9.1 Trauma and Stressor Related Disorders
We have been living through a collective traumatic event called “COVID 19” In a study published by University of Washington’s Institute for Health Metrics and Evaluation, who looked at excess mortality from March 2020 through May 3, 2021, indicated estimates that the number of people who have died of COVID-19 in the U.S. is more than 900,000, a number 57% higher than official figures, where as Worldwide, the study’s authors say, the COVID-19 death count is nearing 7 million, more than double the reported number of 3.24 million.
THE FIELD OF PSYCHOTRAUMATOLOGY
(the study of emotional wounds)
Traumatic experiences are one of the few phenomena that have no boundaries, are not culturally specific, ignore age, are not prejudiced or biased, and are not gender specific. In reviewing the literature within the field of psychotraumatology, the continuing controversy about helping-induced trauma is not “can it happen?” but rather, “what shall we call it?” (Stamm, 1997, 2009).
Van der Kolk and McFarlane (1996) discussed trauma, as it has related to the history of the world:
Experiencing trauma is an essential part of being human; history is written in blood. Although art and literature have always been preoccupied with how people cope with the inevitable tragedies of life, the large-scale scientific study of the effects of trauma on body and mind has had to wait till the latter part of this century. (p. 3)
In 1997, the former Director of the National Center for Posttraumatic Stress Disorder (NCPTSD), H. B. Stamm, addressed the effects of trauma on those in helping roles. He said, “it is apparent that there is no routinely used term to designate exposure to another’s traumatic material by virtue of one’s role as a helper” (NCPTSD, 2007; Stamm, 1997, p. 1). There are four primary terms—countertransference (CT); compassionate fatigue (CF), later renamed secondary traumatic stress (STS); burnout; and vicarious trauma (VT)—which are most commonly used in an attempt to describe the impact of another’s trauma on the helper; however, the debate over terminology continues. The primary focus of that debate is involved in describing the emotional toll of working in high stress, seemingly hopeless situations with people who suffer emotional pain (Corey, Corey, & Callanan, 2010; Figley, 1995; Maslach, 1982; McCann & Pearlman, 1990a, 1990b; Saakvitne & Pearlman, 1996).
THE FOUR CONCEPTS
We, as human service professionals, interact with traumatized individuals in our daily work; it is part of the routine, it’s unwritten, job description. The traumatized individuals with whom we work most often seek a safe environment—a therapeutic sanctuary—in which they eventually engage in an interpersonal relationship in order to move toward recovery so that the “stressful” experience is integrated within their ego structure in ways that are no longer disruptive of normal functioning or distressing to the individual (Herman, 1992). As in any therapeutic setting, the establishment of a trusting and safe environment is paramount; however, the helper is not an “outside observer.” Rather, achieving empathy with one’s client requires the ability to project oneself into the “phenomenological world being experienced by another person” (Wilson & Lindy, 1994, p.7). This, indeed, affects the helper. The discussion remains: What shall we call this effect on the helper?
There is a cost for caring? What is trauma?