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Vicarious Trauma and Compassion Fatigue Resources

What is Trauma?

A traumatic experience can mean a number of different things, from being a victim of some form of abuse or life-threatening situation, to witnessing any event where a person’s life or physical safety is threatened or where sexual violence occurs.

Please see our page about emotional trauma to find out more about trauma and trauma responses.

Many people report few symptoms or are able to bounce back relatively quickly after experiencing a trauma. And while resilience is our natural tendency as humans, some people find that the typical course of healing goes astray and many symptoms remain. This persistence of symptoms is known as post-traumatic stress disorder (PTSD).

Please see our Post Traumatic Stress Disorder Resources for more information.

PTSD symptoms, including nightmares, upsetting memories of the event, avoiding reminders of the trauma, and increased depression, anxiety, guilt, shame, and irritability or anger, can remain with a person for a long time, even many years, after the initial traumatic event is over. These longer lasting symptoms can interfere with our lives and prevent people from achieving some of the goals that may be most important to them, including performing well at work or school, or forming close and trusting connections with friends and loved ones.

Trauma and addiction have a two way relationship: people who have experienced trauma in the past are more apt to abuse drugs and alcohol as a means to cope with emotional stress; while people who abuse drugs and/or alcohol are more likely to experience a traumatic event due to their addictions. Recent studies indicate that nearly half of people who have PTSD also meet the criteria for substance use and abuse, and 75% of people who are dealing with addiction have experienced trauma(s) in their lives. In addition, many people who abuse substances also have underly

It’s unfortunate that while addiction and substance use and abuse often do help with the feelings of trauma in the short term; however avoiding emotional issues can’t last forever.

Please see our resources about addiction, addiction recovery, and alcoholism for more information.

Understanding Vicarious Trauma, Compassion Fatigue, And Burnout: 

Vicarious trauma generally involves a shift in the way you view the world; your beliefs about the world may be altered and/or damaged by repeated exposure to traumatic material, for example.

Compassion fatigue and burnout are related concepts that share some similarities with vicarious trauma, and a person might find themselves experiencing one or more of these states at the same time. For the purposes of this resource page, we are going to use vicarious trauma and compassion fatigue interchangeably, but for reference, the comparison is written below.

Compassion fatigue is the condition of emotional and physical fatigue that results when you feel compassion for those you care for, see on the news, hear about on the television but do not have adequate time away to refuel and care for themselves. It differs from vicarious trauma in that it is not typically characterized by the presence of trauma-related symptoms and does not necessarily involve a change in one’s world view.

Burnout is a term sometimes used interchangeably with vicarious trauma, but this condition does not necessarily involve a traumatic element. People can experience burnout when they have a toxic work environment or when they feel themselves to be doing tedious or otherwise trying work without getting enough time for rest or appropriate self-care.

What is Vicarious Trauma?

The term was first used by in 1990; vicarious trauma described the constant barrage of life and death situations experienced by nurses, doctors, therapists, first responders, and the police. To really nail down this definition, the American Counseling Association defines vicarious trauma as a “state of tension and/or preoccupation of the stories and trauma experienced by others.” It’s also sometimes referred to as secondary trauma or compassion fatigue.

With all that’s been going on in the world, it’s no wonder so many of us of walk around like zombies, trying to understand how to feel good when life – and the world seems so terrible. Social media has connected us, obviously, but it also tends to show us much suffering of others. And with all the events screaming through your Facebook (or Twitter) accounts, it can become incredibly difficult for us to feel happiness. A lot of us take social media breaks, only to find the same issues blaring at us through our television.

And it’s hard to look away; you want to support campaigns like #MeToo, send love to the survivors of mass shootings, and pray (if that’s the sort of things you do) for those losing house and home. It’s the number of awful of events occurring every single day that can make us fearful, unhappy, depressed, apathetic, and/or pessimistic.

As the speed of news flashes before us, barely giving us the chance to breathe in between horrifying things going on, it’s important for us to understand how these traumas affect us. Are they leading to bad, awful feelings? Are we reminding ourselves to take extra care of ourselves during this stressful time? Are we isolating ourselves from loved ones? Are we behaving differently; as though the constant threat is looming over us? Vicarious trauma is considered to be the cost of caring for others.

