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 Working with people in crisis causes ongoing
exposure to stress and traumatic stress
 Reactions to stress and trauma are normal
 They must be addressed regularly
 Failure to address them as a part of our work
can cause secondary trauma
 Emotional Exhaustion: Chronic state of
physical and emotional depletion that results
from excessive demands and continuous stress.
 Compassion Fatigue: Gradual lessening of
compassion over time.
 Burnout: Long term exhaustion and
diminished interest in work. Feeling
overwhelmed by chronicity and complexity of
problems in a working environment
All are components of Vicarious Trauma
“Life-management” problems that do not
represent a “disorder”
 Exposure to traumatic material when working with
traumatized individuals
 Exposures range from a single episode to frequent and
high intensity
 Traumatic situations are not a direct threat to helpers
themselves
 Exposure are common among:
Trauma counselor
Rescue workers
Humanitarian/crisis intervention workers
Range from stressful to full blown traumatic
reactions
Could be both short and long term
 Also known as Posttraumatic Stress Disorder
or PTSD
 Severity of reactions is greater
 Symptoms are present for one month or longer
and persist when stressful event is no longer
present
 Intrusive Symptoms:
 Obsessive recollections
 Dreams/nightmares
 Flashbacks
 Physiological reactions
 Psychological distress
 Avoidant Reactions:
 thoughts, feelings, or physical sensations that bring
up memories of the traumatic event
 people, places, conversations, activities, objects, or
situations that bring up memories of the traumatic
event
 Hyper-arousal
 Irritability and aggressive behavior
 Impulsive or self-destructive behavior
 Hypervigilance
 Exaggerated startle
 Difficulty concentrating
 Problems with sleep
 Negative Changes in Thought/Mood
 The inability to remember an important aspect of the
traumatic event
 Persistent and elevated negative evaluations about
one's self, others, or the world (for example, "I am
unlovable," or "The world is an evil place")
 Elevated self-blame or blame of others about the
cause or consequence of a traumatic event
 A negative emotional state (for example, shame,
anger, fear) that is pervasive
 Loss of interest in activities that one used to enjoy
 Feeling detached from others
 The inability to experience positive emotions (for
example, happiness, love, joy)
 The inner transformation that occurs in the
inner experience of the professional that comes
about as a result of empathic engagement with
the victim’s trauma
 Cumulative in nature
 May parallel those symptoms experienced by
the traumatized victims
 More common among those who work with
traumatized population
 Feeling helpless/hopeless regarding taking
care of self or others
 Disillusionment about concepts of justice and
freedom
 Change in beliefs (e.g. cognitive schema)
 Self
 Others World
 Mood disturbance (e.g. anxiety, depression)
 Depersonalization
 Feeling of reduced personal accomplishment
 Increased feelings of cynicism, sadness, or
seriousness
 Increased sensitivity towards violence
 Distrustful and alienation
 Alcohol and drug abuse
 The Impact on your work with clients:
 Compromising boundaries with victims
 Anger towards clients
 Doubts in professional skills of self and other
 Loss of focus on client’s strengths
 Avoidance of discussing trauma with clients
 Intrusiveness when discussing trauma with clients
 Reversal of roles
STRESS VICARIOUS TRAUMA
Characterized by over-engagement Characterized by disengagement
Emotions are over-reactive Emotions are blunted
Produces urgency and hyperactivity Produces helplessness and
hopelessness
Loss of energy Loss of motivation, ideals, and hope
Leads to anxiety disorders Leads to detachment and depression
Primary damage is physical Primary damage is emotional
May kill you prematurely May make life seem not worth living
Source: Helpguide.org
 Every day is a bad day
 Caring about your work or life seems like a waste
of energy
 You’re exhausted all the time
 You find the tasks involved in your work mind-
numbingly dull or overwhelming
 You feel like nothing you do makes a difference
 The 3 “R” Approach:
 RECOGNIZE: Watch for the warning signs
 REVERSE: Undo the damage by managing stress
and seeking support
 RESILIENCE: Build your resilience to stress by
taking care of your physical and emotional health
 Start the day with a relaxing ritual such as
meditation, stretching, journaling, or reading.
 Adopt healthy eating, sleeping, and exercising
habits.
 Learn how to say “no” and avoid over-
extending yourself.
 Take DAILY breaks.
 Nourish your creative side.
 Slow down!
