ARTIC Subscale #5, ProQOL- Reactions to the Work

Vicarious Traumatization- What To Do

  1. Have team discussions of what is going on and how it is affecting us as people
  2. Connect with anyone who has been hurt and express your concern
  3. Make sure that supervision is happening
  4. Is our environment too noisy?
  5. Can we add music?
  6. Can we make the space more pleasant, add decorations?
  7. Recognize staff for special effort
  8. Plan fun staff activities like pot luck lunches
  9. Continue to talk about anything that is going on, with compassion and respect, recognizing that everyone is doing the best they can
  10. Remind yourself of your role with your clients, that you do not have infinite power, and that you are only a part of their healing journey.
  11. Listen responsively to your client’s stories without making them your own or visualizing them too vividly
  12. Remind yourself of your specific role as a treater, and do not expect yourself to solve all the clients’ problems.
  13. Remind yourself of the power of the therapeutic relationship and do not expect yourself to also take on other roles in the client’s life.
  14. Have some time in your life in which work does not intrude.
  15. Have support around the limits of your responsibility and your ability to change your clients.
  16. Utilize mindfulness practices
  17. Use journaling and other creative expressions to increase self-awareness.
  18. Participate in therapy for yourself.
  19. Seek out on-going training.
  20. Notice when you become cynical and hopeless about your work and challenge your negative beliefs
  21. Have and use support at work.
  22. Create a balance in your day through scheduling of cases and including breaks for connection and renewal
  23. Take time off and vacations.
  24. Stay home if you are sick.
  25. Receive regular supervision that includes discussion of your reactions to your work.
  26. Use techniques such as breathing, connecting to items around me, and remembering your resources to manage painful client interactions.
  27. Include in your space some items such as pictures and objects that remind you of people that you love and good things that you have experienced.
  28. Stay in the present while listening to painful stories, and remember that your client has survived and now has your support.
  29. Use your breathing and physical sensations to stay in the present.
  30. Remember that you are only one part of the client’s journey, and you do this work in a community of other healing people.
  31. See your clients as resilient and as having the resources to heal.
  32. Notice your client’s strengths and resiliencies.
  33. Process painful work-related experiences creatively through movement, writing, sculpture making music or art or designing a garden
  34. Connect to a community.
  35. Have a spiritual connection with something larger than yourself, whether that be: the best of all that is human, nature, history, or a spiritual entity such as God, Yahweh, Allah, the Goddess or any other practice such as prayer or meditation
  36. Regularly take time to think or talk about the rewards of your work.
  37. Take time to talk about or think about the painful feelings you have at work and the lessons or wisdom you receive from them.

A  Simple Centering Exercise

Have participants stand with or without music, feel the connection of their feet to the floor, then bend their knees to lower their center of gravity, creating a feeling of greater stability.

Next have them sway, shifting their weight gently from side to side, from foot to foot. Direct their awareness to the sense of going off balance and coming back into balance by finding their center of gravity. After they have explored this movement for a while, have them repeat the exercise and share the sensations they feel in each position. Participants can point to the place in their body where they feel “centered”. For most it will be the area near the navel and about two inches inside the body.

They can repeat the above, this time moving forward and backward instead of side to side. Young children can pretend to be a toy top moving about in a circle with hands on hips. As the “top” slows down, it wobbles until in finally rests, stopping completely.

Adapted from Levine, P and Kline, M. Trauma Through a Child’s Eyes (2007).

Guidelines for De-Escalating

  • Take a deep breath, take one step back and ground yourself first. Let your energy settle into your feet and lower legs, feeling the support of the ground.
  • Remind yourself that you know what to do because you have memorized this list.
  • Adopt a soothing tone of voice; raising your voice provokes more adrenaline.
  • Avoid threatening behaviors or gestures.
  • State the behavior you observed without shaming or exaggeration.
  • Show you understand by reflecting the student’s overwhelming feelings.
  • Avoid threatening or punishment.
  • Make a statement that you are there to support the student. They are not alone.
  • Make a statement that shows the relationship can be repaired between the two of you.
  • Make a statement that gives a choice to save face.
  • Make a statement that directs the participant toward what they can do to “fix” or repair the situation.

Focused Breathing

This is simple exercise developed to bring body awareness and calmness. Give participants a large Post-It on which they write from 1 to 5 and write the following:

  1. Inhale
  2. Pause
  3. Exhale
  4. Pause
  5. Changes noted

With eyes open have the participants follow their breath, carefully tracking the route, rhythm, and length of exhale and inhale. They also notice if pauses occur between inhale and exhale.

Next they are asked to observe whether the length of inhale and exhale is even, uneven, or what they notice about the pauses.

There is no right or wrong way to do this. The exercise is designed to bring focus and awareness to the breath without changing anything.

Assists with self-regulating and increases body awareness.

Butterfly Hug:

  1. When you begin to think about that “terrible” thing
  2. Cross your right arm over to your left shoulder and your left arm across the right arm to the right shoulder.
  3. Alternately tap your hands against your shoulders with little taps—right, left, right, left while thinking of something pleasant.
  4. Do this for a few minutes until the pleasant picture replaces the “terrible” picture.
  5. Continue as you feel the “terrible” picture coming back.
  6. Between sets, shake out your arms.
  7. Take deep breaths.

 

“When life sucks you under

you can kick against the bottom,

break the surface and breathe again.”

Sheryl Sandberg

Resilience refers to a dynamic process encompassing positive adaptation within the context of significant adversity. Implicit within this notion are two critical conditions:

  • exposure to significant threat or severe adversity; and
  • the achievement of positive adaptation despite major assaults on the developmental process (Garmezy, 1990; Luthar & Zigler,

1991; Masten, Best, & Garmezy, 1990; Rutter, 1990; Werner & Smith, 1982, 1992).

