Vicarious Trauma to Vicarious Transformation

A big part of my clinical work with people is focused on trauma – helping others respond, individual healing, and relationship repair after a traumatic event. As a result, I am frequently asked about how I stay positive and hopeful in the work that I do. In other words, how do I avoid vicarious trauma (VT)?

People will hear that I support others who have experienced really horrible things, or endured hurtful actions from their own family, for example. I’ve learned to cautiously answer the question, “What do you do for a living?” as it tends to shift the mood of the conversation.

Common questions I hear:

• How do you not get filled with despair when you hear all that hurtful stuff?
• Don’t you just start to hate some people?
• Do you ever feel like it is just pointless to try to help?
• Wow, do you have a martyr complex?

The honest answer to some of these questions is a qualified “Occasionally.” However, I don’t say that because that is only 5% of my answer. There is so much more to what this work means to me and how it has impacted and shaped me over the years. Now, I can honestly answer that this work has actually made me more hopeful – I am more appreciative of humanity in all its diversity and more realistic of what I can and cannot do.

What these questions are touching on are very common experiences of people working with others’ trauma (some of the time). One of the key things that started to allow me to build a prevention toolbox for myself to ward off the negative impacts of trauma work was to have a way to understand them when they showed up.

Shortly after I started working in the field of family violence, I started feeling physically sick. I was anxious about some of my clients, and then started having dreams that included the stories I was hearing during the day. A seasoned coworker listened thoughtfully as I described this very confusing shift in my state of well-being. She told me, “Yes, it happens to the best of us. There’s a name for that – you’re experiencing vicarious trauma.”

I felt a surprising sense of relief when she said that. Only then did I realize how guilty I was feeling for the negative thoughts and lack of energy. I was also getting a little worried that this job was really changing me and changing who I would be in the future. I wondered if I was cut out for it, or if I had what it takes to do it well.

What my colleague helped me understand was that I was passionate about the work, and the fact that I poured so much of myself into it was also what made me vulnerable to the vicarious impacts from it. This conversation started my passion for understanding Vicarious Trauma.

Without support or a way to understand and integrate traumatic experiences, the impact can deepen and take on more and more layers.

VT does not show up exactly the same for everyone, but I’ve come to think of it as the grey hairs you earn from doing this work. For some, it shows up early and slowly increases over a long period of time. For others, it happens more suddenly and quickly – bringing noticeable changes fast. The signs may be sporadic, much like looking in the mirror and seeing something different that you hadn’t noticed the day before. Or the signs may be a gentle fading away of something and the slow emergence of something else.

The point is that it’s a natural, inevitable process and outcome of working with trauma. I resisted the idea of VT being inevitable at first (as I did with grey hair). However, over time I’ve come to hold a much more complex and deeper appreciation for the parallel process of being changed by the work that I do and the stories to which I am given the privilege to bear witness.

VT is uniquely different from burnout and compassion fatigue in that it is a layer on top of potential tiredness, desensitization, overwhelm, and loss of motivation. Here’s the thing: we choose to pour our energy, passion, and time into work that is often filled with despair, hopelessness, fear, threat, anger, disconnection, and chaos.

Experiences of trauma are inherently experiences without choice. As we brush up against that experience and feel it in our own bones, we lose the edges of our own sense of choice, control over change, and confidence that we can make a difference. In order to connect in a way that can provide the catalyst for change, we have to let ourselves feel some of this. This affects all different parts of who we are.

Some of the signs of vicarious trauma may be:

• Confusion, apathy, spaciness, and self-doubt
• Anxiety, guilt, helplessness, depletion
• Irritability, sleep and/or appetite changes, compulsive coping
• Loss of meaning, questioning faith or beliefs, disconnecting from others
• Loss of intimacy in relationships, extremes of control with children or partners, loneliness

Note that these are very parallel to the ways an individual is impacted by a traumatic experience.

Without support or a way to understand and integrate these experiences, the impact can deepen and take on more and more layers.  However, if we bring back choice and approach it thoughtfully, the impact can shift into positive transformation. This still ultimately changes us, but I’ve come to believe it may change us for the better.

What if we make “VT” stand for “vicarious transformation”? In contrast to vicarious trauma, the signs of vicarious transformation can be:

• Increased curiosity and openness to new information
• Increased tolerance for the unknown and a trust in the process over time
• Balanced self-awareness, knowing intimately our own vulnerabilities alongside deep appreciation for our strengths
• Profound belief in the adaptability of humanity, and the ability to use choice to make change
• Deepened intimacy and ability to be vulnerable with others, and to respond compassionately to the vulnerability of others

How do we facilitate this transformation?  The strategies are embedded in the transformation itself.

• Build capacity to be curious and open
• Get support to stay regulated in the midst of the unknown
• Be honest with yourself and get to know your own signs of trouble well 
• Be honest with yourself and celebrate and use your strengths
• Risk connecting with others, asking questions and learning about how others grow
• Take good care of yourself and let others help you

These strategies can be easy to list, and they are really just a start. The real work is in embodying them in our day-to-day lives.  This work is humbling, messy, confusing and at times, exhilarating.  If we pay attention, it is inevitable we will get wiser. The grey hairs are our testament to that.

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