Starting the Conversation about Secondary Trauma

The statistics on children and trauma can feel overwhelming. Some basic numbers are:

• 60 percent of adults report experiencing abuse or other difficult family circumstances during childhood;
• 26 percent of children in the United States will witness or experience a traumatic event before they turn four;
• nearly half of children and adolescents were assaulted at least once in the past year; and
• the average age for viewing pornography is now about 11 years of age. New research from security technology company Bitdefender, has reported children under the age of 10 account for 22 percent of online pornography consumption under 18 years old.

Trauma has different definitions around the world, and there is much debate currently about what the standardized definition of trauma should be. The standard American Psychological Association definition of trauma is that trauma is an emotional response to a terrible event like an accident, rape, or natural disaster. Immediately after the event, shock and denial are typical. Longer term reactions include unpredictable emotions, flashbacks, strained relationships, and even physical symptoms, like headaches or nausea.

This definition is very narrowly construed. When working with children and adolescents, a trauma response can also occur with the removal of a child from the home, the incarceration of a parent, the overdose of a parent, exposure to pornography including child pornography, and of course, child abuse and neglect in all of its ugly forms. Initially, we might think of trauma as a life or death scenario that the child is involved in or has witnessed, however, it encompasses so much more.

Everything we see, hear, touch, and experience is stored in our brain. It cannot be erased. We may not remember it all, but it is still there, influencing the subconscious mind.

Additionally, when considering trauma we must take into account the effects of primary trauma and secondary trauma.

Very little is taught about secondary trauma—it is not often a topic of conversation and few studies exist on this subject with lawyers or judges. Work by Andrew Levin and Linda Albert on secondary trauma in the Wisconsin State Public Defenders office is the largest study on secondary trauma to date. There are also many terms used to describe secondary trauma—including vicarious trauma, secondary traumatic stress, and post-traumatic stress disorder—and some posit that there are subtle distinctions between those terms. For instance, Charles Figley, one of the preeminent professors in the study of secondary trauma, stated the difference between secondary trauma and vicarious trauma is that secondary trauma can happen suddenly, in one session, while vicarious trauma is a response to an accumulation of exposure to the pain of others. I spoke with Figley recently, and we discussed the idea that in the United States, as well as globally, this definition continues to change. Some now believe that secondary trauma can occur with one exposure to another individual’s trauma narrative, images, etc.

In general, secondary trauma is caused by witnessing another individual’s trauma experience or hearing his or her trauma narrative. Although the exact use of terms varies, there is agreement that the impact is real, costly, and pervasive, and without the proper knowledge on how to heal from secondary trauma, those who suffer from it might deal with anxiety, depression, and suicidal ideation. Thus, it is important, perhaps imperative, that legal professionals have the tools to help manage and better cope with these issues.

Of particular interest to legal professionals is Tehila Sagy’s work. Sagy discusses that when a listener believes a narrative, there exists a heightened emotional impact regardless of the legal outcome. She points out that listening to and eliciting detailed narratives can cause emotional impact, especially when the narratives are reoccurring without time to process in between. This can cause a cumulative effect, and the risk of secondary trauma is significant. However, Sagy contends that this is barely acknowledged as an issue within the profession, let alone a source of concern. But such secondary trauma is also often closely associated with the experience of burn-out, generated by consistent exposure to traumatic material results.

Some studies suggest that just as professionals working with traumatized children are becoming seasoned and confident, they leave the profession. How tragic for the children and adolescents who desperately need these finely-honed professionals, and how tragic for the professionals themselves, who now have experience, know the system, and are confident, but for their own health must leave.

What does all of this mean? It means we all need to take care of ourselves around secondary trauma, knowing there is much in the balance. As I state in my book,

We have the child and adolescent who must share their story with you. Sometimes that is very difficult to do because the level of trauma is so significant that they cannot talk. They are afraid. They have already told their story to so many people—the first person they talked to for help, police, first responders, family and now yet another person—you. This is a daunting task for everyone. The brain does not always recognize the difference between remembering and retelling and actually being there. Thus, the conversation can indeed be a fear-filled, apprehensive undertaking on the part of both parties . . . Ultimately, we need to ask several questions; how do you make this ok for them and ok for you?

