Secondary Trauma

by Susan Butler, LMFT, LPC

There’s one more aspect to our trauma series that is particularly relevant to cross-cultural workers. Secondary trauma is “the emotional distress resulting from indirect exposure to trauma” (source) and as you might expect, it shows up more commonly among workers who have gone to places wanting to help vulnerable populations. 

Many cross-cultural (or global) workers may find themselves in places that have a high level of trauma within their cultural history. Others are exposed to traumatic events as part of a regular experience of listening to other’s stories of loss, struggle, and distress. Global workers “go” because they care and want to help others.

Is it possible to have a reaction to trauma without experiencing the event? 

YES! It’s called Secondary Trauma. 

Who might experience secondary trauma?

• Those who work with victims of violence

• Someone who provides aid to survivors of natural disaster
• An individual helping friends and family members cope after a traumatic event
• A professional that views crime scenes, evidence, or listen to courtroom testimony
• Someone exposed to watching graphic new reports or social media
• Someone listening to disturbing stories

Secondary trauma, also known as vicarious trauma is caused by hearing details about or being a witness to the outcome of a traumatic experience. First responders, firemen, policemen, medical providers, counselors, social workers and global workers can experience secondary trauma. People can experience trauma by indirectly hearing and or seeing the event over and over especially when someone you know and love is in danger or experiencing the trauma. Witnessing atrocities, forced evacuations, health crises, natural disasters, relational conflict chronic emotional strain, culture shock, and spiritual abuse all can open the door to secondary trauma. 

People with a significant history of exposure to trauma may be at a higher risk especially if their trauma is unprocessed. People with more empathic natures are more likely to experience secondary trauma, better know as compassion fatigue. Secondary trauma can harm a person’s mental health in the same way primary trauma does and often those who work with trauma are unaware of the danger and may function normally for years before the symptoms begin to appear. 

Possible Symptoms: 

Symptoms of secondary trauma can resemble symptoms of PTSD. Secondary trauma can trigger negative coping skills such as addictive behaviors, acting out sexually, numbing and isolation which has the potential to lead to dangerous, self-destructive, reckless or socially unaccepted behavior. It can shatter a person’s perception of the world and sense of safety. 

If you’re not sure if you’re experiencing secondary trauma, look for these signs:

• Emotional exhaustion
• Flash backs – reliving the story of traumatic events
• Experiencing intrusive or frightening thoughts
• A loss of compassion or empathy towards self and others
• Depression
• Overwhelming feelings of guilt 
• Increased negative perception of self
• Identity crisis when returning to passport country
• Irritability, anger or resentment towards others
• Anxiety
• Decrease in productivity 
• Pressure to perform (produce results)
• Inability to focus, lack of motivation
• Difficulty eating or sleeping (nightmares)
• Hypervigilance – constantly being on guard
• Feelings of hopelessness
• Complaining about or blaming others

Effects on the Whole Person:

Prolonged periods of stress from trauma (including secondary trauma) impact every part of our being. It can show up as chronic exhaustion, gastrointestinal and hormonal disturbances, heart and  blood pressure issues, unexplained pain and tension, spiritual crisis, social disengagement, emotional outbursts, even problems with our muscular skeletal system. 

Mary’s Story: 

Mary is cross-cultural worker  who has been on the field for 5 years. She and her family live in a small village in a country that has seen a lot of conflict. During their 5 years of ministry they have returned to their passport country twice. Although Mary has not witnessed the conflict first-hand, she frequently hears stories from those she ministers to of violence, poverty, chronic stress and loss. Mary has grown very close to many in their community and often feels overwhelmed, inadequate and helpless because there is little she can actually do to help alleviate their destress. 

Mary began having problems sleeping, and having nightmares because she could not get the images of what she was hearing out of her mind. She often found herself becoming overly attached to the suffering of those she was working with and began to withdrawal form her work, her family, and her organization. Mary was struggling with her faith and questioning God, and became increasingly cynical, depressed and apathetic. On the edge of burnout, she began thinking they may have to return to their passport country and walk away from the ministry they felt called to.She felt guilt because she wasn’t experiencing the same hardships her community was and tried to stuffed her feelings. She felt shame around the possible need to “go home”. Mary felt isolated and alone and that she was failing her community, her organization, her supporters, and her family because she was so emotionally fatigued. 

