Cynthia Wilson PhD, MA, ATR-BC, Co Chair Vicarious Trauma SIG

The holiday season is fast approaching. For those of us in the northern hemisphere, this also means that winter weather, less sunshine, shorter days and time changes are upon us. There are many elements to this time of year that can make it more stressful. If you find that change is something you need time to adapt to, if you don’t enjoy time around people that you only see 1-2 times a year, if you find that your family is not the healthiest, you or family members have a history of childhood traumas, or if the lack of sunshine really effects your mood, then listen up.

Everyone can be affected by something called vicarious trauma (VT). As caregivers we may be exposed to this possibility on a daily basis. The winter months can actually increase the chance that we experience VT. VT is when another person’s experiences affect us internally, leaving us feeling harmed or altered in our own experiences with self and the world (Newell et al., 2016). Of course, if we are off balance mentally, emotionally, psychologically or physically, then the trauma shared with us or seen in the news or social media can more easily infiltrate us and cause harm. The symptoms of VT are quite similar to that of PTSD (Jenkins & Baird 2002) with the exception of being less deeply ingrained as a secondhand trauma and therefore more manageable (Scarce & Wilson, 2022). Symptoms may include making repeated mistakes (distracted or decreased concentration and sleep) withdrawal (from work, others and even self), criticizing colleagues, irritable, hypervigilant, paranoia or neglectful (spilling over into personal life), nightmares, feeling physically ill, hating/resenting clients, no sense of humor, no patience with others, highly reactive temperament, or zombie like (American Psychiatric Association [APA], 2022; Gentry, 2022).

Now, if you are like many people in the world, you may have family and friends who have a history of trauma or you may have trauma in your past as well. Over the holidays these traumas can be brought back to the surface as family and friends gather. Our clients are more likely to bring up past issues and events that otherwise never get discussed except at this time of year because the people that are involved in the issues are going to be discussed, or even seen, during holiday gatherings. There being a lot more traumas discussed, as well as potential re-traumatization of having to be around the people who are part of the trauma, can be extensive for a therapist to hold. VT is very normal and not at all a symbol of being a poor or unskilled therapist.

Here are some ideas for self-care that can get you through this season. For starters, if you live in the northern hemisphere the holiday season coincides with winter, so please assess if you are someone who needs more sunlight. If so, consider getting a red light/UV light therapy pad to use, or get some UV lights for your home or office and any chance you can get, open the curtains and/or go outside. Personally, my office is in the basement of a building so there is a window well with very little natural light that comes inside. I know that I need to open my door and step into the open space where more light is filling, or when the sun peeks out from the clouds I need to just stand for about 30-60 seconds with the beam on my face or feel with my feet, the warmth it creates on the floor. What could you do to get more sunlight between clients and throughout the day?

Other non-time consuming self-care tactics can be implemented daily and can be flexible to the way the day is going for you. Print these out or set aside as a reminder to give yourself the love you need throughout the day to stay healthy, prevent VT as best as one can and heal from VT or destabilization from the wintery and holiday season.

