Dr. Chris Marchand: Caregivers, Take Care!

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Mental Health Initiative 2018

An Interview About Secondary Trauma

with Dr. Chris Marchand by Irma Janzen

Irma Janzen: Secondary trauma, also called vicarious trauma, is a relatively new term for many of us. Could you give us a definition of what it is?

Chris Marchand: Secondary Trauma refers to the indirect trauma that can occur when we hear about difficult or disturbing images and stories from people who have experienced these disturbing incidents.

IJ: When and who are people susceptible to secondary trauma?

CM: It’s common with professionals and volunteers serving in health care, chaplaincy, pastoral ministry, palliative care, youth work, firefighters, lawyers studying a case, emergency response teams, policing, child and family services, teaching and/or any other role where people find themselves witnessing trauma. Typically, it brings a sense of feeling overwhelmed, perhaps even of fear or feeling sick because of what we have heard.

IJ:  What symptoms are clues for caregivers that they are nearing the brink of succumbing to secondary trauma?

CM: There are lots, but some of the more significant clues include loss of meaning connected to our caregiving (example: “What’s the point?”), loss of hope (“Nothing I do matters, so why bother?”) and loss of connection (isolation from people). Other signs include a reduced capacity for caring, decreased ability to express empathy, fear/terror, reoccurring nightmares, easily startled, paranoia, inability to say no, feeling sick when expected to care, anger/rage, burnout, and sleep problems.

The discomfort we feel when we experience Secondary Trauma can lead to a desire for comfort. Medicating behaviours are common, including an increase in alcohol or narcotic use, pornography, using food for comfort, or even increased use of technology, in an attempt to keep the traumatic thoughts or images from awareness.

IJ: What are your suggestions to help prevent secondary trauma?

CM: If we want to be present to people in pain, love them, hear them, and care for them, there will always be a risk of Secondary Trauma. There is no way to bear witness to those who have suffered inexcusable violation while fully protecting ourselves from the effects of their suffering. This is risky and painful for those who care deeply, but for Christians, it can also create a deeper bond with Jesus. When the Apostle Paul writes to the church in Philippi, he connects knowing Jesus with the experience of sharing in his sufferings.

Phil. 3:10 reads, “I want to know Christ—yes, to know the power of his resurrection and participation in his sufferings, becoming like him in his death, and so, somehow, attaining to the resurrection from the dead.” As we share in suffering with people, as followers of Jesus, we share in the suffering Jesus himself bears for his creation.

Having said all of this, your question is valid. It would seem a wise choice if we could prevent us from succumbing to Secondary Trauma. While it cannot be easily avoided, here are a few suggestions.

  1. As Christians, we bring the pain back to Jesus. We realize it is not ours to hold and that we cannot bear it on our own.
  2. Debriefing the traumatic encounter can help to relieve the stress of the event and provide a space to express and release feelings of rage, anger, or disappointment with God.
  3. Practicing self-awareness. This is a simple, yet powerful tool for self-preservation. Paying attention to strong feelings and allowing ourselves to feel through pain can be restorative and lifegiving. When I hear stories as a pastor about child sexual abuse, rape, or violence in the family, they can make me feel sick. After a conversation that feels overwhelming to me, or leads me to feel deep sadness, I place a large letter X in my journal. Placing an X in my journal tells me I need some time to process. I do my best to take some time off, or I arrange to speak to a therapist to let go of some of my strong emotions.
  4. Nurture relationships with friends. Fatigue and isolation are major problems for those experiencing Secondary Trauma. Having friends who won’t let you sit at home alone can help.
  5. Engage in any kind of regular physical activity. It’s best if the activity is already built-in to your schedule.

IJ:  What are good ways to deal with Secondary Trauma if indeed a person has already gotten to that place?

CM: Good question.

  1. Be gentle. Experiencing Secondary Trauma is painful, but having an emotional injury is also frustrating. Let me explain. If you’re working in your garage and you hit your thumb with the hammer, you immediately change your behaviour. You easily associate the pain in your thumb with the head of the hammer. This helps you to understand why your thumb is throbbing and it helps you with your response. An emotional injury is often baffling. People feel the pain, but there’s no hammer.

Example: During a long death-oriented conversation, you hear a friend say, “I’m sick of living. No one would even care if I went missing. Maybe I should just kill myself.” That friend does not attempt suicide, but a few days later you feel restless; you can’t sleep. You feel afraid for what seems like no reason at all. You think about your day, what you ate, what you saw on TV. It doesn’t make sense.

Secondary Trauma can show up in our feelings and behaviours days after the traumatic event. Things can be even more intense if you’ve had a friend die by suicide. You might be terrified, even obsessed with keeping your friend safe. Secondary Trauma might be even more intense if you yourself have experienced thoughts of suicide, or have attempted to end your life.

The trauma of that conversation might actually lead to some of the symptoms or medicating behaviours listed above. When the temptation to medicate feelings strikes you a week after the traumatic event, it’s often treated as a moral failure or a spiritual problem to be confessed. It’s rarely treated like the normal personal consequences of caring deeply for someone in pain.

  1. Education. Awareness is powerful. The more we know about Secondary Trauma, the faster we can recognize the symptoms in our own lives. This is not a terminal illness. We can heal through Secondary Trauma although the experience of feeling wounded by trauma never fully leaves us. Get help. Find a caring therapist who understands Secondary Trauma and can help you heal.

 IJ: Other questions or comments you want to add.

CM: Sometimes people will gravitate to God, recognizing their need for strength. At other times, people who really love the Lord will find themselves overwhelmed with anger at God, asking questions like, “How could a loving God allow this to happen?” Those folks need grace.

They need Christians in their life to understand that they’re now living with an emotional injury. They will likely never be able to see God as they once did. This is painful and sad to watch. When we sit with people who’ve experienced trauma, we might find ourselves asking, “Who is God now?” Before we experienced this pain, we thought we knew. We thought our vibrant relationship with God was enough to sustain us, but sometimes it’s not.

My first funeral was for a family who lost a three-day-old baby. I was a 25-year-old pastoral intern. I’d never experienced pain like I saw that day as I stood beside the grave with those parents. I’ve had many more experiences like this one now, and each time it makes me wonder again about the character of God. It’s not that I don’t want to follow Jesus. It’s just that trauma has a way of reorienting our theology.

Irma

Irma Janzen

Chris

Chris Marchand

Chris Marchand, DMin (Pastoral Care), has taught in the area of youth ministries at Providence University College and Theological Seminary, served as a pastor (most recently at Niverville Community Fellowship), and led many workshops about self-care for caregivers. He is currently the director of Red Rock Bible Camp in Manitoba.

Irma Janzen, MEd, MA, has served in education, as the coordinator of MCC Canada’s Mental Health and Disabilities Program, and as a pastor. She is part of Fort Garry EMC.

Note: Chris will be teaching some of this material in an upcoming SBC course called “Self-care for Caregivers” on Oct. 11-13. See the details: http://sbcollege.ca/events/2018-10-11-co210-self-care-caregivers

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