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Introduction
Vicarious trauma refers to the impact that working with trauma survivors can have on the individuals working with them (McCann and Pearlman, 1990). Vicarious traumatisation is described through Constructivist Self-Development Theory as a cumulative and pervasive process in which the helper’s inner experiences are negatively and permanently transformed through listening to traumatic material frequently and repeatedly over time (Pearlman and Saakvitne, 1995). This can include changes in the way individuals view themselves, others and the world (Bride et al., 2007). Beliefs around trust, safety, intimacy, esteem and control are challenged or disrupted by trauma work (Pearlman and Saakvitne, 1995). This may result in increased cynicism, hopelessness and risk awareness in daily life. It shatters people’s view of the world as being safe, predictable and caring through witnessing the cruelty of mankind (Bartoskova, 2017; Janoff-Bulman, 1992; Sui and Padmanabhanunni, 2016). Herman (1992) proposed that ‘trauma is contagious’ (p. 140).
Individuals may experience emotional and behavioural responses because of repeated exposure to traumatic narratives (Newell and MacNeil, 2010). This can include exhaustion/lethargy, anxiety, sadness, anger, guilt, shame and fear as well as a difficulty managing these intense emotional experiences (McCann and Pearlman, 1990). As a result, helpers may avoid situations that they perceive as potentially dangerous (Resick and Schnicke, 1992). Additionally, McCann and Pearlman (1990) identified the potential for helpers to internalise their client’s traumatic stories which can consequently alter their memory systems. Paivio (1986) purported that therapists may experience intrusive images, flashbacks or dreams as the part of their memory that stores imagery is altered. Numbing, dissociation and hyper-arousal may also be present (Herman, 1992). Although post-traumatic stress disorder (PTSD) symptoms can be experienced to a lesser degree, it is the cognitive shift that defines vicarious trauma (Elwood et al., 2011).
The paralleling of vicarious trauma and PTSD symptoms, along with the idea that ‘trauma is contagious’ (Herman, 1992; p. 140), indicates that it is likely that there are adverse clinical implications for the therapeutic relationship. A disruption to the therapeutic alliance, over-stepping boundaries, conflict within professional teams and a pull to rescue or control clients may occur as a defence against overwhelming emotions (Herman, 1992). An alternative response may be to avoid, minimise or deny the clients experiences (Baranowsky, 2002).
The cost...