What Is Vicarious Trauma, And What Are Its Long-Term Effects?

You may be familiar with post-traumatic stress disorder, or PTSD, a mental illness that may arise in response to traumatic events and that may have a significant impact on one’s daily functioning and overall well-being. However, another mental illness may arise as an indirect result of trauma, which may be equally distressing to those it affects. This mental illness is known as vicarious trauma. 

This article aims to provide an introduction to vicarious trauma, a description of symptoms, and an explanation of the difference between vicarious trauma and PTSD. We will also explore the potential side effects of vicarious trauma, as well as possible treatments and management strategies.

What is vicarious trauma, and how is it different than PTSD? Secondary traumatic stress

The term “vicarious trauma” may often be used to describe a phenomenon among therapists and counselors working with survivors of trauma. However, the condition may also affect those working or volunteering in fields such as:

• Law enforcement

• Firefighting

• Emergency medical services

• Journalism

• Child protective services

On the surface, vicarious trauma may appear to have features with post-traumatic stress disorder, or PTSD. Both conditions may originate as a result of traumatic experiences or a traumatic event, leading to possible symptoms that may include hyperarousal, changes in sleeping or eating patterns, or persistent feelings of irritability or anxiety. 

However, a distinct difference is that, while PTSD may arise among those who have directly experienced trauma, vicarious trauma occurs among those who work closely with trauma survivors—typically on a regular basis.

The symptoms of vicarious trauma may include, but are not limited to:

• Sleeping difficulties, such as insomnia or oversleeping

• Changes in eating habits (such as over- or under-eating)

• Panic attacks

• A heightened startle reflex

• Hyperarousal or hypervigilance

• Trouble concentrating 

• Feelings of anxiety or fear

• Nightmares or intrusive thoughts

What are the effects of vicarious trauma? 

Indirect exposure to trauma, or secondhand trauma, can have various implications. Vicarious trauma may have potential short- and long-term effects on those who experience it. Those involved in professions that work closely with trauma survivors (for instance, trauma therapy, social workers, or emergency medical services, such as first responders), or “helping professions,” may find themselves having difficulty meeting work responsibilities or having frequent conflicts with coworkers. Some may even find their lines of work too challenging to continue, potentially leading to career changes. Vicarious traumatization can impact other professionals as well, such as those with low occupational safety, and anyone who is close to someone else’s trauma or experiences trauma exposure, whether they work in a trauma-related field or not. Those who work in helping professions or victim services, or who hear traumatic stories, may also experience compassion fatigue. 

Vicarious trauma may also have effects beyond the workplace, such as withdrawal from friends and family or an increased use of drugs or alcohol. It may lead to changes in one’s worldview, feelings of detachment, a sense of hopelessness or helplessness, a lack of interest in hobbies, or challenges with intimacy. In some cases, changes in eating or sleeping patterns may raise the risk of health conditions like hypertension and obesity. 

Managing the symptoms: How to deal with vicarious trauma

If you are experiencing issues related to your closeness to another person’s trauma, you might wonder how to deal with vicarious trauma. Various practices are available that may help survivors of vicarious trauma manage their symptoms and improve their overall quality of life. These strategies may include:

• Taking time off from work if needed, particularly when it comes to professions that are heavily involved with trauma survivors, and establishing a healthy work-life balance

• Practicing self-care, such as eating a healthy diet, getting physical exercise, getting enough sleep, practicing good hygiene, and engaging in enjoyable activities

• Seeking emotional support and social support, whether from a family member, friends, or other trusted sources

• Journaling, which may be helpful for exploring thoughts and emotions, including personal trauma

• Asking a healthcare provider about medication, which may be prescribed in some cases for managing certain symptoms

• Spend some time on outside interests to help take your mind off stressful situations

• Seek support from a professional

No two people are exactly alike, so the “right” strategies for managing and treating vicarious trauma may vary from person to person. Consulting a healthcare provider or mental health professional may be advisable for understanding the best option for your situation. The American Counseling Association may also be able to offer support for therapists and counselors who experience vicarious trauma and compassion fatigue. 

Therapy: Another resource for managing vicarious trauma and the effects of a traumatic event

In addition to the above strategies, therapy is another resource that may be helpful for those experiencing vicarious trauma who need extra support. Therapy can help you learn helpful coping strategies and other skills to benefit your mental health. Your therapist may reference various reputable sources, such as the National Institute of Mental Health, when determining an appropriate diagnosis and treatment plan. Forms of therapy that may help treat trauma-related disorders may include, but are not limited to:

• Cognitive behavioral therapy: Also known as CBT, cognitive behavioral therapy is a form of therapy focused on identifying unhelpful or problematic thinking patterns, finding ways of reframing them, and learning to respond to future situations.

• Cognitive processing therapy: Also known as CPT, cognitive processing therapy is a form of CBT focusing on challenging and reframing thought patterns related to traumatic experiences. 

• Eye movement desensitization and reprocessing: Also known as EMDR, this form of therapy aims to use specific eye movements to aid in processing the memories of a traumatic experience. 

• Prolonged exposure therapy:Prolonged exposure therapy aims to help survivors by slowly and gradually exploring memories related to traumatic experiences with the aid of a therapist. 

These forms of therapy, among others, may help reduce the severity of vicarious trauma symptoms. However, making the trip to a therapist’s office for in-person counseling may present challenges for those with vicarious trauma, which may sometimes make it difficult to leave the house. In these cases, online therapy may be a helpful alternative, offering the option to connect with a licensed therapist from the comfort of home via voice call, video call, or in-app messaging.

When it comes to treating various mental illnesses, several studies have found online therapy to be an effective alternative to in-person therapy, with many positive outcomes. One 2017 study found that internet-based CBT was an effective form of treatment for PTSD, depression, phobias, and panic disorder. 

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.