By Cyndi Jahn
Victim Services Director in the Criminal District Attorney’s Office in Bexar County
Due to the subject matter of the cases we all handle, it is important to remember that every member of our office should take care of themselves on both a physical and mental level. Similarly, to serve crime victims to the best of our abilities and see that justice is done, we must make sure we are in the best place mentally and physically. Listening to others’ stories and trauma may impact us, and we should listen to our minds and bodies as they tell us daily how we feel and if we are at our best. To do so, it’s important to be educated on the variety of ways we can be affected by the trauma of others.
One thing to understand is why we do what we do. We are helpers! Helping others brings us a number of positive outcomes. We are providing valuable services for others, we want to do good, and it makes us feel worthwhile. We sometimes help others because we have suffered ourselves—maybe we want to repay the kindness shown to us, or we want to provide the assistance that was not available when we needed it most. We also help because we have empathy for others. We can identify with the pain of those who have endured often-terrible things. This empathy can and does make us vulnerable to other people’s grief, fear, anger, and despair, and it brings these emotions into our own awareness and experience. Lastly, being a helper makes us feel committed or responsible to serving others. Most prosecutor office employees have lofty expectations for themselves and maintain a high work ethic, which often makes us vulnerable to feeling burdened, overwhelmed, and extended beyond what is reasonable for our own wellbeing.
We need to realize that we work in a toxic environment. We may not go to the office in a hazmat suit, but we are exposed daily to trauma and victimization transmitted through the victims we serve. Our daily duties are full of repeated and cumulative stories of violence and trauma. We provide our total dedication to the needs of others, and trials and sentencings involve our complete attention. These things, especially when they are occurring simultaneously, can cause our minds and bodies distress, emotional disruption, re-experience (meaning, re-living the trauma), and avoidance of negative feelings. These notions are wonderfully described by Charles R. Figley in his 1995 publication Compassion Fatigue: Toward a New Understanding of the Costs of Caring: “We have not been directly exposed to the trauma scene, but we hear the story told with such intensity, or we hear similar stories so often, or we have the gift and curse of extreme empathy, and we suffer. We feel the feelings of our clients. We experience their fears. We dream their dreams. Eventually, we lose a certain spark of optimism, humor, and hope. We tire. We aren’t sick, but we aren’t ourselves.”
The negative results of shouldering others’ burdens can have one or more effects: vicarious trauma, compassion fatigue, or burnout. Each is different and can affect us in different ways. Fortunately, there are also positive outcomes from helping others, which I will discuss later in this article (namely compassion satisfaction and vicarious resilience.)
First, let’s look at what Figley refers to as the “cost of caring.” Vicarious or secondary trauma is the profound change in our psychological, physical, and spiritual wellbeing that occurs when we work with victims of trauma. Compassion fatigue is the profound emotional and physical erosion that takes place when we are unable to refuel and regenerate our minds and bodies. Lastly, burnout is the physical and emotional exhaustion that we can experience when we develop low job satisfaction, we feel powerless, and we are overwhelmed at work. One of my favorite quotes regarding the topic of job wellbeing is from an anonymous source: “It’s not the load that breaks us down; it’s the way we carry it.”
Vicarious trauma
Let’s first delve into vicarious trauma (VT), also referred to as secondary traumatic stress. VT is a change that happens because we care about others who have been hurt and we feel committed to helping them. This change can be physical, psychological, and spiritual. We may begin to question our deepest beliefs about the way life and the universe works, and we may question the nature of meaning and hope. This process unfolds over time. It is the cumulative effect from daily contact with victims, survivors, and people who are suffering.
Those who are the most at risk for VT are those who may have suffered trauma themselves, those who have added stress in other areas of their lives, and those who lack a social support system. People who do not practice good professional and work-life boundaries are also susceptible to vicarious trauma.
The following are common signs of VT to look for: We may experience difficulty in managing our emotions and making good decisions. We may face problems in managing our professional and work-life boundaries. We take on too much responsibility. We may find it difficult to leave work at the end of the day, or we may try to step in and control others’ lives. We may begin to experience problems in our relationships with friends and family. Feeling disconnected to what’s going on around you may also be a sign of VT. Even suffering from physical problems, such as aches, pains, and illness, can be a sign of vicarious trauma.
How do we cope with it? It’s important to identify strategies that help prevent VT from becoming severe and to manage it during times when it is more problematic. The solution is: “escape,” “rest,” and “play.” Escape means to get away from it all, both physically and mentally. Enjoy a book, go to the movies, take a day off during the workweek, play video games, or talk to friends about things other than work. To rest, do something relaxing without any goal or timeline: lay in the grass and watch the clouds, sip a cup of tea, take a nap, or get a massage. Playing might involve engaging in activities that make you laugh or lighten your spirits—share funny stories with a friend, be creative, craft, or take part in physical activity.
