Vicarious trauma and stress management

Abstract

Research has established that those who work with victims of violence suffer serious VT due to their daily contact with these victims and their stories. Among the researchers are Maslach (1982) with her work on burnout; McCann and Pearlman (1990) with their work on vicarious traumatization; Figley (1995) with his work on compassion fatigue; Catherall (1995) with his work on secondary traumatic stress; Dutton and Rubinstein (1995) with their work on post-traumatic stress disorder; Saakvitne and Pearlman (1995) with their work on VT; Ochberg (1988) with his work on post-traumatic therapy; Rothschild (2000) with her work on the effect of trauma on the body; and Richardson (2001) with her guidebook on VT. However, not much research has been done regarding interpreters. Ochberg has been a leading authority on the treatment of post-traumatic stress disorder(PTSD) since the 1960s. An expert on PSTD and the Stockholm syndrome, he helped define trauma and PTSD. Figley started studying traumatized nurses in 1970. He is the editor of the series on “Compassion Fatigue” which focuses on trauma and secondary traumatic disorder on those who provide therapy to the traumatized, and their treatment. The first book of the series, Trauma and its Wake, was published in 1985. Other pioneer work in the field of VT, in addition to that done by authors noted earlier above, includes Pearlman and Maclan (1995), who described the profound effects suffered by professionals exposed to the traumatic experiences and narratives of those they work for and with, in their study titled “An empirical study of the effects of trauma work on trauma therapists”. They laid the foundation for most subsequent work on stress, trauma and vicarious traumatization management. In the literature reviewed, VT is often linked to post-secondary traumatization, burnout,compassion fatigue and countertransference. It is therefore necessary to define these terms in order to understand the signs we may see and differentiate them. For Gilmore (2011, p.4), “Burnout refers to extreme circumstances where the worker is suffering personally and professionally from their work; it is usually accompanied by a high degree of negativity. Compassion fatigue came from Charles Figley who used it to refer to people who suffer from being in a helping capacity for a long time. “Countertransference in the context of psychotherapy is the distortion on the part of the therapist resulting from the therapist’s life experiences and associated with her or his unconscious neurotic reaction to the client’s transference” (1995, p.9). Ochberg (cited in Landau 2009) makes a distinction between compassion fatigue, which forhim is empathy developed by therapists when listening to traumatized persons, and vicarious trauma, which goes beyond that. He says the following: “It’s not that I am feeling sorry for them and empathizes with them, it’s that I am becoming them”. McCann and Pearlman first used the term vicarious traumatization in 1990 specifically withreference to the experience of psychotherapists. Talking about vicarious traumatization, McCann and Pearlman (1990, p.133) stated that “Persons who work with victims may experience profound psychological effects, effects that can be disruptive and painful for the helper and can persist for months or years after work with traumatized persons. We term this process “vicarioustraumatization”. At the vanguard in the field and authors of numerous studies and articles on the subject, Saakvitne and Pearlman defined vicarious traumatization as being:a profound change in the therapist sense of meaning, identity, world view, beliefs, and about self and other … Vicarious traumatization refers to a transformation in the therapist’s (or other trauma worker’s) inner experience resulting from empathic engagement with clients’ trauma material. That is through exposure to clients’ graphic accounts of sexual abuse experiences and to the realities of people’s intentional cruelties to one another and through inevitable participation, re-enactments in the therapy relationship. The therapist is vulnerable through his or her empathic openness to the emotional and spiritual effects of vicarious traumatization. These effects are cumulative and permanent and evident in both the therapist’s professional and personal life … [it] is marked by profound changes in the cores aspects of the therapist’s self or psychological foundation.