Vicarious Trauma

“The baby isn’t breathing. You need to meet me at the hospital.” A phone call in 2007 that propelled me out of my Saturday morning doziness and into a situation that quickly became a nightmare. The baby had died by the time I got to the hospital and it was clear it wasn’t just of natural causes; someone was to blame. It was the final straw for me in my job as a caseworker with women involved in street-based sex work. Not a week went by that we didn’t hear multiple stories of sexual trauma, rape, kidnapping, violence, domestic abuse, and drug addiction. We were endlessly getting women into rehab then rehousing them when they left and relapsed, or attending meetings where their children were being removed by social services, or going on prison and hospital visits. It was an amazing charity and an amazing job. I had some of the best colleagues I’ve ever worked with who were supportive and fun in the midst of what was pretty heavy work. But by the end, I was deep in vicarious trauma territory. 

I couldn’t watch the news, or even documentaries - too real. I was numb to a lot of life, not really enjoying things or feeling sad about things anymore, just numb. I didn’t have any hope left that anything would change for the women, but also for myself; I didn’t have any idea of what my life would look like, or hope that it would be ok. I had a pretty dim view of all men; seeing them as the problem, the threat, the perpetrators over years had left me with a heightened sense of fear. I couldn’t stop crying when a man in a hardware store showed me how to set a mousetrap and set it off with a piece of paper; the loud snap propelled my system into overdrive and my fight or flight response took over. I left without paying for the trap! The only option in my mind was to flee the country. I packed up, sold up and left. But the damage was done. My brain had been re-wired for trauma.

Our brains are amazing in so many ways. We have these incredible things called mirror neurons which allow us to emapthise with the stories of other people - to feel the same emotions as the person who is telling the story as though they were our own. The problem is, when we hear too many stories (without proper safeguards in place), our mirror neurons become overstimulated, leading to empathy fatigue; a state in which we can no longer distinguish between others’ emotions and our own, and we become emotionally exhausted and detached. The term ‘vicarious trauma’ was coined by Laurie Anne Pearlman and Lisa McCann in the 90s to describe this impact which they discovered during research with first responders and therapists who regularly were witness to the trauma of others. 

What they found was that repeated exposure to others’ trauma can lead to dysregulation in the nervous system, changes in brain function, and alterations in stress-related hormones. When exposed to trauma, whether directly or indirectly, the body activates the hypothalamic-pituitary-adrenal (HPA) axis—the body's main stress system.

• The amygdala (the brain's fear center) becomes overactive, increasing emotional reactivity and hypervigilance.

• The prefrontal cortex (responsible for rational thinking and emotional regulation) becomes less active, making it harder to process emotions and make decisions.

• The hippocampus (which helps differentiate between past and present threats) may shrink, leading to difficulty distinguishing real danger from perceived threats.

• Cortisol and adrenaline levels fluctuate, leading to chronic stress, exhaustion, and emotional numbness.

Over time, dysregulation of the autonomic nervous system (ANS), leads to difficulty transitioning between fight-or-flight (sympathetic nervous system) and rest-and-digest (parasympathetic nervous system) states. I flew home to Belfast at the end of 2007 for Christmas and behind me an older gentleman fell down some stairs in the airport. He was fine, but I cried for 2 hours and felt like I might never stop. I could not get my system to transition back to rest-and-digest. 

Are you recognising any of this? It might also look like

• Chronic fatigue, pain or muscle tension

• Insomnia

• Difficulty in regulating your food intake

• Emotional numbness/dissociation

• Brain fog

• Anxiety/hypervigilance

• Irritation with others

• Inability to relax

• Increased startle response

• Lack of ability to connect with others, feeling isolated. 

• Loss of executive function 

• Changes in beliefs about the world (loss of faith in humanity) 

  
  

Oh my goodness! Is there any hope in all of this?! Yes! Of course there is. In the same way that our brain’s neuroplasticity allows it to change in response to trauma, it can also be rewired to respond to safety and ‘normal’ life. Some of the practices that are useful are:

Mindfulness & Meditation. This strengthens the prefrontal cortex which is responsible for rational thinking and emotional regulation.

Somatic Practices (Yoga, Deep Breathing, Progressive Muscle Relaxation).  These help reset the nervous system from fight or flight to rest and digest. 

Social Connection. Supports oxytocin release, which counteracts stress hormones. It also reminds us that we aren’t alone, there are good people, and we are loved. 

Exercise & Movement. Reduces cortisol (panic hormone) and increases serotonin and dopamine (happy hormones!).

Sleep & Restorative Practices. Allows the brain to process and integrate emotional experiences. (Did you know scientists think our brains ‘wash’ themselves while we sleep to get rid of toxins and extra hormones we don’t need!? Too long to go into here, but check out the work of Maiken Nedergaard if you’re interested in this!). 

But, of course, my TOP TIP for dealing with vicarious trauma, is to get yourself a good THERAPIST or CLINICAL SUPERVISOR (in any helping profession you need one) who will help you to work through it. Therapists and supervisors have the skills necessary to hold a safe and non-judgmental space for whatever comes up in your vicarious trauma work. They are able to carefully pace the work so you don’t end up feeling re-traumatised, and they can help you to regulate your autonomic nervous system through somatic exercises or specific interventions to deal with intrusive thoughts, flashbacks, dissociation etc. 

I would not have been able to work through my vicarious trauma on my own because the impact was too significant. Don’t leave it too late before you ask for help. And if you lead a team of people who work with trauma, make sure there is adequate help available for your team from skilled professionals so that they don’t burn out. No one should have to flee the country to escape from vicarious trauma!