On the Front Lines: Handling Secondary Trauma

 

Stress. I'm not really sure if the word 'stress' can be said to mean the same thing for Social Workers. There are a few buzz words we in the bizz' use to describe the amount of anxiety and unrest we experience in delivering services in the manner and environments that we do.

'Secondary Trauma' is one of the biggest terms you'll hear in relation to Social Workers in 'high-stress' situations (95% of us, I'd say.) I'd say one of the biggest terms we also hear is 'burnout'. How do we avoid 'burnout' as they say? What does 'burnout' mean any way? I'm pretty sure we've all experienced it at one point, or as you are reading this you may currently be, as they say, burnt out. They use this phrase in other professions as well, law enforcement officials (especially correction officers), members of the armed services, doctors, nurses, lawyers, judges, and a whole host of other professionals in our society experience this same phenomenon.

When I hear the phrases 'burnout' and 'secondary trauma' the first word that comes to mind (thanks to my graduate professors) is 'self-care'. Simply put, take care of yourself. It seems so simple, so easy. It's such a casual concept that often you'll hear people use it as a farewell; "Take Care!" "Hey you too!" But as we get older, it's anything but easy. In highly traumatic professions, I look at it as an act of undoing. All of the things we hear, all of the things we see, all of the things we feel; I liken them to layers of paint on old walls. Eventually, all of those layers hide and suffocate what's underneath, leaving it unrecognizable. What's underneath is our happiness, and too often, our sanity. Not to worry! There are ways of stripping this paint, or better yet, with enough practice we might be able to have a constant smock at the ready, that can be removed and set aside after a long day's work, leaving us clean and ready for the rest of our day, maybe a spot of paint here or there, nothing that a little soap and water can't fix.

So first, let's talk about what the manifestation of secondary trauma looks like.

First, the biological:

• Headaches
• Stomach Aches
• Teeth-Clenching/Grinding (whether daytime or night-time) 
• Nervous Habits (nail-biting, hair-pulling i.e. trichotillomania, skin-picking) 
• Loss of Appetite or Increased Appetite 
• Extreme Fatigue or Insomnia

Now, these are just some examples. This is by NO MEANS meant to be a diagnosis in lieu of care from your physician. However, most of us can tell when these things are brought on by the work that we are doing as opposed to actually diagnosable illness. (Once again, if you are feeling ill in any of the aforementioned ways and/or other ways, see your doctor.)

Second, the less biological:

• Nightmares
• Paranoia
• Anxiety
• Rage
• Extremely low frustration tolerance
• Depression (this can be biological as well, but for our purposes I'll leave it in this category)
• Displacement (lashing out at those close to you)

I'm sure you're reading this and remembering your own symptoms, or the many ways you've felt coming home from a day that basically no one could ever have prepared you for. I think that, in and of itself, is the issue. You can hold all of the degrees, certificates, and trainings humanly possible, but nothing prepares you for things that come to you in the moments of our day. Nothing prepares you for a patient/client (depending on your setting) telling you that he was locked in a room for hours because his mother thought he was being possessed, or a client weeping in your arms having flashbacks of abuse, or a child coming up to you at the end of their school day and looking directly into your eyes and saying with glassy eyes, "I don't want to go home. Please, don't make me go."

We are the people who they call when children are being abused. We are the people expected to carry them out of their homes, pack up a bag of their things, and find them safe shelter for the night. We are the people they call when a student has just said out loud that they almost killed themselves last night.  We are the people others turn to when someone is battling addiction, has lost their job, home and family, and they now need someplace to stay.

These processes are completely non-existent to the general public. The inner-workings of the systems we navigate are dark, shadowy, and almost imaginary to your average Joe on the street. It isn't until you have been a physical working part of these systems, whether a service recipient or a service provider, that you really know what goes on.

Alas, I digress. We all know what it is we see, hear, feel, and experience day in and day out. Now, what to do about it? These are some of the things that I have found help me, and help some of my colleagues when we are at our breaking point.

• Family- Now, for some us family might be an added stressor. However, for others, our family is our safe place, our haven, all that is warm, fuzzy, and true in the world. Make some time to spend with your family, when the world feels like it's spinning out of control.
  
• Friends- How many times have you said this phrase, "I would absolutely love to go, but I'm just so exhausted. Work was insane this week, I think I'm just going to sit this one out." Right? WRONG! While we may feel like a sack of sorrow at the end of some days and weeks, changing our environment can make all the difference. I'm not saying going to a rave, get some kandi bracelets (that's a whole other blog post, if you don't know, Google it), and throw caution to the wind. But go OUT, have a drink, or go to a nice dinner, and most importantly LAUGH. I know they say laughter is the best medicine, and well, it's kind of true.
  
• Your Zen- This sounds extremely vague, doesn't it? Truth is, there isn't a blog long enough in the world to list all the different kinds of Zen people have. What is Zen, you may ask? While there is, I'm sure, a much more precise and historically-based definition, to me, Zen is anything that successfully clears your mind. I'm talking about CLEARS your mind. Not the type of clear where there is an incessant buzz in the background, I'm talking about crystal clear, Jet-Dry clear, squeaky clean bleached white shirt out of the dryer clean. Some example for me are cooking, crafting (sewing, crocheting, knitting, making just about anything), dancing, working out, and reading. For me, these things really and truly clear my mind and allow me some time to just focus simply on what I am doing. One foot in front of the other concept. Like I said, there millions of things that provide Zen to people, you just have to find yours.
  
• Dissassociating- I have a feeling that this one is going to be controversial, but as said previously, these things are my personal suggestions. For me, putting a certain proverbial distance between me and what happens at work every day, has made all of the difference. What I do is picture my work, my therapy sessions, as movies or television shows. Bare with me here, it will make sense in a minute. The same way you can watch a horrific movie or heart-breaking film and simply go home afterwards, this is how I look at my work sometimes; like a movie that when I leave my job, I hit pause. Tomorrow, I hit play again. It's really kind of a visual thing, it allows me to materialize what it is I do into something that can be left behind, and picked back up again. There are days I need it to stay there, I absolutely cannot take it with me. I'm sure you're family and friends have told you a million times "Ya know, you can't take work home with you." It's very easy to say that, and a whole other thing to walk away from work and literally, sometimes, there are lives hanging in the balance. Remember, there is only so much you can do. There are only so many of us on the front lines. 

I hope these things might help you along your way, and if they're things you already knew, then maybe they'll just act as a friendly reminder to you. Please feel free to add the ways that you 'strip off the paint' in your own life.


"Unless someone like you cares a whole awful lot, nothing's going to get better. It's not." -Dr. Seuss