My Preliminary, Highly Complicated Thoughts on the Notion of "Vicarious Trauma"

My Preliminary, Highly Complicated Thoughts on the Notion of "Vicarious Trauma"

As an editor, one topic that crosses my mind a great deal is the notion of "vicarious trauma," i.e. the negative emotional effects that can result from bearing witness to or being exposed in some way to another person's trauma. Much of my job involves being inundated by the stories of individuals who have been horrifically and brutally traumatized both inside and outside the mental health system. 

The stories I hear affect me. The pain in each writer's voice, the levels of psychological and physical violence that each one has been subjected to, the ways their trauma has been denied and minimized by almost everyone around them, the pervasive sense of hopelessness and alienation - it all seeps deeply under my skin in ways I cannot fully tease out. Most impactful of all is my own powerlessness - the fact that I cannot do anything or take any action to change each person's circumstances. If I had to describe the internal experience of being an editor in one sentence, it would be a collection of moments in which you want so badly to smash everything around you, to set fire to institutions and watch oppressive systems burn - in which you thirst for this, pine for this, crave this ability to react and go crazy and rebel - but all you can do is hit the publish button. 

Yet, the narrative that I have been "vicariously traumatized" through my job feels uncomfortable to me. Too often, I feel that narratives around "vicarious trauma" or "secondary trauma" hold the primarily traumatized party responsible. Bearing witness to the stories of those who are traumatized is presented as a burden. They frame traumatized individuals as inflicting their pain (albeit unintentionally) onto their clinicians, friends, family members, and significant others merely by sharing their story. In just listening to traumatized individuals, clinicians and others are framed as heroic, self-sacrificing saviors who persist in their role as helpers despite the pain they are being subjected to. 

I also worry that in talking about "vicarious trauma" - and even in writing this article - we shift the attention from the original, excruciating pain that traumatized individuals live with every day, to the milder, more short-lived discomfort that clinicians and other professionals experience after hearing trauma stories. In other words, we shift the focus from the most marginalized people, whose voices should be centered, to a less marginalized and sometimes even privileged group. 

Once upon of time, I was in graduate school for Jewish nonprofit management, and I was put on a leave of absence because I was vociferously (and maybe even obnoxiously) critical of the charity model (among other reasons - you should also ask me about the time I called circumcision sexual assault to a rabbi's face, and the time I passed out at AIPAC, but that is for a different day and a different blog post). My main criticism was that in the charity model of nonprofits, donors' voices are the most centered and drive the vast majority of decision-making, not clients'. Although clients of nonprofits are the ones living through hardship, marginalization, and deep pain, it is the donors' financial sacrifices that are most recognized and rewarded. Clients are framed as needing to feel grateful and express their gratitude for these donors' tremendous sacrifices. In this way, clients are not seen as inherently deserving of resources but rather lucky beneficiaries. 

I worry that narratives around "vicarious trauma" follow a similar model. Unlike "regular," "everyday" experiences, experiences of trauma need to be prepared for. They take extra time, attention, and effort to hear, and one must be careful to avoid burnout. One narrative around "vicarious trauma" is that it takes special training to be able to listen and respond to stories of trauma. Victims of trauma are told to be careful who they share their stories with, to make sure no one gets too uncomfortable. In other words, the stories of traumatized people are not framed as inherently deserving of being heard. 

This is something that greatly bothers me. As an editor, and as a human being, I believe that I am obligated to hear the stories of traumatized individuals. Every day, I am complicit in so many forms of oppression and bigotry. The absolute least I can do is listen to the voices of the people most affected by it. And if it causes me pain? If it causes me hopelessness, terror, and powerlessness? Good. Maybe I deserve to feel that.

And although I, too, am a victim of the mental health system, compared to so many of the stories I read each day, I have a tremendous amount of privilege - namely, that at the end of each story, I get to walk away and go on with my work day, while the writer of the story has no choice but to continue living it. I get to hit the publish button, mark it off on my to-do list, and proceed to my next task, while the writer does not get to escape. For me there is an ending - there is a piece of writing, with an introduction and a concluding paragraph, and it gets posted online and shared on social media, and marked in gray on our submissions tracker. For the writer, there often is no happy ending. In many ways, it feels absolutely ridiculous for me to complain about the "vicarious pain" I experience. 

