Vicarious Trauma Symptoms and Warning Signs and the COVID-19 Pandemic

Twenty years have passed since my first experience of compassion fatigue and vicarious trauma. Since then, I have recognized that I am not alone in that experience.

McCann and Pearlman coined the phrase, vicarious trauma, in 1990. Vicarious trauma, also known as secondary traumatic stress, can happen through indirect exposure of another person’s suffering. They described it as changes in an empathetic helper’s inner world due to repeated engagement with a person’s grief and trauma-related thoughts and emotions.

Vulnerability Factors for Vicarious Trauma and the COVID-19 Pandemic

• having a history of trauma
• history of mental illness
• moral distress
• addiction
• traumatic grief in the workplace
• being threatened or attacked at work

Employees at risk for vicarious trauma are victim service providers, mental health professionals, spiritual leaders, child protective services, court personnel, members of the clergy, school-based professionals, emergency medical services, fire services, law enforcement, and funeral services. Repeated exposure to traumatic material during a pandemic can alter an employee’s thoughts, which can range from playing down vicarious trauma, not realizing it is happening to them, to feeling a shift in their beliefs about their world, their role at work, and their perception of self. An employee’s sense of self gives them purpose in life. They view their world based on how they grew up, and what they learned throughout their lifetime. When their sense of self deeply changes because of a pandemic, their values and personal identify change with it. They can become vicariously traumatized.

Vicarious Trauma Symptoms

EMOTIONAL: The emotional experience of vicarious trauma is painful and overwhelming. Emotions can include sadness, depression, numbness, guilt, irritability, helplessness, and powerlessness. Employees may experience heightened fears about being unsafe. Possible emotional reactions are changes in mood, anger at work, and hypersensitivity, Due to low compassion satisfaction, employees can become distracted, emotionally exhausted, and have reduced ability to feel sympathy and empathy.

COGNITIVE: Cognitive symptoms can include intrusive thoughts/imagery, repetitive images of the other person’s trauma, racing thoughts, flashbacks, a negative self-image, an impaired ability to make decisions, and cynicism. Also, difficulty concentrating, or confusion can occur. Other symptoms include lowered self-esteem, increased self-doubt, and dealing with issues related to perfectionism.

BEHAVIORAL: Behavioral symptoms can include sleep disturbances and nightmares, a decreased interest in intimacy, boundary violations, loneliness, difficult separating work and personal life, and becoming overprotective of family members. Other symptoms include hypervigilance, an exaggerated startle response, losing things, and becoming clumsy. It is not uncommon to avoid clients/patients or colleagues. Negative coping is shown through smoking, drinking, eating unhealthy foods, acting out, or binge shopping.

PHYSICAL: Physiological symptoms can include dizziness, rashes, breakouts, sweating, irritable bowel syndrome, body tension, wrist pain, headaches, pains, sore back and neck, and grinding teeth at night. With a weakened immune system there is increased susceptibility to illness. Symptoms that can be frightening include a rapid heartbeat and difficulty breathing.

SPIRITUAL: Spiritual symptoms can include loss of hope, decreased sense of purpose, and feelings of disconnect from others and the world. Feeling unworthy of love or not deserving love can be a painful experience. Moreover, during COVID-19, where many are becoming ill or dying, it is difficult to find meaning in a pandemic. 

Vicarious Trauma Warning Signs 

One of the most important things you can do as a supervisor or leader in your organization is to learn the warning signs of vicarious trauma. Warning signs are indicators that an employee may need urgent help. 

Although warning signs will vary depending upon the employee, learning to recognize their warning signs early can prevent a terrible outcome. 

Characteristics that may be detected:

• Compromising care of clients/patients
• Increasing use of alcohol or drugs
• Dreading working with certain clients/patients
• Frequent negative gossiping or venting at work
• Displaying extreme mood swings
• Sleeping too little or too much
• Talking about going on extended sick leave or quitting
• Withdrawing and feeling isolated
• Acting anxious at work and/or at home
• Talking about feeling hopeless

In short, supervisors and leaders can establish a culture of staff wellness and team collaboration by discussing self-care techniques as a group.

• Select ways to increase hope and morale by establishing a communication protocol through personal conversations, telephone calls, texts, emails, meetings, and online meetings.
• Illustrate ways to change an employee’s negative language. Help them reframe the way they describe their work situation from a negative world view.
• Examine ways they can maintain a positive sense of self.
• Remain flexible like Gumby!

Notes:

• Rubel, B. (2019) Loss, Grief, and Bereavement: Helping individuals cope. MA: Western Schools
• McCann, L. and Pearlman. L.A. (1990) Constructivist self-development theory as a framework for assessing and treating victims of family violence. In Stith, S., Williams, M. B., and Rosen, K. (eds.), Violence Hits Home.NY: Springer

Barbara Rubel, MA, BCETS, DAAETS, a leading thanatologist, is a keynote, trainer, and consultant on Vicarious Trauma. Her website is www.griefworkcenter.com