Vicarious Traumatization of Psychotherapists

"... vicarious traumatization, the /psychotherapist's/ disease, the illness that afflicts the healer, unveils the polarities--all systems of `them' and `us' --as they explode. And the neat divisions erupt, spilling over, within ourselves." Wayne Scott Unshielded "Because I worked with many sex offenders and their victims, I watched these symptoms appear in my own life: Emotional numbness, forgetfulness, overeating, depression-a profound disconnection from my feeling and my world" (Scott, 1996, p.18). These are the words of Wayne Scott, a psychotherapist who once worked with a sexual offender group. Finally, he is able to express those words and feelings. Unfortunately, for years he held them all inside--"I felt trapped between my duties as a helper and the fear and vulnerability I felt as a human being. I hide the emotional toll of my work from everyone, "he said. Research shows that Wayne's emotions are not independent, but rather shared amongst a variety of individuals within the helping fields; especially psychotherapists working in the field of sexual trauma. Most suffer in silence. Diagnosis/Symptomology, Theoretical and Prevalence. Diagnosis/Symptomology: The field of trauma therapy has evolved its attention toward what happens to the psychotherapist dealing with the victims of trauma. Although there is no uniform designator for the phenomenon, it has been discussed in the literature and is referred to as: secondary traumatic stress (Figley, 1983,1985), secondary suvivor, the ripple effect or trauma infection (Remer & Elliott, 1988a,b), and co-traumatization (William & Weaver, 1998). The terms compassion fatigue and indirect trauma (Stamm, 1997) have also been used. I prefer using the terms, vicarious Traumatization (VT) as dicussed by McCann & Pearlman (1990) and will do so throughout the report. VT represents the impact of the psychotherapist's psyche of their empathic engagement with victims of trauma. VT represents a constellation of symptoms, much like those of Post Traumatic Stress Disorder (PTSD). According to the American Psychiatric Association's 4th edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV), PTSD is the "physiological reactivity on the exposure to internal cues that symbolize an aspect of trauma." As a result, the victim is defined as taking efforts to avoid thoughts, feelings, or conversations about the traumatic event. Victims can suffer from feelings of detachment or estrangement from others. They display a range of affect (e.g. unable to expressing loving feelings); suffer from other symptoms such as: difficulty sleeping; irritability or anger; difficulty concentrating, and hypervigilance. Although the symptoms may be shared, the dichotomy of PTSD victims and the VT victims are unique: The PTSD victim experiences the trauma first-handedly while the VT victim experiences the trauma secondarily or indirectly, that is as a direct result of learning about the trauma from the victim or the source (e.g. through the perpetrator). Listening to trauma victims in the clinical process can lead to a secondary rraumatization of the psychotherapist. A phenomenon probably not too uncommon. Pearlman & Saakvitne (1995) identify other characterizes of the traumatized helper such as: demoralization; becoming cynical; often sad; serious; or an increased sensitivity to violence or defaulting to antisocial behavior patterns. I recall one "cynical" psychotherapist exclaim, "Seeing those nuts, makes me nuts." That further reminded me of the major motion picture, What about Bob? whereas a psychiatrist patient drives his psychiatrist "nuts" by always following him and feeding him his problems in-so-much that the psychiatrist broke into a store, became estranged-even to the point of hostility. The movie, although a comedy, is ironic. Berhah, Jones & Valent (1984) found that the helper's role could lead to shock, confusion, and sadness. …