Preventing Original Infant Trauma When Possible For The Prevention Of Schizophrenia (Part Two)

Delayed Posttraumatic Stress Disorders from Infancy The Two Trauma Mechanism.

ANTECEDENT TRAUMA:

As with posttraumatic stress disorder from adult life, antecedent trauma sets the stage for a more severe response to subsequent trauma. Anxiety and suspense cause the event to be more frightening. If one is among friends, in daylight, and someone attempts to startle him, consider the response-versus, if he is walking down a lonely path, on a dark night, full of anticipation and fear, and the same person attempts to startle him.

Thus, we must look to antecedent trauma that could cause the early infant trauma to be experienced as more severe. It is possible that all the second trimester assaults may operate in this way, including viral infections, famine, malnutrition, paternal death, toxins, and anything that threatens survival of the infant or upsets the mother. For references see Second Trimester Factors in Chapter One. Another major antecedent trauma is the birth trauma. A number of researchers have found a higher incidence of schizophrenia among those who have experienced birth trauma. Trauma at birth has to be frightening to the newborn. Anoxia, brain injury, prolonged compression through the birth canal, near death experience-all must leave a mark. The average one year old still flashes back to the birth experience, which is why it fusses and screams when a tee-shirt is pulled over its head. An infant who is severely compromised with a near death experience at birth is even more primed for a later trauma to be more frightening.

In one family, the ninth of ten children had severe anoxia and brain damage at birth. All children were closely spaced and this one was 15 months older than the next. None of the others developed emotional difficulties, but when this one experienced a major separation later in life, there was a return to age 15 months reality. Had the person not experienced the brain injury at birth, it is possible that the age 15 month trauma might not have been sufficiently terrifying to allow for the reawakening as schizophrenia, 30 years later.

Birth trauma is not intentional and for the most part it can not be avoided. Child birth education and good prenatal care can eliminate some of the trauma, but when birth trauma occurs, it should serve as a warning to make greater effort to avoid subsequent trauma, particularly over the next 34 months.

A PREVENTABLE TRAUMA OCCURRING AT BIRTH:

The immediate clamping of the umbilical cord is one birth trauma/injury that has become common practice and which can be avoided. The immediate clamping of the cord prior to the infant taking its first breath has been shown to result in petechial hemorrhages throughout the brain in higher primates sacrificed at birth-as compared to ones in which the cord was not clamped. After the struggle through the birth canal, the infant needs all the oxygen he can get and the pulsating cord is still an important supplier of this oxygen. Thus, it should be left intact until the lungs have been inflated fully and are working properly. Conceivably this anoxia and brain hemorrhage at birth could set the stage for later trauma to be more frightening. Both the birth trauma and the brain anoxia/hemorrhagic trauma are associated with a separation (birth), and this may contribute to setting the stage for later separations being more frightening. Just as childbirth classes and good prenatal care are important for reducing birth trauma, prior discussion and planning are important for eliminating this unnecessary cause of traumatic brain hemorrhage.

CIRCUMCISION:

Another trauma, occurring shortly after birth, is circumcision. This generally is done without anesthesia-because the baby is thought to be too young and therefore unable to feel anything. More accurately, it cannot say or do anything. Undoubtedly it is traumatic and likely it has an effect. If this trauma were to increase the incidence of schizophrenia appreciably, then there would be a much higher occurrence of schizophrenia in men than in women-which reportedly there is not. Nonetheless, this could be studied by evaluating male schizophrenics vs. super normal males and comparing the number of non-circumcised persons in each group.

Other disorders that are more common in males should be studied for correlation with circumcision. This is particularly true with infantile autism. Currently great emphasis is placed on the neurological findings in autism, with the assumption that correlation proves causation. This assumption is false. Some of the neurological change may be the result of the disease process, just as it is in schizophrenia.

Autism is associated with conditions that have neurological lesions, such as congenital rubella, phenylketonuria, tuberous sclerosis, fragile X syndrome and Rett’s syndrome and it is associated with infant trauma in the first 18 months of life.

