Anne Ranee Farrar, MA
Seton Hall University
(This article was first published in the Winter 2002 issue
of the APAGS Newsletter.)
In one way or another, all of our lives have been recently changed. September
11, 2001 is a day that everyone will remember—from the details of where they
were, what they were doing, and the shock they felt when they heard that four
planes were hijacked, the Pentagon was hit, that the two World Trade Center
towers as well as several other buildings were destroyed, and thousands were
killed. The reaction from so many on that day and continuing is "how can I
help?" We all want to know what we can do. As workers in the mental health
field, this is a common reaction. The question is: Are we prepared?
Vicarious traumatization is also referred to as a secondary trauma. It can be
experienced by a clinician who works with traumatized individuals, whether they
work with victims of child maltreatment, domestic violence, victims of torture,
or victims of large-scale disasters. Pearlman and Saakvitne (1995) emphasize the
need for the therapist to be aware of vicarious traumatization and its impact on
the therapist. "Vicarious traumatization is the process through which the
therapist’s inner experience is negatively transformed through empathic
engagement with clients’ trauma material" (p. 279). For example, a
therapist may experience nightmares related to events in which they have heard
graphic details. They may experience fear, may have concerns about their own
safety, or they may feel compelled to question own their life experiences or
their own vulnerabilities after hearing the stories of survivors.
Pearlman and Mac Ian (1995) reported that therapists who work with trauma
victims and who have a personal trauma history show more negative effects from
their work than those therapists without a personal trauma history. McCann and
Pearlman (1990) suggested that vicarious traumatization among professionals
working with victims result from the inability of the therapists to process the
traumatic clinical material in which they hear. Brady, Guy, Poelstra, and Brokaw
(1999) reported that vicarious traumatization has symptoms which are similar to
Post Traumatic Stress Disorder (PTSD) and may disrupt the cognitive schemas
reported by the therapist.
In a study of international relief and developmental personnel (Erisson,
Vadne Kemp, Gorsuch, Hoke, & Foy, 2001) reported that 10% of returning staff
who worked in the field with trauma survivors met full criteria for PTSD,
reporting at least moderate symptoms such as re-experiencing the event,
hyperarousal, as well as avoidance.
Friedman (1996) reported that therapist self-care is essential when working
with patients who suffer from PTSD because this work can be functionally
disruptive and psychologically destabilizing for the mental health
professionals. Kinzel and Nanson (2000) found that educating and debriefing
volunteers (mental health professionals) were two strategies, which they found
to prevent the onset of compassion fatigue and also to reduce the resignation of
the volunteers. They indicated that debriefing was found to help many of the
volunteers cope and deal with processing the traumatic events which they heard.
For those who are volunteering their time it is important to take care of one’
self and to reduce stress. Mitchell and Everly (1998) indicate that stress
management is "a personal process" (p. 23). They note that there is no
one "right" answer to stress management but that the most important
element is consistency and that it should become part of one’s lifestyle, not
just some techniques which are utilized by a person when they feel stressed.
Different methods of management techniques can be proper sleep and nutrition,
progressive muscle relaxation, imagery, meditation, and physical exercise.
The question at all times remains, "How can we help someone else, if we
first can’t help ourselves?" The only way for a mental health
professional to help others is that they must first be as psychologically
healthy as possible. We all have limits of what we can do. There is nothing
wrong with taking time off to be alone, or spend time with family and/or
friends, and to not volunteer. Follette, Polusny, and Millbeck (1994) report
that peer support networks, employee assistance programs, and personal therapy
represent some possible methods for reducing the negative impact of work related
stressors.
The American Red Cross (2001) reported, "Most disaster workers are
dedicated individuals who also tend to be perfectionists. Because of this, they
are at risk of pushing themselves too hard and of not being satisfied with what
they have accomplished" (p. 1). One of the most important recommendations
the American Red Cross (2001) made is that as difficult as it might be when your
shift is over "leave and take time to recharge" (p. 2).
All of us, including children and adults, have been affected by the events of
September 11th. Driving through NYC
the other day, I was reminded of the event, not by viewing the skyline which has
been drastically changed, but by viewing the faces of the people who work in the
city. There was a somberness which was manifested. The information presented
above has been gained by research conducted with therapists who focus on trauma
work. The difference is that now at some point we will all be doing trauma work
due to the events of September 11, 2001. We all must do what we can to take care
ourselves in order to best help others.