The goal is to transform vicarious trauma. Transforming VT is deeper than just coping with it. How do you nurture a sense of meaning and hope? What instills and renews hope? To answer these questions, undertake growth-promoting activities such as learning something new, writing, or being creative or artistic. Identify and challenge your own cynical beliefs. Stay connected and mark transitions, joys, and losses, and remind yourself of the importance of your work. One of the best ways to do so is to reach out to others who do similar jobs. Gather strength and hope directly from those who serve as you do.
Compassion fatigue
Compassion fatigue (CF) evokes specific behaviors and emotions in response to a victim’s traumatic event. The result is very similar to the manifestation of PTSD (post-traumatic stress disorder), the difference being that the prosecutor office employee didn’t experience the trauma first-hand. Unlike vicarious trauma, CF can occur from working with a single victim. It is not always from a build-up of trauma, but vicarious trauma can turn into compassion fatigue.
Symptoms of CF include physical and emotional exhaustion, insomnia, headaches, and increased susceptibility to illness. We also see increased use of alcohol and/or drugs in CF. Many of those suffering from compassion fatigue experience problems in their personal relationships; they may have poor self-care and suffer from depression. They experience a loss of purpose and apathy, which may lead to absenteeism and avoidance of work duties. When we are dealing with compassion fatigue, we must be aware of changes in our level of CF and make self-care a priority.
Cope with CF by spending time with friends, joining a caregiver support group, or writing in a journal. It often helps to cope with the stress in positive ways, such as spending time on hobbies or working with a counselor or therapist.
Burnout
Lastly, we need to discuss burnout. Burnout is complete physical and emotional exhaustion. If you are burnt out, you will feel powerless and overwhelmed at work. Any joy that you once received from work is now gone. Although this is occurring, our view of the world has not been damaged—most employees experiencing burn-out have not lost their ability to feel compassion and empathy. What feelings does burnout cause? You may feel chronic fatigue, lack of concentration or focus, and physical symptoms of anxiety, depression, anger, isolation, emotional detachment, and even hopelessness.
Can someone overcome burnout? Burnout will not go away on its own! It will continue to worsen unless you address the underlying issues causing these feelings. Focus on the basics: good nutrition, exercise, and sleep. Take a vacation or leave of absence. Most people who experience burnout cannot overcome it while continuing to place themselves in the same work environment. Learn to politely say “no,” as taking on more responsibility is generally not healthy when trying to combat burnout. Practice positive thinking. It’s important to start small. Focus on a positive thought each morning. Then at the end of the day, think back to one good thing you accomplished.
Avoiding VT, CF, and burnout
Is it possible to avoid vicarious trauma, compassion fatigue and even burnout? Definitely! The answer is self-care. Always think to yourself: I nurture myself so I can nurture others. You must make a personal commitment to self. Why is this important? If you don’t, you can get hurt! And because you matter! Because our crime victims matter! And because the work we do matters! Audre Lorde, an American writer and poet, said, “I have come to believe that caring for myself is not self-indulgent. Caring for myself is an act of survival.”
It is extremely important to create a self-care plan directed specifically for yourself. As you construct this plan, ask a few questions:
• Why do I do this work?
• How do I measure success in my work?
• What can I control in my work?
• What are the costs and rewards of my work, and how am I personally changing?
Focusing on the development of your plan, you can look to the ABCs of self-care: A for awareness, B for balance, and C for connection.
First, awareness. Be aware of your own needs, limits, emotions, and resources. Know your own “trauma map”: Have you experienced suffering in the past? It may serve you well to inventory your current lifestyle choices and make any changes you feel are necessary. Take care of yourself. Create a self-care list and post it in your home and office.
Next, balance. How are you able to balance work and play? How do you take care of others at work and home and still take care of yourself? Balance is hard to achieve. If you concentrate specifically on balancing your work and home lives, you might find that it is extremely difficult—and if you aren’t successful, you may feel as though you failed.
Sometimes we simply need to focus more heavily on work, such as during a trial. Other times, you may need to turn your attention more directly to home and family. More simply, try to learn when and where you need to place priorities while not letting one side suffer as your attention is directed elsewhere. Remember not to keep emotions bottled up. Maintain clear work boundaries and set realistic goals for yourself. It’s important to learn and practice time management skills, as well as recognizing negative coping skills.
Finally, connection. We must understand and determine our connection to ourselves, others, and often, something larger than ourselves. This may be a spiritual or religious aspect to our lives. One idea for maintaining a connection is to develop a strong support system. Find friends and colleagues with whom you can talk about work. Debrief after difficult cases. Avoid professional isolation—you can’t do this job alone. Also, find those friends with whom you can spend time without any interaction regarding your work life. Lastly, seek training to improve your job skills. This can open a better understanding to both the negative and positive forces around you at work.