Most autistics are mentally retarded, language is poorly developed, about one-forth develop grand mal seizures and as many show ventricular enlargement. Thus, a great variety of assaults to the brain appear capable of producing the group of symptoms called autism. Severe early emotional trauma-possibly including circumcision-must not be excluded as a major factor. Fixation and continued activation of early trauma sites-to the partial exclusion of later developing sites, such as the language centers-also can account for the symptoms of autism as well as the differences in brain volume and electrical activity.

There is growing evidence offered by the Pre and Perinatal Association of North America that circumcision may represent a serious trauma to many infants. For this reason it should be studied using our methods. While the trauma of circumcision might or might not heighten appreciably the later trauma of separation (depending on how closely it is linked with separation), it could heighten subsequent castration fears during the Oedipal stage of development. Sigmund Freud described castration anxiety as existing in men and not in women because women cannot be castrated. This explanation is plausible and likely is the primary reason why males have castration anxiety and females do not. Another possibility, however, is that women do not experience circumcision, and circumcision could account for added fear of further cutting injury to the same part later in life. A simple research study of circumcised vs. uncircumcised individuals, using an anxiety rating scale, could determine if this early trauma indeed had an effect on the later development of castration anxiety. Until all correlations between circumcision and emotional disorders are studied further, we recommend against circumcision without anesthesia, and against circumcision or any other painful procedure without the mother being present.

OTHER EARLY TRAUMAS REQUIRING SPECIAL ATTENTION:

Preemies:

Premature babies are left alone in the hospital. While we do not yet have good data on the separation in the first weeks of life, those who were adopted in the first two weeks of life experience an early separation, and they also have a very high incidence of the later development of mental disorders, including borderline syndromes.

If it is possible to stay with the premature baby during its hospitalization, without sacrificing an older infant or toddler, this is the safest alternative based on present findings and projections. The emotional difference may relate primarily to the early separation from the mother. An interesting study would be to determine the number of non-adopted borderline individuals who were incubator babies and compare this with the number of non-adopted super normals who were incubator babies. If the origin of the borderline syndrome is in the first month of life, the study would confirm this. Until the completion of such a study, we recommend the mother stay with the baby until it is ready to come home.

Fetal Alcohol Syndrome:

This carries with it physical attributes related to the in-utero blood alcohol level. While a host of emotional/mental symptoms also are attributed to the in-utero blood alcohol level, more likely these relate predominantly to the lack of mothering or the inconsistency in mothering that occurs in the first months or years of life, as a result of the mother’s alcohol dependence. For prevention, this may be a time for institutionalization of the mother while she is pregnant, and a time for a continued serious treatment of the alcohol dependence after the baby is born. Ideally, the alcohol dependent woman should be informed about the devastating impact of alcoholism on the baby, and she should have her alcohol dependence treated before she becomes pregnant.

Adoption:

Adoption should take place at birth, not two weeks later. Nine months should be sufficient time to make the necessary arrangements.

With adoption there already has been a major separation. Every effort has to be made in the direction of providing security, to avoid reawakening and inflaming the original trauma. Adoption must be reserved for the person who wants to be a full time mother to the baby. She must delight over everything the baby does-each developmental landmark, every new utterance, all “cute” behavior. The adopted baby has already endured one separation and must have the devoted attention of one constant mother figure who will be as close at hand as a mother bear with her cub. The busy professional who is not able to take time for a pregnancy and who plans to utilize a “nanny” or a daycare service to rear the child, should rethink the decision in light of our findings. The idea of having an adorable loving child must begin with one full time mother who provides for the needs of the child during infancy. The needs of the mammalian baby for the mother have been established and are deeply entrenched. The adopted baby has already been traumatized or injured and therefore must feel fully protected by having its needs fully met. The adopted baby needs a devoted, full time mother, preferably beginning at birth.

OTHER EARLY TRAUMAS: OTHER PHYSICAL SEPARATIONS:

Histories of approximately 300 schizophrenics, and at least as many depressed individuals and borderline patients, have revealed other early traumas that occurred at ages that were specific to the expected age of trauma-based on the symptoms the patient experienced. For example, one patient whose symptoms matched those of a person traumatized at 24 months, was found to have moved into a new house at age 24 months. By using the clinically based expected age of origin, various other early traumas were identified. On occasion it was confirmed that the expected age of origin matched the time the mother was sick and was hospitalized.

