Understanding Secondary Trauma: A Comprehensive Guide for Caregivers

Introduction

Secondary trauma, also known as vicarious trauma, compassion fatigue, or secondary traumatic stress, is a serious condition that can affect individuals who are exposed to the trauma of others. This is especially common among those who work closely with traumatised individuals, such as therapists, social workers, first responders, and caregivers of children who have experienced significant trauma.

Secondary trauma can manifest as a range of emotional and psychological symptoms that can profoundly impact the well-being and effectiveness of the caregiver. This comprehensive guide explores secondary trauma, its symptoms, its impact on caregivers and siblings of traumatised children, and strategies to protect oneself from its effects. It also provides guidance on where to seek help and support.

What Is Secondary Trauma?

It refers to the emotional and psychological distress that arises from indirect exposure to another person’s traumatic experiences. Unlike primary trauma, which occurs when a person directly experiences a traumatic event, secondary trauma develops in those who care for or support individuals who have undergone traumatic events. Caregivers, birth parents, foster parents, adoption parents, teachers and mental health professionals working with traumatised children are at significant risk of developing secondary trauma due to the emotionally intense and challenging nature of their work.

This distress is more than just feeling empathy or sympathy for someone who is suffering; it involves internalising their pain and distress to the point where it begins to affect one’s own mental health. Over time, this can lead to symptoms that are strikingly like those experienced by the individuals directly affected by the trauma.

Symptoms of Secondary Trauma

The symptoms can be wide-ranging and vary in intensity depending on the individual’s exposure to trauma, personal resilience and available support systems. Some of the common symptoms include:

1. Emotional Symptoms

  • Anxiety and Fear: Caregivers may experience heightened anxiety, often worrying excessively about the safety and well-being of the children in their care. This anxiety can sometimes escalate into panic attacks or generalised anxiety disorder.
  • Depression: Persistent feelings of sadness, hopelessness, or worthlessness can develop. The caregiver might struggle to find joy in activities that were once pleasurable, leading to a pervasive sense of despair and not feeling enthusiastic about any activity.
  • Emotional Numbness: To cope with overwhelming emotions, caregivers might become emotionally numb or detached, finding it difficult to feel empathy or connect with others, including their loved ones. They may begin to dislike them intensely.

2. Cognitive Symptoms

  • Intrusive Thoughts: Caregivers may experience intrusive thoughts or flashbacks related to the traumatic events they have learned about from the children they care for. These thoughts can be distressing and difficult to manage.
  • Difficulty Concentrating: The emotional toll of secondary trauma can make it challenging for caregivers to concentrate on tasks, leading to decreased productivity and an inability to focus on day-to-day activities. They can struggle to manage their day job.
  • Negative Worldview: Exposure to trauma can alter a caregiver’s perception of the world, making them view it as a dangerous or hostile place. This shift in worldview can contribute to feelings of helplessness and despair.

3. Physical Symptoms

  • Fatigue and Insomnia: Chronic stress from secondary trauma can lead to physical exhaustion and difficulty sleeping. Caregivers may find it hard to fall asleep, stay asleep, or feel rested after sleeping.
  • Physical Ailments: Headaches, stomach-aches, and other stress-related physical symptoms are common among those experiencing secondary trauma. These symptoms can further diminish the caregiver’s quality of life.
  • Weakened Immune System: Prolonged stress can weaken the immune system, making caregivers more susceptible to illnesses and infections.

4. Behavioural Symptoms

  • Isolation: Caregivers may withdraw from social interactions, feeling unable to relate to others who are not exposed to similar trauma. This isolation can exacerbate feelings of loneliness and depression.
  • Hypervigilance: Constant exposure to trauma can make caregivers overly alert and sensitive to potential dangers, even in safe environments. This hypervigilance can lead to a state of constant stress and tension.
  • Substance Abuse: In some cases, caregivers may turn to alcohol, drugs, or other substances to cope with the overwhelming stress and emotions associated with secondary trauma.

The Impact on Caregivers

The impact of secondary trauma on caregivers can be profound, affecting not only their emotional and physical health but also their ability to perform their caregiving duties effectively. Over time, secondary trauma can lead to burnout, a state of emotional, physical, and mental exhaustion caused by prolonged and intense stress. Burnout can result in caregivers feeling overwhelmed, detached, and unable to continue in their caregiving role.

