Freeman Medical Musings Blog


Vicarious Trauma and Secondary Traumatic Stress

Posted by Dr. Kimberly Fielding, on October 15, 2015

Fun in the swimming pool often involves jumping in with legs tucked in tight. It’s a cannonball! As soon as a body lands in the pool, water is pushed out to make room for the plunging object. Since the water has no other place to go, it shoots upward and outward. A precision dive might produce a slight splash, but a cannonball splatters and leaves a ripple effect. Within the compassion continuum, similar risk exists for caring child-serving adults who help children during intense emotional situations. Calm waters can be disturbed by unfortunate events. Without an awareness and after-care plan for the possible cannonball, the helper may be vulnerable to significant water loss of their own.

Vicarious trauma and secondary traumatic stress can impact the helper’s own emotional state. These two terms are similar because the starting point of the water splatter is not due to the helper’s own events in the moment – rather, the helper intends to be a resource and knows that being authentic is crucial to build rapport. The helping alliance brings a person-to-person connection, with the helper serving as a resource. The helper must keep his or her heart open to let their sources pour in the direction of children. During the helping relationship, however, an event that acts like a cannonball can happen. After the cannonball, the helper may be experiencing waves of emotional distress, challenging the helper’s strength.

Vicarious Trauma
When vicarious trauma occurs, it’s as if two swimming pools are next to each other. The helper is one pool. In this place, the helper is empathetic and sensitive to the needs of the children. The helper is aware and ready to respond to the children’s needs. Openness is necessary for the relationship to be beneficial.

However, exposure to someone else’s trauma can disrupt the calm pool of the helper. In the second pool, when the person being helped experiences an unfortunate event, the situation could catapult like a cannonball into his or her swimming pool – leaving water to splatter across and begins to ripple the water in the helper’s pool. A swell of emotions impacts the helper due to empathy. The helper may be keenly able to identify with the other person’s pain and loss – so much so that the helper is now flooded with the intense emotions of the other pool. The unfortunate event did not happen for the helper, but he or she may react as if it did. The helper may be exposed to pictures, sounds or other sensory input that is overwhelming. He or she is able to imagine the pain and loss of the other to the point that it feels so real. At the vicarious trauma point along the continuum, the helper is underwater due to waves of empathy.

Secondary Traumatic Stress
Secondary traumatic stress happens when the cannonball splats into the helper’s pool! During secondary traumatic stress, sensory immersion takes place: heart racing, sweating and confusion. A helper may experience secondary traumatic stress if his/her own history is similar to the child’s. The helper may be reminded of his or her own challenges, and this realization can activate the threat mode and produce a defensive reaction. If the helper is not self-aware and using self-care strategies, unanticipated events can burst in like a waterfall as if the helper had no warning signal. This surprise can bring disorientation and survival reactions. Additionally, the helper may be exposed to elements of the cannonball through another person but internalize possibilities for him or herself. For example, if child is in a crisis situation that has a lot of similarities to characteristics of the helper’s own life (e.g., same kind of car in an accident, same age of child, or the “that could have been me” realization), a helper may feel the weight of fear. Similar to the first hand experiences of those who are helped, the helper may then proceed to his or her own first hand experiences with intrusive memories, second guessing, and other avoidance and alarm reactions. At the secondary traumatic stress point along the continuum, the helper feels as if he or she is sitting empty and frightened.

Vicarious trauma and secondary traumatic stress prevention and intervention strategies:

  • Use checklists to frequently evaluate stress levels
  • Participate in healthy self-care in the areas of thinking, feeling and doing
  • Utilize mindfulness practices
  • Engage in reflective supervision