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Dangers of Secondary Trauma

Posted on February 10, 2017

Our next topic in this series of dangers confronting helpers, secondary trauma, is one of the most intense experiences that we can have in our professions. Secondary trauma is when empathetic intensity triggers a powerful countertransference reaction that overwhelms the helper’s capacity. When someone experiences secondary trauma, something about a client’s traumatic story connects with something in the personality or past experiences of the helper and leads to an intense emotional reaction.

Secondary trauma means that the trauma of the client is being internalized by the helper. The helper now needs to manage their own responses and triggers, as well as those of the client. The pain and hurt associated with this type of trauma can be very intense. Secondary trauma occurs when something about the pain and suffering of the client triggers a traumatic response in our own mind. Sometimes this can be caused by our minds connecting something in our past with the client’s trauma. Other times, there is something about the dynamics of our relationships with the client that creates the powerful reaction.

As mentioned in previous posts, part of our work is to connect with clients’ hurt and pain. We walk through minefields of suffering. If there is any unresolved pain in our past, or residual effects of present struggles, an intense client interaction can bring these up to the surface and cause a traumatic reaction. Secondary trauma is far from a sign of weakness, and we might have the resiliency to do any other job without this being a threat. However, the intensity of our work makes even the strongest among us vulnerable.

Clients, with their traumatic stories and struggles, can hit helpers deep in their psyche. Secondary trauma is trauma. The same debilitating fear and intense emotions associated with all other forms of trauma appear with secondary trauma. We get triggered, which elicits an emotionally-charged survival response, flooding the body with cortisol and epinephrine. Suddenly, the world and other people appear unsafe and dangerous, and we act from that place of fear.

Secondary trauma happens in our psyche, and the resulting behaviors can range across a spectrum. On one end of the spectrum is over-identification, where we can move towards the stressor and have the desire to make the situation better. This is a manifestation of the fight response. In this state, we become overly involved with the client, crossing professional boundaries as we deal with our sense of vulnerability and uncertainty.

We internalize the belief that the client is in a dangerous world and they are not capable of taking care of themselves. While some, if not all, of this might be true, we assume responsibility for the client’s well-being instead of empowering the client to regain control of their life. Our empathy turns into enmeshment as we bear the role of caretaker, and unintentionally foster client dependency on us.

On the other end of the spectrum is avoidance. Here we might also find ourselves wanting to get physically and emotionally as far away as possible – a manifestation of the flight response – or we might be overwhelmed by the stress and shut down mentally, emotionally, and physically – an expression of the freeze response. We are hurt and wounded from experiencing the client’s pain, and we may begin to associate the client, or all clients, as the cause of this pain.

Our response is to put physical and emotional space between us and this pain. At an extreme, we might leave our job, or the helping professions altogether. More often, we withdraw emotionally from our work. In this place, we struggle to connect empathetically with clients. Relationships with clients that were once healthy suffer, as the helper puts their emotions behind walls of logic and denial.

When we feel this type of pain in our work with clients, it’s important to reach out and process this with a supervisor or therapist. Many graduate programs in psychology encourage people to be in therapy themselves as they start seeing clients. This practice is effective, because, as new therapists, the graduate students are not only confronted with their clients’ pain, hurt, and trauma, but also their own reactions and pain. Seeking help is a strength to be admired and practiced. Recognizing the need to talk to someone means the helper is conscious that their past or present pain is impacting their work. It also means that they are actively taking steps to become a stronger professional and person.

Many of us are drawn to this field because we have overcome trauma in our own pasts and feel called to help others in pain. To maintain our well-being and the quality of services we deliver to clients, it’s vital that we work on our past hardships. This work is emotionally challenging, but people can be terribly hurt, personally and professionally, when they work with trauma without first resolving their past pain.

I want to open the comment section to any thoughts or experiences you might have had with secondary trauma. Take care of yourselves, my friends!

8 responses to “Dangers of Secondary Trauma”

  1. Rachel Post says:

    I think it’s also important to note the long term health impact of the neuro-chemical and physiological response to the brain of cortisol and epinephrine. I have friends whose depression and detachment, I believe are related to this exposure. Matt, can you reference the other physiological/ disease impact of long term exposure to this flooding? Thanks! Rachel Post, LCSW, Public Policy Director, Central City Concern

    • Matt Bennett says:

      Great question. We know work stress has been connected to cancer, stroke, diabetes, early onset Alzheimers disease along with many other medical issues. Long-term exposure to stress releases cytokines which (simply stated) increase the opportunity for disease to take hold and then magnifies the symptoms of the disease. I can sum this up simply by stating that “work stress can kill us!” The transfer of trauma is real and can devastate lives variously as well.

  2. Rachel Post says:

    I think it’s also important to note the long term health impact of the neuro-chemical and physiological response to the brain of cortisol and epinephrine. I have friends whose depression and detachment, I believe are related to this exposure. Matt, can you reference the other physiological/ disease impact of long term exposure to this flooding? Thanks! Rachel Post, LCSW, Public Policy Director, Central City Concern

    • Matt Bennett says:

      Great question. We know work stress has been connected to cancer, stroke, diabetes, early onset Alzheimers disease along with many other medical issues. Long-term exposure to stress releases cytokines which (simply stated) increase the opportunity for disease to take hold and then magnifies the symptoms of the disease. I can sum this up simply by stating that “work stress can kill us!” The transfer of trauma is real and can devastate lives variously as well.

  3. Randy Hylton says:

    So grateful for your commitment to keep on dispensing wisdom. I can only imagine that there are some weeks where you don’t feel a great deal of enthusiasm for writing another post. Thank you for staying with it, because this information is SO helpful and important. Such a strange aspect of the human condition that we subtly forget the things that are the most essential to our well-being. Keep shining the light!

  4. Randy Hylton says:

    So grateful for your commitment to keep on dispensing wisdom. I can only imagine that there are some weeks where you don’t feel a great deal of enthusiasm for writing another post. Thank you for staying with it, because this information is SO helpful and important. Such a strange aspect of the human condition that we subtly forget the things that are the most essential to our well-being. Keep shining the light!

  5. Matt Bennett says:

    Thanks my friend! It is comments like this and readers like you that keep it fun.

  6. Matt Bennett says:

    Thanks my friend! It is comments like this and readers like you that keep it fun.

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