Secondary Trauma and the Need for Resiliency

compassion fatigue

Treating emotionally traumatized patients/clients can make huge emotional demands on those who perform these tasks.  Through their professional work, care-providers can suffer a special kind of trauma.  Of course, unlike the primary sufferers of trauma, it is not direct.  Healthcare providers are not bloodied, but instead they suffer an accretion of exposure to the traumas suffered by their clients.  These are dedicated people who perform some of the most emotionally difficult work that society desperately needs.  But in doing this crucial, moral work, the personal consequences are often severe.  Symptoms of secondary trauma or vicarious trauma include such reactions as depression, anxiety, sleep disturbances, mistrust of others, isolating from family or friends, frequent or increased illness, persistent trauma imagery, and often a shift in outlook from optimism to helplessness.  Many of these symptoms are similar to Post Traumatic Stress Disorder (PTSD) and can be as damaging.  Care-providers incur harm across the spectrum of mental health impacts – on the emotional, cognitive, physical, relationship, and spiritual levels.

The irony is that it is people of good heart who choose to go into these helping professions and then their good hearts are assaulted by the work they do.  Many are at a painful crossroads:  their professional service represents the most important, for some, the most spiritual, work they could imagine doing but they are feeling so diminished or broken by that work that they can't imagine going on any longer.  These are not problems which overtake less competent workers.  It is, paradoxically, those with the greatest capacity for feeling and expressing empathy who are most at risk for vicarious trauma.

There are also significant personnel costs for healthcare organizations that fail to attend to the secondary trauma and compassion fatigue suffered by its staff.  The cost of replacing personnel who depart prematurely is the obvious one; included with that are the costs of selecting, hiring and training new staff.  The loss of seasoned staff means that any organization must function without its most skilled practitioners.  Their departure can, in turn, have demoralizing effects on the care-providers who remain and reduce the quality of services available to the clients.