Vicarious Trauma: Definition, Symptoms, & How to Cope

What Is Vicarious Trauma?

Clinical psychologists Dr. Mccann and Dr. Pearlman developed the vicarious trauma response theory to explain the emotional, physiological, and spiritual effects of listening and caring for a traumatized person. When experiencing vicarious trauma, an individual will go into a fight, flight, freeze, or fawn and may be separated from what is happening in the present moment.⁵

Vicarious Trauma Vs. Secondary Trauma

Vicarious and secondary trauma are trauma responses that an individual develops from hearing the trauma story of another person. The difference between the two responses is that secondary trauma can develop after a singular exposure to another person’s trauma, whereas vicarious trauma develops over time after repeated exposure. Because of its repetitive nature, vicarious trauma can shape a person’s viewing of the world, whereas secondary trauma may not have as much of a lasting impact.⁵

The Different Responses to Vicarious Trauma

An individual can have a neutral, negative, or positive response when experiencing vicarious trauma. The health of a person’s nervous system, resiliency, and support system are factors that impact the type of response the trauma exposure will have on them.

It is important to note that an individual is far more likely to have a negative response to vicarious trauma in environments where the workload is too high and workers are not receiving necessary emotional, financial, and spiritual support.

Here are the different responses to vicarious trauma:

• Neutral response: A neutral response is when a trauma worker can experience vicarious trauma and continue to sit in a space of self-awareness and tap into healing strategies that create emotional safety. In this neutral position, a trauma therapist or first responder can keep a hopeful and mostly optimistic outlook on the world.
• Negative response: A negative response is when the nervous system moves to a trauma-informed way of protection. The nervous system overtakes the prefrontal cortex and initiates your fight and flight response, making it difficult to tune into daily life with hope and awareness of the present moment.
• Positive response: A positive response from trauma exposure is an awareness of the ongoing need to use tools that support resilience, such as mindfulness and social support.

The Vicarious Trauma Toolkit (VTT)

The vicarious trauma toolkit looks at ways to develop and bring resilience to the organization of a workplace. It outlines the organizational structures needed in the workplace that insulate trauma workers from adopting a trauma response that results in fear-based thinking. It emphasizes the importance of leadership and mission statements focusing on safe communication and proper health and wellness programs.⁵

Who Is at Risk of Being Affected by Vicarious Trauma?

A wide variety of people are affected by vicarious trauma. Vicarious trauma affects all ages, but women are more likely to be exposed to trauma as they are often in positions caring for vulnerable people such as young children and the elderly.¹ Additionally, women of color who provide child care or health care are more likely to experience vicarious trauma.⁷

The last three years during the pandemic have been particularly difficult for trauma workers and those who provide care and support without the important safeguards to help protect their emotional and physical health.

Factors that put an individual at higher risk of having a negative response to vicarious trauma include:

• Trauma workers who have prior trauma that mirrors the trauma of the trauma victim
• Trauma workers, such as nurses and doctors, who care for patients in a medical setting
• Teachers and daycare workers, who hold the feelings of children, some of who have experienced abuse
• Trauma therapists who are routinely exposed to trauma
• Emergency medical technicians who are exposed to physical as well as emotional trauma
• Social workers who are exposed to systemic-induced trauma may feel overly responsible for others
• Janitorial service workers who may be exposed to unsafe environmental conditions

Symptoms of Vicarious Trauma

Vicarious trauma can negatively impact how a trauma worker views the world and cause the individual to develop harmful habits and behaviors due to these intense feelings of worry. The body’s fear or trauma response makes it difficult to tune into one’s intuition and deeper awareness of what one needs to feel well again.⁷

Common symptoms of vicarious trauma include:

• Emotional symptoms: Someone experiencing vicarious trauma may have difficulty recognizing their emotions due to repeated trauma exposure, making it difficult to tune into their internal wisdom.
• Behavioral symptoms: Holding emotional space for traumatized persons may trigger fear-based behavior such as isolation and difficulty setting boundaries with others.
• Physiological symptoms: The body may respond to hearing traumatic stories of others by going into fight, flight, freeze, or fawn. These responses affect blood pressure, heart rate, and glucose levels in unhealthy ways
• Cognitive symptoms: Providing care for those who have been abused can change trauma workers’ neural pathways of processing the world. This can cause blocks in certain types of thinking and a negative loop of perceiving and responding.
• Spiritual symptoms: Vicarious trauma impacts the mind/body experience, which shows up in daily habits and a worldview that reflects the fear and uncertainty that is felt by a first responder or other healers experiencing vicarious trauma.

How to Cope with Vicarious Trauma

There is hope for those experiencing vicarious trauma. Compassion fatigue and burnout are essential to address to help healers and workers find hope and support when caring for others.

