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Secondary Trauma & Compassion Fatigue: A Guide to Self-Care

Updated: May 9


Fight, Flight, Flee, Flop: Understanding Trauma Responses

Healing trauma is an act of bravery, confronting pain head-on. Yet, it's equally demanding for those who stand witness to suffering daily. Without diligent self-care, both individually and as a collective, the risk of burnout and compassion fatigue escalates, igniting a secondary crisis where depleted reserves go unaddressed (Figley & Ludick, 2017).


Helpers, immersed in vicarious or secondary traumatization, find themselves deeply affected. They bear witness to relentless crises, chasing solutions on the frontlines, their resilience tested as they observe suffering, yet are expected to remain invincible. This continuous exposure to trauma, if left unaddressed, extracts a significant toll, regardless of the most altruistic intentions. Gradually, the ability to harbor hope amidst dark human experiences stretches thin, weighed down by the heavy burden of unprocessed grief and loss.


Recognizing secondary trauma as an occupational hazard is crucial for anyone intimately engaged with suffering. A lack of sufficient practices for preventing, treating, and mitigating accumulative strain results in a depleted workforce, limiting the sustainability of this vital work. The symptoms closely mirror those of PTSD, including declining optimism, mood swings, emotional numbness, and intrusive memories. Sleep disorders, heightened anxiety/depression, and physical ailments like autoimmune diseases or heart conditions further compound the initial symptoms (Simionato & Simpson, 2018). Caregiver burnout exacerbates these issues, leading to ethical lapses, apathy, and at its most severe, an increased risk of suicide for caregivers struggling to reconcile the cruelty they face with insufficient support.


Staggering statistics reveal the high impact of inadequate self-care practices within trauma healing professions:

  • 62% of human rights workers exhibit PTSD symptoms (Knuckey et al., 2018).

  • 45% of therapists face psychological conditions (Simionato & Simpson, 2018).

  • 32% of journalists covering crises report depression (MacDonald et al., 2016).

  • 71% of physicians experience severe emotional exhaustion (Shanafelt et al., 2019).


These figures highlight a systemic failure to provide adequate care for helpers, perpetuating needless sacrifice. Modern trauma theory acknowledges caregivers' vulnerability to secondary stress. Transforming care delivery systems to prioritize frontline resilience as much as patient care is increasingly vital. Institutions can foster a supportive environment through destigmatizing discussions about psychological difficulties, normalizing routine mental health check-ins, and promoting creative outlets for processing witnessed trauma (Cummings et al., 2018).


While institutions bear a significant responsibility in preventing burnout, individuals can adopt essential practices to fortify against compassion fatigue:

  • Recognize your limits around trauma exposure and balance activities accordingly.

  • Seek support from mentors, therapists, or peers before reaching critical junctures.

  • Engage in personal psychotherapy to address unresolved personal trauma.

  • Prioritize self-compassion as a foundation for compassion towards others.

  • Integrate trauma-informed self-care practices into your daily routine.


Mindfulness, self-care, and stress-reduction techniques are essential for maintaining balance and preventing burnout in trauma-informed professions. Here are some suggestions to incorporate into your daily routine:

  • Mindfulness Meditation: Engage in mindfulness meditation for at least 10-15 minutes a day. Find a quiet space, sit comfortably, and focus on your breath. Observe your thoughts and emotions without judgment, allowing them to pass like clouds in the sky. Regular mindfulness practice can help reduce stress, improve emotional regulation, and increase self-awareness (Shapiro et al., 2005).

  • Grounding Techniques: Practice grounding techniques when feeling overwhelmed or anxious. These techniques help you reconnect with the present moment and regain a sense of stability. Examples include the 5-4-3-2-1 technique (noting 5 things you see, 4 things you feel, 3 things you hear, 2 things you smell, and 1 thing you taste) or the 4-7-8 breathing technique (inhaling for 4 counts, holding for 7 counts, and exhaling for 8 counts) (Campbell, 2019).

  • Self-Reflection and Journaling: Take time for self-reflection and journaling to process your experiences, thoughts, and emotions. Writing can be a cathartic and insightful practice, helping you gain clarity, identify patterns, and release pent-up emotions. Regularly check in with yourself, noting any signs of stress, burnout, or compassion fatigue (Pennebaker & Smyth, 2016).

  • Physical Self-Care: Prioritize physical self-care by maintaining a balanced diet, staying hydrated, and engaging in regular exercise. Physical activity, such as yoga, walking, or swimming, can help reduce stress, improve mood, and boost overall well-being. Ensure you get enough quality sleep each night, as sleep deprivation can exacerbate stress and emotional exhaustion (Winwood et al., 2006).

  • Social Support: Cultivate a strong support system of family, friends, and colleagues who understand the challenges of your work. Engage in regular social activities, share your experiences, and seek guidance when needed. Joining a peer support group or attending workshops and conferences can provide valuable opportunities to connect with others in your field and learn from their experiences (Michie, 2002).

  • Creative Pursuits and Hobbies: Engage in creative pursuits and hobbies that bring you joy and allow you to express yourself. Whether it's painting, music, gardening, or cooking, having a creative outlet can help you decompress, find balance, and maintain a sense of identity outside of your work (Caddy et al., 2012).

  • Nature and Mindful Movement: Spend time in nature, as it can have a calming and restorative effect on the mind and body. Take walks in parks, forests, or along the beach, and practice mindful movement, such as tai chi or qigong, to cultivate a deeper connection with your body and the environment (Bratman et al., 2015).

