Wednesday, April 5, 2017

Tools for Preventing Vicarious Trauma

In the past few weeks of my travel, I have met some very wonderful people who are doing critical humanitarian work. Specifically, they work with refugees coming from the worst of conditions (i.e., war, terrorism, and more). They feel the pain of so many, everyday, all day.

We have been discussing the impact of vicarious trauma. This type of work exposes you to the trauma of others routinely. Often, you can only do your job, what your role entails-- when in truth so much more is needed. When you care, when you have a strong sense of mission- the gap between what you wish you could do to help and what is appropriate and required by your role is so big that you sometimes feel as if you might fall into it and not be able to come out. The feelings you take in everyday, you sometimes take them home, and sometimes- you feel as if they will live inside you forever. This experience can lead to burnout, yes; however it can also lead to vicarious trauma in which you begin to feel the same symptoms as those with whom you work (e.g., stress, overwhelm, hopelessness, and PTSD).

These amazing humanitarian workers (world changers by the way) often feel like there are few tools provided for, or taught to them to help them do two things:

·      Prevent the impact of vicarious trauma in the moment, and
·      Cope with vicarious trauma once it has landed in their bodies, hearts, and minds.

To help, I have created this list of tools for them (and for all of us). Please feel free to use this and share it. If you quote these tools please cite, Tools for Preventing Vicarious Trauma by Catherine Cook-Cottone (2017), The Yoga Bag,

Prevent Vicarious Trauma in the Moment

·      Stay aware that it is present. Know when it is happening, “What this person is saying to me right now is emotionally substantial. They are in pain. I see that. I feel that.”
·      Notice any drive to rescue them. Do you wish they were not feeling the way they feel? Now, remind yourself that feeling deeply is important and it is not up to you to decide what and when another person feels. In fact, you rescuing them from their feelings would not help them in the long run. Rather, you sitting powerfully and steady, validating their feelings, staying present and compassionate is powerful and enough.
·      Ground your feet on the floor and your hand(s) on the table or chair.
·      Imagine the emotional content moving through you and into the your notes from your pen, through your hands into the chair, or through your feet into the floor. Do not hold it in your body.
·      Breathe in a 1:2, inhale to exhale ratio. Know that the breath will help the emotions and trauma continue to move through you and ground.
·      See the bigger space, visualize all of the space around the person allowing the emotional content of the room to have a grand space to diffuse the intensity into (from Kelly Boys at
·      Ride the wave of the emotion. Instead of getting lost in it, imagine you are riding on the wave as it intensifies and grounds (Cook-Cottone, 2015).
·      Take short reliefs or distractions from the intensity of the experience, briefly look away or down. Allow yourself to move in and out of the depth of the moment.
·      As you speak to the person, think, “I wish this person in front of me to be free from pain and suffering.” (for some it is helpful to say a prayer).
·      Have a reminder on your desk or on your person of your “Why?”- a reminder of the reason you do what you do (a photograph, a word, etc.).
·      Take time between each client to clear your space. You might create a ritual of walking to a green/peaceful space, saying a blessing, washing your hands and putting on lotion- something to clear the space for you and the next person.  (see next step).
·      As you place your clients’ files away, imagine that you are also holding the traumas and worries in the files and storing them safely and confidentially in the file storage area (and not in your body, heart or mind). I sometimes tell my clients that is exactly what I do. “I hold these concerns and traumas in my office for you, so that you can let them go too.”

Before and After Care
·      At the end of the day ground the feelings you are struggling to allow to move through you, into a journal, a box, or something else that is a concrete, tangible holding place. Add artifacts, stories, drawings to your journal or box for safe-keeping. Close this box or journal when you are done and tie it up with a string and put it someplace contained (a closet). Allow this box or journal to hold your worries and concerns for you.
·      Balance work and rest. Balance means they have equal weight. Be honest with yourself.
·      Take your vacations and sick days. Seriously, do it!
·      Allow humor and positive emotions to be part of your life. In fact, if they are not there, seek them out for balance. Keep reminding yourself of the joy!
·      Engage in a routine of self-care Practices (see Mindful Self-Care Scale; Cook-Cottone & Guyker here- scroll for short and long-form of the scale).
·      Do self-compassion meditations often (see Kristin Neff at
·      Connect with people who lift you up and help you relax you while doing things not associated with work- seriously- not one bit associated with work.
·      Make sure your activities and play outside of work preserve your sense of identity outside of work. Who are you when you are not at work?  (Do you do yoga? Are you into painting? Do you have a favorite band? Do you love world music? What are your hobbies?…).
·      Use supervision (peer and hierarchical) to process your experiences.
·      Add nurturing and caring features to your workspace (paintings, comforts in the restroom [lotions], fresh water cooler, a well stocked tea break area, plants, soft music, etc.).
·      Connect with management and your team for an ongoing assessment of workload. Confront this gently, but with honesty for each other.
·      Include time to share success stories and moments when you felt your mission was lived in meetings and staff community time.
·      Provide/offer opportunities for non-counseling work (workers give workshops to others, teach yoga to clientele, do web development, keep a workplace garden, etc.).

Try all of this and I promise you will begin to feel better. Share the stuff that works. You are doing import work and we don't want to lose you to burnout, stress, or vicarious trauma. 

For more see Cook-Cottone (2015) Mindfulness and Yoga for Self-Regulation. Springer, NY.

Take good care of your self, so you can take care of others- You can’t give what you do not have.

Much love,

The Yoga Bag

If you quote these tools please cite, Tools for Preventing Vicarious Trauma by Catherine Cook-Cottone (2017), The Yoga Bag,