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Understanding Secondary Trauma: How Therapists Can Navigate Compassion Fatigue and Find Healing

“You may not be personally experiencing the trauma; you’re seeing it or you’re witnessing it. But you body doesn’t know that. It doesn’t know this isn’t my trauma.” -Eleanor Wells

Secondary Traumatic Stress, Vicarious Traumatization, and Compassion Fatigue are all terms that describe negative psychological reactions that can be experienced when working with traumatized clients. The terms are often used interchangeably but they are in fact three distinct conditions. 

I’m a trained trauma therapist and addictions counselor. I was based at the Marine Corps Air Ground Combat Center, 29 Palms California, for four years supporting Marines, sailors, and families. The war in Iraq increased a heightened workload. December 2005 pushed the requirement for sustained counseling as the 2nd Battalion, 7th Marines had a mass casualty incident and the 3rd Battalion, 7th Marines also had a mass casualty incident, in addition to two teen suicides. My role was to organize community meetings conducting defusings for parents, teens and spouses of 2/7 and spouses of 3/7. After the debriefings, I established a new Operation Enduring Freedom (OEF) Spouse Support Group and Teen Support Group. These services were in addition to increased demands for individual and couples’ counseling and group counseling sessions for returning Marines.

Secondary traumatic stress studies show that from six to 26 percent of therapists working with traumatized populations are at high risk of developing Secondary Traumatic Stress. Fifty percent of clinicians who work with trauma survivors report feeling distressed by their work. Thirty percent of clinicians who work with trauma survivors report experiencing "extreme distress." According to David Meichenbaum, Ph.D., American Psychological Association, 2007. “Any professional in a position to hear the recounting of traumatic experiences is at risk,” Meichaenbaum said. “Vicarious trauma can detrimentally affect one's relationship with meaning and hope and the ability to get one's psychological needs met.”

After 48 months in this intense role, including training Combat Operational Stress Response Teams, I was burning out with a heavy caseload working with trauma survivors. Compassion fatigue was creeping up on me while listening to horror stories of death, the fear of death, witnessing the sudden impact of death and the devastation of combat. I was having low job satisfaction and feeling powerless and overwhelmed at work. I was becoming unable to replenish my ability for empathy and refuel emotionally to keep caring for others: caring for others was exhausting me. Trauma had seeped into my bones. I was questioning my sense of accomplishment. I was emotionally changing. My attitude was turning negative. How I saw myself was shifting. I didn’t feel comfortable with myself. I wasn’t the same happy guy I used to be. When I looked in the mirror, I no longer recognized the guy looking back at me. I was hiding my feelings from my myself and my kids. Secondary trauma

During the chaos and confusion of treating Marines, I was raising three teenagers as a single parent and I was stretched to the max. It was becoming difficult to treat chronically needy Marines, who had adjustment issues and severe PTSD. I was discovering that  PTSD is one of the most common mental health disorders found among the branch. I was treating anxiety and depression while triaging marines to four different levels of clinical care, including hospitalization. It pained me to see valiant athletic marines, filled with bravado, experiencing nightmares, and flashbacks. In some cases, marine were self-medicating with illegal substances while on prescription medication: drug use led to being discharged from the Corps, despite wearing the badge of courage and surviving combat.

My tour ended. Now what? What do I do? What emotional barriers are in my way? I was a wounded healer. How do I replenish myself? I have no one to discuss my work with. So, I just choked back my emotions. I had one session with an older male counselor. He said, whatever is inside of me had to come out. I was having nightmares and trouble sleeping. I was in a state of physical, emotional, psychological, and spiritual exhaustion from occupational stress. I decided to write a series of short novels on the paradoxes of conflict. But painful memories don’t go away. There is no emotional eraser. If I over focus inward, I become emotional thinking of the fanatical and psychological pain of combat stories. So, I take deep breaths. I just want to be alone. Psychological scaring has occurred in my brain. The faces and emotions of the marines remain seared in my memory.

“Compassion fatigue. The expectation that we can be immersed in suffering and loss daily and not be touched by it, is as unrealistic as expecting to be able to walk through water, without getting wet,” Dr. Naomi Rachel Remen, Empower Social Worker, said. About the Author:

Hilary Valdez is a freelance Writer living in Tokyo, Japan.  He is an experienced Mental Health professional and Resiliency Trainer. Valdez is a former Marine and has worked with the military most of his career and most recently worked at Camp Zama as a Master Resiliency Trainer. Valdez now has a private practice and publishes books on social and psychological issues. His books are available on Amazon and for Kindle.

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