 Get Support
 Re-evaluate your goals and priorities
 Loss of Idealism
 Loss of the role or identity
 Loss of physical and emotional energy
 Loss of friends, fun, and sense of community
 Loss of esteem, self-worth, and sense of control
and mastery
 Loss of joy, meaning and purpose that make
work – and life – worthwhile
Source: Keeping the Fire from Burnout to Balance, by R. Luban
 “Cumulative emotional and psychological
wounding over the lifespan and across
generations emanating from massive group
trauma”
 Resulting from over 500 years of physical,
emotional, social, and spiritual genocide.
 Relocation
 Assimilation
 Boarding school
 Cultural and language suppression
 Unsettled emotional trauma
 Depression
 High mortality rates
 High rates of alcoholism
 Significant problems of child abuse and
domestic violence
 Repair connections with others, self-image,
values and beliefs.
 Individual counseling, spiritual help, and
group or entire community gatherings are all
important aspects of the healing process.
 Interventions aims to renew hope, positive self-
image, spiritual beliefs, family connections, and
reaffirming one's place in the human
community.
 Particular attention is given to the needs and
empowerment of people who are vulnerable,
oppressed, and living in poverty
 Interventions promote social justice and social
change
 Interventions integrate cultural history and
values with the contemporary reality of clients.

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Secondary Stress - Strategies For Helping Professionals

  • 1.
  • 2.  Working with people in crisis causes ongoing exposure to stress and traumatic stress  Reactions to stress and trauma are normal  They must be addressed regularly  Failure to address them as a part of our work can cause secondary trauma
  • 3.  Emotional Exhaustion: Chronic state of physical and emotional depletion that results from excessive demands and continuous stress.  Compassion Fatigue: Gradual lessening of compassion over time.  Burnout: Long term exhaustion and diminished interest in work. Feeling overwhelmed by chronicity and complexity of problems in a working environment
  • 4. All are components of Vicarious Trauma “Life-management” problems that do not represent a “disorder”
  • 5.  Exposure to traumatic material when working with traumatized individuals  Exposures range from a single episode to frequent and high intensity  Traumatic situations are not a direct threat to helpers themselves  Exposure are common among: Trauma counselor Rescue workers Humanitarian/crisis intervention workers
  • 6. Range from stressful to full blown traumatic reactions Could be both short and long term
  • 7.  Also known as Posttraumatic Stress Disorder or PTSD  Severity of reactions is greater  Symptoms are present for one month or longer and persist when stressful event is no longer present
  • 8.  Intrusive Symptoms:  Obsessive recollections  Dreams/nightmares  Flashbacks  Physiological reactions  Psychological distress  Avoidant Reactions:  thoughts, feelings, or physical sensations that bring up memories of the traumatic event  people, places, conversations, activities, objects, or situations that bring up memories of the traumatic event
  • 9.  Hyper-arousal  Irritability and aggressive behavior  Impulsive or self-destructive behavior  Hypervigilance  Exaggerated startle  Difficulty concentrating  Problems with sleep
  • 10.  Negative Changes in Thought/Mood  The inability to remember an important aspect of the traumatic event  Persistent and elevated negative evaluations about one's self, others, or the world (for example, "I am unlovable," or "The world is an evil place")  Elevated self-blame or blame of others about the cause or consequence of a traumatic event  A negative emotional state (for example, shame, anger, fear) that is pervasive  Loss of interest in activities that one used to enjoy  Feeling detached from others  The inability to experience positive emotions (for example, happiness, love, joy)
  • 11.  The inner transformation that occurs in the inner experience of the professional that comes about as a result of empathic engagement with the victim’s trauma  Cumulative in nature  May parallel those symptoms experienced by the traumatized victims  More common among those who work with traumatized population
  • 12.  Feeling helpless/hopeless regarding taking care of self or others  Disillusionment about concepts of justice and freedom  Change in beliefs (e.g. cognitive schema)  Self  Others World  Mood disturbance (e.g. anxiety, depression)
  • 13.  Depersonalization  Feeling of reduced personal accomplishment  Increased feelings of cynicism, sadness, or seriousness  Increased sensitivity towards violence  Distrustful and alienation  Alcohol and drug abuse
  • 14.  The Impact on your work with clients:  Compromising boundaries with victims  Anger towards clients  Doubts in professional skills of self and other  Loss of focus on client’s strengths  Avoidance of discussing trauma with clients  Intrusiveness when discussing trauma with clients  Reversal of roles
  • 15. STRESS VICARIOUS TRAUMA Characterized by over-engagement Characterized by disengagement Emotions are over-reactive Emotions are blunted Produces urgency and hyperactivity Produces helplessness and hopelessness Loss of energy Loss of motivation, ideals, and hope Leads to anxiety disorders Leads to detachment and depression Primary damage is physical Primary damage is emotional May kill you prematurely May make life seem not worth living Source: Helpguide.org
  • 16.  Every day is a bad day  Caring about your work or life seems like a waste of energy  You’re exhausted all the time  You find the tasks involved in your work mind- numbingly dull or overwhelming  You feel like nothing you do makes a difference
  • 17.  The 3 “R” Approach:  RECOGNIZE: Watch for the warning signs  REVERSE: Undo the damage by managing stress and seeking support  RESILIENCE: Build your resilience to stress by taking care of your physical and emotional health
  • 18.  Start the day with a relaxing ritual such as meditation, stretching, journaling, or reading.  Adopt healthy eating, sleeping, and exercising habits.  Learn how to say “no” and avoid over- extending yourself.  Take DAILY breaks.  Nourish your creative side.