Caregivers who are suffering may also experience a diminished sense of personal accomplishment. They may feel that they are not making a difference in the lives of the children they care for, leading to feelings of inadequacy and self-doubt. This can create a vicious cycle where the caregiver becomes increasingly distressed, which in turn affects their ability to provide effective care.

Furthermore, the effects can strain personal relationships. Caregivers may become irritable, withdrawn, or emotionally unavailable to their partners, children, and friends. This can lead to conflicts, misunderstandings, and a breakdown in communication, further isolating the caregiver.

The Impact on Siblings of Traumatised Children

While the focus is often on the child who has experienced trauma, it’s important to recognise that siblings of these children are also at risk of experiencing secondary trauma. Siblings may be exposed to the same traumatic events or may witness the aftermath of these events through the behaviour and emotions of their traumatised sibling. This exposure can have significant psychological and emotional effects on the siblings, leading to what is known as secondary traumatic stress.

1. Feelings of Neglect and Resentment

Siblings of traumatised children often feel neglected as the family’s attention and resources are directed toward the child who has experienced trauma. This can lead to feelings of resentment, jealousy, and anger, which may be directed toward the traumatised sibling or the parents. Over time, these feelings can strain sibling relationships and contribute to emotional distance within the family.

2. Anxiety and Guilt

Siblings may also experience anxiety, worrying about their traumatised sibling’s well-being and the impact of the trauma on the family. They may feel guilty for not being able to protect their sibling from the trauma or for having negative feelings toward them. This guilt can be overwhelming and contribute to the development of anxiety disorders or depression.

3. Behavioural Issues

In some cases, siblings may act out in response to the emotional turmoil in the family. They may engage in disruptive behaviour, struggle in school, or withdraw from social activities. These behaviours are often a cry for attention and support, reflecting the sibling’s unmet emotional needs.

4. Internalising Trauma

Siblings may internalise the trauma they are exposed to, leading to similar symptoms as those experienced by the traumatised child, such as nightmares, anxiety, or depression. This internalisation can affect their mental health and development, potentially leading to long-term psychological issues if not addressed.

Protecting Yourself

Given the significant impact secondary trauma can have on caregivers, it’s essential to take proactive steps to protect oneself from its effects. While it’s impossible to eliminate all risks, there are several strategies caregivers can employ to reduce the likelihood of developing secondary trauma and to manage symptoms if they do arise. This is the same approach as ‘putting your own oxygen mask on first’ when approaching danger on an aircraft. If you become ill, then you can’t support the children who need you.

1. Establishing Healthy Boundaries

One of the most important steps in preventing secondary trauma is establishing and maintaining healthy boundaries. This involves recognising the limits of your emotional and physical capacity and ensuring that you do not overextend yourself in your caregiving role. It’s crucial to set aside time for self-care and personal activities that are not related to caregiving. This might include hobbies, exercise, or spending time with friends and family.

2. Practicing Self-Care

Self-care is vital for maintaining emotional and physical well-being. Caregivers should prioritise activities that promote relaxation and stress relief, such as meditation, yoga, or deep breathing exercises. Regular physical activity, a healthy diet, and adequate sleep are also important components of self-care. Additionally, engaging in activities that bring joy and fulfilment, such as creative pursuits or spending time in nature, can help buffer the effects of stress.

3. Seeking Supervision and Support

Regular supervision and support from peers or professionals can be invaluable in managing the emotional challenges of caregiving. Supervision provides an opportunity to discuss difficult cases, process emotions, and receive guidance on best practices. Peer support groups offer a space to connect with others who understand the challenges of caregiving, share experiences, and provide mutual support.

4. Developing Resilience

Resilience refers to the ability to adapt and recover from stress and adversity. Building resilience can help caregivers better cope with the demands of their role and reduce the impact of secondary trauma. Strategies for building resilience include cultivating a positive mindset, practicing gratitude and developing strong social connections. It’s also important to recognise and celebrate successes, no matter how small, to maintain a sense of accomplishment and purpose.

5. Professional Help

If symptoms of secondary trauma become overwhelming, it’s important to seek professional help. A mental health professional can provide therapy and coping strategies to manage symptoms and prevent further deterioration of mental health. Cognitive-behavioural therapy (CBT), trauma-focused therapy, mindfulness-based stress reduction and therapeutic art are some of the therapeutic approaches that may be beneficial.

