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  • Writer's pictureFabricia Prado

Learning How to Navigate Secondary Traumatic Stress in the Helping Professions

Updated: Aug 28, 2023

Author: Fabricia Prado, LCSW, Resilient Georgia Executive Board Member


This guest blog post mentions sexual abuse and significant weight loss. While we believe it is important to have open and honest conversations about mental health, we also understand that these discussions can be triggering for some. If you or someone you know is struggling, help is available. In the US, the number 988 is the Suicide and Crisis Lifeline, available 24/7 in English and Spanish.



We’ve all been there: that off-guard moment when we’re getting to know someone, and they ask about our profession. In the helping professions, we often try our best to make light of it. Still, a common reaction would be something along the lines of, ”Oh, I could never do that”. Then, they proceed to explain how they could not take the emotional toll of constantly seeing, listening, or dealing with other people’s suffering.


That recurrent reaction prompted me to elaborate a few questions based on my own experience as a Clinical Social Worker with a history of trauma, working with trauma survivors.


Are we, as helping professionals, possessed with special gifts that allow us to have an infinite source of compassion and empathy?


How can we routinely witness poverty, injustice, inequality, trauma, grief and seamlessly go back to our vacation, promotion, warm beds, supportive families and so on? Can we passionately give 100% of ourselves in the helping fields and NOT develop compassion fatigue or secondary traumatic stress? How do we do the work for the longevity we are supposed to, without losing ourselves in the process, and ultimately leaving the field worsening the workforce shortage?


A profound implication in the off-balance of caring for others while caring for ourselves is what we call secondary traumatic stress (STS) defined as “a syndrome among professional helpers that mimics post-traumatic stress disorder and occurs as the result of exposure to the traumatic experiences of others” (Baird and Kracen, 2006). The term STS has been used interchangeably with other terms, such as Compassion Fatigue, Secondary Posttraumatic Stress Disorder and Vicarious Traumatization, but can hold some differentiations.


Undeniably, being a helping professional comes with major rewards and gifts from the experience of serving others and witnessing transformation. We even gain a sense of purpose, hope, and personal growth to boot.


However, for me, it was not the case when approximately 10 years ago I first worked with a caseload focused on trauma survivors. Overall, I felt extremely angry. At that time, I was not feeling blessed to be helping. I was feeling useless and morally injured because justice was so rarely served, and I did not have the vocabulary or ability to identify how organizational and societal factors from a broken health system were also failing me and my clients, adding its weight to my personal suffering. I was not feeling rewarded because I was experiencing something similar to my clients’ feelings, thoughts, and behaviors. I had nightmares and fantasies of punching and kicking their perpetrators, just like they did. I lost hope for them and with them when their caregivers would try to silence them to protect the perpetrators, or they’d simply say that the victims were lying, and it had never happened. Still, I had to listen, unsurprised, to the first confessions of parents, saying that they had also been abused and are only now realizing it upon learning about their own children’s abuse. I became impatient to hear “normal” life problems from others and stopped giving everyone else the right to be hurt if their situation or level of hurt didn’t compare to what my clients (and myself) were experiencing. There was also the moral injury experience in being fearful that I was not helping my clients enough or facing the reality that I couldn’t be and do everything for them. That’s exactly how I felt the day I saw a client become highly triggered after seeing their sexual perpetrator in court being hardly punished or not at all, and still having to go back to the same home where the abuse took place.


It was only when my pants size went down to zero while wearing a belt, that I accepted I had reached the point of no return. I took all the steps to quit my job and take some time to recover. It was the first time in my life that I had that significant weight loss and appearance. And as Sonya Renne Taylor states in her book, “The body is not an apology,” society has a huge problem with bodies. Oh boy, is it true! I can’t think of anything else I did or said in my life that bothered people as much as existing in that type of body. I certainly received kindness from some of my colleagues in their own ways of well-intended gestures, but I also heard several comments and questioning that threw me off. Some were perhaps triggered by the situation and would not do or say anything that was helpful to me at all.


Not everyone can be compassionate for every type of problem or situation, not even therapists, clerics, or leaders. I have learned that this is expected and acceptable too. We all have biases, limitations and personal histories that are sewn into our professional profiles.


I understand it now. But I was feeling alone and ashamed for a long time, when I naively believed that it only happened to me because something was wrong with me.


I had no vocabulary to name what I was going through and lacked awareness of the multitude of factors beyond me and my personal trauma history that should take up some slices on the responsibility pie spinning in my head.


So, how did I scoop myself out of that hole?


