Reducing Unnecessary Trauma Exposure in Service Providers

Many years ago, when my dear friend Robin Cameron and I developed our very first compassion fatigue workshop, we came across the term “limited disclosure” in Laurie Anne Pearlman and Karen Saakvitne’s book Trauma and the Therapist.

The authors, who were well ahead of the curve on all matters related to VT and Compassion fatigue solutions, suggested that we, as professionals, should consider taking a careful look at “how much detail about the violence or abuse [we] want to share [with one another].” (Pearlman, personal communication)

This concept of “limited disclosure” rang so true to us that we immediately integrated it in our training. We called it Low-Impact Debriefing in a cheeky nod to the aerobics craze of the 80s and also because it formed the acronym L.I.D. The idea of low impact debriefing is twofold: to be able to share the information that we need to, while at the same time not having a highly negative impact on the listener. We were not suggesting that we should keep a lid on difficult things but wanted to suggest that we should all perhaps take a careful inventory of how much graphic information we need to be sharing when debriefing difficult stories or consulting on cases with colleagues. Perhaps a better analogy is that of a pressure cooker that lets the steam out little by little rather than in one giant burst with potentially negative consequences.

Over the past decade, my team has received many invitations to present at trauma trainings: child abuse symposia, conferences for parents of murdered children, workshops for sex crimes investigators, courses on the Dark Net and cybercrime, and many similar other conferences. We are often struck by the extremely graphic details that are almost invariably shared during these events: gruesome photos shown on a giant screen during a lunch time keynote, detailed descriptions of a murder or assault on a child, minute details about the smells, sounds and sights of a crime scene and even, at times, graphic audio and video footage. Some of these scenes can be very difficult to forget.

When is Trauma Exposure Gratuitous and When it is Necessary?

I think that we can all agree that many media outlets share an excessive amount of potentially disturbing images in their coverage (and in fictional shows, but that’s for another post). I remember listening to CBC news radio on my headset a few years ago while I was out for a run, and suddenly, without warning, the host played an actual audio of a child being victimized. I remember tearing the earpieces away from me and thinking “WTF just happened? Why was this necessary during a midday radio show? And I that instance, I don’t think that the now overused customary warning “content may be disturbing to some” was enough to justify airing that footage.

I am also well aware that at times, graphic details are essential to a trauma training – if you are a forensic examiner or an investigator of any sort, you must be able to recognise and differentiate between an accidental injury and one that has been deliberately caused by another person, or you may need to learn how to assess a crime scene and the related details that are present. You may need to learn how to interview a criminal in order to develop better investigative or clinical skills. Sometimes, we need videos, photos and details in order to do our job properly.

But here is my question to you: how much detail is too much? Even at a trauma conference, are all details required at all times? Is it enough to give people a warning at the start of our talks “this may disturb you” or do we all have a responsibility to reassess what we are sharing and how much detail is enough?

We were recently asked to create a brand-new course called “The Things We Can’t Unsee: Reducing the Impact of Secondary Trauma Exposure” which we have had the privilege of offering to legal professionals, child abuse investigators and victim service providers across North America this year. The response has been extremely positive and has led to some powerful discussions and reflection among participants. A good place start addressing this issue is to perform a personal “trauma audit” for ourselves and see how much extraneous trauma stories we are sharing with one another. To go further, please read The four steps to Low Impact Debriefing as discussed in my book (Click here).

“I’m not bothered by these stories”

Now, I have been in the field long enough to know that some of you will say “I have been exposed to thousands of stories, they don’t bother me anymore” and perhaps this is true. We all have a different level of sensitivity to difficult images and traumatic details based on a whole host of personal factors. But it would be interesting to be able to measure our stress hormones and see whether that is actually true, or to be able to perform a brain scan and see how our limbic system responds to repeated exposure. As psychiatrist Dr. John Bradford so eloquently explained in his testimonials a few years ago, after 30 years of exposure to gruesome images, he also thought that he was immune, until, one day, he was not: http://www.ottawacitizen.com/health/Tough+forensic+John+Bradford+opens+about+PTSD/9152171/story.html

To Learn More:

 

Sources:

Mathieu, F. (2012) The Compassion Fatigue Workbook: Creative Tools for Transforming Compassion Fatigue and Vicarious Trauma. New York: Routledge.

Pearlman, L. A., & Saakvitne, K.W. (1995). Trauma and the therapist: Countertransference and vicarious traumatization in psychotherapy with incest survivors. New York: W.W. Norton. pp. 383-384.

 

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