D’Amico, Dawn. 101 Mindful Arts-Based Activities to Get Children in Adolescence Talking; Working with Severe Trauma, Abuse, and Neglect Using Found and Every Day Objects. London: Jessica Kingsley Publishers, 2016.

The good news is that there are many interviewing techniques for working with children and adolescents, including VentArt. VentArt is a creative, demonstrative, and restorative way to express emotions. It does not require any actual artistic ability. It only requires the want and or need to express emotion. It is simple enough that a child or adolescent who is either not willing or not developmentally able to verbally express feelings of emotions can demonstrate those emotions through their art.

Once you have gathered the information from the child or adolescent, the question is how are you taking care of yourself surrounding this potentially traumatic information? You may be thinking, “What? Take care of me? I am trained to take care of them.” As a colleague once said, you are a legal professional. You are not a machine into which people input information, and the answer comes out, and you remain unaffected. As another one of my colleagues stated, you are a human being with an emotional life. You will have an emotional response—sometimes more intense than other times. How do you cope? What do you do?

One thing you can do is access where you are through the use of the Secondary Trauma Spiral.

You can start anywhere on the spiral. Some individuals, due to the amount of trauma narratives they are exposed to, no longer recognize the narratives as potentially traumatic. So, you may find yourself identifying with aspects on the outermost regions of the spiral first. Move around the spiral and check off what you are noticing about yourself. 

Use the spiral to touch base with yourself from time to time. Then use tools to help cope.

In addition to the Secondary Trauma Spiral, in my 2020 book, Trauma and Well-Being in the Legal Profession, you will find over 101 tools which you can use to help cope with secondary trauma, stress, and work-life balance.

Another option is creating a resiliency specific tool kit. This kit is one that you keep with you, in your briefcase or backpack, and you can use in the immediacy. In it you put what makes you stronger: a photograph of a loved one, a book of prayers, a favorite quote, a list of support people to call or email who provide upbeat and encouraging energy.

You could also create and practice a list of Self-Soothing Behaviors (SSBs). These SSBs provide an emotional calmness or release. Please take time to think about and jot down your own SSBs. This might be difficult for some, as the self-soothing techniques they are currently using may not be healthy, such as drinking too much alcohol or using other substances to quiet down or forget our internal emotional state. Other examples may include emotional eating or binge eating.

Instead of unhealthy ways of self-soothing, it is critical to have some healthy ways. Do some brainstorming about things that you could do that would actually be soothing for you. For example, I love to walk in nature, hug my dog, be with family and friends, cook, and write. Other ideas for you to consider:

• Listening to music that you like or trying a new genre of music
• Cooking a healthy meal at leisure and eating it at leisure
• Going for a walk
• Gazing up at the stars
• Listening to nature
• Petting a companion animal
• Reading a book
• Breathing
• Stretching
• Practicing meditation
• Praying
• Practicing mindfulness
• Calling a friend or family member

These are just a few examples of self-soothing. This is a jumping off point for you! Pick up the lead and go for it! Create your own list. Write it down and keep it somewhere that it is easy to get to. Use it when you need to self-sooth. Start using more and more healthy self-soothing behaviors. As you use these behaviors, you will be creating new neural pathways; these pathways when strengthened become the new “go to” healthy thinking and behaviors.

The work we do with children and adolescents is difficult, emotional, and as we have discovered, potentially traumatic. It is important therefore, that you tend to yourself as you tend to your client.

If you are struggling to cope or are having difficulty with emotions, please seek professional support. You deserve it and so do the children and adolescents that you work with.

Dawn D’Amico is a psychotherapist, educator, and consultant in Delafield, Wisconsin.

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