Secondary traumatization is a term that refers to the stressful consequence to working with traumatic material. When you are empathetic, you open yourself up and become vulnerable to internalize the traumatized individual’s experience. This is especially the case when workplaces do not offer enough recovery time between emotional cases.

Symptoms you may feel

Arousal symptoms from secondary traumatic stress such as irritability, avoidance, and intrusion can be difficult to manage. You may have a difficult time balancing your role. Having difficulty leaving your job in the workplace, you stay late at work, take work home with them and feel isolated. You may shut down and not talk about what you are going through with family, friends, or coworkers. You experience an inability to empathize and are no longer emotionally connected to those you serve. Your health suffers, especially if you have your own interpersonal trauma history. Aches and pains become a common problem. Furthermore, you can become cynical to manage your intense feelings.

Secondary traumatization

Although another person experienced the primary stress, your body reacts like you were the one who experienced the primary trauma. Secondary traumatization occurs when you are triggered by someone’s trauma material. You experience a physical reaction called the stress response.

Secondary traumatic stress is associated with perceived stress and the amount of time a professional spends with the trauma material. The stress response starts as the brain is triggered and warns the muscles in the body. At that point, adrenal glands release stress hormones, adrenalin, and cortisol, that prepare the body to keep safe, known as the fight or flight response.

Stress response

The stress response helps your mind and body to quickly react to a life-threatening situation by fighting or fleeing. The fight or flight response is a survival mechanism. The heart pounds as blood pressure rises. As blood is sent to muscles and the brain, breath quickens so more oxygen can get into the blood.

You need energy to manage the stressor. Therefore, sugars and fats are released into the blood. Stress hormones produce physiological changes in the body, and you begin to sweat. There is no harm to your body if this only occurs occasionally. However, if you continually navigate trauma material day after day in the workplace, it can become chronic stress.

Reflective Question

If you have ever experienced the stress response, what happened?

Chronic stress is not healthy and can bring about high blood pressure, diabetes, heart disease, anxiety, worry, frustration, anxiety, exhaustion. Any emotional distress felt from someone else’s traumatic material (e.g., hearing a traumatic story, seeing the traumatic aftermath, seeing images related to the trauma, talking about the trauma), can impact your overall health, which can cause you to feel detached from others.

Where Do You Go from Here?

When you are emotionally overwhelmed because of the firsthand trauma of another or several difficult cases, seek out support, especially if the condition persists for more than a month. A traumatizing event experienced by one individual can become a traumatizing event for another individual. Therefore, reduce secondary traumatic stress symptoms and general distress by getting educated about protective factors, identifying your strengths, and putting them into practice to meet the demands of your job.

On an organizational level, secondary traumatic stress training should focus on improving a supportive work environment. Leaders, management, and supervisors must recognize the effects of traumatic exposure by training professionals in evidence-based methods of coping with traumatic stress..

Where should you start when you want to mitigate the impact of secondary trauma? You may want to immediately go to mindfulness training and self-care techniques. However, first, you need to learn about secondary trauma, risk factors, and symptoms. To fix the problem, you need to understand the problem. Being that the emotional toll of caring can compromise your functioning, this article lays the foundation for your self-care and addresses the following:

1. Describe secondary trauma following exposure to primary trauma.
2. Identify professionals at risk.
3. Compare two types of indirect contact with trauma material.
4. Examine secondary traumatic stress symptoms.

What is Secondary Trauma

Imagine a day when no child suffers from physical abuse, when no teenager lies in an ICU bed after a drug overdose, and no parent grieves their child’s suicide. These experiences, stressful and traumatizing, are considered incidents that bring about primary trauma. As professionals learn of this traumatic material, they can experience secondary trauma. Although the trauma did not happen to them, somehow, they experience the same symptoms as the person who suffered the primary trauma. Secondary trauma symptoms mimic the symptoms of post-traumatic stress disorder (PTSD).

Secondary or vicarious trauma can occur immediately following the exposure to another person’s single traumatic event or after several events. It occurs when there is some interaction between the professional and the traumatized person or their traumatic material (e.g., watching a video, reading a document). This is especially challenging when professionals are exposed to these traumatic events daily.

When you experience primary trauma, you experience certain symptoms. Secondary trauma symptoms mirror the other person’s primary trauma symptoms such as high levels of stress, anxiety, depression, insomnia, and avoidance. You may be easily triggered and have racing thoughts.

When secondary trauma symptoms are experienced in the workplace, your functioning decreases due to impaired judgment, low productivity, pushed boundaries, and poorer quality of work. Staff friction can develop. Your working environment suffers due to increased absenteeism and higher staff turnover.

Reflective Question

What secondary trauma symptoms have you experienced?

You may consider yourself empathetic and compassionate. Compassion satisfaction is the feeling of gratification you get from caring. However, you may lose your ability to feel compassionate, and become less satisfied with your level of compassion satisfaction. As you re-experience the other person’s phenomena, you no longer feel clinically competent. Your perceived self-efficacy diminishes as does your level of compassion satisfaction.

Who is at Risk for Secondary Trauma?

Secondary trauma risk factors are those who are younger, female, and have less experience in their job. Exposure to a person’s traumatic material could bring up unresolved issues from your past. If you experienced a prior trauma, and that experience is unresolved, you are at a higher risk for secondary trauma. If you experienced domestic violence, sexual assault, or a traumatic death, and have not worked those events through, your job can reactivate that personal experience. Another person’s primary trauma can become a trigger. Being exposed to their trauma material while sharing the same trauma history, can put you at risk.

Forensic nurses, emergency department nurses, oncology nurses, pediatric nurses, and hospice nurses are particularly at risk for secondary trauma. Others at risk include those practitioners who are exposed to traumatized populations in the courts and criminal justice system, such as victim advocates, prosecutors, trial attorneys, judges, probation officers, and court reporters. Therapists who work with children, child welfare workers, and case managers involved in the care of traumatized children are also at risk.

Those who work with traumatized persons and those who indirectly have contact with trauma material are at risk of secondary trauma. Two indirect exposures to trauma material:

1. Indirect trauma person/person: professionals at risk for secondary trauma work directly with those who experience primary trauma as they listen to or observe traumatized individuals, or –  those in physical pain or psychologically suffering. Those at risk include professionals, such as clinicians, clergy, lawyers, child protective services workers, probation officers, foster parents, shelter staff, police officer, fire fighters, first responders, and teachers.
2. Indirect trauma person/data: professionals at risk for secondary trauma may read traumatic material in records, documents, files, and letters. Those at risk include a professional who watches videos of a traumatic incident or listens to frightening 911 calls. Those at risk include court coordinators, magistrate support clerk, and victim advocacy administrative staff.

Reflective Question

Based on your job description, what puts you at risk for secondary trauma?