Secondary PTSD and how to deal with it.

Secondary PTSD occurs in those people, who were involved in emergency relief operations: fire-fighters, rescue workers, law enforcement officials, nurses, doctors and psychologists, etc.

Working with traumatized patients require a lot of emotional contribution. As a result, life-guards or therapists become the witnesses of all these accidents, which lead to the development of secondary PTSD.

Secondary PTSD manifests itself in the form of flashbacks, depression, feeling of helplessness, isolation, regression and cynicism. There is also a great risk of psychosomatic disorders, such as fatigue, sleep disorders, overexcitement and uncontrollable outburst of feelings.

Talking about therapists, there can be distinguished two main behavioral patterns – escaping (depreciation) and hyper-identification.

Escaping or depreciation is the first reaction along with hesitations like “No, I cannot stand working with this patient!” and so on. The personal feelings of therapist (fear, disgust) hinder to perceive the story of the patient; distrust of some details can be also possible. Such defensive behavior is a fundamental error in the treatment of traumatized patients. Unwillingness of the therapist to touch upon repulsive vital events of the patient pushes them apart, which ultimately can lead to the development of chronic PTSD.

Hyper-identification – is another extreme position of the therapist, associated with fantasies of revenge and salvation, which appears due to excess of empathy. Taking the role of companion in misfortune or fight, it significantly limits the ability to offer a remedial emotional experience. A danger of this position resides in the fact that any debunking of illusions, which is inevitable in therapy, can have a destructive impact on therapeutic relationship.

Reaction of uncertainty in the therapist can be explained by embarrassment or fear of exacerbating the trauma, causing decompensation of the patient during the questioning about the content and details of the traumatic event. The patient’s story can cause a temporal loss of control in the therapist: he may become unable to collect his thoughts, the story he heard may draw the tears to his eyes. The patient begins to doubt in the actions of therapist, since the latter cannot stand his story. Thus, the emotional reaction of therapist cannot be too strong or too weak, since both are equally harmful.

A common rule for the therapist, who works with PTSD patients, must be a friendly attitude towards himself. Permission to experience the joy and pleasure are essential for the work in this area, without which it is impossible to perform one’s professional duties.

Here are some tips, which can help to avoid the secondary PTSD:

  • Pay attention to your own reactions and body signals: insomnia, headaches, sweating and so on.
  • Try to find the verbal expression of your own feelings.
  • Control your
  • Find the optimal level of comfort, which contribute to openness, tolerance and willingness to listen to the patient.
  • Remember that every feeling has its beginning, midpoint and end.
  • Learn to mitigate your feelings without slipping into defensive position.
  • Accept the fact that everything changes and the old times will never come back.
  • If your feelings are hurt, take a break to think over the situation before you continue to work.
  • Use the existing contacts with your
  • Join the professional association of therapists, who work with traumatized people.
  • Use and develop your own methods of relaxation and