that’s in-person or online. It’ll make you feel like you’re moving the world forward.
19. Accept that you will be changed by this field, and nothing can stop that. And if you don’t want do, it’s okay to pick something else. And if you stay, know that the kind of self-changes that happen are also making you into a stronger, resilient person.
20. Give yourself permission to let go of people and activities that no longer make you a better person. Surround yourself with people and activities where there is a 50-50, back-and-forth, regenerative flow. No one is perfect, and we all have flaws, but not everyone is meant to be with you for every chapter of your life. Find the ones who should be in this chapter and cherish them.
These are just some things that help me experience meaning, healing, and joy. Because in the trauma field, or whichever field you’re in, you have to put on your own oxygen mask first before you can help the person next to you put on theirs.
There’s a reason I say “we” here more than “I”. Because healing takes community and integration. Not isolation or segregation. We all have a story to tell, and all of our stories matter. Don’t for one second think yours is less-than. We all have things to offer and contribute to this world and the creatures in it. And we can only do that if we take care of ourselves and nourish our spirits.
We’re here with you. We love you. And you’re not in this alone.
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