Reducing Unnecessary Trauma Exposure in Service Providers

by Françoise Mathieu, M.Ed., CCC., RP

Many years ago, when my dear friend Robin Cameron and I developed our very first compassion fatigue workshop, we came across the term “limited disclosure” in Laurie Anne Pearlman and Karen Saakvitne’s book Trauma and the Therapist.

The authors, who were well ahead of the curve on all matters related to VT and Compassion fatigue solutions, suggested that we, as professionals, should consider taking a careful look at “how much detail about the violence or abuse [we] want to share [with one another].” (Pearlman, personal communication)

This concept of “limited disclosure” rang so true to us that we immediately integrated it in our training. We called it Low-Impact Debriefing in a cheeky nod to the aerobics craze of the 80s and also because it formed the acronym L.I.D. The idea of low impact debriefing is twofold: to be able to share the information that we need to, while at the same time not having a highly negative impact on the listener. We were not suggesting that we should keep a lid on difficult things but wanted to suggest that we should all perhaps take a careful inventory of how much graphic information we need to be sharing when debriefing difficult stories or consulting on cases with colleagues. Perhaps a better analogy is that of a pressure cooker that lets the steam out little by little rather than in one giant burst with potentially negative consequences.

Over the past decade, my team has received many invitations to present at trauma trainings: child abuse symposia, conferences for parents of murdered children, workshops for sex crimes investigators, courses on the Dark Net and cybercrime, and many similar other conferences. We are often struck by the extremely graphic details that are almost invariably shared during these events: gruesome photos shown on a giant screen during a lunch time keynote, detailed descriptions of a murder or assault on a child, minute details about the smells, sounds and sights of a crime scene and even, at times, graphic audio and video footage. Some of these scenes can be very difficult to forget.

When is Trauma Exposure Gratuitous and When it is Necessary?

I think that we can all agree that many media outlets share an excessive amount of potentially disturbing images in their coverage (and in fictional shows, but that’s for another post). I remember listening to CBC news radio on my headset a few years ago while I was out for a run, and suddenly, without warning, the host played an actual audio of a child being victimized. I remember tearing the earpieces away from me and thinking “WTF just happened? Why was this necessary during a midday radio show? And I that instance, I don’t think that the now overused customary warning “content may be disturbing to some” was enough to justify airing that footage.

I am also well aware that at times, graphic details are essential to a trauma training – if you are a forensic examiner or an investigator of any sort, you must be able to recognise and differentiate between an accidental injury and one that has been deliberately caused by another person, or you may need to learn how to assess a crime scene and the related details that are present. You may need to learn how to interview a criminal in order to develop better investigative or clinical skills. Sometimes, we need videos, photos and details in order to do our job properly.

But here is my question to you: how much detail is too much? Even at a trauma conference, are all details required at all times? Is it enough to give people a warning at the start of our talks “this may disturb you” or do we all have a responsibility to reassess what we are sharing and how much detail is enough?

We were recently asked to create a brand-new course called “The Things We Can’t Unsee: Reducing the Impact of Secondary Trauma Exposure” which we have had the privilege of offering to legal professionals, child abuse investigators and victim service providers across North America this year. The response has been extremely positive and has led to some powerful discussions and reflection among participants. A good place start addressing this issue is to perform a personal “trauma audit” for ourselves and see how much extraneous trauma stories we are sharing with one another. To go further, please read The four steps to Low Impact Debriefing as discussed in my book (Click here).

“I’m not bothered by these stories”

Now, I have been in the field long enough to know that some of you will say “I have been exposed to thousands of stories, they don’t bother me anymore” and perhaps this is true. We all have a different level of sensitivity to difficult images and traumatic details based on a whole host of personal factors. But it would be interesting to be able to measure our stress hormones and see whether that is actually true, or to be able to perform a brain scan and see how our limbic system responds to repeated exposure. As psychiatrist Dr. John Bradford so eloquently explained in his testimonials a few years ago, after 30 years of exposure to gruesome images, he also thought that he was immune, until, one day, he was not: http://www.ottawacitizen.com/health/Tough+forensic+John+Bradford+opens+about+PTSD/9152171/story.html

To Learn More:

 

Sources:

Mathieu, F. (2012) The Compassion Fatigue Workbook: Creative Tools for Transforming Compassion Fatigue and Vicarious Trauma. New York: Routledge.