Combination Traumas: Pain Plus Separation From Family Plus Separation from Familiar Surroundings:

If the infant/toddler is sick and hospitalized, this can be a multiple trauma. First, the pain or the sickness intensifies the need for the mother. The fear that accompanies the pain makes the child more vulnerable to separation. Furthermore, the child is not only separated from the mother for part of the hospitalization, but the child is separated from its familiar surroundings as well. If this occurs when the baby has stranger anxiety, the trauma conceivable could be even greater.

One parent described the look on the face of his oldest son shortly after his son had surgery at age 18 months. He knew then that something was terribly wrong. When the man and his wife divorced 16 years later, his son returned to age 18 months and spent the next 12 years in institutions. The surgery was the finest available and the surgeon went on to become one of the most noted in the land. Nonetheless, the emotional trauma eventually destroyed the mind of the baby (the parents were not able to follow the recommendation that would have brought about a total or near total recovery). Thus, as a preventive measure, when the infant/toddler is hospitalized, the mother must go to the hospital and remain there with him. This is especially true when painful procedures are involved.

A Second Child:

If there is another child at home under the age of 35 months, the mother must try to offer as much security, reassurance and support as possible to this child as well. The other child can stay with her or visit in the hospital lobby when the hospitalized one is asleep, and/or have telephone contact upon request. If the older child is very young and at an age of origin of schizophrenia or schizoaffective disorders, it could stay in the same room with the mother and baby. While many hospitals are not aware or tolerant of this need, it is necessary to insist because of the potential harm when the infant/toddler is separated from its mother.

When the mother has to be at the hospital and when it is impossible for the infant/toddler to be there with her, this is not a time for the father to place the infant/toddler in a daycare center or in someone else’s home. This would be a double separation-a separation from the mother and a separation from home (which also represents a degree of security). A family member with whom the infant/toddler is familiar or attached, or preferably the father, should stay with the child in the child’s own home. Ideally, the child should know that the caregiver will not leave until the mother returns.

In summary, physical separations are very traumatic to a child under two years eleven months, and the younger the child the more severe it can be. Thus, physical separations have to be avoided or attenuated as much as possible. This includes separation from mother and separation from home and separation from father. If the child is comfortable with the father, he may go places with the father as long as he does not exhibit signs of distress or withdrawal. One must not equate the vacant stare with not being upset. While this is not likely to occur when the infant is with the father, it certainly is present in the early daycare situation:

Back From The Brink: Trauma and Homemopathy

My career in psychotherapy actually started when I found out that a local Rape Crisis Center was desperately in need of volunteers. This was in the early 80′s. I was young, still in freelance advertising, but searching for a new path. “Just come to one meeting,” the woman on the phone said. “No obligations.” Before I could say “sure,” I was in the middle of an eight-week intensive training in crisis counseling and in short order taking shifts on the hot line at three in the morning.

It was an initiation that retrospectively reminds me of the polar bear club-those insane men and women who jump into icy waters in the middle of winter. They call it brisk. I call it shocking.

And I was shocked-by what I heard, by what I felt, by the incomprehensible ways that people hurt one another and the long, lonely road to recovery so many had to walk in those days.

PTSD, now a part of our common parlance, was then a fairly new addition to the Diagnostics and Standards Manual (DSM) that mental health professionals use for assessments. In fact, while I was still in college, I proposed a research study on the long-term effects of severe stress on Holocaust survivors to the dean of psychology at a “prestigious” university in NY. He laughed and told me that it would be impossible, that I was overly-ambitious, and besides there was no such thing as stress-disease in the way that I had framed it. There wasn’t even a diagnosis for it at that point.

Yet, those people who didn’t exist for that Dean managed to find me…on the hot line and then in my office after I finished graduate school. And what I came to find in them was a variation and complexity much broader than I had been prepared for. Trauma is rarely the result of one horrifying moment. It is almost always compounded by constitution, causality (was the event precipitated by a loved one?), and consequences (was the person ignored, dismissed after the trauma?). Just as Hahnemann teaches us, every person comes to his or her life with a unique individuality. Every event is received and integrated differently and every person must be approached with that understanding-we treat the person not the disease. No two people-and no two traumas-are alike.

