Everywhere I go I find a poet has been there before me.
Sigmund Freud
Last year Helen Garner published a book about Robert Farquharson, the man found guilty of drowning his three young sons by driving his car into a dam. Garner attended his trials, finding it both a compelling and gruelling experience. In a piece she wrote recently for The Monthly, reflecting on her own and others’ reactions she said,
What people find really hard to bear, I’ve noticed, is the suggestion that they themselves might contain their share of human darkness, hidden inside their souls. I believe this refusal lies behind the strange hostility I encountered, many times, when I was trying to write about Robert Farquharson’s trials. Friends would ask me what I was working on. When I told them, they would be at first quite curious – what’s he like? What sort of man is he? I would be barely three sentences into an account of his family background, his broken marriage and his broken heart, when my questioner’s mouth would harden into a straight line and she would make a sharp stabbing movement at my chest with a straight forefinger and say, angrily, “You’re making excuses!”
Well no….she was simply trying to put herself in his shoes. And as we know, any social worker in direct practice does this routinely in her daily work, immersing herself in the lived experience of others. Being empathic is often straightforward, but sometimes it means bearing witness to the unbearable: a death or trauma, bringing fear, rage, loathing, shock or impossible grief.
The memory may be fresh or a recollection from 50 years before…it matters not.
Nevertheless it is an essential component of our work. We travel the liminal space between high and low tide, love and hate, compassion and fear – the no man’s land between monsters and angels.
Vicarious trauma is an ever-present possibility. Without supportive colleagues and good supervision we would burn out, stumble and fall. But as dangerous as this space is, it is the space of shared understanding. How can we possibly help our clients if we do not truly understand them?
Yet increasingly we live in a world where empathy is conflated with agreement; (If you see it from their point of view -you can’t be one of us!) The monsters are cast out and the liminal space is simply denied. If monsters do exist, they live in another country entirely- never in our own hearts. ‘There but for the grace of God go I’ is replaced with membership of ‘Team Australia’.
In this brave new world of black and white, marketing plays an essential role- expunging monsters and polishing our claims to membership of the just and righteous brigade. Politicians surround themselves with flags, and we too burnish our images on Facebook and Linkedin reflecting a world without fear, rage, doubt or failure.
Professional bodies of all disciplines manage their marketing with great care. In our sphere the promotion of counselling or psychotherapeutic intervention is so relentlessly upbeat, that a visitor from another planet would conclude that a kind of utopia (of the Stepford Wives variety) has already arrived. Writing about this issue in 1913 Freud said,
A friend and colleague of mine.. once wrote to me: What we need is a short convenient form of treatment for outpatients suffering from obsessional neurosis. I could not supply him with it and felt ashamed; so I tried to excuse myself with the remark that probably physicians would also be very glad of a treatment for consumption or cancer which combined these advantages.
The talking cure has gotten longer and shorter, gurus come and go; solution focused, narrative, CBT, mindfulness, and so on. Whatever the form, the variables make it impervious to randomized controlled trials – but easy to promote as the next good thing.
But the need for empathy and understanding will never go away; nor the implicit knowledge that we all carry darkness in our hearts. To be understood is a necessary and visceral experience- not achievable via text message, website or user manual. In the real world therapeutic gains are often hard won and provisional; bullies thrive and the oppressed are permanently damaged, along with those who try to help them. Too many of us are depressed and despairing because we cannot live up to the shiny expectations of our social milieu.
This however is not an invitation to cynicism or despair; it is a reminder to temper hope with reality, to know our limits, to use language for truth rather than propaganda, to admit that our best is sometimes not good enough and to acknowledge that we are both monsters and angels.
..much will be gained if we succeed in transforming your hysterical misery into common unhappiness
Sigmund Freud
Thanks Vittorio!
Social Work is a great profession and I feel proud to be one!
With over 35+ working years in a number of organisations and now as a private practitioner and educator I feel experienced enough to say-
VT has many aspects to it and empathy is integral to the Social work role. Being effective and offsetting the effects of VT includes: Preparedness for the roles we will perform and the opportunity to reflect upon the potential of vicarious trauma and explore protective behaviours from a perspective of self -efficacy, self -competency, the ability to access our own personal creativity, belonging & social connectedness to both professional and social supports, development of resilience, use of regular reflection, supervision, inspiration from eastern philosophies & teachings including mindfulness, a mix of physical and ‘slow activity’ such as meditation, music, yoga,walking, reading etc.
You may find this article useful – which was developed through work with social workers at the Peter Mac Cancer Centre in Melbourne.
Soc Work Health Care. 2013;52(2-3):296-310. doi: 10.1080/00981389.2012.737902.
Social work in oncology-managing vicarious trauma-the positive impact of professional supervision.
Joubert L1, Hocking A, Hampson R.
Abstract
This exploratory study focused on the experience and management of vicarious trauma in a team of social workers (N = 16) at a specialist cancer hospital in Melbourne. Respondents completed the Traumatic Stress Institute Belief Scale (TSIBS), the Professional Quality of Life Scale (ProQOL), and participated in four focus groups. The results from the TSIBS and the ProQol scales confirm that there is a stress associated with the social work role within a cancer service, as demonstrated by the high scores related to stress. However at the same time the results indicated a high level of satisfaction which acted as a mitigating factor. The study also highlighted the importance of supervision and management support. A model for clinical social work supervision is proposed to reduce the risks associated with vicarious trauma.
