Secondary Trauma
It's very common
Today, we will begin our first of what will be many Wednesday health articles based on current research. Today’s focus is on secondary trauma. Secondary trauma is the result of being exposed to the trauma of others. This takes place through conversations, through the media, and when working with those who are experiencing trauma. Frequently referred to by clinicians as secondary trauma stress, it has recently become recognized as a form of posttraumatic stress disorder in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). (Link for the Spanish version found here).
What is Secondary Trauma (ST or STS)?
Direct or indirect exposure to traumatic experiences has been frequently identified in those who work in the psychiatric field. It has been commonly referred to as vicarious trauma, compassion fatigue, or even burnout. McCann and Pearlman (1990) identified it as having long-term effects that can be ‘disruptive or painful,’ which for some can last many years. Figley (1998) found that these effects were considered common in those who have either witnessed a traumatic event or even by becoming aware of a traumatic event. The transference of the trauma, is something I have also coined in my book “RootEd: How Trauma Impacts Learning and Society” as a form of ‘abuse hot-potato.’ Only in my book (found on this Substack for paid subscribers $7/month or $70/year), I was referring to the way in which abusers end up creating a cascade of abuse. As one person abuses another, the abused then pass it on to the next, and then the next, and so on. The phenomenon has even been coined in memes on social media. Frequently depicted as the boss yelling at the employee who then goes home to yell at his wife. The wife then yells at the child, and the child then yells at the dog. Only with ST or STS, the person traumatized wasn’t actually a victim of abuse. They were a mere observer. This reinforces how important it is that we address the sources of abuse to begin with (which is also addressed in “RootEd”).
Described by the American Counseling Association (2010) as ‘emotional residue of exposure,’ they have come to define it as a direct result of exposure (visually or auditorily) to pain, fear or trauma that others have endured.
Who Is Most At Risk?
The complexity of our world makes it quite difficult to live a life absolutely devoid of secondary trauma. This is especially true if your media sources are constantly priming the population with fearful information. In daily conversations, you may hear about something horrible happening to someone you know or someone you are familiar with. You may work in an environment where those you serve have experienced tremendous trauma (medical facilities, psychologists/psychiatrists, counselors, school systems, university systems, social services, or nonprofit workers to name a few). The desire to help and make a difference is an important social need for the welfare of our communities. However, it also comes with a cost.
Maslach (2015) has also reinforced that those who work in front-line emergency fields or those who work therapeutically with individuals who have experienced trauma are prone to the phenomenon. Potential risk has been identified with those who work in fields such as police officers, military personnel, emergency healthcare, rescue workers, counselors and therapists (Brown, 2017). Many more researchers have since identified that those who work in the helping professions are equally at risk. These include humanitarian workers, suicide helpline workers, social workers, healthcare professionals, faith leaders, justice system workers, and journalists (Figley, 1998; Day et al. 2006; Shah et al. 2007; Rafferty 2004; Pryce et al. 2007; Sansbury et al. 2015).
I can speak from personal experience that teachers are absolutely just as exposed to these types of traumas not just outside of the school, but inside of the school. In my past teaching experience, we had scenarios where staff were assaulted and hospitalized by students, students are also frequently abused in what some schools think is necessary by putting them in isolation chambers, cutting them off from all of the population, or even expelling them from school (which may be the safest place they have to be). Teachers without proper awareness of what trauma looks like can frequently assume they should be fearful of these students and this honestly escalates the situation. I have many experiences working with gang members and imprisoned youth to know exactly the types of behaviors that occur, and I know from experience that the only way to have a safe environment is to never demonstrate any fear, nor to demonstrate any dominance. You have to remain steady in the face of all manner of situations that may have your heart beating and your head sweating, but don’t let them know that. You have to remain stable. They are used to people fearing them as this gives them the understanding of whether YOU are safe for them. Being unmovable is no small feat, but if you can accomplish that, you will have absolutely loyal students who will do the work and make sure everyone else does it as well. That does not mean that dealing with that wasn’t hard on my health.
What Does This Look Like in Society?
Unfortunately, due to the sheer numbers of people who work in the helping fields as well as the huge numbers of people experiencing first-hand trauma, the numbers (although not statistically counted) are likely quite large. From what I gather, this can only mean a large society with a lot of abuse hot-potato going on. All one needs to do is look around you to see the behaviors of the population. Then you can add the manipulation of fear and panic in the media, and you have a recipe for disaster. Many will shove things under the rug and pretend it doesn’t exist. Many will refuse to help or be exposed to anyone who has experienced trauma (which actually re-traumatizes the victims). Others will manifest fight or flight behaviors (I see many of you pulling our your Karen labels and also dismissing the mass shooting incidents as isolated mental illness - oh right, schools have regular mass shooting drills - another perfect STS activity). Now that I pointed out the mass shooter drills in schools, I am immediately taken back to when I was in 5th grade, in 1984. Our school did a pretend “real” fire in our school where they brought the fire trucks and everything. They had fake victims that were taken in the ambulances and we all thought it was real. I’m 50 now. I still remember that. I was traumatized that day. It has impacted me and stuck in my memory for a huge chunk of my life. It’s not the only trauma I’ve endured, but it was definitely one of those examples of “a safe trauma meant to teach you” that honestly, I think wasn’t necessary.