For many years, vicarious trauma was considered in terms of the helping professions: an ER doc, a hospice nurse, a therapist, a firefighter, a police officer. These were the people on the front lines: they saw things no one else had to, experienced things that not everyone would understand, and it tended to increase as time went on. How many years can a therapist listen to rape victim(s), doctors try to save dying people, nurses put into untenable situations that no one really understands before it’s all too much to handle.

It’s the advent and increasing access to the news as it happens that’s now causing previously unexposed people to feel these traumatic situations as if they were right there.

pet loss

Caregiver Stress and Burnout:

When we typically discuss vicarious trauma and compassion fatigue, it’s assumed that we’re talking about medical staff, therapists, and first responders. Perhaps, though, the biggest number of people who are experiencing compassion fatigue and vicarious trauma are those who are unpaid, untrained caregivers. Caregivers are unpaid people who care for a number of different kind of people:

  • Ailing Parents
  • Friends
  • Mentally Ill People
  • Special Needs Children

And often at the same time with various people.

Over 50 million people in the United States alone provide care for aging and ailing parents. 

And if you’re a full-time caregiver, it’s likely a 24/7 job with no breaks, no reprieve, no time for personal care, no time fo fun, and no time to process anything that is thrown at you every minute of every day. This can lead to major health issues, mental health issues, feelings of being overwhelmed and not appreciated.

Please read Caregiver Resources for more information on caregiver burnout, stress, and ways to help alleviate some of that stress. 

Please read Hospice Resources for more information.

What Is The Sandwich Generation?

Most notably the sandwich generation, which is a descriptor for people who are both caregiving for their older adult parents who are sick AND trying to care for their children – sometimes they try to work as well. This is a major stress and often, with finances being drained quickly, caregiver stress can feel unmanageable.

As people around us age, “learning to parenting your parent” is becoming increasingly common. People in this Sandwich Generation are generally stuck in the middle between caring for aging parents and caring for their own children. The ever-increasing lifespan of people means that more and more of us will be put in this position – many of us having to do this on top of a full-time job. While living longer and longer can be excellent, each year that goes by means that age-related problems are becoming a burden on the members of the sandwich generation. These problems can include chronic illnesses, long hospital stays, multiple medications, dementia, deafness, becoming bedridden, and eventually unable to properly care for themselves. Often, without the funds, these caregivers must care for their aging parent in their own home – often with parents who need round-the-clock care.

This is nearly impossible feat and it can put a strain on everything from finances, to relationship issues, to being unable to properly parent your child.

Please visit our caregiver resources for more information on coping with caregiving


How Do We Know If The Impact Is Too Much For Us To Handle?

As is the case with any type of traumatic event, some people will be able to handle vicarious trauma and have it not affect their daily lives. Others feel a sense of hopelessness and feel overwhelmed. Don’t expect that your response will be the same as, well, mine. This isn’t a contest and there are no real rules as to how vicarious trauma affects us. If you’re wondering if you’re experiencing vicarious trauma, look below and see if you see yourself in these symptoms:

  • How’s your daily mood? Is it the same as it usually is? Are you experiencing mood changes?
  • Are you increasingly worried or irritable?
  • Do you feel unsafe?
  • Do you feel hopeless and helpless?
  • Are you isolating yourself from your loved ones?
  • Are you engaging in risk-taking behavior by drinking or drugging to escape your daily life?
  • Has it become hard to concentrate?
  • Do you find yourself constantly thinking about the traumas?
  • Has your beliefs about the world changed?

If you see yourself in these statements, you may be dealing with vicarious trauma and compassion fatigue.

Who Is at Risk of Being Affected by Vicarious Trauma?

Really, anyone who has been working with trauma survivors, trauma as a part of their job, or those who experience vicarious trauma from the news can be affected. These factors may increase your vulnerability:

  • Having lived through other traumatic experiences
  • Difficulty discussing your feelings
  • Having traumatic experience happen on the regular at your job
  • Feeling social isolation, loneliness – both at work or in your personal life
  • People who withdraw to avoid experiences, feelings, or blame other people in super stressful situations
  • At work, people who’ve not been properly prepared, oriented, or trained in their job
  • If you’re newer and less experienced in your job
  • Unending, constant intense exposure to trauma on the job
  • Lack of availability of people to support and help you discuss your trauma

What Are Some Of The Warning Signs That You’re Developing Compassion Fatigue?

