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Trauma 103:
Recognizing Vicarious and
Secondary Trauma for
Caregivers
Because we will be interactive, we ask that everyone be mindful about
maintaining a safe environment for discussion.
• Preserve confidentiality.
• Respect all opinions.
• Be self-protective.
• Share air space.
• Be question sensitive.
• Limit side conversations (including technology).
Please share:
• Your name
• Something you would like to share that you know about trauma
• Identify and distinguish between the various ways trauma impacts caregivers
• Recognize signs and symptoms of secondary traumatic stress
• Practice self-care exercises
Goals
• This information may be a review for some.
• Each person is unique and handles stress differently. You may or may not directly relate to what is presented today.
• May Angelou reminds us that when we know better, we do better.
Predictions, Acknowledgment and Disclaimers (PADs)
Trauma 103:
Recognizing Vicarious and
Secondary Trauma for
Caregivers
Personal Safety Plan
A Safety Plan is a list of simple external and internal activities that a person can choose touse when feeling triggered or overwhelmed.
• Mentally consider what promotes your safety:
externally (i.e. sit near a door, doodle, walk out)
internally (i.e. picture a safe, peaceful place, breathe slowly and deeply, relax one body part at a time)
Sample Personal Safety Plan
1. Sit on the end of a row – not in the middle.
2. If I need to leave, know where the nearest building exit is to sit outside.
4. Take deep breaths (in for count of 4, out for count of 4).
3. If going outside is not an option, pick a spot in the room to focus on.
5. Mentally think of or sing lyrics to a favorite song.
6. Have a bottle of water with me at all times and take a cold drink.
Trauma 103:
Recognizing Vicarious and
Secondary Trauma for
Caregivers
• Attachment-Related Trauma
• Chronic Trauma
• Complex Trauma
• Chronic Toxic Stress
• Cultural/Political Trauma
• Developmental Trauma
• Medical Trauma
• Trans-Generational
• Occurred in the Past Versus Currently
Being Experienced
• Unprocessed Memories
• Vicarious Trauma
• War Trauma
Kinds of Trauma
Situational
Relational
Acute / Single Event
Adverse Childhood
Experiences (ACES)
Allostatic Load
Trauma 103:
Recognizing Vicarious and
Secondary Trauma for
Caregivers
Paper Tigers
Out of 350
people
working in
social services
Psychological
Abuse
(Parents)
37%
Sexually
Abused25%
Physical
Neglect12%
Substance
Abuser40%
Witnessed
DV21%
Not just the clients…
Dr. Sandra Bloom
Physical
Abuse
(Parents)29%
Emotional
Neglect35%
Separated
from one/both
parents41%
Imprisoned
Household
Member10%
1. What are the needs of a person impacted by trauma?
2. What are the needs of those supporting a person impacted by trauma?
Impact
RelivingWeight
Story
All of this may weigh heavily.
Trauma 103:
Recognizing Vicarious and
Secondary Trauma for
Caregivers
Defining Terms• Secondary Traumatic Stress
Natural, consequent behavior and emotions that result from knowledge about a
traumatizing event experienced by another and the stress resulting from helping or
wanting to help a traumatized or suffering person. The symptoms are almost
identical to those of posttraumatic stress disorder (PTSD).
• Vicarious Trauma
The cumulative transformative effect on the helper of working with survivors of
traumatic life events. The symptoms can appear much like those of PTSD but also
encompass changes in:
•frame of reference •identity
•sense of safety •ability to trust
•self-esteem •a sense of control
•experiences of emotional and relational intimacy
Caregivers are at even higher risk if they have a history of trauma in their own
backgrounds and if they extend themselves beyond the boundaries of good self-
care or professional conduct.
Defining Terms• Compassion Fatigue
The natural, predictable, treatable, and preventable unwanted
consequence of working with people who are suffering (see empathy
fatigue).
• Empathy Fatigue (Dr. Robert Whitaker)
Consider that compassion is empathy in action. Compassion is energizing
and fosters happiness because it involves taking action. Empathy is in
fact what causes the fatigue and burn-out that caregivers may
experience.
• Burnout
A collection of symptoms associated with emotional exhaustion and
generally attributed to increased workload and institutional stress,
described by a process that includes gradual exposure to job strain,
erosion of idealism and a lack of achievement. Burnout may be the result
of repetitive or chronic exposure to vicarious traumatization that is
unrecognized and unsupported by the organizational setting.
Trauma 103:
Recognizing Vicarious and
Secondary Trauma for
Caregivers
Brain Breaks & Fidgets
• Brain breaks are a quick and
effective way of changing or focusing
on the physical and mental state of
participants in a group.
• Research indicates that brain breaks
also improve concentration and
relieve stress.
• Fidgets may look like toys but are
serious tools to help participants
increase focus and attention while
reducing stress.
Brain Break
Trauma 103:
Recognizing Vicarious and
Secondary Trauma for
Caregivers
Dr. Sandra Bloom
Portraits of Professional CAREgivers: Their Passion, Their Pain is a 2015 documentary
film which takes us on a journey into a world the public has not seen. The film depicts
the dramatic emotional costs experienced by professional providers such as nurses,
social workers, clinical psychologists, doctors, firefighters, first responders who rescue,
assist, and when possible heal the injured and traumatized.
Through dramatic stories, CAREGIVERS film probes the emotionally risky aspects
of professional caregiving and public service.
www.caregiversfilm.com
Predictions, Acknowledgments and Disclaimers
• It can be surprising to see the many ways our senses are triggered by trauma.