For that reason the techniques I had learned in graduate school and in post-graduate study were good, but they weren’t going as deep or lasting as long as I had hoped. Hypnosis was great, but only up to a point. NLP helped but, again, just so far and for just so long. EMDR was terrific for short-term relief, but so many variables had to be addressed it took forever and seemed similarly superficial. Each one of these modalities has been invaluable and I still use them in the course of treatment (* for a list of excellent books to read, see end of article) but they never seemed to go far enough, reach wide enough or sink deep enough on their own for me to consider a case completely curedI struggled and juggled technique after technique until I gratefully found homeopathy. Then I started seeing some real miracles.

Case #1: Ailments from Disappointed Love

17-year old Lena (name changed) came to my office in acute distress. Her mother brought her in one day after discharge from a psychiatric facility. She presented with a flat affect, spoke in word salad, and stated that she was pregnant despite medical evidence to the contrary. Her abdomen was quite distended. She had been put on Abilify, Cogentin, Risperdal and benzodiazepines. They planned on weaning her off after her outpatient treatment had started.

Approximately one week before going into the hospital, she had returned from a party in what her mother called a “euphoric” state, “completely changed.” Prior to the party she had been an A+ student, an athlete, popular, diligent, responsible, socially skilled. “Everyone wanted to sit next to Lena,” her mother said.

When asked about the party, Lena was incoherent, answering in rambling, irrelevant monologues. I asked her if she understood what she was saying and she responded, “I’m confused. I’m having so much word salad.” She seemed genuinely frustrated.

Although she couldn’t articulate what had happened at the party that might have contributed to her current state, she did say: “All I want to do is be with my boyfriend.” She had been dating the same boy since she was 15.

According to her mother, Lena’s boyfriend was “a good boy,” although she was worried that Lena’s psychiatric condition would put a strain on the relationship and didn’t know how that would affect her daughter. (As soon as she’d gotten out of the hospital she’d gone to see him at his parents’ home and had started talking in rather vulgar terms about their sexual life in front of the family. She stated she had no memory of it but was told about it by her boyfriend.)

Several days after the party in question, she began speaking unintelligibly and complaining of an inability to urinate. She was soon taken to a physician’s office and transferred to the E.D., where her case was eventually given to the psychiatric department because of her manic presentation. She had insisted that she was pregnant despite sonograms and blood tests to the contrary. She was so sure of her pregnancy that she slept with her hand inside her vagina to keep the baby from falling out.

She hated the hospital and often was more than resistant, having to be restrained. She recalled being put on Fentanyl, feeling paralyzed, raped and hysterical as they catheterized her to release retained urine. They also found it very difficult to draw blood from her, even though her mother stated that was very unusual for her.

Her mother stated there were no infections and that all the medical tests came back normal.

Her case unfolded in starts and stops. While it seemed that there was a clear point in etiology, the cause remained unclear and the symptoms scattered. We asked her and her mother for some general information:

She tended to be chilly and preferred spring and fall for the temperate climate. She liked ice cream and ices. She had left-sided ovarian pain with ovulation and a cyst on the right ovary. She often had faintness during menses and sometimes passed out. She had a tendency to hemorrhages and, despite the experience in the hospital, normally bled easily. She had a vivid imagination, was artistic and said she drew like “Tim Burton.” She played piano, loved animals, had nightmares as a child and sometimes reported seeing angels or spirits.

She presented as very sympathetic and personable. In fact, as soon as she came in, she offered a hug and said, “You look good. Nice outfit.”

Her mother reported a normal pregnancy with Lena although she was delivered via c-section due to mother’s lack of dilation. She was the youngest and a very quiet, easy-going baby. No major childhood illnesses reported.

She had excelled in academics and was quite diligent. When she had this psychotic break, she was just about to graduate with additional certification and get to work right out of high school.

Without more to go on, her first repertorization appeared thus:

Mind, delusions, pregnant

Mind, sympathetic

Generals, faintness, menses

Mind, delusions, specters

Mind, insanity

Mind, thoughts, rush of

Although I had initially felt a strong calling to Phosphorous because of her sympathetic nature, her clairvoyance, and cystic constitution, this first repertorization came up Ignatia. But the whole case seemed wanting. I already knew that Ignatia was a good hysteria remedy, but a psychotic break?

