Trauma is contagious. Anyone helping a rape survivor can be overwhelmed emotionally by what he or she hears and could even begin to experience, to a lesser degree, the same terror, rage, helplessness and despair as the survivor. This is called vicarious trauma or traumatisation. Hearing stories of trauma can also awake the personal memories of suffering that the helper might have had in the past. So engaging in this work presents some risk to the helper’s psychological and emotional health. This risk is often severely underestimated by health care providers as individuals and by their organisations or institutions.
Each person working regularly with survivors needs support in order to avoid “compassion fatigue” or being drained and burnt out by these continuous intense interactions. In the same way that survivors cannot recover alone, therapists, counsellors and medical personal and even police and prosecutors can never work alone, and should not have to.
Common feelings experienced by people working with survivors are as follows:
- Fear of being raped themselves
- Loss of faith in men or in humanity
- A sense of shared helplessness with the survivor
- The same rage that a survivor feels
- The same grief that a survivor feels
- Guilt at not having suffered as much themselves
- Identifying with the perpetrator or trying not to identify with the survivor
These feelings lead to certain clear difficulties in helping survivors as a consequence of slowly and progressively becoming “contaminated” by the trauma of rape. Day after day dealing with the same kind of trauma, the same terrible stories, can deeply affect anyone.
Fear of rape can lead to problems with personal and physical intimacy and even sexual dysfunction.
A loss of faith in people can lead to becoming fearful and mistrustful of others and pessimistic or cynical about the human race in general. This can change one’s worldview and sense of meaning in life quite drastically.
Feeling some of the survivor’s helplessness could mean that the helper begins to devalue her own knowledge, skill or capacity to be of help in the face of such terrible suffering and to believe that in fact nothing can be done by anyone, or she may assume the role of rescuer, and even violate professional boundaries for the sake of playing this role.
Feeling the same rage could cause the helper to become angry with colleagues, “the system” and the cruelty in men, or to become afraid of the survivor who is full of rage and allow herself to be manipulated or become overwhelmed by the survivor’s behaviour.
In feeling the survivor’s grief the helper might succumb to despair.
Guilt about not having suffered could cause a helper to have difficulty enjoying the pleasures and comforts of her own life, or she may feel her own actions are inadequate or limited
Helpers who struggle not to identify with the survivor often feel highly skeptical of the survivor’s story, or minimise the extent of the abuse, or try to rationalise why or how it happened, or feel disgusted or judgmental of the survivor, or fascinated by the sexual aspects of the rape.
The list as it goes on becomes more and more frightening. We start to realise the risk we take in reaching out to survivors and simply doing our jobs day by day. There are three aspects to this risk. The first is a lack of awareness of the risk and the need for support that each of us has when working with rape survivors. We soldier on and on and don’t even realise that we’ve lost our psychological health. Some people even begin to suffer a form of post traumatic stress disorder and start dreaming about being raped. They have difficulty putting the stories they have heard and the rape survivors they have seen out of their minds when they are at home. Certain things trigger an involuntary response of memory. Some have trouble sleeping and eating properly and are constantly preoccupied by the demands being made on them. Physical health begins to deteriorate and stress headaches, upset digestion, aching backs and constant colds add their tell tale signs to the picture. Alcohol consumption increases, too many cigarettes are smoked and impulsive spending sprees eat away at ones resources and sense of reward. So being aware of the need for support is vital.
The second aspect is an organisation that doesn’t understand the risks you face and does not do what it can to protect you. Any organisation that takes its clients or patients’ needs seriously and aims to deliver a good service should have a very clear acknowledgement that vicarious trauma is an occupational hazard for those directly involved in treating survivors. It should nurture and support service delivery staff and volunteers in the following ways:
- Openly acknowledge the need for support and develop structures to offer it
- Have a clear operating philosophy behind its service delivery goals
- Work expectations must be clear and realistic and agreed by all personnel
- There needs to be regular feedback and supervision that is supportive
- Effort and achievement must be recognised
- The working environment should be comfortable and attractive. Even small things like music from a radio, a fresh coat of paint, a vase of flowers or colorful pictures on the wall, or mats on the floor, or cushions on chairs, or bright curtains and magazines to read in a waiting area can make a huge difference to everyone, staff and clients alike. Many local communities, churches and schools are eager to help in this way.
- Communication, feedback and support should happen both up and down the organisational hierarchy as well as with peers on the same level.
- In service training and development should be continuous
- A focus on team work and support should be encouraged and developed
- Written and accessible protocols and procedures must be defined
- Adequate time off for illness and vacation must be available
- A system whereby individuals can vary the work they do and swap rotations to do this should be set up
- Opportunities for advancement and clear rewards and incentives
While much of this is good procedure for any healthy organisation it is especially important for organisations whose staff are at risk for vicarious trauma. Consider the question, is there a difference in the occupational hazard of industrial machinery that cuts off a finger and the occupational hazard that causes you to lose sleep, lose faith in humanity, alienate you from your intimate partner and become dependent on alcohol, drugs or overeating?
You need to do all you can to insist on your organisation’s support. Make requests through all the right channels, lobby continuously, participate in setting up immediate support structures for you and your team and demand worker’s compensation for any expense relating to your own vicarious trauma! And don’t underestimate the untold and expensive damage that is caused by every rape that happens.
The third aspect is very simple. A helper experiencing one or more of the common feelings relating to vicarious trauma is no good to the survivor. In fact that helper is a risk to the survivor in that secondary trauma to the survivor is a very real probability.