Here are nine strategies to help cope with vicarious trauma:

1. Increase Self-Awareness

Repeated trauma exposure can pull us away from our present moment, which distorts our perception of others and ourselves. Becoming aware of unconscious thoughts and how they guide and influence our responses helps develop resilience and protect the health of our personal life.

Symptoms to look out for if you are wondering whether you are having a negative response to vicarious trauma include:

• Increased vigilance or jumpiness
• Overwhelming feelings of sadness
• Difficulty being in the moment
• Taking over responsibility for other’s feelings and actions
• Perfectionism
• Anger that shows up without a prompt or warning
• Difficulty connecting to others
• Increased irritability

Questions to ask if you are wondering whether you are having a negative response to vicarious trauma include:

• Can I stop thinking about victims’ trauma outside of work?
• Do I enjoy my friends and favorite activities?
• Am I becoming rigid in my response to others, with perfectionistic thinking?
• Am I overwhelmed by other people’s opinions of me?
• Am I setting boundaries when I feel overwhelmed by others’ needs?

2. Seek Social Support

It’s helpful to seek support when you experience symptoms of vicarious trauma so that you can receive the emotional care that you are constantly giving to others. This will protect your emotional health and deepen your resilience. Spending time with friends and healthy support systems allows those exposed to trauma a space to practice being in the moment and connecting with others outside a traumatic event.

3. Set Boundaries

One of the most helpful ways to create self-love and self-compassion is to set limits around your work. This is especially important when you feel overwhelmed by giving and caring for others. Also, setting boundaries within work will allow you to observe triggers or heightened physical responses from a space of safety.²

4. Take Your Vacation Days

It is helpful for all of us to get away from work and responsibilities so that you can tune into all of yourself. Breaks are essential to create space between the time you spend caring for others and the time you spend caring for and getting to know yourself outside of work. This is an amazing moment to become aware of your thoughts and reactions that may be influenced by fear.

A practice of short and long breaks to separate the mind and body from trauma exposure is a helpful way to tune into what brings you peace. Small breaks and vacations help you develop ways to interrupt thought patterns and reactions that have been memorized during exposure to trauma and may be showing up in symptoms of anxiety or depression.

5. Find a Therapist

Finding a therapist to process emotions related to trauma exposure can be helpful. Stories of trauma can imprint on our memory, influencing how we see and respond to the world. A therapist can help you unpack the fear and heightened responses you have developed, which can help to shift your worldview to a more positive perspective.

Providing care to a traumatized person may trigger memories of personal trauma. Therapy allows for a creative space to explore feelings and hopes for the future. Life works well when observing relationships and personal emotions from a space of safety and hope, allowing us to tune into what we want and need.

6. Focus on Self Care

Listening to stories of trauma can make it difficult to pay attention to your needs. Focusing on your well-being and connecting yourself with a feeling of safety is helpful. A self-care practice that includes habits and routines that bring peace reduces the risk of vicarious trauma.

7. Practice Daily Mindfulness

Emergency workers and therapists may become overwhelmed by the stories and pain of the people they care for and disconnected from healthy support systems. Practicing 4-7-8 breathing or the 54321 method after trauma exposure can help the nervous system stay at rest, allowing for a deeper emotional connection with others.⁶

8. Try Journaling

Writing helps bring awareness of the present moment and peace to overwhelming thoughts. Journaling uses the brain’s right hemisphere, which helps bring a deeper emotional understanding of our inner world. Journaling about feelings and hopes for the future can bring a more hopeful worldview.³

9. Gain Perspective

Emergency workers and therapists might forget that there are many happy and healthy people out there in the world who are not experiencing severe life-altering disasters. It can be helpful to put your work in perfective by reminding yourself that the actual number of accidents, plane crashes, and severe physical or sexual abuse is quite low. You are helping people in the worst life situations, which is only a small proportion of the overall population.

How to Seek Professional Support

It’s helpful to write down what you want to focus on in therapy and what you would like to see as a positive result from therapy.  This will help you tailor your search.  Typing the words that best reflect your needs in a Google search helps you find therapists that will meet your needs.  I recommend interviewing two to three therapists to support your search for a good fit.  I also recommend talking to a trusted friend or support person in your community to provide possible referrals. An online directory that helps you find a therapist in your area and with an area of focus that matches your needs.

In My Experience

Often healers and those who are exposed to trauma will not communicate or let others know that a trauma exposure has affected them, as it is often felt that our hurt is somehow not important. Listening to traumatic stories for most of the day may make it challenging to maintain a hopeful outlook and interfere with our ability to connect with joy and peace with others.

Boundaries can help protect our energy and let others know we need to take breaks and tune into our needs and emotions. It’s helpful to look at what we are saying to ourselves in areas of our life that are working well and where we are struggling. Boundaries help tell others and ourselves that we need to receive and sometimes take space from giving.