Vicarious Trauma and the Importance of Self Care...2019/03/13 · “Self-care is an ethical...

Building Resiliency: Effective Management of Vicarious Trauma

and Secondary Traumatic Stress

Nicky MacCallum LMFT, NCC

Remember to Keep Yourself Safe

Content might make you

anxious or remind you of

past traumas or losses

Take a moment to

prepare yourself

Throughout the training

do what you need to

take care of yourself

© Nicky MacCallum LMFT, NCC 2017 2

The Cost of Caring

“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.”

(Rachel Naomi Remen)


© Nicky MacCallum LMFT, NCC 2017

4

Direct/Indirect

Changes in:

Frame of reference

Psychological needs

Affect

Behavior

Challenges Compassion Fatigue

Trauma

PTSD

Vicarious Trauma

Secondary Traumatic

Stress

Strengths Compassion Satisfaction

Resilience

Post Traumatic Growth**

Trauma Exposure

Possible

Impact

Possible

Outcomes

Vicarious Trauma Can Disrupt Personal BeliefsFrame of Reference

Identity - Feel less effective, helpless. Over identification with client

Worldview - See world as more dangerous, less hopeful. See others as vindictive/evil

Spirituality – Lose connection with source of spiritual strength

Areas of psychological need

Self-Esteem – Difficulty holding positive self-value

Sense of Safety – fear/vulnerability, excessive concerns for self and others

Ability to Trust - Inability to trust instincts/others

Sense of Control - helplessness /powerlessness. Can lead to “Super Provider”/Micromanaging

Intimacy - Alienation/estrangement/ withdrawal/difficulty with small talk/ continuous small talk to avoid being alone

( Adapted: from Figley)© Nicky MacCallum LMFT, NCC 2017

5

• Survival coping

• Intrusive thoughts

• Nightmares/

Flashbacks

• Sleep disturbance/

sleeplessness

• Compulsive

engagement with

trauma related

material

• Avoidance of

tasks/work

• Inability to listen/

avoidance of clients

• Social withdrawal/

isolation

• Decreased interest

• Hopelessness

• Inability to recall

information

• Negative moods

• Difficulty feeling

positive or happy

• Overly negative

about oneself or

the world

• Guilt

• Excessive self-

blame or blaming

others

• Anger and cynicism

• Hypervigilance

• Inability to embrace

complexity

• Loss of creativity

• Minimizing

• Insensitivity to

violence

• Fear

• Chronic exhaustion

• Physical ailments

• Disconnection

• Poor boundaries

• Diminished self care

Symptoms and Conditions Associated

With Secondary Traumatic Stress

(NCTSN, MacCallum)© Nicky MacCallum LMFT, NCC 2017

6

Factors that can Increase Resiliency/Vulnerability

for VT and STS Impact

Personal History/Identity – The multitudes of self

Family of Origin

Racial

Cultural

Economic/class

Ability

Belief system

Education

Justice system impact

Sex (biological)

Gender (cis gender, transgender, gender fluid, gender non-conforming, gender queer)

Sexual orientation (heterosexual, lesbian, gay, bisexual, asexual)

Trauma experience

Roles/Stereotypes

Work style

Copyright © Nicky MacCallum LMFT, NCC

7

Factors that can Increase Resiliency/Vulnerability for VT and STS Impact

Ongoing experience with trauma

Day to day stressors (sick relative, economic challenges)

Presence/Absence of social support

Societal attitudes

- Traumatic events occurring in community/ society

- Population being served

- Providers/programs


8

Dynamic

Put Your Own Oxygen Mask

On First!

“Self-care is an ethical imperative.

We have an obligation to our clients -

as well as to ourselves, our colleagues,

and our loved ones - not to be damaged

by the work we do.”

(Saakvitne & Pearlman)

“You can’t poor from an empty cup”

(unknown)


Remember

Show yourself

the same kindness, compassion,

and non-judgment,

as you show those you serve


The ABC’s of

Effective VT & STS Management

Awareness

of one’s own needs, limits, emotions

and resources

Balance

of work and play, of taking care of

others and taking care of yourself

Connection

to oneself, to others and to something

larger


Awareness Examples of coping strategies

that can have negative impact

Smoking/using tobacco

Too much caffeine

Too much alcohol

Overuse of over the counter medications/prescription medications/drugs

Overeating/under eating

Spending excessively

Angry outbursts as tension release

High-risk situations/relationships

Too much TV/streaming

Over-engagement with social media

Withdrawing from others

Ignoring/denying stress symptoms


12

Creating Balance


Balance is not something you find, it is

something you create

It is important to create healthy balance

between work, rest,& play!

Balance In the Workplace Start with what you already know

works for you

Start the day with a centering

practice

Create a healthy work space

Balance work schedule and life

demands where possible

Balance more and less challenging

tasks

Schedule time for

paperwork/supervision

Consider two phones/different tones

Take breaks

Establish a “buddy system,” with a

reliable colleague

Set appropriate limits around your

responsibilities and overtime

Before committing to a project or task,

first consider your needs and available

resources

What could you do to add balance to

your workplace?


14

Balance between Self and Others

Spend time with people

whom you don’t have to

take care of or rescue!

Find a balance between

caring for others and being

cared for


Connection & SupportConnection (to oneself, to others and to something larger)

Having connection with others and being willing to receive support can:

Assist during uncertainty

Build emotional strength

Allow space to address fears,

hopes, and dreams

Create feelings of being seen and

understood

Provide space for problem

solving/encouragement

Assist in identifying stress/

distress


16

Proactive Management of VT and STS

Helps us cope with, transform, and inoculate against

the impact of work related stress, vicarious trauma,

and secondary traumatic stress

Should reflect the individual’s needs, experiences,

interests, resources, culture, and values


Building an Self-care On the Spot (S.O.S.) Plan

Start with what already works for you

(E.g., Traditional/indigenous practices)

Breathing

Relaxation

Physical Activity

Imagery

Grounding

Aromas

Positive Self-Talk

Spiritual practice

Support System

Music

Photographs


Building Resiliency

Developing a Lifestyle Self-Care Plan

Include at least:

1 individual & 1 Social

activity from each domain

Spiritual

Emotional

Physical

Mental


How do I keep myself on track?

• Keep plans visible

• Add plans to your calendar

• Set monthly/quarterly/annual calendar

reminders so you can:

– Complete the Professional Quality of Life

Measure (found at proqol.org)

– Re-visit your planning and adapt as needed


Nicky MacCallum LMFT, NCC

Training, and Consultation

MFT#31528, NCC#29263

[email protected]

www.nickymaccallum.com

Copyright © Nicky MacCallum LMFT, NCC 21

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Vicarious Trauma and the Importance of Self Care...2019/03/13 · “Self-care is an ethical...

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Transcript of Vicarious Trauma and the Importance of Self Care...2019/03/13 · “Self-care is an ethical...