Have You Been Affected by Someone Else’s Traumatic Event?
Rachel, not her real name, stood stunned as she witnessed a car run into and knock a bicyclist to the ground. Rachel did what she could to apply first aid because the woman was bleeding badly and she seemed to go in and out of consciousness. She also yelled for others to stop traffic so the bicyclist would not be hurt again. Later after the ambulance had taken the woman to the hospital, she forced herself to be calm when she described to the police officer what had happened. At home she fought off the urge to cry and shake because she did not want to appear weak in front of her children.
Witnessing this accident affected Rachel deeply. For the next month she often awoke sweating from nightmares in which she saw a woman falling off her bike. An avid biker, Rachel no longer wanted to ride her bike. She worried each time her teenage daughter bicycled around town and began to insist that her daughter call to let her know she had arrived safely. When Rachel drove she went much slower than the posted speed on the highway as she looked for bicyclists. By the time she sought counseling, her anxiety had turned into panic attacks.
What Is Secondary or Vicarious Trauma?
Perhaps you, like Rachel, experienced trauma symptoms after witnessing or even hearing about someone’s else’s traumatic event. Whether that person shows signs of trauma or not, witnessing or hearing about their experience can put you at risk of secondary trauma stress or vicarious trauma.
By definition, vicarious trauma happens when you are so overwhelmed that your nervous system is unable to process what you witnessed or heard. It is not the event, but how you respond to it. Trauma happens when you get stuck in a fight, flight or freeze response or any of the other biological responses that naturally arise when you feel threatened.
Unlike “regular” trauma, when the threat comes from the outside such as an injury, near drowning, or assault, the threat in vicarious trauma comes from within. There are several sources of threat when you witness or hear about another person’s traumatic event. These include
· your body’s reaction to horror
· your body’s reaction to shock when you learn that something bad happened to someone good or innocent
· your sense of helplessness when you think that what you can do for another is not enough to alleviate their pain
In vicarious trauma your nervous system cannot seem to “shake off” what you see or hear and move through the threat response. In Rachel’s case, she was stuck in the flight response and had become overly anxious and hyper vigilant.
Who Is At Risk of Vicarious Trauma?
Vicarious trauma can happen to anyone. Those who are at particular risk include people who witness (directly or indirectly through the media) accidents, assaults or natural disasters; family or friends of loved ones who are affected by military actions; humanitarian workers; journalists; clergy; first responders such as police or firefighters; and health care workers including counselors.
Some factors that influence whether you will experience vicarious trauma include:
· The degree to which you are emotionally connected to the other person who is hurt or frightened.
· Your ability to nurture yourself through self-care, rest, and play
· Your ability to engage in a supportive community
· Your personal trauma history
· Your perception of how much your actions help those in need
How Can Vicarious Trauma Affect You?
Like trauma, how you respond to vicarious trauma varies from one individual to another. Symptoms of vicarious trauma mimic those of trauma; your nervous system becomes overwhelmed.
When the nervous system is overwhelmed you may:
1. Replay the event repeatedly in your mind.
2. Feel hopeless and helpless because your help seems to be not enough
3. Become depressed or anxious
4. Become angry or irritable easily
5. Startle or become frightened easily
6. Have problems with digestion or sexual function
7. Find sleeping difficult or interrupted with disturbing dreams
8. Avoid doing things you otherwise would enjoy
9. Isolate from family or friends
How to Best Treat Vicarious Trauma?
Treating vicarious trauma involves helping the nervous system to come out of overwhelm. To do this you must attend to helping the nervous system complete its biological response to threat. Like animals in the wild, your physiology is designed to move through threat and not develop trauma symptoms. Fortunately, you don’t have to think your way through what to do next. The biological response happens unconsciously and extremely fast. Symptoms may develop, however, if the intellectual part of the brain over rides your body’s natural responses. In addition, they can develop if, at the time of the threat, you do not have enough support or enough time to fight off the threat or to get away from it.
There are several biological steps to a threat response. These include:
1. Stop and startle. In Rachel’s case, she stopped walking and stood stunned before taking action.
2. Locate the threat. Rachel heard the sound of the car and falling bicycle and scanned the street to locate the accident.
3. Determine if this is a threat. In the above example, the horror of what she witnessed registered as an internal threat.