I realize this touches upon a highly complicated, emotionally fraught subject - trigger warnings. Narratives around "vicarious trauma" often intersect with narratives about the need for trigger warnings or content warnings so that students or others can abstain from reading or listening to a story that might cause them pain or remind them viscerally of their own trauma. Like narratives around "vicarious trauma," this can send a message to trauma victims and survivors that their narratives are inflicting pain onto other people, and that it is not safe to share their stories.

But at the same time, who am I to say that any one person's feelings don't matter? The vast majority of my activism revolves around the need to believe each person and trust them as the expert of their own experience. If a person is experiencing real distress and agonizing pain as a result of listening to or reading a particular story, shouldn't they have a framework through which to talk about their experience? If a clinician or family member is deeply impacted by the trauma of their client or loved one, shouldn't they be able to address that in whatever way feels appropriate to them? It seems incredibly invalidating - and contrary to almost the entirety of my activism and this blogspace - to say that some people's pain doesn't matter merely because they are more privileged than others. (Additionally, some individuals may request trigger warnings or experience vicarious trauma because they have been more traumatized than the person whose narrative they are currently bearing witness to, which is also highly valid.)

Is there a way to reconcile these two seemingly opposing perspectives? Is there a way to hold space for both the idea that traumatized individuals should never be made to feel responsible for burdening or inflicting pain on others by merely sharing their stories, and also the notion that everyone's pain - including vicarious pain - matters and deserves to be talked about?

I think one important way forward is, in discussing "vicarious trauma," to hold the systems and individuals who perpetrated the original trauma responsible for the subsequent vicarious trauma, rather than the victim/traumatized individual. In holding the mental health system and systemic sanism, not fellow psychiatric survivors or Mad people, responsible for the feelings of distress I experience as as an editor, my vicarious trauma can serve as motivation for me to continue fighting against sanism and psychiatric oppression in any way I can. Rather than framing the psychiatric survivor writer as responsible for inflicting vicarious trauma onto me, I can view my vicarious trauma as a source of solidarity and connection between each writer and myself. Of course, I would never attempt to compare the vicarious pain I experience as an editor with the pain each writer continually experiences. However, I can allow the vicarious pain to help give me a small window into what each writer is experiencing to a much greater extent. 

In many ways, this is similar to my approach to suicide. As a right to suicide activist, I am often asked whether I have ever felt the pain of losing a friend or loved one to suicide. "If you really knew what that was like, you surely wouldn't support the rights of suicidal people," I often hear. "You would realize just how unjust it is for a person to be able inflict this kind of trauma on those who love them."

The truth is that I have lost friends to suicide. And I often ask myself that very question - is it possible to hold space for both narratives about the right to suicide and narratives about the pain - i.e. the vicarious trauma - of losing a loved one to suicide? Is it possible for survivors of suicide to be able to express their pain and grief without framing the suicidal individual as the responsible party, as the inflictor of this pain and grief? 

For me, the answer is a clear yes. Again, the way forward lies in holding the individuals and systems that drove the person to suicide, not the suicidal person themselves, responsible for that pain and grief. Every day, the suicides - and suicidality - of my loved ones serve as a source of motivation not for me to "prevent suicide" or take away suicidal people's rights to their bodily autonomy, but to attempt to create a world that people don't want to escape from. 

In my opinion, it is time to change our perception of "vicarious trauma" from an individual issue to a systemic one. It is time to stop viewing "vicarious trauma" as something that is caused by an individual's expression of their pain - whether through a written account of their abuse, a repetitive retelling of particular traumatic details, or a suicide attempt - and start viewing it as an extension of the pain, grief, hopelessness, and powerlessness inflicted on all of us by our culture of abuse and oppression. Only then can we begin to take part in building a more accepting, empowering culture rather than further silencing or blaming the most marginalized individuals.

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