I called Dr. Karl Robinson when he came into town and I ran the case by him. He was intrigued by the depth and clarity of her delusion. Once he’d heard the case out, he asked me, “So, what happened at the party?”

To my utter chagrin I had to say, “I don’t know. I couldn’t get much detail out of anyone.”

In no uncertain terms, he gave me my work orders, “You need to know what happened at that party!!! That’s where the case is!” And he was absolutely right.

By the time I saw her next, her affect and thought processes were clearly still impacted (free associating, rambling speech, affect blunt), but she was slightly more coherent due to the allopathic medication and could begin to recall what happened before her hospital admission.

Apparently at the party, she had found out that her boyfriend was cheating on her. She remembered that she began “yelling and screaming” until she “couldn’t breathe.”

From that point she became and stayed hysterical. It was trauma. And insanity. The ailments were from disappointed love and mental shock.

With that, the case was revealed and the rubrics were expanded as follows:

Mind, delusions, pregnant

Mind, sympathetic

Mind, ailments from, disappointed love

Mind, ailments from, shock, mental

Mind, insanity, grief,

Mind, insanity, cheerful, gay

Mind, sentimental

Mind, conscientious about trifles

Mind, speech, wandering

Mind, thoughts, wandering

Mind, delusions, specters

Bladder, retention of urine

Generals, faintness, menses

Generals, lack of vital heat

Again it came up overwhelmingly Ignatia and we finally had the emotional point of origin: disappointed love, mental shock. This was yet another crucial lesson to me about trauma: that it was the Great Imitator. It could induce a multitude of symptoms with a range so wide it could look like, act like and feel like any number of other disorders.

She received Ignatia 10M.

On the first dose, she broke out into hives and went to the bathroom until her bowels were emptied of what appeared to be two weeks’ worth of stool. When she came back in to the office, it was as if she were a new person, mentally and emotionally calmer, a clear gaze and expressions that indicated a wider range of emotions. She was more capable of accessing information from memory and expressing it in an understandable manner. Her medications were being reduced but her well-being continued.

She began to have the insight appropriate for a young woman of her intelligence and sensitivity. When she discussed her bowel movements, she said, “It was like having a miscarriage.” When asked how it made her feel, she said, “Sad.” When asked why, she explained that she would have liked to have had a baby and wondered if maybe it was a way of keeping her boyfriend close to her.

She has begun to have other similar insights into her family life, her disappointments, and the way she has been the emotional cornerstone for her family.

It has been approximately 3 months as of this writing. She has broken up with her boyfriend, gone back to school, and continues to pursue her career. While she surely has a way to go emotionally, no clear, new symptoms have developed and she remains calm with no delusions.

Case #2: A Secret Teenage Abortion

Stacy, 35, came in complaining primarily of her relationship with her mother, which was “awkward, tense, uncomfortable.” She was unable to identify why in the initial interview except to say that she felt every conversation with her mother ended in annoyance or anger. “She’s always analyzing me.”

She had no outstanding medical history, denied any sexual or physical abuse, and claimed to have had a happy childhood. She was raised in a split household religiously. Mother was an agnostic/humanistic psychologist but her father was a Catholic who regularly went to church. She often found herself trying to be a peace-maker. “I was the kid who wanted to make other people happy.”

Although the initial complaint was her relationship with her mother and she denied any overt traumatic event, it turned out that she was experiencing a wide range of stress symptoms since she had started a new job working with abandoned children. As she spoke about work, she began to cry. “No one wants them.”

She disclosed that she was often sleepless, intensely sensitive, and frightened for no apparent reason. She had become irritable with her boyfriend and was concerned her mood changes were going to chase him away.

No other symptoms were admitted until the third or fourth session when she disclosed that she’d had an abortion at 16 years old.

“I didn’t want it. I just didn’t know what else to do. My mother wouldn’t help me. So I went alone. I haven’t been whole since them,” she said, sobbing openly. It was more than grief. It was a stricken conscience. She wept as she wished she had been smart enough or informed enough to put the baby up for adoption. “I was just so scared. But I hurt someone for my own gain.”

“And,” I asked her, “your job? The children there?”

“They’re just left. No one wants them. I worry that my baby felt that way about me. That I didn’t want her.”