To practice self-care at work, try not to take on more than you can handle. Develop a plan to coordinate your work schedule to remove distractions. This may involve asking family and friends to honor your work time by limiting their interruptions. Look for ways, if appropriate, to delegate some work to others. Daily, write down your top tasks and priorities. Do what you can to create a healthy work environment, and remember to schedule breathing room into every day. Do your best to work reasonable hours, understanding that there are times when this may not be possible. Finally, try to accomplish something non-work-related each day. Remember what Nicole Urdang, MS, NCC, DHM, a holistic psychotherapist said: “Overworking is often the heart of compassion fatigue and its first cousin, vicarious trauma. Making time for self-care activities leaves less room for overworking.” Another of my favorite quotes is, “It is not selfish to refill your own cup so that you can pour into others. It’s not just a luxury. It is essential.”
Positive results from our work
As I promised earlier, here are the positive outcomes we can take from our jobs: compassion satisfaction and vicarious resiliency.
Compassion satisfaction is the pleasure we derive from doing a job well, from the ability to be an effective helper. It includes positive feelings about your colleagues and their efforts. One of the best examples is working together in a trial team. Seeing justice done for a crime victim is another strong, positive expression, and that contributes greatly toward compassion satisfaction. It is your contribution to the office and the greater good of society.
Vicarious resiliency focuses more directly on the individuals we serve. Resiliency comes from the unique and positive effect from exposure to a crime victim’s ability to move forward with his or her own life. We can—and should—draw strength from the human capacity for healing and gain a more realistic perspective of our own problems. We can develop an appreciation of the positive dimensions of our own lives, reaffirm the value of our work, and strengthen our commitment to help victims of crime. Studies have shown that we must have empathy toward trauma survivors to develop vicarious resiliency.
Conclusion
What should we do if we think someone we care about is suffering from vicarious trauma, compassion fatigue, or burnout? First and foremost, be kind and supportive. This person may think she was successful in hiding her struggles. Remind her she did not do anything to cause these feelings, there are good reasons why we do what we do, and there are positive outcomes from our work with victims. Lastly, share your own experience and self-care plan. Never hesitate to suggest that she consider professional mental health care. It is always best to be safe rather than sorry!
Please remember that you are needed. The work you do is needed. Take care of yourself so you can care for those we serve in our communities.
References
Figley, Charles R. (Ed.), Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder in Those who Treat the Traumatized, Brunner/Mazel Publishers, New York, 1995.
Saakvitne, Karen W. & Pearlman, Laurie Anne, Transforming the Pain: A Workbook on Vicarious Traumatization, Norton Professional Books, New York, 1996.
TEND Academy, “What is Compassion Fatigue?”, available at www.tendacademy.ca/wp-content/uploads/2018/05/what-is-compassion-fatigue-2018-05-20.pdf.
DailyCaring Editorial Team, “How to cope with Compassion Fatigue: 8 Tips for Caregivers,” 2017, available at https://dailycaring.com/how-to-cope-with-compassion-fatigue-8-tips-for-caregivers.
American Counseling Association, “Vicarious Trauma,” Fact Sheet No. 9, available at www.counseling.org/docs/default-source/ trauma-disaster/fact-sheet-9—-vicarious-trauma.pdf.
Pearlman, Dr. Laurie Anne, & McKay, Lisa, “Understanding & Addressing Vicarious Trauma” Online Training Module Four, Headington Institute, available at www.headington-institute.org/resource/understanding-vt-reading-course.
Mind Tools Content Team, “Recovering from Burnout,” 2018, available at https://www.mindtools.com/a487gum/recovering-from-burnout.
Berthold, S. Megan, PhD, LCSW, “Vicarious Trauma and Resilience,” 2020 (a NetCE continuing education course), available at www.netce.com/courseoverview.php?courseid=2029 (expires May 31, 2023).
Koch, Jennifer, MSW, LCSW, “Compassion Fatigue: Vicarious Trauma and Self Care,” CASBHC Conference, 2014, available at www.slideserve.com/adelle/compassion-fatigue-vicarious-trauma-and-self-care.
Gregorie, Trudy, “Finding your path to resiliency: The effects of Vicarious Trauma in Adult Protective Services”, 2015, National Adult Protective Services Association (NAPSA) conference, available at www.napsa-now.org/wp-content/uploads/2015/10/206-Finding-Your-Path-to-Resiliency-The-Effects-of-Vicarious-Trauma-in-Adult-Protective-Services.pdf.