I was jobless with no health insurance and not enough money to fully invest in a typical recovery. I had to learn how to dig myself out with what I had in me. Unfortunately, that requires energy and motivation, which is unavailable when you are depressed; so, it’s a slow process. Basically, I had to do what I had done when I was 12 years old and decided that I was going to be a psychologist. I had to become what I needed because it was not available to me.


I would like to share with you some of the lessons from my lived-in experience in my process of recovery:


1. Ask for help. Reach out anyway you can. I had to change my learned strategy of asking for help as my last resource. I strongly believe that help is more available than it seems; but the biggest challenge is to be capable of asking for it when you’re drowning in shame or paralyzed by emotional shock. You must do it regardless, even if the only strength you have is the blink of one eye. Find others who have been or are going through it as well.


2. Do not discount external and bureaucratic factors. I had to expand my vision beyond my individual trauma history, personality, and sensitivities to identify all the external factors at play, including unhealthy workplace culture, unfairness, lack of resilience training, leadership instability and a system that unintentionally allowed re-traumatization repeatedly. Even if you recover by investing in self-care and your individual resilience, going back to a dysfunctional workplace will make it unsustainable.


3. Examine codependence and perfectionism. I had to analyze if the way I was working was part of a pattern that I was repeating in other dimensions of my life. For instance, compulsively “helping”, over-giving or self-sacrificing, almost always saying “yes,” overextending myself, my hours, my health, having poor emotional boundaries, taking extra responsibilities, overdoing, doing somebody else’s job, being a perfectionist, etc. If any of those behaviors were present in my other life roles, that was a great indicator that I was potentially reenacting past traumas (normally the root of codependence and perfectionism) and engaging with work in a codependent fashion. How expected is it that we’ll experience burnout from that, not only because of the nature of the work, but because of unhealed wounds pulling us to perceive stress and responsibility in this dysfunctional way? Therefore, this belongs to a journey of self-healing, advancing professional experience, obtaining guidance and training coupled with a favorable working culture and structure that reinforces healthy expectations, boundaries, and long-term wellness.


4. Learn about Trauma-Informed care and avoidance of re-traumatization. I had to learn about the importance of Trauma-Informed Care principles, which gave me insight into how it all began in my first day of class when TIC was not yet taught or implemented in curriculum and the workers were not trauma-informed.


5. Engage in spiritual inquiry. I had to review my notions about why we suffer, where God is when we do and what my role is in others’ suffering. I had to back off from urges to intervene and rescue, I had to understand how to operate in God’s silence without despair; I had to develop a calmness within on the borders of radical acceptance and the duty of condemning oppression. I had to develop the ability to tolerate ambivalence and hold contradictory truths that make sense and reflect in my existential or spiritual theory about suffering and purpose. I had to know my place and accept that I could not have total power or control of outcomes. It is a valuable lesson to master the delicate balance between intervention and restraint and to allow some crises to serve as pivotal moments for profound transformation. I shifted my perspective, no longer viewing every challenge as an obstacle demanding my immediate intervention.


Instead, I learned to stand beside individuals in their darkest hours, holding space and patiently awaiting their emergence on the other side, offering them a beacon of hope and the potential for post-traumatic growth in the aftermath of their struggles.


6. Deepen your knowledge, get consultation and mentorship, and achieve optimal attachment. We must believe that we can learn a better way of working and living that can be sustainable in the long run. It goes beyond the primary idea of self-care and should embrace a professional path of growth in which we locate consultants, courses, and colleagues we trust to exchange support and have them evaluate us on how we are doing the work and managing stress. I am currently reading the book, “The Resilient Practitioner: Burnout and Compassion Fatigue Prevention and Self-care Strategies for the Helping Professions” from Skovholt and Trotter-Mathison. It is fascinating how they frame this movement as empathizing and detaching under the idea of The endless Cycle of Caring. Helping professionals who wish to achieve an optimal balance between caring for others while caring for themselves must develop the skills to make positive attachments and positive separations, without overdoing it and allowing time for restoration thus avoiding Compassion Fatigue and Secondary Traumatic Stress.


This balance is attainable!


References:


Baird, Katie & Kracen, Amanda. (2006). Vicarious traumatization and secondary traumatic stress: A research synthesis. Counselling Psychology Quarterly. 19. 181-188. 10.1080/09515070600811899.


Skovholt, T.M., & Trotter-Mathison, M. (2016). The Resilient Practitioner: Burnout and Compassion Fatigue Prevention and Self-Care Strategies for the Helping Professions (3rd ed.). Routledge.


Taylor S. R. (2018). The body is not an apology : the power of radical self-love (First). Berrett-Koehler Publishers.

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