Now, we started to see the case open up. She complained of occasional vertigo at work, chilliness aggravation with menses, menses irregularities, difficulty getting out of bed in the morning.

I took the following rubrics:

Mind, ailments suppressed/silent grief

Mind, terrors of conscience

Mind, self-reproach

Mind, desire for solitude

Generals, Vertigo

Sleep, prolonged morning

The prescription was Cyclamen 30c, once a day for three days.

She felt immediately relieved as the dam was raised and her memories about the abortion and her feelings of abandonment were released. Interestingly, she got her period at precisely 28 days and did not have any of the pain or clotting she normally associated with it. She got a return of migraine symptoms she hadn’t experienced since the abortion, which promptly disappeared.

After approximately 2 months of psychotherapy in which we focused primarily on processing her loss and anger over the way her pregnancy was handled, what began to emerge was a slightly different picture, one that resonated to me as a deeper level of the same constitution:

She described her shame at not being perfect, her feeling the need to control things because of an exaggerated sense of duty and a profound sensitivity to the horror of the world. She preferred to suffer silently and was generally averse to consolation, although she was highly predisposed to offer consolation to others.

We re-took the case: Despite the initial intake in which all the following was denied, she described a history of allergies since infancy, moles and a personal history of precancerous lesions on her face, a childhood history of eczema and nail biting, a personal history of pneumonia, a fear of failure, and numerous serious, early childhood diseases, including scarlet fever. This is one of the many important reasons to continue pursuing the case even though you think you’ve already taken it! Even a client as open and honest and diligent as Stacy may not think of things at the outset of treatment that in homeopathy are considered important. Especially in the treatment of trauma, where there are layers of fear, forgetfulness, and detachment, we will need to ask questions more than once over time.

And it’s a good thing I did, because another trauma remedy appeared: Carcinosin, which we gave in LM potency because of her history of pre-cancerous lesions. We started with LM1, 10 succussions, bid, and within the week she got symptoms of an ordinary cold-runny nose, stuffy sinuses, sleepy-while at the same time she described a sense of “being more centered.”

Over the next two months we moved her from LM1 to LM5, at which point, she reached a calm and happy plateau. With each new level she got a quick series of aggravations and a concomitant her sense of herself improving energetically. She handled her work with just as much compassion but with a healthier admixture of detachment so she could function smoothly. It has been two years since treatment and she regularly stays in touch to let me know how well she is and how different her experience of life has become.

Case #3: Stuck in a Nightmare

A woman in her mid-20′s sat in my waiting room, hunched over. She sat as if cowering, avoiding direct eye contact. She breathed in puffs, barely able to talk. She seemed genuinely horrified, as if she’d just seen a ghost.

When she finally started talking, bits and pieces of a story emerged in which she was used from very early childhood as a sex slave in a rural region of northern Nevada. The word she used over and over was “nightmare.” And, to my eyes, she was still there, a child, lost, bewildered, horrified, barely able to breathe from terror. She spoke hurriedly of waking up in the middle of the night, seeing a man in the room, sleep-walking, banging her head on a wall so hard and shrieking so loud that on several occasions the police had to come.

She then reported she’d been raped by a friend in her own home approximately six months prior to our first session and was terrified that someone was in her home and she was going to be attacked.

Without being able to take a clear history at that point, I just had to watch her. I came up with the following:

Mind, Ailments, fright

Mind, Ailments, violence

Mind, Ailments, sexual abuse

Respiration, puffing, expiration

Breathing, stertorous

Fear, attack

I gave her Stramonium 10M. Within one week, she came back and was able to sit and talk. Her nightmares diminished considerably. Within one month they were nearly gone. She was able to have a normal conversation. Her eye contact had improved. Her fear was being transformed. Instead of terror, she was beginning to access the anger and abject pain of being so unloved as a child.

Over the next couple of months, her nature began to emerge: She had been a good-natured child, clinging, wanting love more than anything else. She couldn’t understand how people could hurt her. She had chosen men poorly, tried to manipulate them to be nicer to her, but clung to them the way she clung to the adults in her early life no matter how they treated her. She wept openly, was sympathetic, and responded to consolation. She was warm-blooded, slept with her feet out of the covers on her back, craved dairy and ice cream.

