Welcome to Vicarious Trauma. Understanding signs, causes, and strategies to manage impact.

The following content may be distressing to some viewers. If you need to, please practice self-care. Step away and take a break. Breathe. Drink water.

In this course, we will define vicarious trauma, gain a basic understanding of the impact of trauma on our brain, understand the signs and causes of vicarious trauma, compassion fatigue, and burnout, define evidence-based strategies to manage or offset the impacts of vicarious trauma, trauma, and how it impacts our brain.

Let’s begin with what vicarious trauma is. As you may know, trauma results from an event, series of events, or set of circumstances that is experienced by an individual as harmful or threatening and that has lasting adverse effects on the individual’s functioning and well-being.

Vicarious trauma is a condition where individuals experience trauma symptoms as a result of indirect exposure to traumatic events, often through their work or interactions with trauma survivors. While not everyone who is indirectly exposed to trauma will experience vicarious trauma, repeated exposure to the trauma others have suffered increases the likelihood of vicarious trauma.

Whether having been traumatized firsthand or experiencing the effects of vicarious trauma from secondhand exposure, there are significant changes in the brain that trauma causes if left unchecked. Following a traumatic event, the brain begins to experience neurochemical changes, altering how it functions. One major change that occurs is increased cortisol, the hormone responsible for our feelings of stress. If cortisol remains elevated, it can lead to long-term health effects.

Another change that occurs is alteration in neurotransmitters such as serotonin and dopamine. As these neurotransmitters change in response to the trauma, it produces negative effects on mood, behavior, and sleep. As another result of the neurochemical changes, the brain itself undergoes physical changes to three key areas.

First, the prefrontal cortex, responsible for decision-making, undergoes a decrease in activity, reducing how well the brain can regulate emotions and reactions. Second, the hippocampus, which is the memory center of the brain, shrinks, leading to impaired memory processing. Third, the amygdala, which regulates fear, becomes hyperactive, heightening fear and emotional reactivity.

Keep in mind that the entire brain will undergo changes and that these are only the key areas affected most significantly.

It is important to understand that existing trauma an individual has can make them much more vulnerable to vicarious trauma. For this reason, it is important for those who work with traumatized persons to understand what trauma they have already been exposed to. This may be childhood trauma, trauma experienced as an adult, or even pre-existing vicarious trauma an individual may have. Using tools like the adverse childhood experiences test and professional support will help identify existing traumas and allow action to be taken so that the vulnerability can be reduced.

Signs and causes of vicarious trauma, compassion fatigue, and burnout.

With an understanding of what vicarious trauma is, the next step is to understand how it manifests in those experiencing it. This will help to identify potential vicarious trauma in yourself and others.

Common signs and symptoms can include physical distress such as headaches, fatigue, insomnia, and stomach distress. Emotional distress such as irritability, anxiety, guilt, depressed mood, cognitive changes such as trouble concentrating, confusion, feeling detached, and changes in behaviors, overeating, socially isolating, avoiding certain people, missing appointments, and being habitually late.

Because vicarious trauma typically develops gradually over time, it is important to monitor for the signs long after exposure to any traumatic event.

Beyond the individual signs, two major outcomes of vicarious trauma are burnout and compassion fatigue. Click on the buttons to learn more about each of these.

Burnout, the cost of doing too much with too little support. This condition is caused by chronic workplace stress, overwork, lack of support, low control, and emotional demands. As you likely know, this can happen to anyone in demanding or high stress jobs, not just those involving trauma.

The core symptoms of burnout are physical and emotional exhaustion, cynicism, and reduced performance, which gradually build over time. Examples: a teacher overwhelmed by unrealistic expectations. An employee feeling unmotivated due to long hours.

Compassion fatigue. The cost of caring caused by exposure to others trauma over time. Compassion fatigue is a condition that anyone supporting people in distress such as caregivers, therapists, nurses, social workers, or first responders may experience. The core symptom of the condition is a reduced capacity or interest in empathy.

Onset of compassion fatigue can be sudden after intense or repeated trauma exposure. Examples of what this might look like are a social worker feeling drained after hearing traumatic stories, a nurse feeling numb after witnessing repeated patient deaths.

So, what does this look like in a real world setting? Let’s look at a scenario.

Sarah, a dedicated case manager with Child Protective Services, has spent the last 5 years investigating cases of child abuse and neglect. Renowned for her empathy and ability to connect with traumatized children and families, Sarah has recently observed subtle changes in her own behavior.

