Vicarious Trauma - Recognising Warning Signs & Protective tips

Vicarious trauma is a term used to describe a range of cumulative and harmful symptoms that develop in response to exposure to other people’s trauma, including reading, watching, listening to sensitive and complex material.

While exposure can occur in all sorts of occupations, particular groups are at increased risk; including those working in the legal profession.

Vicarious trauma, compassion fatigue and moral injury all refer to the cumulative adverse effects on a person’s core beliefs, social relationships, and ability to perform in their work or home life.

A lawyer’s capacity to respond to these events is influenced not only by the nature of the exposure itself, but also the environments they work in, and the social supports and activities that exist for them outside of work.

Key issues contributing to difficulties with mental wellbeing include the stressful nature of the work, intensive work and time demands, poor work-life balance and elevated levels of pressure.

Table of contents: 

The common signs of vicarious trauma 
Protective actions: Prevention 
Enhancing Psychological Resilience Protective Reflective Process
Physical Relaxation and Exercise 
Moral and ethical values 
Collegial support - Peer support programs
Cultural safety and Psychological Safety at work
Support is available

The common signs of vicarious trauma: 

• Invasive thoughts of a client’s situation or distress

• Frustration, fear, anxiety and irritability

• Disturbed sleep, nightmares or racing thoughts

• Problems managing personal boundaries

• Taking on too great a sense of responsibility or feeling you need to overstep the boundaries of your role

• Difficulty leaving work at the end of the day or noticing you can never leave on time

• Loss of connection with self and others or loss of a sense of own identity

• Increased time alone or a sense of needing to withdraw from others

• Increased need to control events, outcomes or others

• Loss of pleasure in daily activities

• Low job satisfaction

• Feeling frustrated by or judgmental of clients

• Feeling under pressure, powerless and overwhelmed

• Not taking breaks and eating on the run

• Unable to properly refuel and regenerate

• The need to take frequent sick days or “mental health days”

• Irritability and anger

• Insomnia – disrupted sleep wake cycle

Cumulative vicarious trauma does not necessarily lead to mental illness, however there is a greater risk of developing a mental illness such as anxiety, depression and alcohol or drug misuse. 

If you find yourself experiencing these symptoms, it is important to recognise that this is not a reflection on your professional abilities but a normal response to the challenging nature of your work.

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Protective actions: 

Prevention 

To help prevent the symptoms of vicarious trauma and burnout from escalating or 
happening in the first place:

• Utilise your team and managers for regular debriefing and other support
• Find out if you have access to an employee assistance program (known as EAP) to access in times of need
• Engage in reflective practice. This can be one-on-one with a trusted friend or your manager, counsellor, or other support person (sometimes called ‘supervision’); with colleagues; or on your own e.g. by writing in a journal
• Honour your scheduled breaks and annual leave
• Evaluate your workspace to ensure it is conducive to wellbeing – enough space for you and your colleagues to have lunch together, ‘chill-out’ spaces, lots of plants/flowers/colour/light.
• Be kind and supportive to your co-workers and make sure to celebrate achievements and birthdays to take time out
• 20-minute walks in nature – being present to your immediate surroundings, rather than lost in thoughts.
• Nourishing your body with healthy food and beverages
• Taking time to enjoy the little wonders of life. 
• Sit watching a water fountain and birds splashing. 
• Self compassion is vital and acts as a protection against burnout caused by perfectionism or negative self-talk. 
• Children’s stories – reading sweet and innocent tales as a stark contrast to the violence, shame, and grief you may be faced with through your work.

Psychological resilience, like physical strength, can grow through regular evidence-based mindfulness and CBT practices - at home and in the workplace.

These protective tips can help guide you in the development of healthy individual and work practices that will build resilience and mitigate risk.

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Enhancing Psychological Resilience 

Protective Reflective Process:

Acronym R.A.I.N

Recognise - Notice an activation has occurred. This is usually felt in the body sensations – feeling sick, heart racing, lump in your throat.  These physical sensations become obvious once you stop to reflect.   Notice where you feel the sensation in your body.  Connect with the feeling rather than numbing it or avoiding it.

Attention - Allow this feeling (emotion) with curiosity and kindness in mind. Give it your fullest attention. Stay with that for a few moments.

