Within the veterinary profession terms such as “burnout”, “compassion fatigue”, and even suicide have been increasingly discussed in recent years. One term that is often overlooked is “traumatic stress”. As DVM360 so aptly explains, “Traumatic stress precedes all of these conditions we name so commonly in veterinary medicine. Educating ourselves on the effects of trauma will improve our health, the health of our practices and the strength of our teams.”
As has been the theme of our mental health blogs thus far, the first step to navigating any mental health concern or challenge is to be prepared to recognize and more accurately identify what is happening to you or to a colleague. Seeking appropriate resources and applying coping practices strategically can then be more applicable and helpful to move through the experience with efficacy.
So what is meant by “secondary traumatic stress (STS)?” Secondary traumatic stress, also historically referred to as vicarious trauma, is a stress response that may occur in an individual after learning about or indirectly experiencing the traumatic experiences of a person or an animal through any form of communication (e.g. hearing, reading, observing). In veterinary medicine, this is commonly a work-related trauma and can be related to caring for and euthanizing suffering animals or providing emotional support and comfort to clients.
There are similarities to PTSD (post- traumatic stress disorder) and STS (secondary traumatic stress) as well as some valuable difference to understand. The National Child Traumatic Stress Network defines STS as “the emotional duress that results when an individual hears about the firsthand trauma experiences of another.” Some of the STS symptoms can be similar to those of posttraumatic stress disorder (PTSD). These symptoms can range from mild to severe and generally parallel traumatic stress symptoms:
Difficulty concentrating
Intrusive thoughts or images associated with a distressing event
Avoiding reminders associated with the event
Increased anxiety; Panic attacks
Sleep disturbances; Lack of sleep
Chronic fatigue; Mental, physical and emotional exhaustion
Feeling on edge or irritable
Emotional numbness
Feelings of anger or guilt
The difference between STS and PTSD is that STS occurs after indirect exposure to threatening events (e.g., hearing patients’ stories, delivering bad news to patients, observing intense emotions in others), while PTSD occurs due to a perceived direct threat to an individual. Like PTSD, STS can be challenging to recognize and manage without help” (Meghan L Marsac; 2020). Secondary traumatic stress is an important contributor to caregiver compassion fatigue/empathic strain and to burnout. Unlike burnout, which is caused through the stress and overworking within a job, secondary traumatic stress is caused through exposure to trauma, hence it can hit at any given time and these symptoms may be rapid in onset.
AAP news suggests the following ways to remain connected to patients while preventing STS or dealing with STS if it happens:
Know what STS is and how to recognize symptoms in yourself.
Pay attention to your body and mind. What are the signs that you are beginning to struggle with a patient or a patient’s story?
Avoid avoidance. Shoving your feelings/symptoms away only works in the short term (and is necessary sometimes). If you need to put your feelings away to get through the day, do it. But make sure to create space for yourself to revisit your reactions and to deal with them.
Plan ahead. Take control of your emotional health by setting aside time for yourself, even if it is a few minutes at a time.
Learn what strategies work for you. Here are a few ideas:
Take time away from work.
Debrief/share your experiences with your team, practice leaders, or a mental health professional
Engage in physical activities.
Connect with friends or family, even if only virtually. This is one of the most important protective factors in helping someone recalibrate and reconnect with trusted community before/during/after traumatic stress.
Connect spiritually and seek to see the bigger picture
Spend time outside. Research demonstrates “Vitamin N” (nature) is powerful in resetting our human nervous systems.
Learn relaxation techniques such as meditation, guided imagery, yoga.
Engage in creativity such as art, music, or writing.
Reflect on the meaning in your work, your ‘why.’
Being aware of the effects that exposure to trauma can have on us as veterinary professionals is a great first step. It is very difficult to remove ourselves from trauma altogether within the industry as it is an inherent part of the medical field. However, it is important to know that those that are highly emphatic or compassionate are most at risk for being affected by STS. Of course, these are excellent qualities to possess as a veterinary caregiver and equally important to acknowledge as increasing our overall susceptibility to traumatic stress. This highlights the importance of preparing and training veterinary professionals to better understand traumatic stress in the veterinary environments and cultivate a culture where mental wellness is a priority within the industry. Equally, it is important that we each prioritize your own mental health. Take the time to truly understand your own needs, feelings, and ways of dealing with different situations. Don’t be afraid to talk about it - chances are a your colleagues are likely dealing similar concerns.
Together, we hope to create a more informed, compassionate community and a safe, supportive environment to deal with these challenges within the veterinary industry!
Worldwide Vets Thrive is a 7 day mental health and self development workshop in Zimbabwe, Africa. The focus of the 32 hours of continuing education is mental health awareness and self-development. These are vital skills for any professional to improve their working environment, career longevity, satisfaction and ability to support and develop themselves and their team. The event is RACE accredited and the perfect opportunity to start learning more about developing a healthy approach to navigating issues such as secondary traumatic stress.
Check it out here: https://www.worldwidevets.com/thrive
Sources and further reading:
DVM360. Still waters: How traumatic stress is poisoning the veterinary profession.
DVM360. Addressing traumatic stress in veterinary medicine
GVMA. Cultivating Emotional Wellness
Meghan L. Marsac, Ph.D.; Lindsay B. Ragsdale, M.D., FAAHPM, FAAP. Tips for recognizing, managing secondary traumatic stress in yourself
Doctor Vanessa Rohlf. Compassion Fatigue – Secondary Trauma and Burnout in the Animal Care Profession
Science Direct. Secondary Traumatic Stress -Range of books and Journals
https://www.sciencedirect.com/topics/medicine-and-dentistry/secondary-traumatic-stress
