The Impact of Working with Traumatised People

for the Helping Professions – Self Care

............

 

Professional Wellbeing

It is interesting that during a counsellor’s training, significant importance is placed on supervision to support the impact of working with trauma, yet for other professionals working with traumatised people, there has been little weight placed in supporting staff who are exposed to trauma which is defined as indirect trauma exposure. Fortunately, there is a gradual change within many professional bodies who are now recognising the value of wellbeing supervision which is now being more widely offered. You maybe a teacher, a police officer, a nurse, or a football coach – the list is endless. This page is to support your understanding of the potential  impact of working with traumatised people.

 

 

“The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet”.

Naomi Rachel Remen (2001)

 

Definitions:

Empathy:

Empathy is an ability to sense another person’s emotions, to feel them as if they are your own, “when you feel physically along with the other person, as though their emotions were contagious” (Daniel Goleman, 1996). Neurons mirror feelings and physical sensations meaning that you as the professional may mirror the experience of the traumatised person. As professionals and experiencing interpersonal relationships with a traumatised person, as compassionate human beings, we tend to want to rescue and help. The danger of being immersed and exposed in another person’s trauma experience is to then be impacted with similar trauma symptomologies.

 

Secondary Exposure to Trauma:

When a person is exposed to another person’s trauma, either verbally or non-verbally, it is possible to be impacted emotionally and psychologically. On hearing the trauma stories, the fear, pain, and terror, you the professional then become witness to the other person’s traumatic experiences and their sense of helplessness and hopelessness.

 

Vicarious Trauma (VT):

VT typically accumulates over time, the impact is experienced as emotional residue, you feel the feelings of the other but feel them as if they are your own.

 

Secondary Trauma Stress (STS):

STS is experienced as PTSD symptomologies as described within the ‘what is Trauma page’. This is when you have been exposed to the trauma however not directly.

 

Vicarious Grief (VG):

This is when you have been in a relationship with someone who is deeply grieving and you have absorbed the sadness, distress and hopelessness and feel it as if it is your own.

 

Burnout:

Defined in ICD-11 (International Classification of Diseases) as:

“Burn-out is a syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed. It is classed as a workplace phenomenon and not a medical condition. It is characterised by three dimensions:

• Feelings of energy, depletion or exhaustion.

• Increased mental distance from one’s job, feelings or negativism or cynicism related to one’s job.

• Reduced professional efficacy.

 

Health and Safety Executive 2020 data:

Work related stress, anxiety and depression increased in recent years.

Industries with higher-than-average rates include education, human health, and social work activities…

https://www.hse.gov.uk/statistics/causdis/stress.pdf

 

 

Psychological Distress:

You are given information from the trauma stories which afford you with a ‘knowing’ that you are then unable to ‘unknow’.

As human beings, we are empathic and compassionate, however when overly exposed to traumatised people, without effective support can lead to psychological distress. You need to be alert to the signs in yourself and your co-workers.

 

Symptoms:

 

     EMOTIONAL     a sense of feeling detached from people at home and at work, feeling overwhelmed by things you would normally cope with, having feelings of hopelessness and helplessness, feelings of sadness, loss, and anger             PHYSICAL     feeling exhausted, drained, headaches, and other somatic responses, an inability to sleep             COGNITIVE     a lack of concentration, an inability to make decisions, seeing the traumatic event as a flashback or dream, intrusive thoughts about the trauma story and questioning life             BEHAVIOURAL     engaging in self-destructive behaviours such as binge eating or gambling             PROFESSIONAL     avoiding work or specific tasks, feeling de-skilled and unable to cope with minor tasks

 

The attached video is directed towards educator’s, but it is helpful to all professionals to help you understand the impact of being exposed to other people’s trauma.

 

https://www.educationsupport.org.uk/resources/video/secondary-trauma

 

Without noticing or not attending to the impact of secondary trauma can in turn lead to you gradually feeling physically and mentally exhausted, feeling that you have nothing left to give.

 

Supervision:

Supervision is essential in workplace settings when professionals are working with people who have been traumatised. This is also true for professionals who are working with colleagues who have also experienced trauma. Supervision allows for debriefing, understanding the impact, and looking at ways to reduce trauma impact in the future.

“Supervision is recommended to anyone working in roles that require regularly giving or receiving emotionally challenging communications or engaging in relationally complex and challenging roles.” (BACP, 2018).

“Supervision is a work-based learning relationship, characterised by relating and reflecting. It is a critical component of safe and effective practice across the helping services, ensuring a containing and reflective space for practitioners to acknowledge and process the often stressful, uncomfortable, and painful experiences of working with children, young people, their families, and the systems around them. Through containment and reflection rooted in a dynamic and relational supervisory experience, both supervisor and supervisee are enabled to learn and grow across their professional career.” (Tavistock and Portman, 2021).

