Can we be traumatised by our clients and their stories?

> Deb Gould is a STARTTS Clinical Psychologist and clinical supervisor.

Work with refugee children evokes a range of responses; from exhaustion (burnout) to complex psychological dynamics (countertransference), these reflect our engagement and the meaning that this work has for us personally. Among these responses, the most difficult construct to define is vicarious traumatisation. It is also the one frequently used by workers who are tired and anxious and who experience the same sorts of symptoms as their clients. To be traumatised is to experience a threat to self or other that overwhelms usual coping mechanisms. Without putting any fine points on it, vicarious traumatisation is said to emerge from having a therapeutic engagement with a traumatised person where we explicitly hear and take their pain and horror and our view of self and the world is challenged. This is an unlikely scenario for most readers of this e-zine. More familiar are feelings of hurt, burden, anxiety and victimisation.

Feeling victimised? Yes. Most of you have come across the triangle that describes the dynamic shifts in our responses to students in our care. For many reasons (for example, our own need to heal ourselves vicariously) we start our contact with a child in the rescuer position. Here, we work hard for them, advocating, giving, worrying, and going above and beyond the call of duty. And then we feel tired, despondent and victimised:

• By the child who “doesn’t appreciate” what we do for them and doesn’t change their behaviour;
• The child who ‘leaves’ their own terrors and losses with us;
• The child whose persecutors become ours as we learn about what was done; or
• The child who persecutes us with their anger.

As this scenario builds, our sense of mastery, comfort and empathy are threatened. This feels horrible and we need support from peers and a commitment to caring for ourselves. Some options for this include:

• Reflecting, self awareness and putting feelings or senses into words;
• Balancing engagement and centring on your self;
• Conceptualising this work with traumatised children as being meaningful but stressful.

We are moved and changed by it, but is it useful to think of ourselves as being traumatised? Food for thought…

> Deb Gould

Deb is a Clinical Psychologist and clinical supervisor at STARTTS. She was trained in South Africa and has over 20 years experience as a clinician and supervisor in the psychotherapy field.

© 2010 STARTTS  Contact: hintsforhealing@startts.org.au