Vicarious trauma is a process of change resulting from empathetic engagement with trauma survivors.

Anyone who engages empathetically with survivors of traumatic incidents, torture, and material relating to their trauma, is potentially affected, including doctors and other health professionals.

Common signs of vicarious trauma

If you are currently or have recently been working with survivors of traumatic incidents or torture survivors, you should be aware of the following signs:

• experiencing lingering feelings of anger, rage and sadness about patient's victimisation
• becoming overly involved emotionally with the patient
• experiencing bystander guilt, shame, feelings of self-doubt
• being preoccupied with thoughts of patients outside of the work situation
• over identification with the patient (having horror and rescue fantasies)
• loss of hope, pessimism, cynicism
• distancing, numbing, detachment, cutting patients off, staying busy. Avoiding listening to client's story of traumatic experiences
• difficulty in maintaining professional boundaries with the client, such as overextending self (trying to do more than is in the role to help the patient).

If you are experiencing any of these signs, this could indicate that you are suffering from vicarious trauma.

Strategies for reducing risk of vicarious trauma

If you feel you may be suffering from vicarious trauma, try following these coping strategies to reduce the risks.

• Increase your self-observation - recognise and chart your signs of stress, vicarious trauma and burnout.
• Take care of yourself emotionally - engage in relaxing and self-soothing activities, nurture self-care.
• Look after your physical and mental wellbeing.
• Maintain a healthy work/life balance - have outside interests.
• Be realistic about what you can accomplish - avoid wishful thinking.
• Don't take on responsibility for your patients' wellbeing but supply them with tools to look after themselves.
• Balance your caseload - mix of more and less traumatised clients, victims and non-victims.
• Take regular breaks, take time off when you need to.
• Seek social support from colleagues, family members.
• Use a buddy system - particularly important for less experienced doctors.
• Use peer support and opportunities to debrief.
• Take up training opportunities.
• If you need it, take up time-limited group or individual therapy.
• There are also significant organisational factors that can increase the risk of a person being vicariously traumatised, which should be assessed and addressed.

Freedom from torture

This guidance was provided by Freedom From Torture who run bespoke and regular open-access training in self-care and vicarious trauma.

Find information on training days