Inquire – “What is the emotion I am feeling?   Have I been here before? What association am I making?” Notice your inner responses, for example: The world is not safe. I am not safe. How can I keep my child safe?  Your emotional state may connect to personal memories, other thoughts, and significant times in your life. You may start to doubt your capabilities and feel hopeless or unworthy.  This stream of consciousness can be filled with many habits of thinking that are unhelpful.  This is why it is important to be the observer of all this mind chatter and ask the next question.

Need and nurturing self-talk— What do I need right now to best support or help me?  Bring kindness to yourself (judgement and criticism is not appropriate in this inquiry). With greater conviction, you might have an empowering statement such as: “This is not mine. This is not about me. This is not what I am about. This is not what I have in my life.” You can feel grateful for your support network and your own circumstances.

Going deeply into this whole activation, we come to realise that this reactivity indicates our own values of humanity, honesty and the limitations of the human existence. Your response could be I need to book a weekend away or another opportunity to lock in some time out.
  
R.A.I.N Mindfulness process is useful to let go and unwind after work

Acronym guide

Recognise - Take time out, notice and bring attention to a feeling or sensation arising in you. This could be at the end of your working day.

Allow/Accept – An attitude of I can allow this feeling, by noticing it, and caring about this feeling – it is understandable.

Investigate/Inquire- With mindfulness and kindness, bring attention to the sensations in the body and ask, what is related to? Name the emotion present. What are the memories, thoughts or beliefs?

Needs Nurturing - What do I need right now? Notice your self-talk toward this experience and practise self-compassion rather than judging or shaming. Ask the question of yourself “what do I need?”  Listen to the response.  Sometimes, by simply allowing and giving yourself this time, the intensity subsides and nothing else needs to be done.
  
A note on self-compassion: If you are working to help people and end up being witness to stories of abuse and violence, it is good to remember that an emotional response is also a human one. While it is important to maintain professional composure with your clients/patients, emotional responses related to abuse and violence are natural and even appropriate.

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Physical Relaxation and Exercise: 

• Exercise is important for wellbeing and mental health.  Find an activity you enjoy and can fit into your schedule each day.

• Importance of regular relaxation – Vagus nerve stimulation (Breathing practice 4 = 2 = 8 = 2 repeat 6 times) to regulate nervous system, switch on the rest, and digest parasympathetic response.   

• Massages, yoga and gentle muscle relaxation all activate the vagus nerve.

• Spend time listening or performing music, writing, singing songs, dancing

• Listen to salsa or other upbeat music. 

• Try abstract painting and getting creative with your emotions

• Journal your experiences and state of being.

• Nurture your family and friendships 

• Spend quality time with family and friends

• Try computer games and relaxation and mindfulness apps

• Ensure adequate rest and recovery and reset sleep hygiene 

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Moral and ethical values: 

Reflect on your role and the limitations of your role.  It helps to identify and be clear about your boundaries.
 
Vicarious resilience is a protective factor: hearing of the positive stories and outcomes of the lives of those you are working with. Acknowledge these positive outcomes.

Value alignment

Virtues In Action (VIA) character strengths website has a self-administered questionnaire to identify your top 25 values out of 44. Values such as gratitude and hope are particularly helpful to enhance emotional wellbeing.

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Collegial support - Peer support programs: 

Pursue trauma-informed approaches.

Peer support groups or one-on-one debriefing with a colleague or supervisor is recommended. 
Psychoeducation is provided to assist members to recognise their response is a normal part of recovering from exposure.  Likewise, reflective supervision can provide a safe space, to unpack how you are feeling and discuss self-care strategies to assist recovery. 
 
Mindfulness and compassion training are evidenced-based approaches that increase self-awareness, and acceptance of what is arising in the mind. Building self-awareness, being present with one’s feelings with a kind attitude can improve job satisfaction and resilience.

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Cultural safety and Psychological Safety at work: 

• Reading the WH&S Policy with leadership to ensure ongoing consultation with workers

• Reducing stigma and encouraging wellbeing can be inspiring when leaders are visibly supportive toward their own wellbeing and implement workplace programs to mitigate the risk of vicarious trauma or psychosocial injury.

• Mental Health First Aid training.

• Encouraging inclusion and diversity of workers.

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