Appendix C. Vicarious Trauma

© Joyful Heart Foundation. Reprinted with Permission

About the Issue

It is part of the human condition to be affected by the pain of others, especially if one feels a responsibility to “make things right.” Over time — and as a result of cumulative exposure to suffering — someone experiencing vicarious trauma may have the sense that all the upsetting things they see and hear are slowly seeping in. It may seem as if something has shifted inside them,  and this person they could feel fundamentally different from how they did back when they first started helping others.

“It has been decades since I can recall feeling joy in my work.  I know I should be happy and filled with gratitude, but it has been just squeezed out of me.”

Some people struggle with feelings of depletion, overwhelm, vulnerability and acute sensitivity, while others may construct a set of rigid defenses to keep distressing feelings, images and stories at bay.3 Such reactions are attempts to manage and process an increasingly high volume of traumatic information. They are widespread and even rational reactions to these feelings.

Unfortunately, these responses may inhibit our individual health and wellness, as well as our ability to be our full selves and do our best work.

Thankfully, this work can be done in a sustainable way that protects the health and wellness of those doing it and that benefits the community. We can mitigate the detrimental consequences of vicarious trauma through education, self-awareness and participation in activities to prevent vicarious trauma, compassion fatigue and burnout. As we become educated about the ways we are affected by trauma  individually and organizationally and explore strategies that assist in managing trauma, we are able tocan rekindle a light of wellness that radiates out from the helper and enables user/him to share that light with others.

As vicarious trauma develops as a field of study, more information is available about what contributes to an individual experiencing — or being at risk for experiencing — these negative consequences. Having multiple risk factors does not mean you will definitely experience vicarious trauma. It does, however, indicate that you would likely greatly benefit from creating proactive strategies in your life and work environment to promote sufficient and significant time away from work, and ensure your body and mind have ample time to renew themselves on a regular basis.

Think of work engagement as a marathon, not a sprint. And while the very real life and death pressures may push us to sprint, the reality is that we can serve more people over the long term —and serve them better — if we pace ourselves during the marathon and receive support along the way.


Related Terms and Definitions

While vicarious trauma is most commonly used, you may hear similar experiences referred to in the following terms which hold slightly different meanings. While these terms often overlap, each has unique characteristics as well. Understanding similar terms and the variations in experience they describe is helpful as you begin to identify your own personal experience or the experience of someone you care about.

Vicarious trauma is often defined as a change in a person’s inner experience or the cumulative effect of bearing witness to the suffering of others on a person. At times, this can result in experiencing similar distressing thoughts, feelings or somatic experiences related to traumatic exposure as those of the people we are serving. Intrusive thoughts and images or avoidance of situations that are related to trauma or the workplace are some common examples. 

Compassion fatigue and secondary traumatic stress can be described as the deterioration of our ability to empathetically respond to the pain and suffering of others. As we continually offer support and compassion to others—but are not able to nourish ourselves—we can be left feeling depleted of our inner resources. Just as vicarious trauma fills us up with stories, compassion fatigue drains us of energy, vitality and optimism.

Compassion fatigue can make us feel resentful towards family, friends and colleagues, and those we seek to help. This feeling of having nothing left to give can make it difficult to find the compassion necessary to serve the people we intend to and to nurture our personal and professional relationships, and most importantly, ourselves. 

Burnout can occur when the demands placed on an individual exceeds available resources. Burnout is related to stressful working conditions that leave the worker with feelings of frustration and powerlessness. When a worker is unsupported and overburdened, the resulting low job satisfaction and sense of being overwhelmed can be characterized as burnout. The condition can make a person more vulnerable to vicarious trauma and compassion fatigue, but it is the consequence of the challenging work conditions, not the difficult material, that precipitates burnout.

Trauma exposure response is a general term used to describe all responses to trauma exposure including burnout and compassion fatigue.4

Trauma mastery refers to the healing from trauma by re-visiting it or recreating situations similar to the incident with the hopes of experiencing a different outcome. The re-visiting of the trauma can occur in different ways.

For example, a survivor may remember a repressed memory, which may support his or her recovery process and in this way begin to cope with the feelings surrounding the trauma. Others may become involved with the issue space in hopes of healing. Healers who have experienced a personal trauma may feel the need to support others as a way of contributing to more positive outcomes than what they experienced. Although this can be a constructive way of mastering a personal trauma, it cannot substitute one’s own recovery process.

Most of the above terms — vicarious trauma, compassion fatigue and secondary traumatic stress, burnout and trauma exposure response — can be experienced separately or in combination with one another. How each challenge manifests varies from person to person and circumstance to circumstance.

