Vicarious Traumatization: An occupational hazard for caregivers
05 November 2012
By Diane Langberg, Ph.D.
In interacting with Christians involved in crisis work, I find many are feeling the powerful impact of evil and suffering on their lives. They are hungry to know how to withstand such an impact without being misshapen by it. What happens to us as we sit day after day with sin and suffering, and what do we need to do to protect ourselves?
We are told in the first chapter of Genesis that God said, “Let us make mankind in our image, in our likeness” (1:26). If something is to be in the image of or bear the likeness of something else, it must by definition be capable of bearing an image. It must, in its very nature, be malleable or capable of reflecting. You can stand in front of the trunk of a tree until you are 100 and you will not see your image reflected there. However, put yourself on the edge of a pond and you will find yourself staring back. To have been created in the image of something is to be, in your very nature, an image bearer. Paul speaks of this principle when he says, “by reflecting as a mirror the glory of the Lord we are changed” (2 Corinthians 3:18) .
As image bearers, however, we not only reflect but we are also shaped. We carry within that which we reflect. We are image bearers, not simply image reflectors. If you stand in front of a mirror, you see yourself reflected there. But if you walk away, the image is gone. Nothing within the substance of the mirror is any different than before you were reflected in it. Mirrors do not assimilate your image. I believe that human beings, over time, take into their very substance the things that they reflect. They hold such reflections preserved within themselves. We become like that which we habitually reflect. Recognizable bits of one soul, over time, begin to show in another. I know of a man who has worked for years with those who are dying of AIDS. He is touched by death and dying every day. Someone who works alongside him recently said, “His character is changing before our very eyes.” In other words, he is so profoundly impacted by what he does, he does it so much, that he now bears in his person the image of death and grief.
Judith Herman, in Trauma and Recovery, says, “Trauma is contagious. In the role of witness . . . the (caregiver) at times is emotionally overwhelmed. She/he experiences, to a lesser degree, the same terror, rage and despair as the patient . . . This phenomenon is known as . . . vicarious traumatization.” Dr. Herman is reiterating the same principle: if you sit with evil and suffering long enough, you will begin to show characteristics similar to those of the victims you are trying to assist.
Vicarious traumatization is an occupational hazard, an inescapable effect of trauma work. It is not viewed as something people do to us but rather as a human consequence of knowing, caring and facing the reality of trauma. Victims deal with horrific things, and the care and concern you have (and should have) create a door to the inside of you, and you can easily find yourself overwhelmed and shut down. It can result from the relentless nature of the work or it can happen suddenly.
How are we to protect ourselves from being misshapen? Self-care includes your food, exercise, sleep, medical care, schedule and recreation. When we are dealing with people in great need or crisis, we tend to neglect the care of our bodies (mirror the victim). Sometimes that is unavoidable, but it cannot continue for long or we will break down both physically and emotionally. We live in frail, finite bodies that require care and nurture. It is critical not to get so caught up in the needs of others that we end up destroying ourselves.
Good, supportive relationships have a tremendous effect on an individual’s resiliency and emotional health—for both trauma victims and their caregivers. Pain and suffering often isolate us from others. Stressful schedules and overwhelming needs keep us busy, and one of the first things to go is supportive connection with others. The sense of being cared for by others is very important for our endurance.
A living faith that brings truth, comfort and hope is also crucial. Being prayed for and praying are vital supports. Evil and suffering have a tremendous capacity to swallow up our faith and leave us full of despair. They can also distort our thinking. Working with war, violence, atrocities, trafficking and rape carries within it things like evil, darkness, chaos, isolation and despair. It is crucial that you find ways to counteract the impact of those things. It means you must deliberately seek out good, beauty, order, safety, connection, intimacy, comfort and hope. These are antidotes to the poison in the work. Without such antidotes we will slowly die emotionally, physically and spiritually.
I have realized even more clearly in recent years that these antidotes are not just helpful in coping with the effects of this work but they are also part of a life that is obedient to God. I find many caregivers feel guilty pursuing beauty and peace and order in their own lives, knowing of the chaos and torment in those for whom they care. As if somehow they should not have good in their lives while others suffer. However, the Word of God says that He gives us richly all good things to enjoy. To turn from such things is to turn from the gifts in His hand. Even more, these things are tastes of His character in our lives, for He Himself is life, beauty, order, harmony and glory. How we need to pursue and soak in the things that are of Him and reflect his character so that we not only can endure in the work but also bring His character to others in their suffering.
These things will not prevent us from bearing the image of others’ suffering in our own lives. In doing so, however, we must remember that we are following in the footsteps of our Savior. He became flesh and entered into our trauma, literally taking our sin and suffering on Himself. Think about the impact of working with evil and suffering: (1) It affects our identity. His identity was eternally altered—He who was God became man. (2) It damages connection. He who was one with God cried out, “My God, My God, why have you forsaken Me?” (3) Trauma overwhelms us with strong feelings. “My soul is sick unto death! . . . I am deeply distressed and troubled . . . My soul is overwhelmed with sorrow.” (4) Trauma threatens our sense of safety. He was abandoned by the Father and entered hell itself.
Paul says in Colossians 1:24, “I find joy amid my sufferings for you, and I fill up in my person whatever is lacking in Christ’s afflictions on behalf of his Body, the Church.” As we sit with the trauma of others and feel it reverberate throughout our persons and our lives, let us remember that there is nothing that Christ has called us to do that He himself has not undergone. Following in His ways we bring His comfort and healing to those whose lives are so damaged by the evil of others. Not only has He endured the same things in a far greater measure, He has promised to be with us and in us as we do this work to which He has called us. Pursuit of Him in all areas of our lives is vital, or we will fail to bring His image to our clients and only end up mirroring theirs instead.
Entering into the suffering of others is a privilege. It is also difficult to do. The task of serving as a representative of the character of God so that who He truly is can be grasped, understood and believed in some measure, is far beyond any capability of yours or of mine. It is a work, however, that if we let it, will take us to our knees with hearts hungry for more of God, that we might in turn bring His presence in very concrete ways into places and lives where He has not yet been known.