• Please keep your safety plan in mind.
• It can be difficult to reflect on vicarious and secondary trauma, especially if you or someone you know is impacted.
Small Group DiscussionWhat new insights have you gained
from viewing this clip?
Portraits of Professional Caregivers
Small Group DiscussionWhat new insights have you gained
from viewing this clip?
CAUSE
EFFECT
Taking on too much responsibility
Wanting to cry during or after a meeting with client
Feeling:
• Helpless about work
• Enraged at client’s perpetrators
• Frustration or anger about client’s choices
• Anxious
• Dread
• Angry
Feeling:
• More worried than necessary
• De-skilled or incompetent
• Disconnected or Dissociated
• Traumatized (after talking with client)
• Physical discomfort or pain
• Physical reactions to client’s stories
Vicarious TraumatizationSigns & Symptoms when with a client
CAUSE
EFFECT
No time, no energy
Disconnection
Social withdrawal
Chronic stress
Chronic crisis
Hyperarousal
Silencing of dissent
Increased authoritarianism
Despair and hopelessness
Diminished self-efficacy
Changes in identity, worldview, spirituality
Increased silos
Loss of memory
Repetition of failed strategies
Loss of participation
Loss of critical thinking skills
Unresolved grief
Sensitivity to violence
Alterations in sensory experiences
Nightmares
Cynicism
Lack of safety and basic trust
Loss of emotional management
Communication breakdowns
Conflict increases
Learned helplessness
Increased bullying, aggression
Vicarious TraumatizationSigns & Symptoms
Parallel ProcessOrganizations Under Stress
Clie
nts • Feel unsafe
• Angry/aggressive
• Helpless
• Hopeless
• Hyperaroused
• Fragmented
• Overwhelmed
• Confused
• Depressed
Sta
ff • Feel unsafe
• Angry/aggressive
• Helpless
• Hopeless
• Hyperaroused
• Fragmented
• Overwhelmed
• Confused
• Demoralized Org
an
iza
tio
n • Is unsafe
• Punitive
• Stuck
• Missionless
• Crisis Driven
• Fragmented
• Overwhelmed
• Valueless
• Directionless
©2017 Sandra Bloom.
Brain Break
Brainstem
Midbrain
Limbic
Cortex
Abstract thought
Concrete thought
Affiliation, Attachment
Sexual behavior
Emotional reactivity
Motor regulation
States of arousal
Appetite, Sleep
Blood Pressure
Heart Rate
Body Temperature
©Bruce Perry, MD, PhD. www.childtrauma.org. All rights reserved. May not be duplicated. Used with
permission.
©Dr. Bruce Perry. www.childtraumaacademy.org. Licensed material. All rights reserved. May not be duplicated. Used with permission.
Trauma 103:
Recognizing Vicarious and
Secondary Trauma for
Caregivers
Admit – Permit - Commit
• Admit: Recognize you are like an ecosystem than a computer, you run on living energy that cycles through times for work and rest.
• Permit: Allow yourself time to recharge. Affirm that you are worthy of receiving care. Treat yourself with loving kindness.
©Partners on the Path 2017. www.partnersonthepath.com
Admit – Permit - Commit
• Commit: Include self-care moments in each day. Like daily dental care, small things add up. Regular practice of self-care leads to better physical and mental health. Take breaks. Schedule “down time.” Seek respite. Postpone what can be done later. Ask for and accept help.
©Partners on the Path 2017. www.partnersonthepath.com
Self-Care Stations
• You will be divided into groups of approximately 12 people per group.
• We will provide an opportunity to engage in a short activity at each of the stations (coloring, play doh, fidgets, aromas with essential oils)
• After three (3) minutes, you will hear chimes and rotate to the next station.
• All participants will have an opportunity to experience each station.
Trauma 103:
Recognizing Vicarious and
Secondary Trauma for
Caregivers
Personal Somatosensory Interventions
• Healing Touch / Massage
• Primary Somatosensory
• Rocking / Swinging
• Bilateral Stimulation
• Animal-Assisted Activities
• Music and Movement
• Muscle Relaxation / Stretching
• Trampoline / Bouncing
• Art / Tactile Activities (clay, sand)
• Weighted Vest / Blanket / Lycra Wrap
• Rhythmic, Repetitive Activities
• Aromatherapy
• Yoga / Martial Arts
• Pulse Oximeters
• Drumming
• Furniture Changes
• Oral Input
• Balance / Movement
• Facility Dogs
• Tactile Input
Dyad: Share your self-
care plan.Commitment and
accountability
Self-Care Plan
Trauma 103:
Recognizing Vicarious and
Secondary Trauma for
Caregivers
Self-Care: Doing your PART
• Prevent: Create an intentional safety and self-care plan
• Avoid: Being triggered by creating high levels of self-awareness
• Respond: With respect and tenderness for yourself
• Therapeutic Interventions: Get support, especially somatosensory
therapies
TherapeuticProcesses
Prevent RespondAvoid
To “listen” another’s soul into a
condition of disclosure and discovery
may be almost the greatest service that
any human being ever performs for
another.
D o u g l a s S t e e r e
• Lakeside Global InstituteBeth Hall, Director of [email protected]
• NeurologicJoshua MacNeill, Director of Neurologic [email protected]
• Training Optionslakesideglobal.org
• Lakeside’s Bloglakesideconnect.com
Contact Information
