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Training 'Amnesty International' in Vicarious Trauma

This blog was written for the Amnesty International blog (https://citizenevidence.org) to capture our presentation at their international summit in Mexico City, 2022.




Commitment to Self-Care: Vicarious Trauma Training


Working as an open-source researcher documenting human rights abuses places you at risk of vicarious trauma. Like firefighters, medical staff at an emergency department or therapists in a crisis center, you will be exposed to trauma. However there are actions you can take to safeguard yourself.


Amnesty International is committed to supporting the mental health and wellbeing of their staff and volunteers. As psychologists, we were invited by FD Consultants (https://fdconsultants.net) to participate in the Digital Verification Corps Summit in Mexico City to provide training on Vicarious Trauma. Digital Verification Corps is a network of students from six global universities supporting Amnesty’s human rights research. This blog outlines key lessons from these workshops that may be relevant for the wider open-source community.


What is Trauma?

It is important to first have an understanding of trauma. A traumatic event, feeling traumatised, and Post Traumatic Stress Disorder (PTSD) are terms and concepts that are often used interchangeably. So let’s start with some definitions.



Term Definition Example Traumatic event The event that overwhelms one’s capacity to cope Car accident, assault, act of terror, or exposure to death. Feeling traumatised The person has been exposed to traumatic event/s and experienced overwhelm that exceeded their capacity to cope. Being assaulted in a robbery and for the following two weeks, feeling terror when outside, having flashbacks and believing that the world is unsafe. PTSD This is formal medical diagnosis and is defined in the Diagnostic and Statistical Manual of Mental Disorders, Version 5 (DSM-5), 2013. Two months after seeing a video of torture, there are ongoing intrusive thoughts and flashbacks, reminders of the video are avoided, and there is depressed mood and insomnia. The severity of these impacts are interfering with daily life.



How we respond to each potentially traumatic event is influenced by three main groups of factors. They are:


  1. Factors related to the incident. For example, severity, threat to life, unpredictability, duration, feelings of horror, single versus recurring etc .

  2. Factors related to the individual. For example, history of trauma, mental health vulnerability, relatability, overall wellbeing, age, gender, cultural beliefs, family history, economic status, access to resources, coping abilities, capacity at the time, and previous incidents within a short time frame.

  3. Factors related to the social response. For example, support after the incident/exposure, blaming, safety, buffering factors.


Feeling traumatized and/or the development of PTSD involves a complex interplay of factors linked to the incident, individual and social response Thus we can never know what will be traumatic for one person and not for another by only knowing details about the traumatic event. For example, consider someone who was sexually assaulted. The social response could be that the person was believed, provided with services, and the perpetrator brought to justice. In another instance, the person was disbelieved, blamed, and placed in high risk situations with the perpetrator. The impact of that initial event is influenced by these external ‘social response’ factors.


Similarly, consider someone who sees photos of a murder. They walk into a dedicated work space and view the photos for a specific research purpose. They speak to a colleague who provides empathy and validation. They physically leave work and shift to self-care and being with friends. Compare this to being on a night out with friends and receiving a WhatsApp message that unexpectedly has multiple photos of the murder. They feel distressed but do not feel it’s appropriate to talk to friends about what they’ve seen. They become quiet and withdrawn but are distracted by thoughts of the photos. By nighttime, the images continue to run through their head and they cannot fall asleep. They get up to have a glass of wine.


Consider that in both cases the person was exposed to the same material. However due to the circumstances around the exposure being different they can have a different level of impact. If you multiply this experience over many exposures each day, week, month or year, the difference in the cumulative impact becomes even greater.


What is Vicarious Trauma

Vicarious Trauma is sometimes called secondary trauma. It refers to indirect exposure to someone else’s trauma. Vicarious Trauma may result from viewing graphic imagery, supporting a trauma survivor or hearing accounts of traumatic experiences. It can be just as traumatic as primary trauma i.e. when it occurs directly to you. PTSD may be induced by vicarious trauma. Therefore if you are exposed to traumatic material it is essential that careful thought and planning goes into modifying the variables that are under your control in order to minimize the impacts of vicarious trauma.


Caring for yourself

Here are some tips for caring for yourself.


Preparation:

  • Ensure all traumatic material is labeled before sharing it with others. Labels allow someone to be prepared to only view the material when their circumstances are right for this.

  • Reflect on what is most distressing for you. This is individual and often (but not always) links to what is personal to us. For example, a new mother with a 2 year old daughter may be much more impacted by a video of a 2 year old girl than someone else. Where possible, minimize exposure to videos that hold a high level of personal impact for you.

  • Before starting, have your research question in mind.

  • Have a designated space for viewing traumatic material. Keep it out of your bedroom.

  • Turn off the sound when viewing videos when possible.

  • Create an individual care plan. Start with identifying how you’re impacted by trauma exposure and think of a strategy to intervene. E.g. My heart rate increases = 10 minutes of deep breathing. Rumination (excessive and repetitive thoughts) = journaling for 15 minutes to process my thoughts, and then engaging in another activity. Telling myself I’m not doing enough = actively challenging these thoughts and replacing them with what I would say to a friend or colleague who was thinking this way.


Response:

  • If you’re feeling overwhelmed by watching something then take a break. Ask yourself, “Do I feel I can rewatch this material right now?” If the answer is “no”, then respect that and take a break from it. You can ask yourself again at a later time.

  • In times of distress many people withdraw or disconnect however we gain greater benefit from connecting with others. Push yourself to connect.

  • If the feelings of distress linger, then reach out to someone to debrief. Tell them what you saw (details aren’t necessary, just a ‘headline’ description is enough), what you felt emotionally, what you thought about it, and what is still ‘sitting’ with you. Then make a plan for taking care of yourself.

  • If you feel unsettled, engage in relaxation or exercise to help regulate your nervous system. Do not engage in avoidance-based behaviors such as drinking excessive alcohol to feel calmer.


Your greatest resources are other staff and volunteers at Amnesty International. Stay connected, support each other, share ideas and be open and authentic about your experience with each other.







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