Trauma informed supervision is incorporated within clinical supervision or wellbeing supervision though the supervisor needs to be adequately trained and qualified. Being reflective within supervision normalises secondary trauma as a systemic issue and not the pathology of the individual. Supervision reinforces the need for professionals to access self-care, to acknowledge their experience which will diminish the impact of the secondary trauma from which they have been exposed to.

 

Workplace Wellbeing:

https://www.youtube.com/watch?v=2cFeyjI4umQ

 

What is it you can do to prevent VT, STS and Burnout?

Self-help:

 Supervision   Support from family& friends   Self-compassion -take care of yourself   Take time to relax!   Exercise   Boundary your work

 

This section is to help you understand how secondary trauma may impact you. Whilst this page is useful, further support maybe beneficial. Please follow the link to the counselling information page ……

Supervision can be sourced face to face or online. You can contact local counselling agencies who will have a team of supervisors, or on the British Association of Counsellors and Psychotherapy website, a supervisor’s and counselling directory is available:

https://www.bacp.co.uk/search/therapists

 

Interesting Data:

Post-Traumatic Stress Disorder Widespread in Policing, May 20219:

The Job and The Life is a survey of 17,000 police officers, from 47 forces in the United Kingdom, which was carried out by Cambridge University from October to December last year, with funding from Police Care UK.

 

It shows:

    21% of police officers who responded reported symptoms consistent with PTSD or the more severe Complex PTSD (CPTSD);

    73% of those with PTSD or CPTSD will be unaware that they have it;

    66% of those reported a psychological or mental health issue which they felt was a direct result of police work.

    69% of officers feel that trauma is not well managed in their force;

    93% still go to work even when suffering from a work-related psychological issue.

 

https://www.polfed.org/news/latest-news/2019/post-traumatic-stress-disorder-widespread-in-policing/

 

Community Care, Sept 2020:

Social work job-related stress was common among current practitioners (85%), though children’s practitioners were more severely affected, with 33% reporting being very stressed and 55% fairly stressed, compared with 28% and 54% respectively for adults’ practitioners.

 

https://www.communitycare.co.uk/2020/09/04/four-ten-social-workers-anticipate-quitting-profession-within-five-years-back-high-stress-caseloads/

 

References:

https://www.bacp.co.uk/events-and-resources/ethics-and-standards/ethical-framework-for-the-counselling-professions/

 

Goleman, D. (1996). Emotional intelligence. Why it can matter more than IQ. Learning, 24(6), 49-50.

 

https://tavistockandportman.nhs.uk/training/cpd-courses/supervision-applied-psychologists-schools-and-community-contexts-working-relationally-and-reflectively/

 

Remen, R. N. (2001). My grandfather's blessings: Stories of strength, refuge, and belonging. Penguin.

 

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Tackling Trauma

 

Definitions:

Empathy:

Empathy is an ability to sense another person’s emotions, to feel them as if they are your own, “when you feel physically along with the other person, as though their emotions were contagious” (Daniel Goleman, 1996). Neurons mirror feelings and physical sensations meaning that you as the professional may mirror the experience of the traumatised person. As professionals and experiencing interpersonal relationships with a traumatised person, as compassionate human beings, we tend to want to rescue and help. The danger of being immersed and exposed in another person’s trauma experience is to then be impacted with similar trauma symptomologies.

 

Secondary Exposure to Trauma:

When a person is exposed to another person’s trauma, either verbally or non-verbally, it is possible to be impacted emotionally and psychologically. On hearing the trauma stories, the fear, pain, and terror, you the professional then become witness to the other person’s traumatic experiences and their sense of helplessness and hopelessness.

 

Vicarious Trauma (VT):

VT typically accumulates over time, the impact is experienced as emotional residue, you feel the feelings of the other but feel them as if they are your own.

 

Secondary Trauma Stress (STS):

STS is experienced as PTSD symptomologies as described within the ‘what is Trauma page’. This is when you have been exposed to the trauma however not directly.

 

Vicarious Grief (VG):

This is when you have been in a relationship with someone who is deeply grieving and you have absorbed the sadness, distress and hopelessness and feel it as if it is your own.

 

Burnout:

Defined in ICD-11 (International Classification of Diseases) as:

“Burn-out is a syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed. It is classed as a workplace phenomenon and not a medical condition. It is characterised by three dimensions:

• Feelings of energy, depletion or exhaustion.

• Increased mental distance from one’s job, feelings or negativism or cynicism related to one’s job.

• Reduced professional efficacy.

 

Health and Safety Executive 2020 data:

Work related stress, anxiety and depression increased in recent years.

Industries with higher-than-average rates include education, human health, and social work activities…

https://www.hse.gov.uk/statistics/causdis/stress.pdf

 

 

Psychological Distress:

You are given information from the trauma stories which afford you with a ‘knowing’ that you are then unable to ‘unknow’.

