Secondary trauma
You can think of secondary trauma or vicarious trauma as the negative changes that happen to humanitarian workers over time as they witness other people's suffering and need (Pearlman & McKay, 2008). It refers to the range of negative effects associated with cumulative exposure to clients' experiences of trauma.
This type of trauma can affect a wide range of professionals. It is a process that unfolds over time and is the cumulative effect of contact with survivors of violence or disaster, or people who are struggling (Ibid.; Saakvitne & Pearlman, 1996). Secondary trauma can be an occupational hazard for providers who are repeatedly exposed to clients' experiences of trauma.
When providers experience secondary trauma, it can change their assumptions and beliefs about themselves and the world in a number of ways.
Frame of reference
Identifying too closely with clients' situations of helplessness, horror, sadness and cruelty disrupts providers' frame of reference, comfort zone and basic beliefs that people are good and the world is safe.
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Safety
Service providers feel a loss of safety due to so much knowledge about how others take advantage of vulnerable people.
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Trust and dependency
Service providers become aware of violations of trust and the way clients can become dependent on abusive people.
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Power
Service providers may identify with clients' feelings of helplessness and powerlessness, taking on those feelings—to the disadvantage of clients.
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Independence
Service providers may feel their own freedom of movement is restricted by awareness or fear.
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Esteem
Service providers can develop the perception that people are “bad” because of exposure to the malicious and cruel behaviour of others.
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Intimacy
Service providers can feel increasingly alienated and estranged from those who don't do the same kind of work.
As seen earlier, the more aware providers are of the details of their clients' traumatic experiences, the greater their chances of developing secondary trauma.
Risk factors
Why do some people who work with trauma survivors experience secondary trauma, while others do not? The risk factors for experiencing this type of trauma can be grouped into three categories—personal, work-related and other psychosocial factors—as shown in the chart below.
- Personal
- Work-related
- Other
Signs and symptoms
How do providers know if they or someone they know are experiencing secondary trauma? The signs and symptoms derive from a number of different domains, some of which may overlap.
The most important ones include the following:
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Denial of clients' trauma
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Over-identification with clients
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No time and energy for oneself
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Feelings of great vulnerability
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Feelings of alienation
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Social withdrawal
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Disconnection from loved ones
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Cynicism
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Feelings of insecurity
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Increased sensitivity to violence
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Generalized despair and hopelessness
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Changes in identity, world view, spirituality
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Changes in sensory experiences (e.g., intrusive imagery, dissociation)