When Our Healers Hurt

When Our Healers Hurt

After the recent mass casualty incidents in the United States during the past several years, I wonder how these experiences have impacted our healthcare professionals.  This topic has become of greater importance to me because of my colleagues and family members who have responded to these traumatic events.  I have also become more aware that the media has recently started interviewing some of the physicians who have been at hospitals during these times of crises.  I think that we have started recognizing the trauma that our first responders (paramedics, Police, Firefighters, etc) have endured as a result of these horrific events.  However, I believe the negative impacts of these events effect significantly more people than we realize.  How do these events influence other medical providers?  What about our children?  People who organize events for the public? Mental health providers?  Spiritual and religious communities? 

I think part of the reason these questions can be so challenging to answer is because we don’t know.  We don’t know how emergency room nurses or a child who watches the live coverage on television will react to what they have seen.  There is not one way that reflects how individuals will react to witnessing a traumatic event.  We do know that there can be some protective factors or helpful things that can help to minimize the impact of witnessing trauma.  Some of these include; having adequate support systems, healthy coping skills, and not having experienced traumatic events personally or having had a mental health disorder prior to the event.  Following 9/11 I think the concept of vicarious trauma or secondary trauma became more apparent.  The media became aware of how much they could be contributing to secondary trauma when they continued to replay the videos of the twin towers collapsing.  We have learned through prior disasters that the more that an individual is exposed to the event, the more likely they are to develop symptoms of vicarious trauma.  These symptoms closely resemble those of post traumatic stress disorder (PTSD).  They can include changes in sleeping habits, being easily startled, nightmares, a feeling of re-experiencing the event, and a desire to want to avoid people or places that remind them of the disaster.  When an individual begins to experience these symptoms, they will likely benefit from seeking counseling and being able to process the event with a trained therapist.

I believe that we, as a society need to find more ways to prevent and treat the impacts of vicarious trauma.  When I look at research that indicates a rise in substance abuse among those individuals who work in the helping professions, I can’t help but wonder how much of this may be accounted for as a result of secondary trauma.  Statistics that indicate that 10-20% (psych central) of nurses and 10-15% (Gastfriend, David 2005) of physicians are struggling with substance abuse are very concerning.  From my experience working in a variety of settings with diverse individuals, I have frequently been witness to the colleague who describes using substances as a way to cope with a “bad” day.  What if we were able to better prepare our helping providers to cope with experiencing vicarious trauma?  What if we were able to identify some kind of effective debriefing that could be implemented in a variety of settings within the community, following a tragic event?  My hope is that individuals who are dealing with symptoms of secondary trauma can start to remove the feelings of shame, embarrassment, and denial that frequently accompany their experiences and begin to feel safe to reach out for help and support.