Tuesday, July 5, 2016

When Domestic Violence Takes a Toll on the Helpers: Understanding vicarious trauma and compassion fatigue in support persons

When Domestic Violence Takes a Toll on the Helpers

We can all feel a sense of information overload sometimes. Our emotional psyches can only take on so much of other people’s burdens. Even when our intent is to provide compassion and care, listening day-in and day-out to others’ trauma can begin to make it feel like our own.

The results can leave those in support positions, such as counselors, advocates, volunteers, law enforcement or even close friends and family members of survivors, feeling depressed, detached, vulnerable or fearful. This condition is called vicarious trauma, also sometimes referred to as compassion fatigue or secondary trauma.

“It happens when you take on the burden of other people’s pain,” explains domestic violence advocate and educator Julie Owens. “Working with traumatized survivors can cause trauma. Our coping mechanisms can get overwhelmed.”

Vicarious trauma and compassion fatigue are slightly different with the prior being related to a change in how one views the world, say from believing the world is safe to believing the world isn’t safe. Compassion fatigue is experiencing deep physical and emotional exhaustion and a significant change in one’s ability to feel empathy for others.

What the two share in common is that some say that they are the cost of caring or the emotional, mental, physical and spiritual impact that can naturally arise from prolonged and frequent exposure to trauma material, be that listening to people’s stories, reading cases, witnessing violence, working hotlines and other exposures.

Many support persons who work with survivors of domestic violence are survivors themselves, continually healing from their own trauma while simultaneously helping others. That’s why it’s especially important for those in helper positions to have support systems of their own and place taking care of themselves high on their priority list before vicarious trauma or compassion fatigue turns into burnout, a constant feeling of overwhelming stress in which problems seem insurmountable and that leads to a sense of detachment from one’s job or life, which Owens says is much more difficult to bounce back from.

Symptoms of Vicarious Trauma and Compassion Fatigue
In addition to the above, vicarious trauma can look like the following:
  • A constant feeling of exhaustion
  • Becoming ill soon after taking a break, such as a vacation
  • Physical tension or pain
  • Hypersensitivity (e.g. crying at the drop of a hat)
  • Intrusive imagery or nightmares
  • Feelings of helplessness or hopelessness
  • Being overwhelmed
  • Having a sense that you can never do enough
  • Avoiding listening to the stories of other people’s trauma or avoiding clients or participants at your job
  • Irritability
  • Missing work
  • Anger
  • Cynicism
  • Isolating self from others
These symptoms can lead to support persons using drugs, alcohol or other unhealthy behaviors as a means to escape, and can put them at higher risk for substance abuse
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Ask Yourself These 4 Questions

If you’re wondering if what you’re feeling could be the result of vicarious trauma, you can start by asking yourself these questions from the Joyful Heart Foundation, a sexual assault and domestic violence prevention project started by Mariska Hargitay, star of Law & Order: Special Victims Unit. Answering yes to any of these questions is a good indicator that looking into support options for yourself will only be of benefit.

1. Do I bear witness to the suffering of others on a regular basis? You could be a counselor or advocate or a volunteer answering calls at a crisis line. You could be reading case files regarding abuse. You may be the media, reporting on these stories. Or you may be a concerned friend or family member who consistently hears about abuse from a loved one.

2. Am I in a position where I feel responsible for someone’s safety or well being? You may do this directly, with a client or a loved one, or you may be in charge of raising funds for an organization that is working to keep others safe.

3. Do I intuitively know — even if I’m not ready to say it out loud — that my work is starting to impact my health, life or relationships? Joyful Heart says this one can be hard to identify because vicarious trauma and compassion fatigue build up slowly and cumulatively. Simply ask yourself, “Have I changed?”

4. Do I work harder than is healthy for my mind and body because the issue feels deeply personal to me? Having a personal connection to the issue, like being a survivor yourself, can set a support person up to be re-traumatized by their own trauma. It’s especially important to prioritize self-care in this situation.

Prevention
Owens says some of the best advocates she’s ever known have dealt with vicarious trauma. “They were so compassionate, so dedicated, that they didn’t know when to say no. They did everything for the right reasons, but they lost sight of themselves in the process.” It goes back to the analogy of oxygen masks on airplanes, she says. Put your own mask on before helping others.

To that effect, preventing vicarious trauma in your life means setting professional boundaries. “You need to have a life outside of your work. You also need to identify when you’re becoming overwhelmed.” And, make sure you have a plan in place in case you do, be it talking to a trusted friend, exercising, journaling or finding solace in mindfulness and meditation.

A 1994 study asked support persons to state and rank the prevention techniques that they found most helpful, using a 1 to 6 scale with 6 being most helpful. The top ten techniques included vacation (4.60), social activities (4.34), emotional support from colleagues (4.21), reading for pleasure (4.10), seeking consultation for difficult cases (4.06), reading relevant professional literature (3.91), taking breaks during the workday (3.88), emotional support from friends and family (3.83), spending time with children (3.78) and listening to music (3.70).
More self-care tips can be found in “How Survivor Advocates Can Avoid Burnout.

Test Yourself
The most commonly used tool to measure compassion fatigue is called the ProQol Test. It measures the negative and positive effects of helping those who suffer from trauma. A free, self-scoring version is available here.

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