What Do You Do?
I have worked with many schools as well as with hundreds of nonprofits. I’ve seen the STS on a very regular basis. I see a lot of people acting like they are just fine when it is very clear that they are not fine. Many put on facades of positivity, but then go home and cry. Others are dealing with direct abuse that they never speak of because they fear that no one will believe them. Many are told to go on anti-depressants and everything will be fine. I’m not personally a fan of masking trauma. It does not heal it nor does playing kum-bah-yah cure it. Utilizing dissociation, escapism, fake positivity, drugs, or aggression to cope is nothing but non-stop trauma response that will not only continue to harm the person experiencing it, but also those around them. I’ve seen some go into fantasyland woo-woo escapism and it deeply terrifies me because I know that isn’t sustainable. They think that cutting off the world will cure them. Even the monks in Buddhism who isolate are not living in some fantasyland. They are forced to deal with all of their previous baggage and come to learn how to manage the struggle so that they aren’t suffering anymore. They aren’t living in comfort. They don’t have everything provided and they know that they have a responsibility to their fellow monks and to the people they meet. They do not escape the harsh realities of the world. They learn how to be with them. How to be with them and how to overcome the struggle.
In My Research & Practice
In my research and in practice, I have found that you have to start identifying patterns so that you are not taking the information into yourself personally. You can witness what you see or hear. You can even witness what you feel. You can pull yourself away from those feelings and observe. In observation, you are better able to identify why it is you feel that way. It may be the result of abuse or trauma, or it may be that the world is so full of secondary trauma that you feel like you cannot escape. The most important thing that you can do is learn how to not internalize it. Learn how to observe it. Respect it, honor it, and stay with it until you are ready to release it. If it comes back, then spend some time with it.
Trauma needs to be heard and it needs to be released. You can’t ignore victims nor is it good to pass it on to others so it is off of you. When you learn the predictable behavior patterns associated with abuse, you are better able to navigate them when people try to do them with you. There are many people who are subscribing to the narcissistic abuse cycle and many may not even be fully aware of what they are doing. It is just what they are familiar with. Do not allow them to abuse, but you can also help redirect them so they can learn alternative ways to address the reason they feel they need to manipulate. Manipulation is definitely rooted in trauma and fear. Sure, sometimes it really is pathological, but that could also very well be epigentic trauma (see “RootEd” for more information on that). The most important thing we need to learn is how to stop the transference of trauma from one person to another. That may mean you are the one that has to witness it, transmute it within yourself, and stop the passing on of more trauma.
References
American Counselling Association. (2010) Fact Sheet #9. Vicarious trauma. Retrieved September 26, 2023, from https://www.counseling.org/docs/default-source/trauma-disaster/fact-sheet-9---vicarious-trauma.pdf?sfvrsn=f0f03a27_5
Brown, S. (2017). Burnout…the high cost of caring. Therapy Today, 28(9), 8–11.
Day, J., Vermilyea, E., Wilkerson, J., & Giller, E. (2006). Risking connection® in faith communities: A training curriculum for faith leaders supporting trauma survivors. Baltimore, MD: Sidran Press.
Figley, C. (1998). Introduction. In C. Figley (Ed.), Burnout in families; the systemic costs of caring. Boca Raton, FL: CRC Press.
Maslach, C. (2015). The cost of caring. Los Altos: Major Books.
McCann, L., & Pearlman, L. (1990). Vicarious traumatization: A framework for understanding the psychological effects of working with victims. Journal of Traumatic Stress, 3(1). https://doi.org/10.1007/BF00975140.
Pryce, J., Shackelford, K., & Price, D. (2007). Secondary traumatic stress and the child welfare professional. Chicago: Lyceum Books.
Rafferty, J. (2004). Interviewing: The unspoken compact. In M. Smyth & E. Williamson (Eds.), Researchers and ‘their’ subjects: Ethics, power, knowledge and consent. Bristol: Policy Press.
Sansbury, B., Graves, K., & Scott, W. (2015). Managing traumatic stress responses among clinicians: Individual and organizational tools for self-care. Trauma, 17(2), 114–122.
Shah, S., Garland, E., & Katz, C. (2007). Secondary traumatic stress: Prevalence in humanitarian aid Workers in India. Traumatology, 13(1), 59–70.