Self-Care and Trauma Work1 When we choose to address systems of oppression, help those who have been victimized, and hear traumatic experiences, we might become weary or emotionally changed from the weight of the work. Feelings of burnout and stress in helping professions are a result of vicarious trauma and are not only normal, but to be expected. Organizational structures that reduce vicarious trauma are critical. In addition, individually we can employ methods that fit within our culture and faith to manage our own experiences with vicarious trauma. How we manage the physical, emotional, spiritual and intellectual responses to trauma can either help or hinder our ability to continue to do this work. By learning how to recognize when the work is affecting us in a negative way, we can learn how to manage stress and overwhelming feelings in a healthy way. When we are healthy, we can bring our best self to the work every day. What is Vicarious Trauma? Laura Van Dernoot Lipsky (2009) describes vicarious trauma as a “trauma exposure response.” In, Trauma Stewardship: An Everyday Guide to Caring for Self While Caring for Others, she explains the cyclical nature of vicarious trauma and the ways one can take care of themselves. She describes this process as being trauma stewardship: “the entire conversation about how we come to do this work, how we are affected by it, and how we make sense of and learn from our experiences” (Lipsky, 2009, p. 6). Other terms for vicarious trauma are: provider fatigue, compassion fatigue, and/or secondary trauma. They all refer to the same experience of having exhausted hearts, minds, bodies, and souls from helping survivors through their painful experiences. Some signs that you might be experiencing vicarious trauma include: . Physical symptoms, such as changes or disturbances in appetite and/or sleep patterns and chronic illness . Starting, resuming, or increasing use of caffeine, nicotine, alcohol, or drugs as a means of coping with or numbing out from work . Experiencing intrusive thoughts or visualizations of client stories . Withdrawing from or becoming very dependent on others and/or disturbed intimacy needs . Feeling anxiety or frustration with clients and coworkers . Feeling helpless or paralyzed, or becoming very controlling and regimented . Avoiding your work or coworkers because you are feeling overwhelmed . Having no reaction to stories that used to affect you or that friends and family find disturbing . Emotionally distancing yourself from work frequently . Laughing at humor you once would have considered offensive . Feeling less available or sympathetic to the problems of friends or family members . Feeling as though you have less energy or interest for things that you typically enjoy What Can We Do? Organizations should recognize that vicarious trauma affects staff both personally and professionally. Organizations can start by developing a plan for reducing vicarious trauma. This can include having regular check-ins for debriefing; supporting the development of staff capacity in the area of vicarious trauma through resources, education and training and creating outside opportunities for staff to engage in wellness-related activities. Individuals can begin by recognizing that being affected by this work is normal. The very nature of anti-violence work is physically and emotionally taxing. Here are some suggestions on practices that you can begin incorporating in your daily life. Remember that when you tell yourself you don’t have time for any of the following, that that is exactly when you should take the time. The following practices will help you return to your work day refreshed and renewed. Start by being present. Being present is being aware and living in the moment, rather than dissociating (numbing out) from yourself. Ways to do this vary greatly, but you can start by Developing a mindfulness practice. Mindfulness is a technique that helps to cultivate an intentional awareness of the present moment, and consequently, helps us to develop more skillful and creative responses to life stressors. Engaging in simple practices such as beginning each day with a handful of deep and slow breaths or quietly repeating a phrase that brings peace or grounding to you are examples of a mindfulness practice. In moments throughout the day and especially when you feel stressed or overwhelmed, try this simple and quick technique. Sit in a safe and quiet space and close your eyes or hold a soft, unfocused gaze. Inhale deeply, feeling your shoulders inch up around your neck and exhale slowly, feeling your shoulders slowly release downward. Try this a few times, each time gently noticing how your body feels in that moment. By simply having an awareness of your feeling in that moment, you can ease feelings of tension and revisit a task or project with a greater sense of calm. Choose your involvement. This is different from the old saying, “choose your battles.” Choosing your involvement in various office activities gives you control over your own happiness instead of the other way around. By giving yourself permission to opt out of harmful practices, you can free your mind and heart of the extraneous stress you didn’t realize you experience on a regular basis. Choose to maintain a positive outlook. A positive attitude can be contagious, even in the face of difficulty. By putting negative energy out to the world, it perpetuates negativity instead of inspiring healing. So, when those around you begin to go to a spot of negativity, try politely excusing yourself and going to a place you feel at peace. Soon, those around you will understand that you are not going to participate and will not burden your time and energy with pessimism. Start an organizational practice of creativity. When creativity is diminished people often feel helpless and hopeless; as if what they do is not making a difference. Therefore, stimulating and fostering creativity helps renew that sense of achievement and brightness that is vital for workplace production. For example, decorate your office or workspaces to reflect your personal style. Often we forget about our physical space and how colors, textures, and stimuli in our surroundings can affect our mood. By incorporating plants, artwork, and lamps, a space can be transformed into a meditative and relaxing environment for all who enter. This also helps to set the stage for those we serve to feel more at home. To get all your coworkers involved in the make-over, Have an all-staff meeting and discuss ways to decorate that will revitalize each work space. At that meeting, encourage each staff member to paint a picture to hang on their wall or somewhere in the building. Encourage family pictures, personal mementos from vacations, and radios at low volume Create an organizational culture that reduces vicarious trauma. When we recognize that vicarious trauma is a normal reaction to this work and that organizations have a responsibility to create an atmosphere that reduces this experience, it can create a sense of organization-wide support that can help to remove any feelings of shame or inadequacy associated with the experience of vicarious trauma. Create a safe and comfortable work environment through the way that offices and break rooms are set up and the security that is offered. Encourage self-care, continuing education and other methods of employee empowerment. Offer or encourage outside support from counseling, health and wellness services, or an Employee Assistance Program (EAP). When considering your organizational plan to reduce vicarious trauma, consider these ideas: . Incorporate trauma-specific supervision into your supervision plans. . Integrate discussion of vicarious trauma throughout all aspects of your work . When recruiting, discuss self-care practices with job candidates. . Include a section on vicarious trauma in staff orientation. . Develop and deliver regular trainings on the topic. . Provide regular resources on self-care and wellness. . Create policies that support reducing vicarious trauma. Make a Commitment to Reduce Vicarious Trauma Now that you have recognized that the work you do may be affecting you, remember to take care of yourself in healthy and positive ways. Refreshing your mind and spirit will not only make you feel better, but will positively affect those around you. By working in the field of anti-violence we fight oppression on many forms and it eventually seeps into our hearts and minds. Recognizing this and taking care of ourselves is the first step to refreshing and sustaining our energy in the work. Lipsky, L. V. N. (2009). Trauma Stewardship: An Everyday Guide to Caring for Self While Caring for Others. San Francisco, CA: Berrett-Koehler. 1From “Vicarious Trauma” by Pennsylvania Coalition Against Rape, 2010, Technical Assistance Bulletin, 5(2). Copyright 2010 by Pennsylvania Coalition Against Rape. Adapted with permission. © National Sexual Violence Resource Center and National Sexual Assault Coalition Resource Sharing Project 2012. All rights reserved. This project is supported by Grant No. 2009-TA-AX-K011 awarded by the Office on Violence Against Women, U.S. Department of Justice. The opinions, findings, conclusions, and recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the views of the Department of Justice, Office on Violence Against Women.