However, any and all manifestations can lead to negative physical, emotional, and relational health outcomes for individuals and organizations, and, as the situation escalates, the cycle feeds on itself. Francoise Mathieu explains, “[i]ronically, helpers who are burned out, worn down, fatigued, and traumatized tend to work more and harder. As a result they go further and further down a path that can lead to serious physical and mental health difficulties.”


Identifying Vicarious Trauma: Is My Experience Related to Trauma Exposure?

Many books and websites list risk factors where you can learn more about vicarious trauma, compassion fatigue or burnout. However, to start understanding these concepts a little deeper on a personal level the following questions can help you see if taking a closer look into your own experience may be beneficial.

  • Do I bear witness to the suffering of others on a regular basis? This could be a multitude of ways. You might hear someone tell their story, or read a case file or be debriefing with a colleague or supervisee on traumatic material. You also could be reporting on these issues for the media, managing social media content for an organization that does work in this field or answering the phone when crisis calls come in.
  • Am I in a position where I feel responsible for someone’s safety or well-being? This could be direct, such as helping a family relocate due to a threat of safety, or indirect, such as pressure to raise enough funds to keep crucial programs running or being involved in a prevention campaign.

If you answered yes to these two questions, learning about way to prevent or address vicarious trauma may be of support in your personal and work environment. The third question asks you to look at how you are feeling now.

  • Do I intuitively know—even if I’m not ready to say it out loud—that my work is starting to impact my health, life or relationships? This is tricky to identify because the toll of vicarious trauma is slow and cumulative. Our worldview changes over time and in such a way that even if we do feel differently towards our health, life and relationships, it seems OK, if not inevitable. Right now, simply ask yourself “have I changed?” and then if so, the next section on the signs of vicarious trauma may be helpful to you as a next step in understanding your experiences.
  • Do I work harder than is healthy for my mind and body because the issue feels deeply personal to me? When a healer has a personal connection to the issue space, it can be natural to feel more invested in the work. However, it is important to do so with responsibility and self-care. As healers, we are continuously exposed to the suffering of others and it is imperative that we have been able to process our own healing. Expecting to find healing through the work can set a healer up to re-experience the impact of our own trauma. In addition, in these moments, our work moves away from being in service to the members of our community, who each have their own unique healing paths.


Signs of Vicarious Trauma

When we are experiencing overwhelming volumes of information — especially information that holds an emotional charge—our bodies, minds and spirit adapt to help us cope. At times, the way we cope may help in the moment but may have longer term negative results. For example, our bodies may give us an extra push of adrenaline to make it through a challenging time period. However the moment we go on vacation, we immediately get sick for the first three days. The adrenaline push that was needed in the moment eventually “catches up” with us and we feel the full effects of pushing ourselves beyond a healthy limit.

The following list is not meant to be an exhaustive catalog of symptoms, but rather one that may spark reflection on how your work affects you in both personal and professional situations. We encourage you to read this list with no judgments; we all cope with emotional situations to the best of our ability. However, understanding the costs associated with some coping strategies help us grow closer to solutions. If you notice any of your own experiences in the following list, please remember that solutions exist and there are ways to engage in your work without harm to self or others, and which amplify our sense of resiliency and hope associated with doing work in a traumatic field.

Exhaustion and physical ailments:

  • Constantly feeling tired, even after having time to rest.
  • Physical tension in the body when its not needed, e., sitting at your desk or when commuting
  • Physical pain throughout the day like headaches, back pain, and wrist pain that you “push through”.
  • Difficulty falling asleep, or excessive sleeping.
  • Falling sick the moment you are able to rest, like on a vacation. 

Emotional shifts:

  • Hypersensitivity to emotionally charged material.
  • Feeling disconnected from your emotions and/or your body.
  • Guilt for having more resources/opportunities than those you serve.
  • Feeling like no matter how much you give, it will never be enough.
  • Feeling helpless or hopeless toward the future.
  • Increased levels of anger, irritability, resentment or cynicism.

Thought patterns:

  • Difficulty in seeing multiple perspectives or new solutions.
  • Jumping to conclusions, rigid thinking, or difficulty being thoughtful and deliberate.
  • Asking questions like,“Is any of this effective?” and “Am I making any difference?”.
  • Minimizing the suffering of others in comparison to the most severe incidents or situations.
  • Intrusive thoughts and imagery related to the traumatic material you have heard/seen. 

Behavioral shifts: 

  • Absenteeism and attrition.
  • Avoiding work, relationships, responsibilities.
  • Dreading activities that used to be positive or neutral.
  • Using behaviors to escape (eating, alcohol/drugs, caffeine, TV, shopping, work). 

