Vicarious Trauma: Self-care – necessary, but insufficient


When working with people affected by trauma, especially complex trauma carried out at the hands of others, self-care is necessary. However, in my experience it is insufficient.

The expression ‘self- care’ can conjure up images of actions like getting regular exercise, spending time in nature, taking holidays and personal therapy. I’d like to be clear that these actions are important! Such self care has significantly helped me and other professionals I have worked with over the years to balance out the adverse impact of working with severe trauma and injustice, but it is not the whole story.

Self- care implies solely personal responsibility and does not acknowledge the duty or important role of others.  Others may include the organisation or setting the worker is located in, the team they belong to, their professional body, prevailing culture, society as a whole and the political establishment.  These are known as levels of context and are inspired by the work of Cronen and Pearce.[i]

These levels of context are different for each person and the levels interact with each other to create a unique situation for every worker. For example; consider both a young woman working with survivors of rape based in a uk women’s charity as a counsellor, and a middle aged male freelance journalist working overseas. While they could be coming across the same traumatic narratives, the impact on each of them will depend on their unique contexts, not solely their individual personalities and skills. These levels of context can mitigate or increase the effect of the vicarious trauma on each of us and determine whether and how much we are affected by secondary traumatic stress.

Some of the trauma we come across is vicarious, which is to say that we do not experience it directly, rather we hear, read or witness others’ experiences of trauma.  In this line of work it is also likely that some of the trauma we will experience is direct e.g. when clients harm themselves or we feel personally at risk. This needs to be acknowledged as an additional occupational hazard. With increased proximity to trauma, there is increased risk of impact on workers.

We know that people heal from trauma within the context of relationships and as workers, of course, we are no different.  This means that we must make sure we are connected in both our professional and personal lives by considering our connections in relation to the levels of context within which we are located.

Let’s look at three areas of connection and support

Professionals and peers.   As a therapist and member of BACP I need 1.5 hours of 1 to 1 supervision each month. While this can be an anchor and a lifeline, I have always made sure to have more. Having peer supervision, both formal and informal, with colleagues who are working with the same client group has been vital. I can use short hand and jargon and my colleagues know where I am coming from and what the key issues are. I have also had peer supervision with a colleague who shares my person-centred counselling background but does not work with the same client group. I have really benefitted from seeing the impact of the work reflected back to me – and their response to some of the content of the work – which can help me see more clearly the extreme nature of the work rather than normalising it and wondering why, at times, I am being strongly affected? Line management supervision is also vital – is the impact on you a standing agenda item? After all, we will always be impacted, it’s a matter of how much.

Allies are more important than they might appear. Who else cares about this work? Who in your immediate & extended family, social group and community is? Are there campaigning organisations, artists, writers, film makers, political parties, groups, musicians or publications who document,  speak out about or stand up for the rights of those you work with? Are there fundraisers putting on gigs or running marathons in aid of the client group you work with? It is important to connect or have contact– whether directly or indirectly – with others who care. In working with trauma we are at risk of isolation and replicating the clients experience.  Allies can help us connect more widely than our peers, profession and immediate work setting and we need this: to feel part of the world.

Work context – if we work with clients in an organisational context, then this has a weighty influence on how we are impacted by VT.  Is there a language around VT in the organisation and team setting and is it talked about openly? Do all levels of managers understand the ongoing, inevitable risks of both trauma and VT? How is workload, space between clients, time for processing, lunch hours, working late, supervision? Are policies relevant but not excessive? What are the expectations on the therapist or worker around client’s recovery? Are there employee friendly policies re time off and time out? This is just the tip of the iceberg. The organisational context is an important area and we plan to come back to this in future posts and upcoming Onlinevents interviews such as the one scheduled for 12th February 2019‘ Organisational trauma - steps toward recovery’


You might want to consider your contact and connection in each of these three realms: Professional/peer, Allies and Work context -  what needs your attention or action?


Meanwhile, if you would like to hear more about my thoughts on self care – a misnomer, please watch my interview on Onlinevents available through this link to facebook or in the library.


Author : Elise Marshall

[i]  taken on 7.2.19