Vicarious trauma: how first responders absorb patients’ experiences

The best way for first responders to recover from vicarious trauma is community conversation, but it’s often not discussed.

Like a contagious disease, “we pick up on another person’s emotions in a twentieth of a second,” said Sandra Bloom, an associate professor of health management and policy at Drexel University and a 1975 Temple University doctorate of psychiatry alumna.

For first responders or people who administer care to trauma survivors, this emotional exchange may result in vicarious trauma. Vicarious trauma, also known as secondary traumatic stress, is the trauma absorbed from engaging with a survivor. Often, this can take the form of post-traumatic stress disorder.

Despite its prevalence, Bloom said vicarious trauma is less talked about in the workplaces it manifests — including hospitals, prisons, police departments and news organizations — which she said are dubbed “macho” professions. She added that emotions are historically labeled as feminine. 

“It’s a huge disability in the culture because emotions are not gendered,” Bloom said. Students training for future careers as first responders can also experience this.  

Soomin Seo, an assistant journalism professor at Temple, said she felt pressure as a young journalist to bottle up emotions to appear strong.

“I did not want to admit I was traumatized,” said Seo, who spent the early part of her career as a police beat reporter. “I’ve seen some pretty gory stuff.  …It took a very long time to realize how big of a toll this was taking on my life.”

Bloom described vicarious trauma as a gradual “burn out,” which first responders may not initially feel. From 1980 to 2001, she developed a psychiatric inpatient program for trauma-related emotional disorders called the Sanctuary. 

The programs operated under Bloom’s Sanctuary Model, a theory-based approach, trauma-informed approach to treating people who have experienced trauma. From working with patients in the program, Bloom said she experienced this burn-out. 

“I never thought I could get burnt out,” Bloom said. “But that exposure took a toll on my mind and body. Only in retrospect could I see that toll.”

Bloom created The Sanctuary Model as a community-based approach to trauma and has authored multiple books on trauma. In some cases, she said that too much trauma exposure can lead to desensitivity. 

Jim MacMillan, the assistant director of external affairs at the Klein College of Media and Communication, worked as a photojournalist during 9/11 and the Iraq War. At times, he said he was desensitized to the trauma he was experiencing. 

“It probably happens to lots of people, and it’s not good,” MacMillan said. He regained sensitivity to trauma before the war in Iraq. 

MacMillan stressed the importance of talking and seeking professional help if needed.

“The trauma experience can do great harm, but it can also leave one more resilient if they process or transform the experience and heal,” MacMillan said. “And I did, eventually.” 

Brett Kelly, a junior nursing major who works with trauma survivors in his nursing clinical and interned for Bridging the Gaps, a Philadelphia-area camp for children who are recently experiencing homelessness, said he was emotionally affected by his work.

“Dealing with multiple kids really gets into your head because you feel like you can’t make a difference,” Kelly said. “Really, you can make a difference. It just takes some time talking.”

Kelly held debriefings with a group of Temple representatives working at Bridging the Gaps, which he says helped to put these feelings into perspective.

Lizzie Birmingham, a junior psychology major, also works with trauma survivors in her job at the Philadelphia location of Gaudenzia Addiction Treatment and Recovery on Spring Garden Street near 13th, where she assists patients recovering from severe drug and alcohol addictions who come directly from prison. 

Gaudenzia also has alcohol and drug addiction treatment facilities in Maryland, Delaware and Washington, D.C. 

Other than personal conversations with her boyfriend, Birmingham said she is instructed to leave her emotions at work. Doing so is easier said than done, she added.

“I spend 20 hours a week with them,” Birmingham said. “I get so attached. They are like a family, so it’s hard to just leave it at work. The other night, I just got in my car, crying.”

While engaging with a trauma survivor, Bloom recommended devising a five-step safety plan to best take care of yourself and others. If either person needs a break, she suggests pretending you are getting a phone call or leaving to buy coffee for both people.

“Ideally, you want to prevent trauma,” Seo said. “That’s rarely possible. Realistically speaking, you are talking about [taking care of yourself] after. It’s a good idea to sit down with friends over coffee, not over alcohol, and really talk it out.”

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