Secondary stress and public safety personnel
Public safety personnel who interact with trauma survivors are themselves exposed to a form of traumatic stress. More recent diagnostic formulations of Post-traumatic Stress Disorder such as those in DSM-IV have broadened the definition of trauma to include participation in others’ traumatic response. As you encounter and provide rescue and relief to those who have experienced disaster, you will be exposed to secondary stress and traumatization, the focus of this fact sheet.
- Secondary stress has also been termed Secondary Traumatic Stress Disorder (STSD), vicarious traumatization, compassion fatigue or empathic strain.
- Some responders exposed to stress develop PTSD, but the experience of the full syndrome is only one of the ways in which public safety are affected by their exposure to secondary traumatic stress.
- Your vulnerability to secondary stress is influenced by:
- personal history, current life circumstances, as well as proximity and personal connection to the events and people involved in the disaster
- your level of empathic engagement with victims’ experience of the disaster
- your perceived similarity to the victims of the disaster
- Secondary stress involves the following features:
- A broadened sense of “what can happen” sometimes experienced as a “loss of innocence” or as cynical detachment influencing your frame of reference and identity, worldview, and spirituality.
- Cognitive distortion around normalcy and baseline rates. Our awareness that planes actually do crash and innocent appearing adults actually do molest children can transform into an expectation that every plane is likely to crash and every adult is likely to hurt our child. When we lose our sense of perspective in this way, we enter the world of the traumatized.
- Heightened arousal and vigilance, a way of being human in which we are characteristically aroused and remain constantly on our guard because we anticipate danger at every turn. At work, this can be a very desirable thing, but you must be able to ‘turn it off’ when you go home.
- Avoidance, as we find ourselves organizing our lives around what might happen, rather than what is happening.
- Emotional consequences of involvement, experienced as:
- Threats to Self-Capacities of emotional management, self-worth
- Changes in basic beliefs about psychological needs: Safety, trust, esteem, intimacy, and control
- Loss of hope and meaning: Increased cynicism and pessimism; nihilism, existential despair
- Anger at the disaster or the perceived causes
- Symptoms similar to those of the people you help: a blurring of what experiences are “ours” and what belongs to the victims (a process involving dissociation)
- a sense of unworthiness and survival guilt
- a persistent and extreme sadness, or dysphoria
- a sense of mourning and grief
- Behavioral changes such as:
- Becoming judgmental of others
- Tuning out
- Having a reduced sense of connection with loved ones and colleagues
- Becoming cynical or angry and losing hope or a sense of meaning
- Developing rescue fantasies, becoming overly involved, taking on others' problems
- Developing overly rigid, strict boundaries
- Feeling heightened protectiveness as a result of a decreased sense of the safety of loved ones
- Avoiding social contact
- Avoiding work contact
- Secondary stress can affect your:
- Relationship with meaning and hope
- Ability to get your psychological needs met
- Sense of humor
- Ability to protect oneself
- Existential sense of connection to others
- Dangers of secondary stress lie in both direct negative effects (intrusive imagery, disrupted beliefs) and in our way of responding to it (numbing, overgeneralized negative expectations, and cynicism).
Coping with secondary stress:
- Self-assessment: Ask yourself, "How am I doing?" "What do I need?" "How have I changed?" Discuss the questions and answers with a colleague, friend, or therapist.
- Protect yourself through awareness of your vulnerability and recognition of the negative consequences of your work as echoed in the voices of others.
Work to cultivate a:
- Sense of strength
- Sense of meaning
- Spiritual connection
- Respect for human resiliency
• Address the stress of your work through practicing self-care--Nurture yourself by focusing on sources of pleasure and joy, and allow yourself to escape when necessary.
Fortunately, public safety personnel have tools to manage secondary stress: we have knowledge of the ways in which trauma affects people, we have skills for soothing arousal and processing states of distress, and most importantly, we have each other, a support system with the potential to help each of us maintain perspective and find understanding during those times when we get caught in the web of secondary traumatic stress. We are not invulnerable, but if we maintain a strong sense of community among ourselves, we can be resilient.
Resource is titled Working with Trauma Survivors: What Workers Need to Know. It has lots of good information for anyone working in the impacted environment.