1. Wake up in the morning with healthy blood flow by doing some slow rounded movements of the ankles and wrists to get the blood gently flowing all the way to the farthest appendages and release any toxins that built up overnight.
2. Drink plenty of water throughout the day by starting the morning with a glass of water before anything else. This is based on your height and weight to flush out the toxins of the environment, the added toxins of the holiday foods/treats, and the toxins of the stress that comes with the seasonal changes and holiday trauma triggers.
3. Journal in words, images or lines and shapes before going to bed to place the last few things that you carried with you in the day, onto the page for safe keeping while you sleep. No need to hold onto that argument during the holiday party in the forefront of your mind when you are trying to rest and recover at night. Let that paper hold it for you.
4. Tai Chi hand exercises can be a simple yet effective way to wake up the body between clients and directly support health to specific organs and functions.
5. Tapping or Emotional Freedom Technique (EFT) is yet another way to acknowledge the struggles of the day without spiraling deeper into them. This can be a quick press and holding of pressure points with a deep slow breath or it can be saying the struggles of the day while tapping on the points. This is so flexible it depends on what you need and how much time you’re able to do it, but usually about 1-10 min. And if you’re like me you might forget to write down the score from 1-10 of how stressed or upset you are feeling before and after the tapping. However, it is good to do this to really see how it helped and if you could use another round of tapping or something else.
6. If you will be attending holiday gatherings then team up with one person to have a code word or signal that allows either of you to distance yourself from a person, topic of discussion or even steer away from a food or beverage that is toxic for you. This can not only help support you in getting out of a situation you don’t want to be in, but can also help you feel more secure and stronger going into the gathering in the first place, which ultimately helps you stay grounded.
7. When scheduling clients this season try to balance out in any way you can. I know we don’t always have control over our scheduling so if you can’t do anything at all about it then please focus on the other self-care strategies. That means mixing up kids, families, adults, groups, or changing up phone, in person and zoom. Or even perhaps the severity of trauma your clients have can be looked at. Consider scheduling clients so that you don’t have all the severe trauma cases in one day.
8. If you find new clients coming your way during the holiday season then perhaps reduce the contact with older clients who are currently stabilized or schedule clients in a way that allows for brief recovery moments between them. Be sure not to add in new clients and overwhelm your case load without also being sure to really implement some of these quick self-care rescue tips.
9. Have a self-care tool kits at the ready in the office, the car and at home. This can include things like mementos, images/symbols or messages that remind you that you are safe and loved, essential oils that grounds you, textures/fabrics that calm and sooth, art or writing materials to express something quickly, and a fidget tool or stress squeezer. You may also like to include lotion to use for a gentle hand massage, lip balm or eye drops to refresh your senses or a small hand held massager to use on the forehead, scalp, neck or shoulders.
10. Lastly, one of my favorites, but can be one of the hardest to adapt to, is eating and drinking items during the work day that are antioxidant rich and anti-inflammatory. Items like turmeric and omega 3 go well together to heal in numerous ways. Cinnamon and peppermint are also great. Many fruits and veggies (like walnuts, blueberries, ginger) can boost the immune system, help blood flow and heal inflammation. Some items like omega 3 oils and mushrooms can support a healthy brain. Being on par in your body will help reduce stress or help you heal from it faster and keep you more balanced to take on the heavier holiday load.

Should you have any of the VT symptoms that were mentioned earlier, please pause and do some more in-depth self-care. See a friend in person if possible or at least talk with them. Go to a consultation or peer therapist support group or set up a session with a health professional. ISST-D has a peer support group held every couple months hosted by the Vicarious Trauma and Resiliency Significant Interest Group (VTR SIG). You are welcome to join the VTR SIG and be a part of their zoom gatherings or online forum chats of support, self-care and rejuvenation. To join this group please contact the SIG secretary Barbara Shaya via ISSTD world.

Please take care this holiday season as you are needed and loved and we all want to support each other to be healthy.

References

American Psychiatric Association  (2022), Diagnostic and statistical manual of mental disorders (5^th ed., text revised). American Psychiatric Association.

Gentry, J. E. (2022). Forward-facing trauma therapy. Healing the Moral Wound, (2^nd ed.)., Outskirts Press, Inc.

Jenkins, S. R., & Baird, S. (2002) Secondary traumatic stress and vicarious trauma: A validation study. Journal of Traumatic Stress, 15(5), 423-432.

Newell J. M., Nelson-Gardell, D., & MacNeil, G. (2016). Clinician responses to client traumas: A chronological review of constructs and terminology. Trauma, Violence & Abuse, 17(3), 306-313.

Scarce, J., & Wilson, C. (2022). Art therapy for trauma recovery and response. In Rastogi, M., Feldwisch, R. P., Pate, M., & Scarce, J. (Ed.), Foundations in Art Therapy: Theory and Applications (pp. 413-447), Academic Press.