• Self Care: The Clinician's most CRITICAL tool?

    In the role of witness to acts of violence, the therapist feels, at times, overwhelmed and experiences, to a lesser degree, the same terror, rage and despair as the client - Herman 2001.

    I'll admit I don't always understand what people really mean when they say "be kind and gentle to yourself" as a way to relieve stress. And that's just me coping with day-to-day life on life's terms.

    For those of you who work in the caring professions - a day's work means an average of seven hours, working with others in distress - to try and assist them in overcoming their struggles and painful experiences.  This must inevitably take its toll, and that is how clinical supervision can help.  But things must get particularly difficult and precarious when exposed to the lives of those who have experienced significant traumatic events.

    Many of you working in the helping professions, are regularly secondary witnesses to trauma. Whether you are a therapist, police officer, pastoral worker, youth worker, paramedic, medical professional - whatever your role, your work will inevitably involve witnessing and listening to people’s experience of trauma.

    As you listen to your clients tell about their trauma of incest, rape, domestic violence, alcoholic families or memories of childhood abuse, you bear witness to their victimisation. And as empathetic beings, simply through being in relationship with others who’ve had hard experiences, it is common to experience increased anxiety, depression, hopelessness, or general shifts in your beliefs and experiences about the world. You may find you have collected bits and pieces of accounts of trauma; you may even have pictures in your mind or intense feelings running through your body. Simply by being present and listening, those in the helping professions become a witness to rape, child abuse, domestic violence and death...

    In simple terms, this is vicarious trauma.

    We are becoming more and more accepting of the belief that the origins of an enormous number of mental health problems lie in traumatic experience. Consequently, working in a trauma informed way, and the subsequent risks of vicarious trauma are almost unavoidable. The most important part of coping with the intensity of the work is to acknowledge this work will affect you. Recognising that it is "normal" to be affected by this type of work is the number one coping skill to manage it. It's reasonable to feel outraged, horrified, shocked, saddened, or vulnerable.

    Coping with the feelings and reactions to your clients' trauma is the next step in addressing vicarious trauma. People deal with crises and trauma in different ways. Some may be textbook productive others may veer toward a more destructive, unhealthy and unproductive response or strategy. Often this in itself can be dictated by the individual’s level of wellbeing/burnout. It is a constantly shifting surface, which takes vigilance to manage.

    To minimise the potential for Vicarious Trauma to become a problem, professionals need to:

    • Acknowledge and recognise their own vulnerability to the exposure to trauma
    • Find a healthy balance in how to cope with the effects of vicarious trauma and the repeated invasion of trauma on both the personal and professional life. 
    • Recognise the warning signs when work or a particular case is consuming their thoughts, workday, or personal life.
    • Recognise the symptoms of Post Traumatic Stress Disorder (PTSD) as they can impact 'the helper' as well 
    • Acknowledge they are not immune to nightmares, hyper-vigilence, avoidance, or a preoccupation with the trauma.
    • Understand the basics of the neurophysiology and somatic experiences of trauma and vicarious trauma
    • Actively practice self-awareness and self-compassion
    • Build inner resiliency
    • Identify personal areas of challenge or vulnerability to stress
    • Have a clear plan for self care and follow through with it
    • Know when to seek support

    Saakvitne, et al., 2000

    Pearlman 2003

    Pearlman & Saakvitne, 1995

    In September, ZHUCHI is hosting a two day workshop with one of Australia's leading trainers in Vicarious Trauma - Naomi Halpern from the Delphi Centre, Victoria. This training is a must for any professional in the helping fields and will provide the essential toolkit to manage VT now and in to the future of their personal and professional life. Click here for details.

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