Vicarious Trauma – Recognising Signs & Protecting Wellbeing

A shared responsibility - psychosocial risk at work

Vicarious Trauma is a term used to describe a range of cumulative and harmful symptoms that develop in response to exposure to other people’s trauma, including reading, watching, listening to sensitive and complex material.

While exposure can occur in all sorts of occupations, particular groups are at increased risk including those working in the health and welfare sectors, law enforcement, and the legal sector, as well as the emergency services.

Vicarious Trauma, Compassion Fatigue, Moral Injury all refer to the cumulative adverse effects to a person’s core beliefs, social relationships, ability to perform in their work or home life. Specific to sectors of the law, such as criminal, family and welfare; insurance, humanitarian sectors are at risk. Solicitors in NSW work in a variety of structures and these include sole practitioners, law firms, community legal services, incorporated legal practices and unincorporated legal practices. Other sectors such as self-employed legal professionals, small to medium size legal firms, and regional practices. The risk of VT is relevant to legal professionals, clerks, paralegals, and support workers.

A lawyer’s capacity to respond to these events is influenced not only by the nature of the exposure itself, but also the environments they work in, and the social supports and activities that exist for them outside of work.

Key issues contributing to difficulties with mental wellbeing include the stressful nature of the work, intensive work/time demands, poor work-life balance and elevated levels of pressure.

The common signs of vicarious trauma:

? Invasive thoughts of client’s situation/distress

? Frustration/fear/anxiety/irritability

? Disturbed sleep/nightmares/racing thoughts

? Problems managing personal boundaries

? Taking on too great a sense of responsibility or feeling you need to overstep the boundaries of your role

? Difficulty leaving work at the end of the day/noticing you can never leave on time

? Loss of connection with self and others/loss of a sense of own identity

? Increased time alone/a sense of needing to withdraw from others

? Increased need to control events/outcomes/others

? Loss of pleasure in daily activities

? Low job satisfaction

? Feeling frustrated by or judgmental of clients

? Feeling under pressure, powerless and overwhelmed

? Not taking breaks, eating on the run

? Unable to properly refuel and regenerate

? Frequent sick days or “mental health days”

? Irritability and anger

? Insomnia – disrupted sleep wake cycle

Cumulative Vicarious Trauma does not necessarily lead to mental illness, however there is a greater risk of developing a mental illness such as Anxiety, Depression and Alcohol/Drug misuse.

Protective Actions:

To help prevent the symptoms of vicarious trauma and burnout from escalating or

happening in the first place:

? Use your team and managers for regular debriefing and other support

? Find out if you have access to an employee assistance program (known as EAP) to access in times of need

? Engage in reflective practice. This can be one-on-one with a trusted friend or your manager, counsellor, or other support person (sometimes called ‘supervision’); with colleagues; or on your own e.g., by writing in a journal

? Honour your scheduled breaks and annual leave

? Evaluate your workspace to ensure it is conducive to wellbeing – enough space for you and your colleagues to have lunch together, ‘chill-out’ spaces, lots of plants/flowers/colour/light.

? Be kind and supportive to your co-workers and make sure to celebrate achievements and birthdays to take time out

? 20-minute walks in Nature – being present to your immediate surroundings, rather than lost in thoughts.

? Nourishing your body with healthy food, and beverages

? Taking time to enjoy the little wonders of life. For example, watching a colourful lady bird climbing across a branch.

? Sit watching a water fountain and birds splashing. It is not all bad.

? Self-Compassion is vital and acts as a protection against burn-out caused by perfectionism, negative self-talk.

? Children’s stories – reading sweet and innocent tales as a stark contrast to the violence, shame, and grief you may be faced with through your work.

? Computer games and Virtual Reality

If you find yourself experiencing these symptoms, it is important to recognise that this is not a reflection on your professional abilities but a normal response to the challenging nature of your work.

Psychological resilience, like physical strength, can grow through regular evidence-based mindfulness and CBT practices - at home and in the workplace. These protective tips can help guide you in the development of healthy individual and work practices that will build resilience and mitigate risk.

Enhancing Psychological Resilience

Reflective Process:

Acronym R.A.I.N

Recognise - Notice that an activation has occurred. Usually felt in the body sensations – feeling sick, heart racing, lump in your throat. These physical sensations become obvious once your stop to reflect. Notice where you feel the sensation in your body. Connect with the feeling rather than numbing it or avoiding it.

Attention - Allow this feeling (emotion) memory with curiosity and kindness in mind. Give it your fullest attention. Stay with that for a few moments.

Inquire – What is the emotion I am feeling? Have I been here before? What association am I making? Notice your inner responses, for example your core beliefs may be challenged. The world is not safe. I am not safe. How can I keep my child safe? Or your emotional state may connect to personal memories, other thoughts, and significant times in your life. You may start to doubt your capabilities, as being hopeless, unworthy. The stream of consciousness can be filled with many habits of thinking that are not helpful. This is why it is important to be the observer of all this mind chatter and content and ask the next question.

Need and Nurturing self-talk

What do I need right now to best support or help me? Bring kindness to yourself – (judgement and criticism is not appropriate in this inquiry) With greater conviction you might have an empowering statement such as: “This is not mine. This is not about me. This is not what I am about. This is not what I have in my life. You can feel grateful for your support network and your own circumstances.

