Self-Care and Developing Resilience

1 Self-Care and Developing Resilience Harvard University 2 Self-Care and Developing Resilience Overview of Vicarious Traumatization Vicarious trauma is a kind of emotional trauma that therapists and related professionals are exposed to during their interactions with their patients who have undergone traumatic experiences such as sexual assault (Baker & Gabriel, 2021). In addition to listening to their clients recount their traumatic experiences, Baker & Gabriel (2021) noted that vicarious traumatization can occur from reviewing case files, watching videos of a victim being abused, or responding to the repercussions of violence. Notably, McNeillie and Rose (2021) revealed that vicarious traumatization has a lifelong impact on the professional as it permanently changes their worldview of particular issues. While every professional is at an increased risk of vicarious traumatization, professionals with personal trauma histories have a higher risk of vicarious trauma (Office of Victims of Crime, n.d). Additionally, socially isolated professionals, those who have difficulties expressing their feelings, and those who lack strong social support both at work and outside of work are more vulnerable to vicarious trauma compared to their other counterparts (Office of Victims of Crime, n.d). Some of the key symptoms of vicarious traumatization include difficulty managing one’s emotions, emotional numbness, increased irritability and aggressiveness, physical health problems such as body aches, absenteeism from work, excessive worrying about potential dangers, and relationship issues both at work and outside of work (Office of Victims of Crime, n.d). As such, vicarious traumatization is a major issue of concern that can potentially cripple the professional and personal lives of affected professionals. At the core of vicarious traumatization is empathy. While empathy is a vital quality to have as a professional since it allows them to deliver compassionate care effectively, it exposes them to the risk of vicarious traumatization. The empathetic interaction of professionals and their patients who are victims of different forms of abuse may create an emotional resonance between the professional and the victim, where the professional absorbs the pain of the abuse with the same intensity as the victim (McNeillie & Rose, 2021). As such, professionals engaging with abuse victims need to establish an emotional and empathy boundary when interacting with their patients to minimize the risk of vicarious traumatization. 3 Analysis of Self-Care Needs in Response to Vicarious Traumatization Self-care is an important aspect in mitigating vicarious traumatization. As highlighted by Posluns and Gall (2020), professionals dealing with victims of traumatic experiences tend to neglect their personal self-care and emotional replenishment. These professionals are often overwhelmed by the need to be there for their patients at all times and end up prioritizing their patients’ needs over their well-being (Posluns & Gall, 2020). As such, one of the most critical self-care needs in response to vicarious traumatization is self-awareness. Professionals need to recognize and understand that they are highly vulnerable to vicarious trauma, and thus, they need to have a high level of self-awareness of their emotional triggers and boundaries (Roberts et al., 2022). This self-awareness can be built through self-reflection, where a professional seeks to understand their strengths and weaknesses and use this understanding to improve themselves. In the case of the teacher in the case study, she needs first to develop self-awareness and acknowledge her emotions and feelings towards the situation; this would help her identify and understand her triggers. She then needs to establish a boundary between her professional and personal life, knowing when to prioritize her well-being and step back from a stressful situation at work, consequently minimizing her risk of vicarious traumatization. Another crucial self-care need in response to vicarious traumatization is the need to nurture an individual’s physical, mental, and spiritual life. An effective response to vicarious traumatization requires a holistic approach where a professional takes care of all aspects of their lives (Roberts et al., 2022). While Posluns and Gall (2020) acknowledged that mental relaxation techniques such as meditation and mindfulness could help professionals build emotional resilience and overcome vicarious traumatization, they noted that this is not an adequate strategy. Professionals also need to take care of their physical health by engaging in regular physical activities, getting sufficient rest and sleep, and adopting