Supporting Siblings of Traumatised Children

Given the potential impact of secondary trauma on siblings, it’s essential to provide them with the support and care they need. Here are some strategies to support siblings of traumatised children:

1. Open Communication

Encourage open and honest communication with siblings about the trauma and its effects on the family. It’s important to validate their feelings and provide reassurance that their emotions are normal and understandable. Providing age-appropriate explanations of the trauma can help siblings make sense of what has happened and reduce feelings of confusion or fear.

2. Involving Siblings in the Healing Process

Involving siblings in the healing process can help them feel included and valued. This might include participating in family therapy, attending support groups, or engaging in activities that promote bonding and connection within the family. Involvement in the healing process can also help siblings develop empathy and understanding for their traumatised sibling.

3. Providing Individual Support

Siblings may benefit from individual support, such as counselling or art therapy, to address their unique emotional needs. A therapist can help siblings process their emotions, develop coping strategies, and build resilience. Additionally, providing opportunities for siblings to engage in activities they enjoy and excel at can boost their self-esteem and provide a sense of feeling normal. At Mind Full Of Art we work closely with children combining mindfulness and therapeutic art to reduce anxiety, promote healing, raise self-esteem and foster a sense of hope for the future ‘Calming The Chaos’ in the home.

4. Balancing Attention

It’s important to balance the attention given to the traumatised child with the needs of their siblings. While the traumatised child may require additional support, it’s essential to ensure that siblings do not feel neglected. Regular one-on-one time with each child can help them feel valued and secure.

Where to Seek Help and Support

Caregivers and families affected by secondary trauma are not alone, and there are many resources available to provide help and support. Here are some options to consider:

1. Mental Health Professionals

Psychologists, counsellors, and therapists who specialise in trauma can provide individual or family therapy to address secondary trauma. They can offer coping strategies, support and guidance tailored to the specific needs of the caregiver and family.

2. Support Groups

Support groups for caregivers, foster parents, and families affected by trauma offer a safe space to share experiences, receive support, and connect with others who understand the challenges of secondary trauma. These groups can be found through local community centres, hospitals, or online platforms. See The Therapeutic Couch for caregivers.

3. Training and Education

Organisations that offer training in trauma-informed care can equip caregivers with the skills and knowledge needed to support traumatised children while protecting their own well-being. Training programs often cover topics such as recognising signs of trauma, implementing self-care practices, and managing stress. See The National Association of Therapeutic Parents.

4. Online Resources

Numerous online resources provide information and support for caregivers experiencing secondary trauma. Websites, forums, and webinars offer valuable insights, practical advice, and a sense of community. But fining your tribe with your children can help you to build a community which becomes a new supportive family. This helps to manage your stress, plan each day and build resilience, recovery and healing.

5. Employee Assistance Programs (EAPs)

For caregivers employed in organisations, Employee Assistance Programs (EAPs) can offer confidential counselling, referrals, and support services. EAPs are designed to help employees manage personal and professional challenges, including those related to secondary trauma.

Conclusion

Secondary trauma is a serious condition that can significantly impact caregivers who work with traumatised children. Understanding the symptoms, recognising the risk factors and implementing strategies for self-care and support are essential for protecting oneself from the effects of secondary trauma. It’s also crucial to acknowledge and address the impact on siblings, ensuring that they receive the support they need to cope with the challenges they face.

By prioritising mental health, seeking help when needed and fostering a supportive environment for both caregivers and siblings, it is possible to mitigate the effects of secondary trauma and continue providing effective care for traumatised children. Remember, you are not alone in this journey, you are not a failure, it will get better —there are resources, professionals, and communities ready to support you every step of the way.

If you need support from parents and carers going through similar issues then join my free Facebook group.

The Therapeutic Couch https://www.facebook.com/groups/thetherapeuticcouch


Tags: @secondary trauma, vicarious trauma, compassion fatigue, caregiver support, trauma care, mental health, secondary traumatic stress, trauma-informed care, caregiver burnout, sibling support, trauma symptoms, self-care strategies, emotional health, professional help for trauma, therapeutic resources, trauma education