As human beings, we are empathic and compassionate, however when overly exposed to traumatised people, without effective support can lead to psychological distress. You need to be alert to the signs in yourself and your co-workers.

 

Symptoms:

 

     EMOTIONAL     a sense of feeling detached from people at home and at work, feeling overwhelmed by things you would normally cope with, having feelings of hopelessness and helplessness, feelings of sadness, loss, and anger             PHYSICAL     feeling exhausted, drained, headaches, and other somatic responses, an inability to sleep             COGNITIVE     a lack of concentration, an inability to make decisions, seeing the traumatic event as a flashback or dream, intrusive thoughts about the trauma story and questioning life             BEHAVIOURAL     engaging in self-destructive behaviours such as binge eating or gambling             PROFESSIONAL     avoiding work or specific tasks, feeling de-skilled and unable to cope with minor tasks

 

The attached video is directed towards educator’s, but it is helpful to all professionals to help you understand the impact of being exposed to other people’s trauma.

 

https://www.educationsupport.org.uk/resources/video/secondary-trauma

 

Without noticing or not attending to the impact of secondary trauma can in turn lead to you gradually feeling physically and mentally exhausted, feeling that you have nothing left to give.

 

Supervision:

Supervision is essential in workplace settings when professionals are working with people who have been traumatised. This is also true for professionals who are working with colleagues who have also experienced trauma. Supervision allows for debriefing, understanding the impact, and looking at ways to reduce trauma impact in the future.

“Supervision is recommended to anyone working in roles that require regularly giving or receiving emotionally challenging communications or engaging in relationally complex and challenging roles.” (BACP, 2018).

“Supervision is a work-based learning relationship, characterised by relating and reflecting. It is a critical component of safe and effective practice across the helping services, ensuring a containing and reflective space for practitioners to acknowledge and process the often stressful, uncomfortable, and painful experiences of working with children, young people, their families, and the systems around them. Through containment and reflection rooted in a dynamic and relational supervisory experience, both supervisor and supervisee are enabled to learn and grow across their professional career.” (Tavistock and Portman, 2021).

Trauma informed supervision is incorporated within clinical supervision or wellbeing supervision though the supervisor needs to be adequately trained and qualified. Being reflective within supervision normalises secondary trauma as a systemic issue and not the pathology of the individual. Supervision reinforces the need for professionals to access self-care, to acknowledge their experience which will diminish the impact of the secondary trauma from which they have been exposed to.

 

Workplace Wellbeing:

https://www.youtube.com/watch?v=2cFeyjI4umQ

 

What is it you can do to prevent VT, STS and Burnout?

Self-help:

 Supervision   Support from family& friends   Self-compassion -take care of yourself   Take time to relax!   Exercise   Boundary your work

 

This section is to help you understand how secondary trauma may impact you. Whilst this page is useful, further support maybe beneficial. Please follow the link to the counselling information page ……

Supervision can be sourced face to face or online. You can contact local counselling agencies who will have a team of supervisors, or on the British Association of Counsellors and Psychotherapy website, a supervisor’s and counselling directory is available:

https://www.bacp.co.uk/search/therapists

 

Interesting Data:

Post-Traumatic Stress Disorder Widespread in Policing, May 20219:

The Job and The Life is a survey of 17,000 police officers, from 47 forces in the United Kingdom, which was carried out by Cambridge University from October to December last year, with funding from Police Care UK.

 

It shows:

    21% of police officers who responded reported symptoms consistent with PTSD or the more severe Complex PTSD (CPTSD);

    73% of those with PTSD or CPTSD will be unaware that they have it;

    66% of those reported a psychological or mental health issue which they felt was a direct result of police work.

    69% of officers feel that trauma is not well managed in their force;

    93% still go to work even when suffering from a work-related psychological issue.

 

https://www.polfed.org/news/latest-news/2019/post-traumatic-stress-disorder-widespread-in-policing/

 

Community Care, Sept 2020:

Social work job-related stress was common among current practitioners (85%), though children’s practitioners were more severely affected, with 33% reporting being very stressed and 55% fairly stressed, compared with 28% and 54% respectively for adults’ practitioners.

 

https://www.communitycare.co.uk/2020/09/04/four-ten-social-workers-anticipate-quitting-profession-within-five-years-back-high-stress-caseloads/

 

References:

https://www.bacp.co.uk/events-and-resources/ethics-and-standards/ethical-framework-for-the-counselling-professions/

 

Goleman, D. (1996). Emotional intelligence. Why it can matter more than IQ. Learning, 24(6), 49-50.

 

https://tavistockandportman.nhs.uk/training/cpd-courses/supervision-applied-psychologists-schools-and-community-contexts-working-relationally-and-reflectively/

 

Remen, R. N. (2001). My grandfather's blessings: Stories of strength, refuge, and belonging. Penguin.

 

The Impact of Working with Traumatised People

for the Helping Professions –

Self Care