Relationship changes: 

  • Not separating personal and professional time, being the helper in every relationship.
  • Viewing other people not involved in your field as less important.
  • Difficulty relating to other people’s daily experiences without comparing them to yours or those your serve.
  • Absence of a personal life that not connected to your work.
  • Seeing danger everywhere and being hypervigilant regarding the safety of your loved ones.
  • Sense of persecution or martyrdom, holding external forces responsible for personal feelings and struggles.
  • Isolated self completely from others or only interacting with people who are in your same field or can relate to your experiences.



Organizational Solutions

When we are facing universal challenges, such as striving to meet needs greater than the current resources available, it can be tempting to assume that an organizational culture of stress is inevitable. However, at Joyful Heart, we believe that there is a way to engage in this work without causing harm to ourselves or to others. This may include organization leaders taking a close look at the way we quantify “progress” towards healing.

These are all challenging conversations. Nonetheless, they are critical to the overall health of the field of prevention and intervention addressing violence. They will likely be the cornerstones of the solutions that will create long term organizational shifts toward wellness and sustainability.

Individual Solutions

We at Joyful Heart recognize the importance of each person’s individual health in the here and now, and encourage each individual to prioritize their own health each and every day. By ensuring our daily health on an individual basis, we work collectively toward sustainable long-term solutions that span beyond any one organization. The following questions may be helpful in assessing if you are currently aligned with an organizational culture that will be sustainable for you long term.

  • Are my daily expectations able to be met without sacrifice to my personal well-being?
  • Do I feel able to safely share and seek solutions to the impact of bearing witness to trauma with my supervisors or colleagues?
  • Can I imagine keeping my current pace over the course of my career without negative consequences to my personal health and well-being?

“Long-term effective work in [the field] depends on our integrating self-care into our work and our lives.” As we become aware of how contact with trauma and suffering manifests — and of the various strategies for managing those manifestations — it becomes necessary for us to craft a path to sustainability that works for individually. This path is different for everyone and will only be effective if it is informed by our individual struggles and opportunities for self-care and resilience. Each of us must create and commit to travel our own path to sustainability.

We can find our direction by looking inside. We all have a place inside us where we keep our deepest knowledge — our truth. That place knows us, and it has a voice. It knows what we need to heal, to be happy, to accept and give love, to feel at home on this planet and in our world. This place knows what is best for us, how to best find the nurturing and care we all need. Its voice can sometimes be obscured by depression, anxiety or feelings of guilt and obligation. It may be drowned out by other voices, the voices of “should” and “shouldn’t” and other people’s needs. What other people need — what the world needs — is people who honor, respect, and nurture themselves.

One big way we can do this is by honoring a regular practice of self-care. It is our belief that each day should contain some time — however much feels right for you and is doable — devoted just to ourselves and our own well-being. This can take many forms: journaling on the ride home from work,5 cooking a healthful meal, practicing yoga,6 meditation or mindfulness,7 going for a run, or taking an exercise class. As much as you can, try to make your space away from work a peaceful one8 — one in which you can take refuge, seek clarity, withdraw, be still and relax. This too can take many forms: perhaps limiting or refraining from the use of electronics before bed, adorning a wall with a beautiful piece of art, replacing the television with some soothing music, or even simply taking your shoes off when you enter your home.

The more you can integrate wellness practices into your everyday life, the deeper the root they will take. These practices will enhance your life and the lives of those around you, and will make it more likely for you to find and sustain your voice during difficult times where it might be hard to hear.9

Honor your voice; let it be your guide. You already know the way.

The Vicarious Trauma Toolkit

“In 2013, the U.S. Department of Justice, Office of Justice Programs, Office for Victims of Crime, awarded a grant to Northeastern University’s Institute on Urban Health Research and Practice to work with stakeholders in the field to develop the Vicarious Trauma Toolkit (VTT) — a state-of-the-art repository of nearly 500 resources compiled to assist victim services and first responder agencies and organizations in raising awareness about and addressing vicarious trauma.”10


3 Identifying Vicarious Trauma, Joyful Heart Foundation, (last visited December 5, 2019).

4 For more information on trauma exposure response, an excellent resource is Trauma Stewardship: An Everyday Guide to Caring for Self While Caring for Others, by Laura van Dernot Lispky with Connie Burk.

5 Journaling & Expressive Writing, Joyful Heart Foundation, (last visited December 5, 2019).

6 Yoga, Joyful Heart Foundation, (last visited December 5, 2019).

7 Mediation for a Mindful Existence, Joyful Heart Foundation, (last visited December 5, 2019).

8 DIY Wellness: 10 Easy Steps to Creating a Peaceful Home Retreat, Joyful Heart Foundation, (last visited December 5, 2019).

9 Resources, Joyful Heart Foundation, (last visited December 5, 2019).

10 The Vicarious Trauma Toolkit, Office for Victims of Crime, (last visited May 22, 2017).