Secondary Traumatic Stress – What Is It And Are You At Risk? – Healthcare

Many of you will be familiar with the term secondary traumatic
stress – a form of stress that can occur when one person
hears details of a trauma experienced by another
person.¹ While secondary traumatic stress is most often
associated with healthcare providers, such as social workers,
psychologists, and first responders, it can affect anyone exposed
to trauma. As an investigator, you may be susceptible to
experiencing secondary traumatic stress when you hear details about
a trauma experienced by another person during an interview. The two
best ways to protect yourself from the negative effects of this
exposure to trauma are to: (1) become familiar with the signs of
secondary traumatic stress; and (2) take steps to build your
resilience.

Signs of Secondary Traumatic Stress

The signs of secondary traumatic stress are wide-ranging and can
be quite serious. Secondary traumatic stress is not like regular
work-related stress, which goes away when the stressor does, for
example, when you finish an investigation report. The effects of
secondary traumatic stress do not go away on their own and are
likely to compound over time if not addressed.²

The signs of secondary traumatic stress vary, and include the
following feelings and experiences:³

• Feeling helpless.




• Feeling extremely tired.




• Feeling overwhelmed.




• Feeling disoriented or confused.




• Experiencing frustration, cynicism, or anger and
  irritability.




• Experiencing physical effects, such as shortness of breath,
  increased headaches, heart palpitations, trouble falling asleep, or
  muscle tension.

Ignoring the signs of secondary traumatic stress while
struggling with other workplace stressors can lead to a form of
workplace burnout called compassion fatigue.

Signs of Compassion Fatigue⁴

If you notice any of the following signs, you may be
experiencing compassion fatigue:

• Feeling anxious, sad, irritable, angry, numb, and/or on
  edge.




• A jaded view of the world, cynicism, negativity, and loss of
  purpose.




• Headaches, stomach pain, exhaustion, and other physical
  symptoms.




• Isolating or detaching from others.




• Alcohol or substance abuse.




• Change in eating habits.




• Struggles with concentration, decision making, and memory.




• Difficulty sleeping.




• Loss of empathy.

Strategies for Investigators

If you know that you will be exposed to the details of trauma
during investigation interviews, you should adopt strategies that
will help you to avoid the negative effects of that
exposure.⁵

Research suggests that strengthening your resilience is one of
the best ways to avoid the effects of exposure to trauma.
Resilience is the process of adapting well in the face of
adversity, trauma, or significant sources of stress, including
workplace stressors.⁶

The American Psychological Association recommends the following
strategies for building resilience.⁷

• Prioritize your relationships and create
  community. The effects of secondary traumatic stress can
  lead you to isolate yourself. For this reason, you should be
  mindful about staying connected with empathetic and understanding
  people, and engaging in a mix of interests, activities, and
  relationships.




• Foster wellness. Stress affects you both
  physically and emotionally. Therefore, a regular self-care routine
  is important for maintaining your overall physical and mental
  health and for building your resilience. Positive lifestyle factors
  like proper nutrition, adequate sleep, hydration, and regular
  exercise can strengthen your body to adapt to stress and reduce the
  toll of emotions like anxiety or depression.




• Practice mindfulness.Mindful journaling, yoga,
  and other spiritual practices like prayer or meditation can also
  help you build connections and restore hope, which can prime you to
  deal with situations that require resilience.




• Avoid negative outlets.While it can be
  tempting to mask your stress with alcohol, drugs, or by engaging in
  mind numbing activities, such as binging on social media, this
  conduct is generally counterproductive.




• Normalize the effects of exposure to trauma.
  Being affected by your exposure to trauma is normal, and secondary
  traumatic stress and compassion fatigue are workplace issues. You
  should not be afraid to discuss the effect(s) of your exposure to
  trauma with colleagues. Talking about the effects can also reduce
  the potential for stigma, which can prevent others from coming
  forward and seeking assistance.⁸

When to Seek Help

Taking steps to build resilience will help you manage the
effects of exposure to trauma. Knowing the signs of secondary
traumatic stress will help you to identify when you need to seek
assistance from a healthcare professional.

If you are not sure whether you are experiencing the signs of
secondary traumatic stress or compassion fatigue, you can assess
yourself for free by using the Professional Quality of Life
(“PROQOL”) measure.

Footnote

1 Shirley Porter, “Secondary Trauma: Definition,
Causes, & How to Cope” (May 18, 2022), online:
Choosing Therapy (https://www.choosingtherapy.com/secondary-trauma/)
Secondary Trauma: Definition, Causes, & How to Cope
(choosingtherapy.com)

2 “The Relationship between secondary trauma and
Distress” online: Champions of Wellness (https://www.championsofwellness.com/blog-the-relationship-between-secondary-trauma-and-distress/)

3 “Compassion Fatigue and Self-care for Crisis
Counselors” (July 3, 2024), online: Substance Abuse and Mental
Health Services Administration (https://www.samhsa.gov/dtac/ccp-toolkit/self-care-for-crisis-counselors)

4 “How Workplace Investigators Can Prevent
Compassion Fatigue and Vicarious Trauma” online: Case
IQ (https://www.caseiq.com/resources/how-workplace-investigators-can-prevent-compassion-fatigue-and-vicarious-trauma/)

5 For more information on self-care for investigators, I
encourage you to read my colleague Janice Rubin’s blog on this important
topic.

6 Dr. Russ Newman, “The road to resilience”
(October 2002) 33 American Psychological Association 9,
online: (https://www.apa.org/monitor/oct02/pp)

7 “Building your resilience” (February 1,
2020), online: American Psychological Association (https://www.apa.org/topics/resilience/building-your-resilience)

8 Colin James, “Towards trauma-informed legal
practice: a review” (2020) 27 Psychiatry, Psychology and
Law 2, online: (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7476614/#CIT0028)