Addressing Secondary Trauma: Coping, Healing, and Suggested Activities
Coping & Healing: Self- and Organizational-Care
Many feel a sense of resistance to the concept of "self-care"-- they view it as selfish; they hate its capitalist cooptation by wellness brands; or, they simply see it as a waste of time. This section will hopefully convince you that self-care is the foundation of a sustainable career by keeping secondary trauma and stress symptoms from progressing and doesn't have to be time-consuming. The key to implementing self-care practices is learning how to listen to your body (which can be enhanced through psychoeducation about the symptoms of different issues and why different self-care methods actually work) and choosing practices that work for you. This can take some trial and error to figure out what activities you find enjoyable and nourishing. Make sure to implement practices that address mental, physical, and emotional symptoms of stress, trauma, etc. For a more detailed look at the implementation of these strategies see the guidebook I created here.
Stress Reduction:
7 research-backed methods of discharging stress (Nagoski & Nagoski, 2019)
2 research-backed methods of controlling the way we respond to external stressors (Nagoski & Nagoski, 2019).
Stress & Trauma- Mindfulness & Grounding
Mindfulness, meditation, and yoga activities that focus on noticing and becoming aware of your body’s sensations engage the prefrontal cortex and strengthen the capacity of the medial prefrontal cortex to notice your feelings and emotionally regulate (this is called top-down processing) (van der Kolk, 2014, pp. 55-6). Studies have also shown that the amygdala (which triggers the stress response) can be desensitized over time: a study found that an 8-week mindfulness course reduced the reactivity of the amygdala and increased the activity in the prefrontal cortex (Goldin & Gross, 2010).
Grounding activities that involve work around breath, movement, and touch activate and strengthen our ability to access the autonomic nervous system to stay in the present moment during present and past memories of trauma and calm our stress response. This is called bottom-up processing (van der Kolk, 2014, pp. 55-6).
Coping with Systemic Injustice (Stress, Burnout, Moral Distress, Compassion Fatigue)
5 key ways:
Coping with Loss & Grief
Judith McCoyd’s (2012) “Five Vs of Grief Therapy.”
Social & Organizational Support
Stress Reduction:
7 research-backed methods of discharging stress (Nagoski & Nagoski, 2019)
- Exercise: The most effective way to discharge stress (which is your body preparing to fight or take flight) is to exercise for 20-60 minutes per day.
- Breath Work: Deep slow breathing, exhaling to the end of the breath so your stomach contracts. Breathing works best when stress levels aren’t too high or when you just need to release a bit of stress in the moment, followed by more stress relief later.
- Positive Social Interaction: This tells our body the world is a safe place. Casual and friendly small talk.
- Deep laughter With Others.
- Affection: Expressing affection with those whom you respect and trust. Kiss your partner for 6 seconds a day; hug someone for 20 seconds over your own center of gravity. This works with animals as well. Spiritual connections also foster the same sense of love, trust, and support.
- Creative Expression: This allows us to express big emotions that we usually stifle and creates excitement and enthusiasm.
- Muscle Tension Activity: (This practice is good for those who don’t like to exercise.) Tense your muscles really hard for 10 slow seconds one at a time, from your feet to your face, spending extra time on those muscles that hold your stress. While tensing, you must vividly imagine that you are beating up what causes you stress.
2 research-backed methods of controlling the way we respond to external stressors (Nagoski & Nagoski, 2019).
- Planful Problem Solving: Sometimes you can plan and problem-solve around your stressors by using tools at your disposal to get around obstacles to reaching your goal.
- Positive Reappraisal: Dealing with uncontrollable stressors involves a process called positive reappraisal with 3 sub-categories.
- Reframing: Mentally reframing difficulties as opportunities for growth. Over time, your stress response can be deactivated through this technique & optimism can be cultivated.
- Redefining Winning: There are some very abstract, long-term goals with slow progress that require a “nonstandard relationship with winning, focusing on incremental goals.” This does not mean giving yourself rewards for making progress; it means redefining what success is. The guidelines for setting incremental goals include making the goals soon, certain, positive, concrete, specific, personal.
- Redefining Failing: Redefining failing is for when you have a tough goal that is objective and can’t be modified. You may work in a field characterized by a lot of objective losses and rejections (like immigration law) in which case you need a “nonstandard relationship with failing.” Redefining failing means recognizing that while you didn’t reach your goal, and that may be incredibly painful, “there’s more to success than winning.” This involves taking a step back and looking positively and realistically at the things you gained (for you and your client) along the way towards your goal that you didn’t expect, recognizing that alongside loss there was growth and other positive outcomes.
Stress & Trauma- Mindfulness & Grounding
Mindfulness, meditation, and yoga activities that focus on noticing and becoming aware of your body’s sensations engage the prefrontal cortex and strengthen the capacity of the medial prefrontal cortex to notice your feelings and emotionally regulate (this is called top-down processing) (van der Kolk, 2014, pp. 55-6). Studies have also shown that the amygdala (which triggers the stress response) can be desensitized over time: a study found that an 8-week mindfulness course reduced the reactivity of the amygdala and increased the activity in the prefrontal cortex (Goldin & Gross, 2010).
Grounding activities that involve work around breath, movement, and touch activate and strengthen our ability to access the autonomic nervous system to stay in the present moment during present and past memories of trauma and calm our stress response. This is called bottom-up processing (van der Kolk, 2014, pp. 55-6).