The last remedy she got was Pulsatilla 1M. She has been steadily improving, finding an increased peace, exploring the possibility of dating again, and scraping off the last vestiges of her past.

These are just a few examples of what can be done with homeopathy in trauma. I have been working with cases of anxiety and trauma of varying degrees for more than twenty five years and I sincerely wish I’d had homeopathy in my tool chest from the beginning. The most important thing I’ve learned in using homeopathy with my patients is that even though there are so-called “trauma” remedies, any remedy can be used because it is not the trauma we’re treating. It’s the person. Always the person.

Short List of Recommended Books on Trauma Treatment:

  1. Rothschild, Babette, The Body Remembers (W.W. Norton & Company, NY, 2000)
  2. Erickson, Milton, H., Rossi, Ernest L, and Rossi, Sheila I., Hypnotic Realities, Irvington Publishers, N.Y., 1976
  3. Dolan, Yvonne, M., Resolving Sexual Abuse, (W.W. Norton & Company, N.Y., 1991)
  4. Wolinsky, Stephen, Ph.D., Trances People Live, (The Bramble Company, CT., 1991)
  5. For more information on classical homeopathy, please refer to The National Center for Homeopathy.

Understanding Vicarious Trauma

Nonprofit sectors are filled with committed, overworked social service professionals who help clients overcome various forms of trauma. One common occupational hazard of this profession is vicarious trauma, where the professional helper begins to show signs of the same wear and tear evident in their clientele. Their desire to care for and help their clients combined with feelings of empathy for their clients’ crisis or pain can create ideal conditions for vicarious trauma.

Types of nonprofit workers that experience vicarious trauma include:

  • Victim advocates
  • Mental health clinicians
  • Substance abuse counselors
  • Disability workers
  • Crisis center workers
  • 9-1-1 dispatchers and operators
  • And more

Social service professions often have large staff turnover and worker shortages as well as extensive sick time because of vicarious trauma. It is imperative that social service nonprofit leadership learn more about vicarious trauma and educate their staff and board members to alleviate the negative effects of this condition.

Effects of Trauma on the Brain

The limbic system of the brain is responsible for the “fight, flight, freeze or faint” response which is triggered when the mind senses the body is in danger or experiencing trauma. Information is processed by the thalamus and if the brain sends the message that the body is in danger, the Amygdale starts the response process.

The right side of the brain takes over, which manages the visual, kinesthetic and creative skills, allowing for strength and strategy to help save the day. The left side of the brain, which manages language and coping skills, shuts down. This explains why victims are confused and have difficulty explaining what happened after a crime occurs.

Vicarious trauma can trigger the same brain reactions on a smaller scale. Because a social worker may hear up to 100 traumatic stories each month, the trauma experience can be as debilitating over time as a one-time traumatic experience.

Symptoms of Vicarious Trauma

Physical, emotional and behavioral symptoms can include:

  • Compassion fatigue
  • Headaches
  • Sleeplessness
  • Increased blood pressure
  • Digestion problems
  • Depression
  • Irritability
  • Anger
  • Fear
  • Guilt
  • Helplessness
  • Low motivation
  • Oversensitive feelings
  • Desensitized feelings (numbness)
  • Flashbacks of past cases
  • Memory or concentration loss
  • Poor decision making
  • Self medication (alcohol and over-the-counter medications)

Some of these symptoms have caused social worker licenses to be revoked. It is important that social workers manage their own needs without relying on the affirmation of their clients. Social workers must adhere to their integrity and code of ethics established by the National Association of Social Workers. These ethics include avoiding self disclosure, inappropriate physical contact or discussing cases with friends or family.

Contributing Factors

Many people in helping professions have experienced their own trauma in the past. They may not only experience flashbacks of past clients, but face flashbacks from their own medical or crime related trauma. Some choose the profession to understand their own trauma experience and help end the pain of others who were similarly traumatized.

Falling victim to the general consensus that healers should not need to be healed, social service professionals who experience symptoms of vicarious trauma may be ashamed about their condition and fear the repercussions from their employers, co-workers and clients.

Vicarious trauma is often ignited among counselors who are overwhelmed and overworked because of poor organizational structure surrounding case management. This exhaustion can lead to clinical errors, which can negatively affect an organization’s reputation and future funding.