On Tuesday 29 November my students and I watched a DVD about secondary trauma, compassion fatigue and burn out; all conditions that can effect individuals working with clients who have suffered psychological trauma. Those of us who work with children are particularly at risk of developing a reaction - the vulnerability of children and an inbuilt need to protect them from harm can leave us feeling powerless and helpless when faced with a child's distress and suffering.
Secondary Trauma
Secondary trauma is a term used to describe a range of symptoms effecting individuals who attend traumatic incidents where people are killed or seriously injured. Fire fighters, police officers and paramedics are particularly at risk; but individuals working as nurses, doctors, therapists and support workers, caring for traumatised individuals, can also develop the symptoms of secondary trauma. Our ability to empathise with others leaves us vulnerable to traumatic reactions when we are helping individuals who have experienced overwhelming amounts of distress. Individuals exposed to secondary trauma may experience symptoms that are similar to Post Traumatic Stress Disorder (PTSD), a condition that effects individuals directly involved in the traumatic incident: flashbacks, intrusive thoughts, nightmares, depression, anxiety, avoidance, anger, hyper-vigilance, alcohol and drug misuse.
Compassion Fatigue
Individuals regularly working with the victims of trauma and abuse may develop or be at risk of developing compassion fatigue. Overwhelmed by the amount of traumatic information he or she is seeing, feeling and hearing, the individual's mind reacts to protect the individual. This involves closing down emotionally so the person is no longer emotionally available to their clients (and family); the individual may become tired, impatient, cynical and dissociated from their work. Stress builds and individuals react by becoming frustrated and angry. Losing our sense of humour is one of the first signs of compassion fatigue. An individual my also lose their common sense and become angry - passion replaces compassion. In these circumstances the individual needs to take a break. Once he or she has recharged his or her batteries the zest for work usually returns.
Burn Out
If the individual continues to work with trauma, despite experiencing compassion fatigue, then he or she may go on to experience burn out. In these circumstances the individual loses their desire and ability to do their job, a state of total exhaustion takes over, often accompanied by depression. The individual's mind and body is in revolt and will not allow them to continue being with distress and trauma. Recovery from burn out may take many months, or even years, and often results in a change of role for the individual or even a change in career.
Protecting Workers
Advice from senior professionals on the DVD centred on the need for a work-life balance: plenty of sleep, rest, exercise, sex, relationships, interests and hobbies, innoculate the trauma worker against compassion fatigue and burn out and increases resilience. At an agency level there is a need for supervision in order to help workers off load. Individuals new in post are particularly vulnerable to trauma reactions so effective training and support is essential.
Questions
How did you react to the DVD? What issues were important for you?
List some of the signs of stress in you and your colleagues?
Individuals working with children may be particularly at risk of developing compassion fatigue. What do you do to maintain a work life balance?
Further Reading
Educating Child Welfare Workers About Secondary Trauma and Stress: HERE