Overcoming Secondary Trauma:

Seek support for yourself – Many Global workers live and work in areas that have been hit with trauma and often are effected by the stories they hear on a regular basis. Seek out someone to process with will help you re-fill your tank. Unless you do this eventually you will be running on empty an not be able to support anyone else. 

Pull back and recharge – Work into your daily schedule things that you can do to care for yourself. What soothes you and bring you joy? Engage in creative activities such as writing, art, music, dance, building things, gardening, or exploring a different place can help you find space to engage again.  Allow something else to absorb your attention for a while. 

Self-Compassion – Be kind to yourself. Sitting with sorrow and listening to other’s stories and not being able to help or having limited resources to impact the situation can take a huge toll. Intentionally use kind words when talking to yourself, quieting the “inner critic”, acknowledging it may be out of your control. 

Take time to pause –  Set aside time to use mindfulness practices which may incorporate deep breathing, relaxation exercises, prayer, or schedule a spiritual retreat. Jesus knew we needed this and  instructed his disciples in  Mark 6:31 ”Come with me by ourselves to a quiet place and get some rest”. 

Lighten your workload – Sometimes we need to step back and accept that the needs may be greater than our capacity meet them.  If we don’t take time to pause and restore our own resources, we may burnout and shorten our time on the field altogether. Learn and practice when you need to reduce your workload and set boundaries.

Be in Community – Surround yourself with people who understand the weight you carry; trying to do this work alone is a losing battle. Hebrews 1:24 “And let us consider how we may spur one another on toward love and good deeds”.

Take time to be with friends and family – Recognize when you need to step out of where you are and be with those who know you best. 

Utilize mealtimes – Take time to enjoy your meals and relax instead of eating on the run or skipping meals altogether.  According to “The Family Dinner Project” (familydinnerprojcet.org)  research has shown that regular family meals offer a wide variety of physical, social-emotional benefits such as higher self-esteem, lower risk of depression, and greater sense of resilience. While some of these benefits can be gained through other activities, eating together is the only single activity that is known to provide all of them at the same time.  

If you are single, consider how you might find someone to share regular meals with, whether it’s  teammates, a language-learning friend, or someone who can help to provide that regular space to share your day. We understand for some (or in some seasons) this is just not possible. But when you can, be intentional!

How You Can Help Others: 

It is important to find the right balance between supporting someone who has experienced trauma and tending to your own needs.  

• Be aware of your exposure as you listen to other people’s trauma. 

• Recognize your own warning signs -Seek support for yourself because unless you process your own exposure to trauma you will not be able to support anyone else! 

• Allow time for grief. Create a safe place for people to express openly and honestly what they are feeling and experiencing. This is also important for yourself.

• Help others find a work/life balance.  A person’s sense of balance is disrupted when they are exposed to trauma and it takes a higher level of energy to restore equilibrium. 

• Self Care, Self Care, Self Care! Again…if you do not take care of yourself you will not be around to help anyone else! Make time to exercise, rest, relax, and have fun, even when things seem overwhelming around you. 

• Know your member care people.  Sometimes the trauma or secondary trauma we are exposed to is beyond our ability to heal by ourselves. Seek help within your organization and without. There are trained helpers available when situations are beyond your own adequacies and are unprepared to handle an event. 

So what happened to Mary? 

Mary felt she was at the “brink” and talked with her husband who was sharing some of the same feelings. Together, they reached out and met with their organization’s member care worker. They created a plan that would help them learn how to take care of themselves amidst doing the work they felt deeply called to. Next, Mary found a group of women who did similar work that she could meet with regularly who knew what she was experiencing. This added an ongoing supportive network around her.  Mary and her husband also decided to seek out professional counseling together. This provided intentional space to share, process, and work on organizing their lifestyle to include healthy boundaries that provided self-care for them and their children. It wasn’t a quick fix, and it took time to make all of these pieces come together. But in the end, they found the support they needed  within their organization and through additional groups and therapy. This provided (and continues to give them) ways to process the stories of pain and suffering they hear every week. Mary and her family were able to stay in their community continuing the work they are passionate about. And although there are days when the stories still feel overwhelming, Mary knows she has better tools to process others’ trauma, and people around her to support her when the burdens feel too heady. 

Galatians 6:2

“ Bear one another’s burdens, and so fulfill the law of Christ” 

What a beautiful call to compassion, and community.

We are called to carry our burdens together,

creating a shame free space to heal.