Definition of Vicarious Trauma #
Vicarious trauma is a profound and cumulative transformation of a person’s inner experience, often referred to as a “cost of caring”. It is not a sudden reaction but a process of change in a person’s worldview, sense of safety, and hopefulness that occurs after repeated empathic engagement with trauma survivors.
It is distinct from, but related to, other forms of empathy-based stress:
- Secondary traumatic stress (STS): The stress resulting from exposure to a single, particularly distressing traumatic event experienced by another person.
- Burnout: A state of emotional, physical, and mental exhaustion caused by prolonged work-related stress. While vicarious trauma can lead to burnout, burnout does not stem exclusively from exposure to trauma.
- Compassion fatigue: The general loss of empathy and compassion that occurs when helping professionals become emotionally drained. It overlaps with vicarious trauma but does not necessarily include the same worldview shift.
Emotional Symptoms #
The emotional effects of vicarious trauma can mirror those of post-traumatic stress disorder (PTSD), leading to significant psychological distress. Symptoms may be subtle at first but can worsen over time.
Common emotional symptoms include:
- Persistent feelings of anger, anxiety, or sadness
- Increased irritability or mood swings
- Emotional numbness or detachment
- Cynicism or pessimism about the world
- Feelings of helplessness and powerlessness
- Survivor’s guilt or shame
- Loss of hope or sense of purpose
- Increased fear for one’s own safety and the safety of loved ones
- Intrusive thoughts about a patient’s or client’s trauma
Physical Symptoms #
The mental strain of vicarious trauma can manifest in physical ways, as the body holds the stress and emotional residue of the indirect trauma.
Physical symptoms can include:
- Chronic fatigue and exhaustion
- Difficulty sleeping, insomnia, or nightmares
- Increased aches and pains, headaches, or stomach upset
- Increased susceptibility to illness
- Changes in appetite
- Exaggerated startle response and hypervigilance
Neurobiology of Vicarious Trauma #
Research suggests a physiological basis for vicarious trauma, where the act of empathy can activate stress responses in the brain and body.
The neurobiology of vicarious trauma involves:
- Mirror neurons: These brain cells fire when a person performs an action and when they observe another person doing the same action. In the context of trauma, this system may contribute to an empathetic distress response, allowing helpers to “feel” what others feel.
- Stress hormones: Chronic exposure to traumatic stories can cause an overload of stress hormones like cortisol. This prolonged state of arousal can disrupt the nervous system’s optimal functioning, a concept known as the “window of tolerance,” and lead to poor coping mechanisms and chronic stress.
- Trauma’s imprint on the brain: Just as direct trauma can leave lasting traces on the brain and body, researchers have found that the somatic and emotional memories of secondhand trauma can also leave an imprint. This can manifest as intrusive thoughts, hypervigilance, and other symptoms similar to PTSD.
- Nervous system mirroring: A caregiver’s nervous system can mirror the stress of the person they are helping. While this is a hallmark of good empathetic connection, constant exposure without proper self-regulation can lead to vicarious trauma.
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