What is Secondary Trauma?

According to PTSD UK, “Secondary trauma is an indirect experience of or exposure to a traumatic event. For example, hearing a firsthand account of the event given by a survivor can be a traumatic and emotionally challenging experience for the person receiving it. Health care providers and mental health workers are both frequently exposed to traumatic events in this manner. To provide patients with appropriate medical and psychiatric care following a traumatic event, it is necessary to understand exactly what the patient has experienced, both physically and emotionally.”

Although this definition does not mention end-of-life doulas, we are very much part of the care team that may have exposure to traumatic events or retelling of traumatic stories from our clients. Many doulas are doing more work in the sudden death and suicide space and may be hearing the story of the death from the family or friends of the loved one. The thing that is tricky about secondary trauma is that we have no way to predict what event may create secondary trauma in us.

Researchers who penned an editorial on the topic in Frontiers in Psychology write that those at risk for secondary trauma are “All those individuals who, because of repeated and close relationships with individuals who have directly experienced traumatic events, are at risk of becoming indirect victims of the same trauma and experiencing forms of emotional decompensation. Everyone is potentially exposed to at least one traumatic event during their lifetime; for people in helping professions, the likelihood increases because they themselves and others are exposed to more stressful events. Thus, it can be said that this risk affects all professions that provide assistance and support to individuals and/or populations who are victims of trauma.”

So, if any of us can be at risk for secondary trauma in our doula work, what can we do to address it? The first thing is to understand the signs and symptoms of secondary trauma. Symptoms include hypervigilance, avoidance, reexperiencing, and change in mood. It can also include guilt, anger, problems sleeping, challenges with concentration, exhaustion, and an impaired immune system. According to this article on secondary trauma, research has shown that the most common symptoms center on sleep, including difficulty falling asleep, attempts to fall asleep being interrupted by thoughts of a patient’s story or visions of a patient’s face, and nightmares about a particular patient. 

Addressing Secondary Trauma

There is good news: Once we know we are experiencing secondary trauma, we can address it. Here are some helpful ways to do that:

1. Sign up for a session to process the trauma with an INELDA Emotional Support Center staff member, or engage in therapy with someone who specializes in treating secondary trauma.
2. Consider taking some time off from your doula activities or shifting to work that will allow you to process your emotions without being reexposed to traumatic events.
3. Create rituals and self-care practices that support you as you work through your emotions.
4. Seek support from fellow doulas and community members who can listen and hold space for you.
5. Learn relaxation techniques, such as meditation, guided imagery, yoga, and more.
6. Engage in creativity, such as art and writing.
7. Reflect on the meaning of the secondary trauma in your work.

When I was dealing with my secondary trauma, I took some time off and was able to disconnect and care for myself in a way that restored me and enabled me to come back to the work. One of the greatest gifts of the support we offer is the human connection we create with our people. However, we must remember to allow the humanity in us to be nurtured as we do our work. Self-care and self-reflection are key doula principles that enable us to continue this great journey.