Vicarious Traumatization: The Dark Side of Empathy

Vicarious Traumatization: The Dark Side of Empathy

By Caroline Platzman

As someone who counsels in a tiny residential home situated on the grounds of one of the state’s largest and most infamous psychiatric facilities, my daily norm is anything but. I work closely with clients who have had to work extra hard not only to function in society, but to be accepted in it. I’ve heard self-reports of abuse.  I’ve spoken on the phone with crying mothers. I’ve seen functioning patients decompensate to a point they needed to be hospitalized.  I’ve witnessed delusions so debilitating and seemingly real that they initiate lasting trauma. After a while, some professionals begin to have a hard time drawing the line between their clients’ trauma and their own.

What is vicarious traumatization?

Coined by Pearlman & Saakvitne in 1995, the term vicarious traumatization refers to carrying the effects of someone else’s trauma, almost as if the trauma were your own. Vicarious traumatization is what can happen when someone is exposed to another’s trauma – whether it be at work, at home, on the news – for so long and in such an intense way that they begin to internalize it. Vicarious traumatization is not a mental illness, but a long-term consequence of putting oneself in another’s used, torn up shoes.

Vicarious traumatization is also sometimes called secondary trauma stress (STS) – as secondary witnesses to the pain and suffering of the trauma survivors they work with, those experiencing vicarious traumatization empathize so much with their patients that they begin to literally feel their pain, spiritually, emotionally and physically. Bits and pieces of vicarious traumatization can even play a role in the lives of people who are actually pretty distanced from the trauma they witness. Consider how the news has made you feel in the past few weeks, the past few years… as the world experiences trauma, oftentimes so do we.

Who is most commonly affected by vicarious traumatization?

Vicarious traumatization is common in people who work regularly and closely with victims of trauma, such as therapists, counselors, nurses, and social workers. Other high-risk professionals include law enforcement, military personnel, emergency personnel, first responders and volunteers. When you choose a profession that involves helping people with mental health conditions, who have been historically ostracized from society and continue to statistically rank as being at the highest risk for physical and psychological harm, witnessing the effects of trauma sort of comes with the territory. You see firsthand what living on the outside looks and feels like, and the struggles that come along with being different.

What are the symptoms of vicarious traumatization?

If you experience vicarious traumatization, your world view can change profoundly and feelings of empathy, commitment, and responsibility may become overwhelming. Vicarious traumatization occurs when compassion turns into something debilitating, for both the professional and client. Symptoms of vicarious traumatization may even eventually begin to affect physical, psychological and behavioral well-being.

To begin to address the complexities of countering vicarious traumatization, one must begin to recognize the symptoms of it. Symptoms of vicarious traumatization are similar to the symptoms commonly associated with PTSD. Trauma causes the mind and body to begin to manifest symptoms that shouldn’t go unacknowledged.

Physical symptoms associated with trauma include: 

  • Fatigue or lethargy
  • Insomnia
  • Headaches
  • Chronic pain
  • Sore muscles

Emotional symptoms associated with trauma include:

  • Anger and irritability
  • Intrusive thoughts/feelings
  • Avoidance
  • Mood swings
  • Depression
  • Anxiety
  • Imposter syndrome
  • Negative sense of self
  • Irrational fears/emotional responses
  • Risk of suicide
  • Risk of substance use

The behavioral and physical symptoms of trauma may interfere with one’s overall happiness, decision-making abilities, and maintenance of personal relationships. In fact, vicarious traumatization can induce feelings of hopelessness, guilt, and cynicism, as well as resentment towards work or feelings of inadequacy in the workplace. This is because the relationship with oneself and others shifts when one experiences vicarious traumatization. The relationship between professional and patient can become strained. 

When you are in a position in which you harbor trauma, the symptoms you experience can distort the way you interact with your surroundings as well as your fundamental views about the world. As a professional, you may feel as though you have no empathy left to give to your clients, you may begin to question your safety and sanity in your workplace, and you may even unpack some unresolved trauma in your own past that may explain your inability to cope with your clients’ trauma now. 

Experiencing empathy and trauma-related stress is not uncommon in helping fields. However, if trauma that isn’t yours sticks with you for several weeks to months, it may begin to change you. It is more than being tired or burnt out or sick of your job – it is a genuine response to trauma.

What is the difference between vicarious traumatization and normal work burnout?

We are all familiar with the feeling of burnout from a job, because it is not uncommon. Just the word “burnout” hurls me back into the purgatory-like feelings I would get spending week after week folding clothes at Forever21 in college, wondering how the hell I only made $300 a week for the 500 tank tops I would fold each night.

Typically, burnout happens when we feel unsatisfied with the work we are doing, we work too much, and we rest too little. Burnout can happen in any profession and is typically the result of long-term dissatisfaction in the workplace, but dissatisfaction is not the same as trauma. Burnout can oftentimes be simply resolved by switching jobs or taking a long weekend, but vicarious trauma is not so easily treated. While burnout can be uncomfortable, it does not distort one’s worldview in the way that vicarious trauma can.

How to cope with vicarious traumatization

Combatting vicarious traumatization and moving forward begins with truly taking care of yourself and practicing self-care. This includes increasing resilience and self-awareness in all facets of life – practicing healthy sleeping and eating habits, engaging in extracurricular activities outside of work, exercising, journaling or a similar task in order to monitor emotions and track fatigue, maintaining an open and honest dialogue with others, and seeking support from other mental health professionals in confidence. Counseling from a professional may be beneficial if symptoms lead to serious problems such as depression, anxiety, and thoughts of suicide.

In the context of work, it is important to focus on practicing optimism, actively setting boundaries with clients, and setting goals with them so that together you can work on moving forward. It might be a good idea to take a vacation, a mental health day, or speak with your employer about working independently while you heal. It is so important for mental health professionals to become familiar with the different responses to trauma and the signs and symptoms of vicarious traumatization. You cannot take care of others if you do not take care of yourself first!

Bottom line

Vicarious traumatization isn’t just regular burnout from work – it is a very real and raw response to trauma that can become disruptive to daily life if left unattended to. It is a phenomenon that many do not even know about. Some may be surprised to find that they can put a name to their condition. If you or someone you love is starting to feel discomfort beyond work fatigue due to having been exposed to trauma, working alongside trauma survivors or in a similar setting, it may be time to seek out a mental health professional for counseling and education.

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Waegemakers Schiff J., Lane A.M. (2019). PTSD Symptoms, Vicarious Traumatization, and Burnout in Front Line Workers in the Homeless Sector. Community Ment Health J.;55(3):454‐462. doi:10.1007/s10597-018-00364-7


Treatment Advocacy Center. (2016). Victimization and serious mental illness. Retrieved from https://www.treatmentadvocacycenter.org/evidence-and-research/learn-more-about/3630-victimization-and-serious-mental-illness

About Caroline Platzman

Caroline Platzman

Caroline Platzman is a Behavioral Health Counselor working with adults diagnosed with schizophrenia. She is passionate about mental health, journalism, nonprofit advocacy, and public relations. Caroline is also a dedicated guitarist and artist in her free time.

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