Going deeply into this whole activation, we come to realise that this reactivity indicates our own values of humanity, honesty, and the limitations of the human existence. Ethical inquiry. Or your response could be I need to book a weekend away – lock in some time out.

R.A.I.N (Tara Brach) This reflective process is useful to switch off the active mind, to let go and unwind after work

Acronym guide

Recognise - Take time out, to notice and bring attention to a feeling, sensation arising in you. This could be at the end of your working day.

Allow/Accept -Attitude I can allow this feeling, by noticing it, and caring about this feeling – it is understandable.

Investigate/Inquire- With Mindfulness and Kindness bring attention to the sensations in the body and ask, what is related to? Name the emotion present. What are the memories, thoughts, beliefs,

Needs Nurturing

What do I need right now? Notice your self-talk toward this experience. Self-compassion rather than judging or shaming. Ask the question of yourself, What do I need? Listen to the response. Sometimes, by simply allowing and giving yourself this time, the intensity subsides and nothing else needs to be done. The RAIN process was relaxing and refreshing.

A note on self-compassion

If you are working to help people and are privy to stories of abuse and violence, it is good to remember that an emotional response is also a human one. While it is important to maintain professional composure with your clients/patients, emotional responses related to abuse and violence are natural and even appropriate.

Physical Relaxation and Exercise:

·???????? Exercise is important for wellbeing and mental health. Find an activity you enjoy and can fit into your schedule each day.

·???????? Importance of regular relaxation – Vagus nerve stimulation (Breathing practice 4 = 2 = 8 = 2 repeat 6 times) to regulate nervous system, switch on the rest, and digest parasympathetic response.

·???????? Massage, yoga, gentle muscle relaxation, all activate the vagus nerve.

·???????? Spending time listening or performing: Music, writing, singing songs, dancing

·???????? Salsa, fun upbeat music. Personal preferences apply.

·???????? Abstract painting – getting creative with your emotions

·???????? Journaling your experiences and state of being.

·???????? Nurture your family and friendships

·???????? Spend quality time with family and friends

·???????? Computer games and Relaxation and Mindfulness Apps

·???????? Rest and Recovery and Reset Sleep Hygiene

Moral and ethical values:

Reflect on your role and limitations of your role. It helps to identify and be clear about your boundaries of service of law and justice.

Vicarious Resilience is a protective factor: hearing of the positive stories and outcomes of the lives of those you are working with, acknowledge these positive outcomes. Share the success and the hope for better outcomes.

Value alignment

Virtues In Action (VIA) character strengths website has a self-administered questionnaire to identify your top twenty-five values out of 44 Values such as gratitude, and hope are particularly helpful to enhance emotional wellbeing. www.viacharacter.org

“I am making a difference, I am having an impact, what I do matters to the quality of life, no matter how small that impact might seem. I do not always know how far reaching my kindness and consideration will travel and be remembered.”

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Collegial support – Peer support programs:

Pursue Trauma-informed approaches.

Recommendations for Peer support groups or one on one debriefing with a colleague or supervisor. Critical Incident responders do not ask team members to talk about what happened as this can trigger other people, causing more distress. Rather, psychoeducation is provided, to assist members to recognise their response is a normal part of recovering from exposure. Likewise, “Reflective supervision” can provide a safe space, to unpack how you are feeling and discuss self-care strategies to assist recovery. Mindfulness and Compassion training is an evidenced based approach that increases self-awareness, and acceptance of what is arising in the mind. Building self-awareness, being present with one’s feelings with a kind attitude can improve job satisfaction and resilience.

Cultural safety and Psychological Safety at work:

WH&S Policy and ongoing consultation with all workers

? Reducing stigma and encouraging wellbeing can be inspired when Leaders are visibly supportive toward their own wellbeing and workplace programs to mitigate the risk of Vicarious Trauma or psychosocial injury.

? Leaders trained in trauma-informed communication.

? Mental Health First Aider training for Leaders through to clerical and para legal workers.

? Encouraging inclusion and diversity of workers – communication skills -? compassionate conversations

Support is available:

? Staying in contact with how you feel and having self-compassion can remind you to take care of yourself, to increase your wellbeing activities. There are a number of supports that can help you to grow in psychological resilience and sustain you in your work.

? Reach out to someone. This could be your manager, a trusted friend or colleague, a counsellor, or another support person. You could also access your employee assistance program (EAP), or contact the Law Society Solicitor Support Service (SOS) on 1800592296

Refer to the Law Society’s Mental Health and Wellbeing Articles and Staying in the Law Webcasts for topics relating to Vicarious Trauma, Self-Care, and Overall Wellbeing.

? For after-hours support, the 1800RESPECT telephone and online counselling

Trauma informed Research Institute www.pheonixaustralia.com

Self-compassion test – Neff Kristen https://self-compassion.org/self-compassion-test/

Values alignment www.VIAcharacter.org

PERMA model of wellbeing

https://positivepsychology.com/perma-model/

Wellbeing Checks and Resilience Coaching – Converge International Corporate health provider.

Law Society of NSW

Services and resources - To help members facing challenges to their mental wellbeing.

Solicitor Outreach Service (SOS) 1800 592 296 - A dedicated and confidential counselling service for NSW solicitors. You can access three complementary sessions with independent psychologists through PeopleSense by Altuis.