Pearlman, L. A., & Saakvitne, K.W. (1995). Trauma and the therapist: Countertransference and vicarious traumatization in psychotherapy with incest survivors. New York: W.W. Norton. pp. 383-384.

 

Secondary Traumatic Stress and the Ottawa Shooting

 

Cliquez ici pour lire l’article en francais

Many people were directly impacted by the events in Ottawa last week – most affected, of course, was the victim’s family, the perpetrator’s loved ones, the good samaritans who rushed to Cpl Nathan Cirillo’s help, the paramedics and police officers who responded to the scene, all of the individuals inside the Parliament building who witnessed the gun fight, and everyone else who was on the Hill: those who spent hours in lockdown, the tourists and passersby who witnessed the attack, the media and a whole host of other people I am probably forgetting. Some of these individuals were directly exposed to a trauma while others experienced a more indirect form of traumatic exposure.

As one moves away from the epicentre of the tragedy, we can list millions of other individuals who were deeply affected by the shooting – Ottawa citizens, Canadian viewers who watched it on the news and of course the global community.  These folks were not exposed to direct trauma, but were potentially secondarily traumatized all the same: If you watched some of the raw media footage which was shown on our TV screens minutes after the shooting, you may have noticed some very graphic, rather disturbing images centered around the victim. I noticed that as the day progressed, while the footage was being shown in a continuous loop, it was slightly altered to mask some of the more disturbing elements of the scene.  (You may not have noticed that, but I have a homing device for trauma exposure in the public sphere and how it’s done, call it my own personal mission and obsession). However, with YouTube, and dozens of passersby able to film the scene with their smart phones, it won’t be hard to see that raw footage somewhere on the net, if one looks hard enough. I am not sure why the media outlets decided to stop showing the more graphic details – was it out of respect for the victim’s family? A decision to spare the viewers? Maybe a bit of both, and that’s a good thing. Too bad it doesn’t happen more often.

Thankfully, our degree of understanding of traumatic stress has significantly improved over the past decade – most people are now fairly familiar with the concept of Post Traumatic Stress Disorder (PTSD) and have no difficulty understanding that those at the centre of a tragic event like the Ottawa shooting might be significantly affected for weeks and perhaps months to come. We also know that some individuals are more vulnerable to traumatic stressors and may develop more significant psychological distress as a result of this event: the severity of the reaction is determined by a prior trauma history, a history of mental illness or addiction, a person’s personality and coping styles, whether or not they were able to seek good quality debriefing afterwards, the quality of their social supports and several other factors.

One thing is clear – when we experience a traumatic event, many of us have a strong need to talk about it with others. This is a very good thing. Talk, write, share with your loved ones, with your work colleagues and your friends. This urge to connect and tell our story can also happen to us during very intense happy events – talk to any new mother about her birth story hours or days after the delivery, and she will give you the play-by-play of each cube of ice she chewed on and what centimetres of dilation she was at. Talk to her again a year later, and she will likely tell you, in a nutshell, that “it hurt like hell and took 26 hours” but unless it was a very traumatic birth, she will no longer need to share minute by minute account of what happened. This is completely normal. With traumatic events that involve a criminal act, the need to share and the trauma experienced may be more potent. An “act of God” is very different from one human being’s deliberate decision to cause harm to others, even if the perpetrator is deeply psychologically troubled. So let’s talk about it, absolutely.

However, we should take care to share what is necessary vs “all the gory details” unless those are extremely central to our experience. After 9/11, the Globe and Mail (and many other news outlets) shared some incredibly graphic photos that I will never be able to remove from my mind – I was quite traumatized by those images,  and there were not necessary – I did not need to view these to be compassionate and profoundly distressed by the collapse of the Twin Towers. Fourteen years later, those photos of 9/11 still haunt me whenever I hear mention of the World Trade Centre. The same is true for the Bernardo trial, some 20 years later.

As the events in Ottawa recede, some of you may remain greatly shaken and very affected by the sounds, images and emotions surrounding the shooting. If, a few weeks from now, you feel that you are more distressed than you should be – maybe you are more upset than your colleagues, are having difficulty sleeping or focusing on other things, perhaps you are experiencing intrusive images or nightmares – please seek some support. Let’s take good care of one another.

Helpful Resources: 

Canadian Mental Health Association: Getting Help

CMHA Website on PTSD

© Françoise Mathieu 2014

Photo credits: Michel Loiselle