  • Boundary Setting: Set clear boundaries between your work and personal life to prevent work-related stress from spilling over into your personal time. Establish specific work hours, create a dedicated workspace, and learn to say no to additional responsibilities when necessary. Prioritize time for self-care, relaxation, and personal interests outside of work (Figley, 2002).

  • Professional Development: Invest in your professional development by attending workshops, conferences, and training sessions related to trauma-informed care, self-care, and resilience. Continuously expanding your knowledge and skills can help you feel more confident and equipped to handle the challenges of your work (Norcross & VandenBos, 2018).

  • Gratitude and Positive Reframing: Practice gratitude by regularly acknowledging the positive aspects of your life and work. Keep a gratitude journal, noting three things you are thankful for each day. Reframe challenging situations by looking for opportunities for growth, learning, and meaningful impact. Cultivating a positive mindset can help build resilience and maintain a sense of purpose (Emmons & McCullough, 2003).


Remember, self-care is not a luxury but a necessity for professionals in trauma-informed fields. By prioritizing your own well-being, you can sustain your ability to support others and make a positive difference in their lives. Regularly assess your self-care practices, make adjustments as needed, and seek professional help if you experience persistent symptoms of burnout or compassion fatigue.


Careers in trauma work offer growth and understanding of human resilience, but without a commitment to self-care, battling compassion fatigue is a losing strategy. When self-care is a foundational pillar—supported by adequate training, fair compensation, and organizational reinforcement—trauma workers can thrive without sacrificing their well-being.

For professionals in healthcare, education, social services, and coaching, integrating trauma-informed self-care practices is essential for sustaining your vital work and preventing burnout. The NeuroNarrative Approach™ offers a comprehensive framework for nurturing your resilience while supporting your clients' healing journeys. To learn more about how you can deepen your understanding of trauma-informed self-care and expand your skill set, visit www.treymalicoat.com. Explore classes, coaching, retreats, and intensives designed to equip you with the tools and insights needed to thrive in your professional and personal life.


Compassion towards others begins with self-compassion. Let's champion systems, organizations, and communities that recognize this truth, ensuring no one has to bear the burden of trauma alone. By prioritizing our own well-being and advocating for supportive environments, we can continue to serve as beacons of hope and resilience in the face of adversity.


Thankfully,


Trey Malicoat, M.S.



References:

  • Bratman, G. N., Daily, G. C., Levy, B. J., & Gross, J. J. (2015). The benefits of nature experience: Improved affect and cognition. Landscape and Urban Planning, 138, 41-50. https://doi.org/10.1016/j.landurbplan.2015.02.005

  • Caddy, L., Crawford, F., & Page, A. C. (2012). 'Painting a path to wellness': Correlations between participating in a creative activity group and improved measured mental health outcome. Journal of Psychiatric and Mental Health Nursing, 19(4), 327-333. https://doi.org/10.1111/j.1365-2850.2011.01785.x

  • Campbell, K. (2019). The 5-4-3-2-1 grounding technique for panic attacks. Healthline. https://www.healthline.com/health/grounding-techniques

  • Cummings, C., Singer, J., Hisaka, R., & Benuto, L. T. (2018). Compassion satisfaction to combat work-related burnout, vicarious trauma, and secondary traumatic stress. Journal of Interpersonal Violence, 36(5-6), NP2325-NP2349. https://doi.org/10.1177/0886260518799502

  • Emmons, R. A., & McCullough, M. E. (2003). Counting blessings versus burdens: An experimental investigation of gratitude and subjective well-being in daily life. Journal of Personality and Social Psychology, 84(2), 377-389. https://doi.org/10.1037/0022-3514.84.2.377

  • Figley, C. R. (2002). Compassion fatigue: Psychotherapists' chronic lack of self care. Journal of Clinical Psychology, 58(11), 1433-1441. https://doi.org/10.1002/jclp.10090

  • Figley, C. R., & Ludick, M. (2017). Secondary traumatization and compassion fatigue. In S. N. Gold (Ed.), APA handbook of trauma psychology: Foundations in knowledge (pp. 573-593). American Psychological Association. https://doi.org/10.1037/0000019-029

  • Knuckey, S., Satterthwaite, M., & Brown, A. (2018). Trauma, depression, and burnout in the human rights field: Identifying barriers and pathways to resilient advocacy. Columbia Human Rights Law Review, 49(3), 267-323.

  • MacDonald, J. B., Saliba, A. J., & Hodgins, G. (2016). Burnout in journalists: A systematic literature review. Burnout Research, 3(2), 34-44. https://doi.org/10.1016/j.burn.2016.03.001

  • Michie, S. (2002). Causes and management of stress at work. Occupational and Environmental Medicine, 59(1), 67-72. https://doi.org/10.1136/oem.59.1.67

  • Norcross, J. C., & VandenBos, G. R. (2018). Leaving it at the office: A guide to psychotherapist self-care (2nd ed.). The Guilford Press.

  • Pennebaker, J. W., & Smyth, J. M. (2016). Opening up by writing it down: How expressive writing improves health and eases emotional pain (3rd ed.). The Guilford Press.

  • Shanafelt, T. D., West, C. P., Sinsky, C., Trockel, M., Tutty, M., Satele, D. V., Carlasare, L. E., & Dyrbye, L. N. (2019). Changes in burnout and satisfaction with work-life integration in physicians and the general US working population between 2011 and 2017. Mayo Clinic Proceedings

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