Physical Warning Signs

  • Getting sick more often
  • Sore back and neck
  • Total exhaustion
  • Insomnia
  • Headaches
  • Irritable bowel, GI distress
  • Rashes, breakouts
  • Teeth grinding during the night
  • Heart palpitations
  • Hypochondria

Behavioral Signs

  • Not returning phone calls at work and/or at home
  • Anger and Irritability at home and/or at work
  • Avoiding social events
  • Using drugs and/or alcohol
  • Bingeing a ton of Netflix/Hulu/TV at night
  • Watching high trauma shows and news as entertainment
  • Decreased decision-making abilities
  • Increasing issues in personal relationships
  • Challenges with intimacy and/or sex due to trauma
  • Frequently negatively gossiping
  • Changing in eating – restrictive eating or overeating
  • Inability to stop thinking about the trauma

Emotional/Psychological Signs

  • Emotional exhaustion
  • Negative self-image
  • Depression
  • Increased anxiety
  • Feelings of hopelessness
  • Guilt
  • Reduced ability to feel sympathy and empathy towards clients or family/friends
  • Cynicism
  • Anger
  • Resentment of demands asked of you at work and/or at home
  • Diminished sense of enjoyment/career(i.e., low compassion satisfaction)
  • Depersonalization – spacing out during work or the drive home
  • Disruption of world view/heightened anxiety or irrational fears
  • Intrusive imagery
  • Hypersensitivity to emotionally charged stimuli
  • Insensitivity to emotional material/numbing
  • Suicidal thoughts

What Are Some Other Symptoms That May Indicate Vicarious Trauma/Compassion Fatigue?

While many of the below symptoms can be described as symptoms of depression, there’s much more to symptoms of vicarious trauma; these symptoms are a bit more like PTSD because they are in relation to a number of involuntarily traumatic situations. It’s the culmination of a large number of problems and trauma all rolled into one.

  • Avoiding talking about the trauma
  • Beginning to feel numb to what they are experiencing
  • In a constant state of fight or flight or flee or free
  • Survivor’s guilt
  • Sleep issues (sleeping too much or insomnia)
  • A free-floating anger or irritation at others
  • Losing sleep
  • Fear that they’re not doing enough to help others
  • Dreams being overtaken by trauma
  • Feeling less and less joy for things they once loved
  • Feeling trapped and helpless; unable to get out
  • Intrusive thoughts about the trauma(s)
  • Less feelings of satisfaction and feeling like they’re not making a difference
  • Absenteeism and tardiness to work
  • Rejecting interpersonal and physical closeness to other people
  • Dropping out of activities once enjoyed
  • Dissatisfaction with like and other people
  • Blaming other people for the trauma
  • Low-self image
  • Hopelessness and/or apathy
  • Problems with interpersonal relationships
  • Changing their world view

Coping With Compassion Fatigue And Vicarious Trauma:

With the news constantly spitting out horrible images of people dying, planes crashing, and catastrophic events, so naturally, we have to find ways to manage and overcome vicarious traumatizations. Let’s go over some good ways to cope:

First, you need to recognize that you’re experiencing this and start to make your very own self-care plan. This may look different for everyone, but the following ideas are the basic tenant of your recovery.

Second, make sure you’re spending quiet time alone. If you can practice meditation, you may like to try it. If you don’t, make sure that you spend some time coming back to the core of who you are. Returning and reminding you of your former self can be very centering and help you achieve some inner balance.

Third, you also need to connect and have meaningful conversations at least once a day. Talking to someone about something other than just pleasantries can do your soul a whole lot of good; especially if you’ve managed to isolate yourself.

Fourth, do something you love every day that’s good for you. Vow to learn to cook, take up a hobby you have time for, and do it every single day.

Fifth, self-care is a total must. Most of us, when we develop compassion fatigue through vicarious traumas have a tendency to avoid taking care of yourself. This isn’t an option when you’re struggling with compassion fatigue.

This is gonna make a lot of people mad, but this is important, create your own principles about dealing with vicarious trauma and your exposure to it – turn off the TV, get off Facebook, and turn your phone totally off when you’re not feeling as though you’re able to handle it. You’re not going to die if you don’t constantly read status updates or see what your BFF is making for dinner.

If your in the medical field, a therapist, or a first responder, making a plan isn’t as easy as clicking a button. This requires some serious soul searching: what makes you happy? What (pardon the phrase) sparks joy in you? These questions should help you understand some principles of care to use in traumatic situations. For example, if you’re emotionally exhausted while thinking about your job, maybe it isn’t the gig you wanted it to be. There are always a zillion different jobs for medical professionals, therapists, and first responders.

