Keeping the Vampire Away of He Rides on Our Coat Tails as Vicarious PTSD
Paula-Susan, M.A., L.C.S.W,

Saturdays are notoriously light for me. I see clients half of the day unless I am running a group; then I have an evening of fun to look forward to with my friends. This Saturday began as any other, maybe a few more phone calls than usual. It was to be a short day with a special treat from my massage therapist. Writing this article on Keeping The Vampire Away was to complete my agenda. So much for the well-planned agenda.

A smile dances on my face as I pen this very time-appropriate article. My first client was a young woman who has grown in leaps and pirouettes since I first met her. She was then married to a man who was sexually and verbally abusive and who refused to come to therapy for help.

The rest of the day was markedly different. My next session was with a couple in their thirties. He had a gun to his head two weeks prior. His wife, denying the severity of this situation - even as he says he doesn't trust himself not to do it again, says why should she have to get rid of the gun?

My next couple presented in our first interview with the wife's very psychiatrically-involved profile, O.C.D., severe depression, and dissociative disorder. The physical, sexual, and verbal abuse began in her infancy - and she finds it impossible to actively participate in life. Her dysthymic husband struggles with his inherited low self-esteem and the reality that his love for her is indeed "not good enough."

I then return phone calls and hear from a referring psychiatrist that our mutual client is in crisis. There's a question as to whether Dyfus should be involved in the case and I support her taking the appropriate measures for assuring safety for the children involved.

My massage is out of this world! I am definitely in my own altered state of consciousness as my body accepts the nurturing and my mind floats in a warm cocoon. We hug and part as I reach for my ringing phone.

The next forty minutes are spent reassuring a frightened woman and her family who had just recognized that an evil part of her "takes over" her personality and is threatening her life. At the end of this conversation, I decide to set this article aside for completion at another less stressful time!

The NIH forum on Mind-Body Interactions and Disease Symposium in Bethesda, Md. cited studies showing the effects of stress and depression on physical health and resistance to disease - and the benefits of measures like group therapy and counseling. (We suggest that for our clients all the time.) Susan J. Blumenthal, a physician and co-chair of this symposium, discussed the benefits of these "low cost psycho-social interventions in treating many patients."

David Spiegel, a psychiatrist at the University of California, discussed the now well-known study that documented that patients with advanced breast cancer, who participated in a weekly support group and therapy group, lived twice as long as those who did not. (This is certainly no surprise to those in our field.)

How is it that we who know compelling information which consistently affirms the value of human support systems, are so lax in assuring that for ourselves?! Why do we who counsel others, hour after hour, trauma after trauma, remain essentially isolated in our enormously responsible and challenging roles? While agencies do provide connection through staff meetings and supervision, not all private practice clinicians choose to avail themselves of such valuable interaction and validation. It's not readily available, and the idea of creating such vehicles for ourselves often feels like another task which takes time and energy.

Many of us are idealists who enter the field with powerful intentions - we are going to make a difference. For those of us who do not dissociate, our idealism is sorely shattered or, we hang on by a thread after hearing, seeing, and feeling the results of man's inhumanity to man/woman/child! Our once profound belief in a core "good" gets rocked and socked and we are face to face with raw pain or that which has been translated into raw, ugly, venomous rage. We sit in our chairs before these hurting people seeking to create a context of hope for our clients - and for ourselves, as well.

McCann and Pearlman, authors of Vicarious Traumatization: The Emotional Cost Of Working With Survivors in Treating Abuse Today state, "Long-term work with survivors can create a sense of cynicism or despair in helpers as they are faced with the darkest aspect of humanity and the horror of senseless violence." They go on to say that clinicians are at risk for alteration to their own cognitive schema and memory - the very focus of our treatment for trauma survivors. Our work may leave us vulnerable to damage to our own beliefs about trust, safety, power, esteem.

Many of us are not only idealists, we are perfectionists as well, and Victor Malatesta, Ph. D. at the Institute of Pennsylvania Hospital says, "rightly so, since (we) hold someone else's life in (our) hands." This author comments, it's vital to know our own limitations, too!

If, indeed, it is our commitment to the excellence of our craft, and a genuine regard with which we hold our clients, it is imperative that we minister to our own mental, physical and spiritual health. Our lives need to be balanced with fun and nurturing, as well as continued learning and professional growth. We need to take note from our colleagues who are personally thriving and who are able to maintain their enthusiasm for their work.

So, how do I cope? Let me count the ways I fight off that vampire who can, indeed, suck the energy and spirit from our lives...

  • I use the phone for human connection - i.e., my friend who says "I love you" and commiserates when I have a rare "no show," or a colleague who shares my love for silly and outrageous banter.
  • An early morning ski on my Nordic (actually increases my energy for the long hours ahead)
  • Having dates scheduled such as interesting trainings or conferences, a woman's day out, a rare disco night
  • A busman's holiday - lunch with a colleague to discuss cases
  • Supervision to keep my diagnostic and therapy skills honed and challenged by a respected peer
  • Massage for some self-centered tactile nurturing
  • A piece of stirring music
  • A peek into my library for a brief scan of some book which has been beckoning me Affiliations with such professionally supportive groups such as the American Association of Marriage and Family Therapists or National Association of Social Workers.
  • Keeping my reading current
  • Deep breathing, self-hypnosis and imagery
  • Exercise, tennis...
  • Spiritual nourishing
  • Bubble baths (but then I have to wash the tub)
  • Aromas, such as flowers, cologne, baking, cup of herbal tea
  • Re-read the articles on "Time" in the January/February 1995 Family Therapy Networker and create a new life-affirming perspective!
  • E.M.D.R., T.F.T., Tapas...

We can choose one from column A and two from column B; and, if we are to remain true to our committed mission as therapists, we need to listen to our own inner music and pay it homage.

The mind and the body are simultaneously stimulated and our life's blood is at stake. Self-love/respect is the antidote to the vampire's fangs. Let him seek his kill elsewhere. We have important work to do!

Now, for that warm, delicious bubble bath! Did I hear the phone? Anyone for T.F.T.?

©1998 by The American Academy of Experts in Traumatic Stress, Inc.