Hi Vittorio
I recently had an opportunity to see the amazing work that the NSW Domestic Domestic Violence and Sexual Assault Service (https://www.1800respect.org.au/service-support/new-south-wales-domestic-family-violence-and-sexual-assault-services/) are doing to support their staff and other organisations with vicarious trauma. They have an award winning program in this area and have great resources and an inspiring track record.
Dear Vittorio,
Thanks for your engaging postings. As a social worker working in the field of child protection, your article on the inquest of Chloe Valentine is even more pertinent when read alongside your latest posting on the importance of supervision in the management of vicarious trauma.
I am a member of the AASW and also a PSA Union delegate in my local office. While these memberships are integral to my work, I often feel as though my needs fall between two stools. The union provides me with industrial protection and comradeship, so important as a frontline worker, particularly in the current climate, but it does not appreciate the specificity of my profession. The AASW provides me with an ethical and professional framework. It understands the fundamental importance of social work supervision but it does not advocate for these things (or me) in my workplace.
You are correct Vittorio, the two bodies need to get together to provide a stronger voice both for members and for the public. As a public-sector employee, I find it difficult to explain to new social-work graduates why they need to join both. As the PSA is not party affiliated, party politics is no barrier. Are there models of this overseas?
This would be a great project to work on. How can we advance this issue?
Hi Vittorio,
Lovely post
May I add that while vicarious trauma is oft spoken, the more insidious thing can be compassion fatigue as it creeps up on us more silently. The two are cousins and often though not always, interlinked. The great thing that vicarious trauma benefits from is ‘compassion satisfaction’, a rarely discussed phenomena. Compassion satisfaction is the good stuff we derive from the work we do, and promotes ‘vicarious resilience’. The conversation around VT can get very depressing so keeping an eye on opportunities for compassion satisfaction and vicarious resilience can really help. Organisational input here can be tremendously successful in protecting staff from burnout, compassion fatigue and vicarious trauma also – 3 very different things, though in Australia, we have so far lumped them together. Positive culture and supportive approaches on the part of both managers and colleagues helps more than any one other intervention (including self care) both for prevention and for recovery processes. Thanks for adding so eloquently to the conversation.
Thank you for a very stimulating post Vittorio. The interesting thing for me to think about is that Helen Garner is possibly far less likely to experience ongoing traumatisation than her critics who fail to self reflect and who also fail to strive for personal truth in the way she has always done in her work. As you imply, her critics might also be rather ‘fused” within their political camp and thus are not permitted to differ.
As well, Helen Garner works to achieve “outcome”, ie her book, something her critics also fail to do. Authenticity enables creativity in the way being imitative does not .
You’re absolutely right, empathy is not agreement.
I believe that Vicarious Trauma is more likely where there is fusion in relationships with others, (clients or whoever). Fusion can be love or hate, but it’s fusion and it’s the opposite of standing solidly in one’s dealings with others. Fusion does not allow for self reflection and it certainly does not tolerate “difference”, (by definition).
The lack of focus on outcome also increases one’s vulnerability to VT. When you work towards outcome, you “get” what you’re there for. Having a purpose, an outcome in mind, is grounding.
To quote Jon Kabat-Zinn ” where there is compassion fatigue, there is no compassion”. I reckon Helen Garner would “get” that. Her critics would mistakenly think Jon Kabat-Zinn is promoting fusion.
Cheers
Akivra
Thankyou Vittorio for your very thought provoking post on Vicarious Trauma. I felt in tune with all the responses to your post as well. After 40 years of doing a job that I feel matters I can deeply relate to the idea that compassion satisfaction mediates compassion fatigue. An article that resonates strongly with me was Pooler, Wolfer & Freeman (2014) in Social Work, 59, (3) – Finding Joy in Social Work II: Intrapersonal Sources.
I felt similarly to many who were researched in the article – for eg I have learnt so much from those I have served and am still growing and developing as a person. Plus I have a strong sense of purpose and direction in my life through my work. I totally agree with Akriva that clear boundaries, honest self reflection and regular quality supervision supports my ability to develop emotional connections with others and walk in their shoes without judgement. Yes Vittorio the Cherokee legend of all of us having two wolves battling within is true and as the legend goes we can thrive if we feed the angel not the monster.
I find for me feeding the angel is supported by mindfulness practice and stopping to remind myself why I do this work before every time I meet with those we serve as well as contributing to a positive work environment, ensuring regular supervision and being a lifelong learner to improve outcomes.
cheers Karen
Vittorio, let me be upfront here – I bloody love your insights here; “In our sphere the promotion of counselling or psychotherapeutic intervention is so relentlessly upbeat, that a visitor from another planet would conclude that a kind of utopia (of the Stepford Wives variety) has already arrived.”
Oh yes! The Gods of absolutism continue to take us on their relentless rides of; one must feel totally centred and always in control. That is to say of course, “in control” of both oneself and arbitrarily, in control of the other ! Indeed, the propagation of the “relentlessly upbeat counselling” discourse has become so profoundly political moreover, hierarchal, I think we may just be drowning in our own surveillance of it all!
Adele