Working with Victims Can Create Its Own Trauma
> 4/23/2008 2:43:56 PM

As the United States and the world at large collectively mourned the lives lost in the 2001 destruction of New York's World Trade Center, many developed a special affection for those who'd given their own time (many as volunteers) to help the city of New York recover from this tragedy. The individuals who performed manual labor at the site were perhaps the most visible heroes, but thousands of citizens desperately needed counselling in the months afterward, and social workers turned out to help those who'd been in or near the Twin Towers, those whose loved ones had been injured or killed, and many who were severely traumatized by the proximity and horrific nature of the attack. These workers did not stop to ask for sympathy at such a trying time, and very few commentators considered the long-term effects that the attack would have on those who worked to treat its survivors. More than 6 years after the event, research indicates that many of these workers continue to be deeply affected by their experiences and that their cases perfectly illustrate the fact that workers who attend to victims can be affected by the very same traumas to a surprising degree.

Many of those who spent the months after 9/11 looking after its survivors now suffer from anxieties of their own. And they're not alone. Individuals who work with the survivors of tragedy often suffer from conditions very similar to those they're trying to allay. Personal counselors, social workers, first responders, emergency rescue personnel, and critical care professionals who administer to the very sick and dying are the prime objects of the phenomenon. Burnout is understandably high among these professions. While it may not always add up to a diagnosable disorder, the "compassion fatigue" or "secondary/vicarious trauma" phenomenon effectively amounts to a mental health disturbance created by the related experiences of others. The condition very closely resembles PTSD itself. Major symptoms include: flashbacks, troubling dreams and sleep problems, heightened sensitivity to perceived threats, etc.

In order to determine the causes and prevalence of this phenomenon, researchers at Pennsylvania's Geisinger Clinic used data culled from surveys performed among more than 200 social workers in the greater NYC area more than a year after the attack on the World Trade Center. Based on participants' scores on a test designed to measure degrees of general satisfaction and fatigue, researchers determined that a disproportionate percentage of the sample suffered from compassion fatigue and that their work with 9/11 survivors was its primary cause. A considerable number of the survey participants also suffered from job burnout, but this was an independent issue as the attacks did not factor into their levels of professional satisfaction.

Hearing detailed descriptions of horrific events and viewing the emotional turmoil that their memory creates in victims is the most obvious source of vicarious trauma. The therapist's job is to provide each patient with a degree of empathy sufficient to aid in his or her recovery, and this process often involves submerging oneself in the experience itself. Emotionally attuned therapists may truly come to feel like they endured these traumas themselves. Researchers also found, unsurprisingly, that peer support and a positive work environment helped the survey's subjects overcome their fixation on the events.

Those directly affected by trauma and tragedy most obviously need immediate treatment, but we cannot discount the difficulties of those who aim to share in their experience and help them move beyond it. Therapists and social workers are not unfeeling objective analysts, and all are touched in some way by working closely with the victims of war, catastrophe, and violent terror. Unfortunately, many are reluctant to report their own anxieties because their jobs seem to demand composure in the face of personal horror stories. The fact that secondary trauma can compromise therapists' ability to perform their jobs makes the development of a specific diagnosis or method for better detecting the phenomenon an absolute necessity.

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