Preventing 'Secondary Trauma' Protects Caregivers from Succumbing to Undue Stress

Sarasota, FL (WorkersCompensation.com) - When tragedy strikes, we rely on first responders, leaders and other supportive professionals to help employees cope and recover. Early intervention can help workers to put traumatic events into perspective and prevent Post-Traumatic Stress Disorder, getting them back to work, life and function.

But what if the caregivers themselves suffer lingering symptoms following catastrophic events? What if the effects of a trauma persist, rending them unable to help others?

Secondary trauma is not uncommon among firefighters, police officers, healthcare providers, mental health professionals or journalists. Knowing the signs and putting preventive measures in place can protect these workers and ensure they are able to help others.

Guiding others during or after a mass shooting, natural catastrophe or other traumatic event takes empathy, openness, trust and intimacy. But those same skills can expose caregivers to risks.

“How is someone viewing the stressor? Does the caregiver see it as an opportunity to help or a problem they can’t resolve,” said Sarah Hathaway, Manager, Clinical Consultant Center for R3 Continuum. “That negative outlook can indicate how someone will cope with providing support.”

During a webinar on Preventing and Addressing Secondary Trauma Hathaway and a colleague described factors that can lead to, or prevent undue stress among caregivers.

Types of Secondary Trauma

Workers trying to help others dealing with the aftereffects of trauma can suffer from a variety of stress reactions themselves. Among them are:

• Compassion fatigue, an extreme state of tension and preoccupation with the suffering of the people the caregiver is trying to help. “You become exhausted in the face of other people’s pain,” Jeff Gorter, the company’s Clinical Director of EAP Relations. “It can be from prioritizing others’ needs. We in the helping profession are drawn to that.”
• Vicarious trauma, when “those exposed to others’ trauma, and trying to help them, become wounded,” he said. “There are significant changes in trust, an increased sense of fear. [The person acts] like a dog who pulls away because he has been wounded.”
• Secondary traumatic stress, a condition in which the caregiver displays psychological symptoms of PTSD related to working with trauma survivors. “It is no longer a temporary wounding, but where we display almost a parallel exhibition of symptoms to those we’re trying to help,” Gorter explained. “We have almost the same reactions and pain and it isn’t going away. While we try to help others, it becomes like an illness, it’s harder for us to get away from.”
• Burnout, associated with exhaustion, decreased productivity and negativity. “It’s a sense that’s, ‘what’s the point, I am powerless in the face of this,’” Gorter said. “It may include resentment or anger toward those we’re trying to help, and it may result in major life or career changes.”

Certain personal factors may contribute to a worker experiencing some of these symptoms. A caregiver’s feeling that he is inadequately trained, for example, or having a personal history of trauma can exacerbate a person’s stress.

“The single biggest factor as to why someone may experience more difficulty the day after a traumatic event depends on how well they were doing before the event,” Gorter said. “If they are already stretched to the limit, managing all they can, and an unusual stressor comes out of the blue, that can create the domino effect.”

Positive, Preventive Factors

There are “some protective factors, things that do sustain us in the profession or in leadership roles in the midst of challenges and how we rise to those occasions,” Gorter said. “A negative outlook is a risk factor, but a positive outlook is a protective factor.”

Caregivers who have a strong support system — especially with people not associated with their work — fare better than those who are isolated, the speakers said. Using that support system is important.

“Knowing how to reach out when you need additional care and concern,” Gorter said. “One thing that’s often key is being able to be directive with your support system. Letting them know, ‘here’s how I’m feeling. I’m overwhelmed.’”

Both speakers emphasized the importance of ‘self-care,’ which often goes by the wayside when caregiving is at its peak. Things the person enjoys doing, such as hobbies allow caregivers to recharge.

“Things that are enjoyable allow us to separate from that stress and provide a distraction from the onslaught of work, people who need so much from us,” Hathaway said. “They allow us to rebuild our energy.  Making them a routine helps us get through the most difficult times.”

Along with self-care is the ability to compartmentalize. “It’s an essential professional skill,” Gorter said. “It’s being able to step away [from the caregiving], to put it in a box and on a shelf; choosing not to dwell on it and feeling like you’ll never get a break from it.”

Maintaining a sense of humor is also a vital aspect to maintain balance for caregivers. “Being able to laugh at something has power over it, it’s a very powerful coping technique,” Gorter said. He cautioned against the humor becoming cynical or mocking.

Ways to Deal

Caregivers and those who work with them should be aware of the potential for secondary trauma. Taking certain actions can keep these workers balanced:

• Training. Education on managing their own stress, how to navigate the feelings of the need to take care of others and bolster their own resiliency
• Self-care. This can be integrated into the workplace culture. For example, caregiver managers who admit to feeling stressed and taking an occasional day off allows other employees to feel they too can prioritize their needs. It can also foster conversations among workers to share the stresses they are experiencing. Also, encouraging workers to reach out for help, through EAP or other resources can help reduce the stigma associated with seeking help.
• Top 10 list. Gorter recommends caregivers create and keep with them a list of the top coping or stress relieving activities that are simple and don’t require a lot of preparation. Taking a walk, calling a sibling, listening to a particular song or playing an instrument, are examples. The idea is to have the list ready ahead of time. “When stress hits, I’m not at my most creative. I can’t think of 10 creative ways to care for myself,” he said. “I need a list of what has worked before and what I can do now. It helps ground me, gets my balance back and empowers me to say, ‘what’s my next choice.’”

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