No news is good news. It’s a familiar enough phrase, between accounts of natural disasters, sexual assault, child abuse, and maltreatment in detention centers and violence against racial, ethnic, and sexual orientation, and gender minorities, there is more than enough going on in the world to lead one to feel anxious and sad.

The emotions and reactions, along with a number of other thoughts and feelings, are challenging enough to cope with. For people who have survived a trauma, this barrage of information can be particularly overwhelming and can result in feelings of hopelessness, despair, paralyzing fear, and rage at the people and systems who commit or condone violence.

The Don’ts of Managing Compassion Fatigue and Vicarious Trauma:

Unfortunately, as much as we don’t like hearing about the don’ts in life, it is necessary when it comes to healing yourself from vicarious trauma.

Don’t blame other people for your issues. They are your own and you must deal with them; even though developing compassion fatigue isn’t your fault. Wait until you’ve healed so that you can properly see what needs to change in your life.

Do not make big decisions: now is NOT the time to buy a new house, divorce your spouse, buy a fancy car. When you’ve recovered emotionally and physically from compassion fatigue, you can better assess what you really need. Even though you get an endorphin rush from a big purchase, it won’t last. And when it stops, the guilt creeps in. Always, always, always, always remember that old AA saying “wherever you go, there you are.”

Don’t bother trying a quick fix – drinking and/or engaging in risky behaviors only cover up your feelings only delays them. They’ll be right there with you when you wake up. Addiction and addictive behaviors can only escalate your continued downward spiral.

This is a toughie for most of us, because complaining can feel sooooo good, especially with people who share your views, but don’t make complaining a habit – it’ll only serve to make you feel worse. If you want to share your feelings, talk to a close friend, loved one, or even a therapist. That way, you’re dealing with your emotions and feelings in a safer, more constructive environment.

a crowd of people hands shaped into a heart

Help! My Loved One Has Compassion Fatigue and Vicarious Traumatization!

One of the best things you can possibly do to help someone struggling with compassion fatigue and vicarious trauma is to be kind and supportive. In fact, be kind and supportive to everyone you meet!

If your loved one is disclosing their compassion fatigue for the first time, it can be extremely hard to hear that what they’ve thought they’d been hiding is being noticed.

With the main focus on treatment of compassion fatigue and vicarious trauma is to do more self-care and find better work/life balances, some people feel blamed – as though they’ve caused this issue themselves and not as a result of their work – “if you feel compassion fatigue, YOU are not doing enough to care for yourself.”

See, the biggest contributions fo developing compassion fatigue is your work location, your workload, the amount of support staff available, working conditions, and whether or not you’ve gotten training in dealing with trauma-related stress.

Self-care, a wonderful ideal, doesn’t look the same for everyone, it must be figured out based upon how we’ve dealt with other types of stresses in our lives. For some, it can involve leisure activities, doing fun things, developing a satisfying physical activity regime, or getting yourself on a consistent eat and sleep cycle. The balance between self-care and vicarious traumatization is incredibly important to give yourself and your body time to process the event.

When you’re feeling overwhelmed, being social and finding good social groups to join is one of the very best things you can do for yourself.

Write it down – let it out. We’re open 24/7 and a lot of people have been where you are. 

When you can’t avoid exposure to traumas and retraumatization, you may feel helpless and hopeless. This is where getting a sense of control in other parts of your life comes in. Helping others, attend local counsel meetings, do something good for others can honestly help to counteract the feelings of helplessness or hopelessness.

Limiting your exposure to traumatic situations is important when you’re trying to reduce vicarious trauma and managing symptoms as they happen can do a lot toward making you feel better about yourself and your life. If you’re in a helping field, reducing your hours, or changing your job to a less-traumatic one can really help reduce vicarious trauma and compassion fatigue.

Additional Resources for Compassion Fatigue and Vicarious Traumatization: 

The Offices For Victims of Crimes offers strategies and a toolkit for professionals and lay-people alike to help to learn to understand traumas and begin to heal

Professional Quality of Life Questionnaire  

National Sexual Assault Resource Center offers a plan to work on your compassion fatigue and vicarious trauma

American Nurses Association did a study on compassion fatigue, PTSD, and vicarious trauma. These are the results – they’re dense but can be applied to any helping professions.