Vicarious Trauma

Vicarious Trauma

It’s important to act if the intensity of your response to patient trauma is affecting you outside the consult room.

I’M AN EMPATH by nature. It’s part of the reason I’m good at my job, and largely why my consults are rarely short. When recording a medical history, conversation naturally covers more ground than just the patient’s physical and mental health – I like to hear their back stories and really learn who they are as a person. While I enjoy my patient interactions, there are times when my investment in them as a person can be overwhelming. Particularly, when dealing with victims of trauma.

We’ve all had those days: when you know there isn’t an easy fix for your patients, and it will take much more than medical advice and medication to make their problems go away. You feel helpless at your inability to help. As many of my colleagues know through their own experiences, these feelings are associated with vicarious trauma: the common, cumulative, and detrimental effect of working with and being repeatedly exposed to traumatic information. It is an occupational hazard for those working on the frontline or in essential service roles such as healthcare, with constant exposure to survivors of traumatic incidents.

Vicarious trauma is the negative transformation in the helper that results from empathic engagement with trauma survivors and material, combined with a commitment to help them. The greater the exposure to traumatic material, the greater the risk of vicarious trauma.

Vicarious trauma varies in intensity and symptoms and can be challenging to recognise. Those working within the health system should be aware of the signs of vicarious trauma in order to better understand how to recognise the risks early and manage them.

Signs of vicarious trauma include:

• Invasive thoughts of the trauma of someone you have cared for
• Feeling hypervigilant/numb/loss of empathy • Frustration/fear/anxiety/irritability
• Disturbed sleep/nightmares/racing thoughts • Problems managing personal boundaries
• Taking on too much responsibility or feeling you need to overstep the boundaries of your role
• Difficulty leaving work
• Loss of connection with self and others
• Loss of own identity
• Increased isolation/withdrawal
• Need for control in your life
• Loss of pleasure in daily activities

Contributing factors

Doctors are particularly prone to vicarious trauma, not only because of the nature of their work and interactions with victims of trauma, but also as a result of several other contributing factors. These include overwork, professional isolation, impact of shift work and irregular sleep, inability to access leave, and the need to maintain patient confidentiality which impinges on your ability to discuss situations with others, to name a few.

Coping mechanisms

Increased self-observation is important. Check in with yourself regularly and cross check the list of symptoms of vicarious trauma with your own responses. For me, the red flags include not being able to laugh at things that I’d normally enjoy. When I feel I’m going down an emotional slippery dip, I open the ‘Photos’ app on my phone and check out the ‘For you’ section. I’m forever thankful for these algorithm-generated little photo montages from my past. Seeing faces and places from my life remind me of the beauty in the world and how much I’ve been able to experience over my time.

Other tips include:

• Maintain a healthy work/life balance
• Be realistic about what you can accomplish
• Don’t take on responsibility for your patient’s well-being but supply them with tools to look after themselves
• Balance your caseload
• Seek social support from colleagues, family
• Practice proper sleep hygiene
• Connect with nature
• Seek professional help

ABOUT THE AUTHOR Dr Danielle McMullen, Board Member of Drs4Drs. For more information visit www.drs4drs.com.au or contact Doctors Health NSW on 02 9437 6552.