  • 19.  Slow down!  Get Support  Re-evaluate your goals and priorities
  • 20.  Loss of Idealism  Loss of the role or identity  Loss of physical and emotional energy  Loss of friends, fun, and sense of community  Loss of esteem, self-worth, and sense of control and mastery  Loss of joy, meaning and purpose that make work – and life – worthwhile Source: Keeping the Fire from Burnout to Balance, by R. Luban
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  • 22.
  • 23.  “Cumulative emotional and psychological wounding over the lifespan and across generations emanating from massive group trauma”  Resulting from over 500 years of physical, emotional, social, and spiritual genocide.  Relocation  Assimilation  Boarding school  Cultural and language suppression
  • 24.  Unsettled emotional trauma  Depression  High mortality rates  High rates of alcoholism  Significant problems of child abuse and domestic violence
  • 25.  Repair connections with others, self-image, values and beliefs.  Individual counseling, spiritual help, and group or entire community gatherings are all important aspects of the healing process.  Interventions aims to renew hope, positive self- image, spiritual beliefs, family connections, and reaffirming one's place in the human community.
  • 26.  Particular attention is given to the needs and empowerment of people who are vulnerable, oppressed, and living in poverty  Interventions promote social justice and social change  Interventions integrate cultural history and values with the contemporary reality of clients.

Editor's Notes

  1. EE – a feeling of being emotionally overextended and exhausted from one’s work. It is manifested by both physical fatigue and a sense of feeling emotionally drained.
  2. Creativity is a powerful antidote to burnout. Try something new, start a fun project, resume a favorite hobby. Choose activities that have nothing to do with work.
  3. Slow Down - When you’ve reached the end stage of burnout, adjusting your attitude or looking after your health isn’t going to solve the problem. You need to force yourself to slow down or take a break. Cut back whatever commitments and activities you can. Give yourself time to rest, reflect, and heal. Get Support - When you’re burned out, the natural tendency is to protect what little energy you have left by isolating yourself. But your friends and family are more important than ever during difficult times. Turn to your loved ones for support. Simply sharing your feelings with another person can relieve some of the burden Re-evaluate - Burnout is an undeniable sign that something important in your life is not working. Take time to think about your hopes, goals, and dreams. Are you neglecting something that is truly important to you? Burnout can be an opportunity to rediscover what really makes you happy and to change course accordingly
  4. Burnout brings with it many losses, which can often go unrecognized. Unrecognized losses trap a lot of your energy. It takes a tremendous amount of emotional control to keep yourself from feeling the pain of these losses. When you recognize these losses and allow yourself to grieve them, you release that trapped energy and open yourself to healing
  5. A theory conceptualized in the 1980’s by Dr. Maria Yellow Braveheart to develop an understanding of why life for many Native Americans is not fulfilling the “American Dream.” The historical trauma response is a constellation of features in reaction to massive group trauma. This response is observed among Lakota and other Native populations, Jewish Holocaust survivors and descendants, Japanese American internment camp survivors and descendants.
  6. There is a sense of powerlessness and hopelessness associated with historical trauma that contributes to…