Helping the helpers

Talking to survivors of trauma also affects the helper. For all helpers empathy is an essential aspect of good help. This is also a source for compassion fatigue, vicarious traumatisation or secondary traumatic stress (STS). How are helpers to manage their own stress?

16.12 2021

Early recognition and awareness is crucial to be resilient to these symptoms. Awareness of this is important for workers in areas of conflict and disaster, and in extreme environments such as these, people may be more vulnerable to secondary traumatisation. We also know that professionals under this kind of stress may be at risk to perform less efficiently and not perform as they would normally do. Even large organizations that have the resources and knowledge about this particular kind of stress may have reduced capacity to deal with or take care of the affected personnel. As for local helpers, there may often not be any support or resources at all to deal with this. On MHHRI’s thematic page for helping the helpers we have gathered links that can be useful for all persons engaged in this kind of important but heavy work.

It is important to develop strategies to cope with situations that might cause vicarious trauma reactions. What helps you to take your mind off your work or your thoughts? How can you rest your body as well as your mind? Does an activity inspire you or put you in a better mood? If you find it useful, you can also use the grounding techniques that you teach survivors. Helpers who have been personally exposed to GBV have additional reasons to be stressed. At the same time, their experience can give them a special understanding of the hardships and vulnerability of survivors, And this should be recognised and valued.

Like survivors, helpers need support groups. If possible, meet regularly with other helpers to discuss your experiences and feelings, or do things together. If there are too few helpers in your area to create a support group, find friends and other people you trust with whom you can share your feelings without breaking the confidentiality of the survivors you are helping.

Secondary traumatization

A particular challenge when dealing with severely traumatised people is that the survivor’s memories, experiences and torments can also affect the helper. Hearing horrific stories can sometimes cause unpleasant fantasies and nightmares in the helper. It can also, together with the survivor’s fear, affect the survivor’s own sense of security and predictability. Many helpers may find that they think the world has become more sinister, cruel and unpredictable. The helper may also feel the same hopelessness as the survivor and thus be less able to communicate hope and see the patient’s strengths.

In many ways, we can say that the survivor’s torment and behaviour are transmitted to the therapist. This is called secondary traumatisation and develops over time, as more traumatised patients are encountered and reactions are not processed continuously.

If you use an interpreter, remember to take care of their welfare too. Even an experienced interpreter can be emotionally overwhelmed by the stories they hear. Although it does not happen often, interpreters may find it difficult to hide their feelings. Helpers can try to care for the survivor and the interpreter by recognising that it is painful for both to hear the frightening, unfair experiences that the survivor tells about.

Compassion fatigue

For all helpers, empathy is an important part of giving good help. However, our empathy is not an inexhaustible resource. If we overuse our empathy, without getting enough replenishment of resources and strength, helpers can get a strong feeling of emptiness or weariness when dealing with people who are hurting. This is often called caregiver fatigue. The helper may feel exhausted and demotivated, demoralised, hollow and hopeless. It can lead to sleep problems, somatic difficulties and substance abuse. Many may feel that their own problems, needs and well-being do not deserve attention and are less important. They often become less emotionally available to their own family or friends, so private relationships become difficult. At the same time, they do not manage to be as committed to the job as the helper.