She has become increasingly withdrawn from friends and family, avoiding social gatherings and preferring quiet evenings at home. When with loved ones, she often feels irritable and frustrated, a stark contrast to her usual calm demeanor.

She has developed an overwhelming sense of fear and worry regarding the safety of her own children, frequently checking on them and imagining worst case scenarios. Even when they are safe at school or with trusted caregivers, she experiences intrusive thoughts and vivid images of the horrific situations she has encountered in her cases.

Even during moments of relaxation, she has been struggling with insomnia, often waking up feeling exhausted, even when she manages to get a full night’s sleep. Her enthusiasm for her job has waned, and she often feels a sense of hopelessness regarding the potential for real change in the lives of the children she strives to help.

Sarah’s experience exemplifies vicarious trauma because her prolonged and empathetic exposure to the traumatic experiences of the children she assists has resulted in a significant shift in her worldview and emotional functioning, leading to various symptoms that affect her personal life and overall well-being.

Overview of evidence-based strategies to manage or offset the impacts of vicarious trauma.

When dealing with trauma, vicarious or otherwise, a person-centered, trauma-informed approach is regarded as the best methodology currently available. To be person-centered is working with people in a setting and manner that is responsive to individuals and their goals, values, and preferences in a system that supports good communication and empowers individuals.

A trauma-informed perspective views trauma-related symptoms and behaviors as an individual’s best and most resilient attempt to manage, cope with, and rise above his or her experience of trauma. To be trauma-informed is learning the concept. A trauma-informed approach requires effort and action as you apply the concept.

When one is trauma-informed, they work with others who have experienced trauma in a person-centered manner. This approach leads to a shift in attitudes from what’s wrong with you to what happened to you. This approach fosters empowerment, choice, collaboration, safety, trustworthiness, and peer support, creating an environment that effectively and sustainably addresses trauma.

Vicarious trauma is a normal response to difficult work that results because you care. So, let’s look at some strategies for managing vicarious trauma. Click the flash card to flip it and learn more. Once you are done with the card, drag and drop it on the right or left edges of the slide to move to the next one. If you would like to reset the cards, you can do so with the reset cards button.

Psychoeducation and awareness. Providing education about vicarious trauma, its signs, and coping mechanisms is critical. Awareness empowers individuals to recognize symptoms early and seek support. Evidence shows psychoeducation is associated with lower distress and increased coping capacity among trauma-exposed professionals.

Reflective supervision and access to peer consultation reduces isolation and enhances resilience. Reflective supervision creates a safe space to process trauma exposure. Evidence shows supportive professional relationships are protective against secondary traumatic stress.

Intentional and routine self-care such as sleep, exercise, nutrition, and engaging in enjoyable activities helps restore emotional balance and reduce stress. Evidence shows self-care significantly reduces the physiological and emotional toll of trauma exposure.

Practices like mindfulness, grounding exercises, and breathing techniques help regulate emotional responses and reduce reactivity to traumatic content. Evidence shows mindfulness has been shown to reduce symptoms of anxiety and vicarious trauma among healthcare and mental health professionals.

Creating trauma-informed organizational cultures through policies that support work-life balance, regular debriefing, and mental health resources is essential. Evidence shows trauma-informed systems reduce turnover, improve staff wellness, and promote resilience.

Encouraging or offering access to professional therapy, especially trauma-informed or EMDR-trained providers, helps workers process secondary trauma safely. Evidence shows mental health services are crucial for long-term recovery from vicarious trauma.

Let’s take a moment for a self-reflection activity. Please download the worksheet from the resources tab of this course and answer the questions on it. To download the worksheet, click on the resources tab, then click the vicarious trauma PDF. The worksheet can be printed or completed digitally. The responses you provide are for you alone and are not tracked or stored digitally.

Once you have completed the exercise, click the next button to finish the lesson.

Let’s review what we covered in this lesson. We defined vicarious trauma as indirect exposure to others trauma, which can lead to symptoms similar to direct trauma. We established how risk of vicarious trauma increases with repeated exposure and pre-existing trauma history.

We looked at the changes trauma causes to brain chemistry and structure impacting stress, memory, and emotional regulation. We explored physical, emotional, cognitive, and behavioral symptoms of vicarious trauma such as fatigue, headaches, anxiety, irritability, confusion, and detachment.

We explored the related conditions of compassion fatigue, which affects our ability to empathize, and burnout, which affects our energy levels. Finally, we explored what it means to be trauma-informed and person-centered to support key interventions such as psychoeducation, peer support, self-care, mindfulness, organizational policies, and access to mental health services.

Congratulations, you have completed this course.