healthy eating habits (Posluns & Gall, 2020). According to Kochi et al. (2017), engaging in regular physical activity and getting adequate rest helps to modulate cortisol levels, which then protects the professional from issues such as vicarious trauma-induced anxiety and depression. In the case of the protagonist in the case study, she needs to seek professional mental help and start engaging herself in different selfcare activities. These activities may include physical exercises, mindfulness, or other hobbies 4 that may excite her. Engaging in activities that bring her happiness and satisfaction will help to decimate the risk of vicarious traumatization. Another self-care need in response to vicarious traumatization is the establishment of reliable social support systems both at work and outside of work. As previously indicated by the Office of Victims of Crime (n.d), the lack of a strong social support system is one of the factors that increases a professional’s vulnerability to vicarious traumatization. A reliable and highquality social support system can help to enhance an individual’s resistance to stress, thus protecting them against the development of trauma-related health complications such as vicarious traumatization (Michalopoulos & Aparicio, 2012). Therefore, individual professionals and organizations need to establish comprehensive support networks and strategies that can be leveraged in times of compassion fatigue or burnout to prevent vicarious traumatization. The protagonist in the case study needs to tap into her social support system, which may include colleagues and friends, to share her experience and help her process the event. This social support is crucial in validating the protagonist's feelings and emotions and would ultimately help her navigate through this negative experience, thus preventing vicarious traumatization. Self-Care Plan in Response to Vicarious Traumatization The self-care plan for the protagonist in the case study will be multi-faceted, integrating various strategies to address multiple emotional and physical aspects in a bid to minimize her risk of vicarious traumatization. Some of the key elements included in the protagonist's self-care plan include: Self-reflection to build Emotional Regulation As highlighted in the previous section, one of the key self-care needs of the teacher is to build self-awareness to enable her to identify and recognize her potential triggers and stressors at the workplace. In this self-care plan, the teacher will be encouraged to engage in regular selfreflection activities such as journaling, mindfulness, self-compassion sessions, and guided selfreflection exercises. As highlighted by Heppner et al. (2015), self-reflection activities such as mindfulness and journaling play an instrumental role in aiding emotional regulation by reducing an individual's reactivity to emotional situations or stimuli, increasing an individual's emotional 5 stability and enhancing their willingness to experience negative situations. As such, these selfreflection activities will aid the protagonist in developing self-awareness and emotional regulation, consequently protecting them from vicarious traumatization. Setting Clear Boundaries Between Professional and Personal Life Another key aspect of the protagonist's self-care plan is to educate the protagonist on the importance of establishing clear boundaries between her professional and personal life, i.e., knowing when to step back from a stressful situation at work and focusing on her well-being. According to Cetrano et al. (2017), maintaining a healthy work-life balance by setting clear boundaries between one’s professional and personal lives is one of the most effective ways of escaping compassion fatigue and burnout, ultimately decreasing an individual’s vulnerability to vicarious traumatization. By maintaining a healthy work-life balance, the protagonist will escape the urge to neglect her needs and prioritize the needs of the victims, ensuring that she still finds joy and fulfillment in her life despite the challenging situation at work. As revealed by Posluns and Gall (2020), most professionals dealing with traumatized victims tend to lose themselves while taking care of the victims, which increases their risk of vicarious traumatization. Seeking Support from Peers and Other Close Relations Seeking support from peers, family, family, and friends is yet another key aspect of the protagonist’s self-care plan. Through this plan, a peer support group where the protagonist can debrief and share her experiences at work will be created. Regular supervision sessions with a senior professional will also be conducted to offer the protagonist a safe reflective space and allow her to process