4. Take action: fight, flee or freeze. In Rachel’s case she was able to “fight”. She took action to avoid further harm to the bicyclist and to keep her comfortable until medical attention arrived. While she was able to “fight” at the time of the accident she may also have had an impulse to flee the horror of it all. Later this incomplete flight response showed up as anxiety and panic attacks.
5. Discharge any remaining energy and return to quiet alertness. Rachel did not let this happen. She over rode this when she forced herself to be calm in front of the police and when she stopped the impulse to shake and cry at home.
Treatment for Rachel
Rachel’s counselor focused initially on what would help reduce the anxiety. By focusing on the part of the brain that controls the threat response, the therapist identified the incomplete biological steps and helped Rachel’s nervous system to move through them.
Some of the principles, which guided their work, included:
· Attending to body sensation. The language of the primitive brain that controls the threat response “speaks” in sensation. For example, the therapist guided Rachel to pay attention to muscle tension, heart rate, quality of breathing, body temperature and impulses to move. By carefully tracking the body this way the therapist and Rachel could tell if her body was becoming charged or relaxing. This kind of awareness helped Rachel to pay attention to what set off the panic attacks and to minimize their effect.
· Moving back and forth between what was calming and upsetting. By shifting her attention this way, Rachel learned that she could pace herself so the memory of what happened did not further retraumatize her. It also helped her to pace how quickly her nervous system shifted into relaxation. If she became too relaxed too quickly, this heightened her anxiety. With practice this approach helped to ease her anxiety so she no longer worried that she would hit a bicyclist or that her daughter was always at risk of being hurt on her bicycle.
· Telling just parts of the story at a time. By telling the end of the story first about how she had indeed been of help, Rachel’s nervous system finally realized that the accident was over. In the safety of the counseling office she allowed her body to shake and cry as this realization discharged excess bound energy. The deep relaxation that followed helped to ease the nightmares.
But Wait…
Aren’t I being selfish if I think that I could be traumatized too?
This is a common response to trauma. You may believe that if you take time to address your own trauma symptoms then you are dishonoring the one who is “really” hurt. Untreated vicarious trauma symptoms, however, can make your efforts to help less than skillful. Your anxiety or depression can block you from seeing what would help your friend. In addition, you may become resentful toward the person you helped or hesitate to help others in need in the future.
My suffering is nothing compared to what the victims of the earthquake went through. I just witnessed what happened on TV. Why should I be concerned about vicarious trauma?
Vicarious trauma often sneaks in under the radar. For example, it can arise through repeated exposure to images of extreme suffering. The threat may be your internal reaction of horror or shock. In addition, the compassionate part of you may feel quite helpless to make a real difference in people’s lives. Both situations can lead to vicarious trauma and lead to trauma symptoms. If you are aware of the possibility that this could happen you can take steps to prevent or minimize its effects.
My friend is not being sympathetic toward how I feel about what happened to him. He says he is the” real victim”, not me.
This sometimes happens with those who have trauma symptoms. Trauma is like a whirlpool and everything that happens revolves around the traumatic event. Consequently, the “real victim” may act as though he needs all your attention. This may pass when he addresses the trauma symptoms. Trauma could also temporarily numb his capacity to be empathetic to your situation. In reality, your pain is as real as his.
Summary
1. Vicarious trauma is your response when you witness or hear about another person’s overwhelming or traumatic event. This can happen regardless of whether the other person develops trauma symptoms.
2. It is your internal reaction to what is seen or heard that your nervous system perceives as the threat.
3. Symptoms of vicarious trauma include anger, anxiety, depression, isolation from friends and family and disturbance in any of the body functions that run automatically such as digestion and sleep.
4. Effective treatment for vicarious trauma focuses on supporting your body to complete the natural and biological steps that arise in response to a threat.
Next Step?
If you are concerned or unsure that you have experienced vicarious trauma, seek professional help if the symptoms significantly impact your daily life or if they worsen over time. While talking or cognitive therapy can help you to understand how you were traumatized, a body-centered therapy such as Somatic Experiencing ®, EMDR or Brain Spotting may be much more effective in resolving the symptoms of vicarious trauma.
If you would like help in finding a body-centered approach that works for you, I offer 30-minute complimentary consultations. I can be reached at 720-635-7943 or Maggie@HealingAfterTrauma.com