- Breathing exercises
- Nagoski & Nagoski’s (2019) breathing exercise: breathe in 5, hold 5, exhale 10, pause another 5. Repeat 3 times, just 1 min 15 sec.
- Square breathing: in 4, hold 4, out 4, hold 4. Repeat 3 times.
- 5-4-3-2-1 Sensory Grounding Technique: Notice and look at 5 things that you can see around you; notice and touch 4 things that you can touch around you; notice and listen to 3 things you can hear around you; notice and smell 2 things you can smell around you; 1 notice and taste 1 thing you can taste around you.
- When you begin your day, set an intention for yourself. It can be concrete or abstract, an action or a mood (van Dernoot Lipsky, 2007, pp. 240-3).
- Before you go to bed, ask yourself “‘What can I put down? What am I ready to be done with? What don’t I need to carry with me for another day?’” Then let it go, and don’t pick it up again (van Dernoot Lipsky, 2007, p. 243).
- Dr. Kristin Neff’s Self-Compassion Break.
- Moments of mindfulness: Mindful eating and drinking (no TV/phone), noticing flavors and feelings; mindful walking for 20-30min/day (no music/podcasts), noticing thoughts and feelings; mindful commute to work (no music, podcast, not thinking about work/planning out the day)
- Journaling: you can journal for 4-5 mins about what pops into your head
- Gratitude exercises, even on bad days
- Stretching
- Creating a photo-journal
- Creating opportunities for mindfulness at work: put lotion on your desk that reminds you to take a break and be mindful when you apply it; drink tea from a “mindfulness mug” that reminds you to be mindful when you drink from it.
- On difficult days it is important to meditate on your values and reference them
Coping with Systemic Injustice (Stress, Burnout, Moral Distress, Compassion Fatigue)
5 key ways:
- Create Meaning. In the face of aspects of secondary trauma and moral distress around hopelessness, powerlessness, and injustice, we must create meaning for our experiences.
- Reflect on your values and your “why” (why you came to this work). Think about the ways you actualize your values; this can help you positively reappraise and restore a sense of control over your life.
- Connect to something larger. This helps us feel less isolated and see the bigger picture of our work. Connection to something larger can be spiritual, but in the context of immigration law, it may also be connection to the migrant justice movement, social/economic/racial justice in general, or a commitment to the values of public interest law. Instead of looking at yourself alone, you can look at the difference your organization or the community of immigration attorneys makes.
- Positively Reappraise (as discussed in the stress reduction section). This helps us to challenge the negative beliefs we have.
- Connect with Peers. Connecting with peers validates your experience and lets you know you aren’t alone (Saakvitne et al., 1996, pp. 70-6).
- Find Balance. Trauma and injustice can impact the way you perceive the world. If you only focus on cases you lose, or if you only practice one area of law, you can start to believe that the whole world is full of loss and injustice. Engage in activities that give you hope—being around children; volunteering for a cause where you can see the difference you make; artistic expression; visiting beautiful places; eating delicious food; being around people (or things if you’re an introvert) who make you happy. These are empowering and can help restore your sense of hope.
- Radical Acceptance: accepting that we can only really control ourselves (van Dernoot Lipsky, 2007, p. 200).
Coping with Loss & Grief
Judith McCoyd’s (2012) “Five Vs of Grief Therapy.”
- Validate: support and recognize the loss
- Value: who/what was lost had value to the person who is grieving
- Verify: seek/give support as the grieving person tells stories/talks about their experience; support the grieving person in developing grief rituals
- Ventilate: encouraging storytelling, expressing feelings, breaking through isolating silence
- Being visionary: looking ahead and integrating loss into who the grieving person is now & how life will be affected.
- Experiential therapies to help people open up—mindfulness, art, music, journaling, animal therapy (Sparks, 2020b)
- End-of-service rituals:
- Saying goodbye and wishing clients well in a calm, controlled environment
- Journaling or writing a letter about how you feel about a case and the end of working with a client
- Lighting a candle
- Walking in nature and reflecting
- Creative expression
- Talking to family, friends, or coworkers about your feelings
Social & Organizational Support
- Physical spaces that convey safety, comfort, hope, beauty (Saakvitne et al., 1996)
- Resources should allow for generous time off, good compensation, and adequate staff
- Supervisors should allow for flexibility in case assignments and scheduling
- Emotional support fostered through reflective supervision, peer mentorship, and peer support groups
- Group activities including debriefing during tough times
- Workplace wellness groups for yoga, meditation, exercise, book club, hobbies
- Destigmatizing mental health and talking about it on a regular basis (not treating it as a one-off workshop)
- Easy to access trauma-related resources in the office
- Creating opportunities to foster a sense of hope, joy, curiosity: celebrating wins and milestones, recognizing efforts meaningfully, creating interesting presentations or programs to inspire and break up the banality, reminding the team of the positive progress that the organization is making.
- Not promoting a toxic work culture: don’t encourage or reward employees for taking on more than they can handle to be a “team player” or “star employee”
- Not promoting “crisis mode” in organizations: if time isn’t created for stress management and grounding activities, then the workplace is penalizing these necessary behaviors (for example by scheduling high-trauma meetings back-to-back)
- Administer surveys to staff and devise interventions when morale is low