and classify her thoughts, feelings, and emotions, thus preventing vicarious trauma-related stress and depression. Besides, studies have shown that peer support is instrumental in reducing feelings of isolation and loneliness, which increases a professional's risk of anxiety and vicarious traumatization (Fallon et al., 2023; Kim et al., 2022; Waegemakers Schiff et al., 2019). As such, seeking peer support will be crucial in enabling the protagonist to overcome vicarious trauma. Providing Training and Development Opportunities to the Protagonist 6 Another key aspect of the protagonist’s self-care plan is to provide them with adequate training and skill development opportunities to help them build resilience to face and overcome different situations at work. The training opportunities will primarily focus on equipping the protagonist with knowledge and skills on the various self-care strategies and techniques to build resilience. Kim et al. (2022) pointed out that professionals dealing with potentially traumatizing situations need to be equipped with practical knowledge and skills to help them build resilience and implement various self-care strategies effectively, thus protecting themselves from vicarious trauma. In the case of the protagonist, equipping her with practical skills and knowledge on multiple aspects of self-care and resilience building will definitely help to minimize her risk of vicarious traumatization and its associated stress and depression. 7 References Baker, C., & Gabriel, L. (2021). Exploring how therapists engage in self-care in times of personal distress. British Journal of Guidance & Counselling, 49(3), 435-444. https://doi.org/10.1080/03069885.2021.1885010. Cetrano, G., Tedeschi, F., Rabbi, L., Gosetti, G., Lora, A., Lamonaca, D., ... & Amaddeo, F. (2017). How are compassion fatigue, burnout, and compassion satisfaction affected by the quality of working life? Findings from a survey of mental health staff in Italy. BMC health services research, 17, 1-11. https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-017-2726-x Fallon, P., Jaegers, L. A., Zhang, Y., Dugan, A. G., Cherniack, M., & El Ghaziri, M. (2023). Peer support programs to reduce organizational stress and trauma for public safety workers: a scoping review. Workplace Health & Safety, 71(11), 523-535. https://doi.org/10.1177/21650799231194623 Heppner, W. L., Spears, C. A., Vidrine, J. I., & Wetter, D. W. (2015). Mindfulness and emotion regulation. Handbook of mindfulness and self-regulation, 107-120. https://link.springer.com/chapter/10.1007/978-1-4939-22635_9#:~:text=Our%20review%20of%20the%20extant,to%20emotional%20stimuli%20an d%20situations%2C%20( Kim, J., Chesworth, B., Franchino-Olsen, H., & Macy, R. J. (2022). A scoping review of vicarious trauma interventions for service providers working with people who have experienced traumatic events. Trauma, Violence, & Abuse, 23(5), 1437-1460. https://doi.org/10.1177/1524838021991310 Kochi, C., Liu, H., Zaidi, S., Atrooz, F., Dantoin, P., & Salim, S. (2017). Prior treadmill exercise promotes resilience to vicarious trauma in rats. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 77, 216-221. https://doi.org/10.1016%2Fj.pnpbp.2017.04.018 McNeillie, N., & Rose, J. (2021). Vicarious trauma in therapists: A meta-ethnographic review. Behavioral and Cognitive Psychotherapy, 49(4), 426-440. https://www.cambridge.org/core/journals/behavioural-and-cognitivepsychotherapy/article/vicarious-trauma-in-therapists-a-metaethnographicreview/CF4E8B70A0DCF3D74D84122251178E9A 8 Michalopoulos, L. M., & Aparicio, E. (2012). Vicarious trauma in social workers: The role of trauma history, social support, and years of experience. Journal of Aggression, Maltreatment & Trauma, 21(6), 646-664. https://doi.org/10.1080/10926771.2012.689422 Office of Victims of Crime (n.d). What is vicarious trauma? https://ovc.ojp.gov/program/vtt/what-is-vicarious-trauma Posluns, K., & Gall, T. L. (2020). Dear mental health practitioners, take care of yourselves: A literature review on self-care. International Journal for the Advancement of Counselling, 42(1), 1-20. https://link.springer.com/article/10.1007/s10447-019-09382-w Roberts, C., Darroch, F., Giles, A., & van Bruggen, R. (2022). You're carrying so many people's stories: vicarious trauma among fly-in, fly-out mental health service providers in Canada. International Journal of Qualitative Studies on Health and Well-being, 17(1), 2040089. https://doi.org/10.1080%2F17482631.2022.2040089 Waegemakers Schiff, J., & Lane, A. M. (2019). PTSD symptoms, vicarious traumatization, and burnout in front-line workers in the homeless sector. Community Mental Health Journal, 55, 454-462. https://link.springer.com/article/10.1007/s10597-018-00364-7