 Exercise:What walls are blocking your personal resilience? What is your plan for removing those walls? Who can you ask for support?

Developing Resilience:

  • Make connections
  • Nurture a positive view of yourself and of life
  • Gain perspective: Crises are surmountable, Problem Solves
  • Stay flexible
  • Humor
  • Forward thinking
  • Belief in something greater than self

“Trauma Stewardship calls on us to remember that it is a gift to be present when people deal
with trauma; it reminds us
of our responsibility to care and to nurture our capacity to help”
(Dernoot Lipsky, 2009).

Working with traumatized clients not only challenges the emotional balance of social workers, but also makes them more vulnerable to overwhelming anger and/or sadness (Herman, 1992).

Secondary traumatic stress symptoms parallel those of PTSD, including the following:

  1. Reliving the clients trauma through thoughts, feelings, and imagery
  2. Avoiding or feeling numb to similar events
  3. Experiencing heart palpitations, or sleep disturbances (Canfield, 2005; Ochberg, 1988).

“The expectation that we can be immersed in suffering and loss daily and not be touch by it is as unrealistic as expecting to be able to walk through water without getting wet” (Remen, 1996)

 Vicarious Trauma Symptoms 

  • Helpless and Hopeless
  • Sense that you can never do enough
  • Hypervigilance
  • Diminished Creativity
  • Inability to embrace complexity
  • Minimizing
  • Chronic exhaustion/Physical Ailments
  • Inability to listen/Deliberate Avoidance
  • Dissociative Moments
  • Sense of Persecution
  • Guilt
  • Fear
  • Anger and Cynicism
  • Inability to empathize/Numbing
  • Addictions
  • Grandiosity/Inflated sense of importance related to your work

What you can do!

Talk to a trusted ally?

 Feeling Helpless and Hopeless

Identify 2 things you did this week that made a difference.

Minimizing Fear

Do you fear bad things happening to people you love?

Name three things you have done to keep the people and yourself safe. Focus on what you have control over and let go of the rest!

Creating Balance
This is about YOU!

Learn to recognize Trauma Exposure Response.

Action: List a trauma exposure response and how it manifests in your life.

Learn what activates your Exposure Responses.

Action: List environmental stressors, people or places that activate your Exposure Response.

Learn to stay present.

Action: Identify what aspects of your Exposure Response are based on personal history that gets activated? What aspects are based on the present circumstances of your life?

Finding Balance

Action: List 3 ways you recognize when your life is out of balance.

Learn tools to clear your emotions and mind.

Action: List 3 tools/techniques that you will begin using to achieve balance.

Learn practices that increase physical ease (diet, exercise, breathing, stretching, bodywork).

Action: List one practice you will incorporate into your daily/weekly routine.

Create your own outcome/goal for finding balance in a demanding world!


I will not die an unlived life.
I will not live in fear of falling or catching fire.
I choose to inhabit my days, to allow my living to open
me, to make me less afraid, more accessible; to loosen
my heart until it becomes a wing, a torch, a promise.
I choose to risk my significance, to live so that which
came to me as a seed goes to the next blossom, and that
which came to be as blossom, goes as fruit.

Dawna Markova

(From her book: I Will Not Die an Unlived Life: Reclaiming Passion and Purpose)

Ideas to Promote Vicarious Transformation

Vicarious transformation refers to the process of integrating a larger understanding of the human condition and humanity as a result of facing the truth and impact of traumatic events.

Individual

  • I remind myself of my role with my clients, that I do not have infinite power, and that I am only a part of their healing journey.
  • I can usually find a way to listen responsively to my client’s stories without making them my own or visualizing them too vividly.
  • I remind myself of my specific role of treater, and do not expect myself to solve all the clients’ problems.
  • I remind myself of the power of the therapeutic relationship and do not expect myself to also take on other roles in the client’s life.
  • I maintain time limits of session, I am straightforward about the financial arrangement with my clients, and I clearly state (and maintain) the limits of my availability outside of session.
  • I have some time in my life in which work does not intrude.
  • I have support around the limits of my responsibility and my ability to change my clients.
  • I utilize mindfulness practices
  • I use journaling and other creative expressions to increase self-awareness.
  • I have participated in therapy for myself.
  • I seek out ongoing training.
  • I keep up with the current literature.
  • I notice when I become cynical and hopeless about my work and challenge my negative beliefs.
  • I have and use support at work.
  • I create a balance in my day and include breaks for connection and renewal.
  • I take time off and vacations.
  • I stay home if I am sick.
  • I receive regular supervision that includes discussion of my reactions to my work.
  • I use techniques such as breathing, connecting to items around me, and remembering my resources to manage painful client interactions.
  • I include in my space some items such as pictures and objects that remind me of people I love and good things that I have experienced.
  • I can stay in the present while listening to painful stories, and I can remember that my client has survived and now has my support.
  • I can use my breathing and physical sensations to stay in the present.
  • I can remember that I am only one part of the client’s journey, and I do this work in a community of other healing people.
  • I feel that I am part of a social movement to help trauma survivors, and that energizes my work.
  • I see my clients as resilient and as having the resources to heal.
  • I notice my client’s strengths and resiliency.
  • I process painful work-related experiences creatively through movement, writing, sculpture making music or art, or designing a garden.
  • I feel connected to a community.
  • I have a spiritual connection with something larger than myself, whether be that the best of all that is human, nature, history, or a spiritual entity such as God, Yahweh, Allah, the Goddess or any other, or practice such as prayer or meditation.
  • I take time to talk about or think about the painful feelings I have at work and the lessons or wisdom I receive from them.
  • I regularly take time to think or talk about the rewards of my work.

Download a PDF of these resources- with cartoons!

Resource Guide Five Reactions to the Work

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