As a professional walking alongside families who choose to carry to term despite a prenatal terminal diagnosis, you have a front row seat to the trauma these parents experience. Providing emotional, physical, psychological, and spiritual support to these families for an extended period of time can take a toll on your own mental and physical well-being. That continual exposure to your patient or client’s trauma can result in secondary traumatic stress.
SECONDARY TRAUMATIC STRESS
Secondary traumatic stress, also known as compassion fatigue or vicarious trauma, is the result of being deeply affected by an indirect experience of trauma. Caring for a family from the time of diagnosis through the bereavement period can result in emotional and physical exhaustion.
Similar to post traumatic stress disorder, secondary traumatic stress can manifest in intrusive thoughts, avoidance, hyperarousal, sleep disturbances, hair-trigger emotions, difficulty focusing, anxiety, and depression. This exhaustion and state of stress can cause desensitization to patient or client trauma, a lack of empathy, lessening compassion, and a pervasive negative attitude. As a result, the quality of care for these families decreases.
You may also find that the lessening of your compassion isn’t limited to just patients or clients. You may notice less compassion for your family and friends, which, in turn, can lead to an increase in personal stress and social isolation.
Secondary traumatic stress can affect doctors, nurses, therapists, social workers, chaplains, and any other professional providing care and support to families facing the loss of their baby or babies.
"You may also find that the lessening of your compassion isn't limited to just patients or clients."
Since secondary traumatic stress affects your empathy and compassion for others - potentially the very reasons you entered the line of work you’re in - you may begin to struggle with self-doubt and feelings of incompetence. You may struggle to communicate well with grieving parents or feel incapable of providing the information and emotional support they need.
Some qualities that can be assets in caregiving work, like perfectionism and high levels of empathy, can put you at a greater risk for secondary traumatic stress. Additionally, a lack of social support, high levels of personal stress outside of work, and a previous history of trauma can increase your risk.
Whether or not you currently exhibit any signs of secondary traumatic stress, a self-care practice is beneficial for anyone in a caregiving line of work. A healthy self-care practice is critical to preventing and overcoming secondary traumatic stress.
What Self-Care is Not:
- Practicing self-care is not a sign weakness.
You are not a lesser doctor or professional if you feel traumatized by the experience of your patient losing their baby or babies.
- Self-care is not only for some.
Doctors are no less in need of self-care than nurses, social workers, therapists, chaplains, or anyone else who is a part of a family’s care team. Everyone can benefit from routine self-care.
- Self-care does not look the same for everyone.
What feels relaxing or restorative for you might be very different than that of your colleague.
- Self-care is not only emotional. Good self-care incorporates all aspects of your being: emotional, physical, social, and spiritual.
It is important to distinguish between your professional self and who you are when you aren’t at work. Both aspects of you require specialized self-care. Personal self-care looks like having a someone to talk to about your experiences, feelings, and stresses at work. Having the emotional support of someone in your personal life is important because it is a way for you to process how you as a man or woman, not as a doctor, therapist, or other professional, feel about what you’ve experienced.
"Self-care outside of work also looks like getting enough restful sleep, proper nutrition, and some form of exercise."
Self-care outside of work also looks like getting enough restful sleep, proper nutrition, and some form of exercise. Taking care of yourself physically helps you regulate your emotions, feel balanced, have energy, and feel healthy. As a professional balancing the stresses of work with the challenges of your home life, it is important to have boundaries. Leave your work at work. Don’t accept work calls or answer emails when you are at home if you don’t absolutely have to.
Incorporate some form of a transition that signals you are leaving work behind for the day. Something that allows you to mentally and physically disengage from work and focus on your home life. This transition can be as simple as changing out of your work clothes before you leave work or right when you get home. You could even use your commute home as a time to begin that transition. Listen to music, a non-work related audiobook, or a podcast to help you shift your mind off the events of the day.
Additionally, cultivate hobbies or activities that you enjoy. This can give you something to look forward to as you transition from work to home, and it can help you curate an identity beyond what you do for a living. Prioritizing personal down time can help you balance the stresses of work and the responsibilities of home.
As a professional in a caregiver role, you likely deal with long days, trying cases, and the weight of your patients’ or clients’ emotions and experiences all day. It is important to break up your day with little moments of self-care. You can practice personal self-care at work by taking a designated break to eat a healthy balanced meal, go for a walk, or find a moment of silence and solitude. It is equally as important to foster a professional self-care practice.
Start by identifying your capacity and needs, and build from there. In terms of capacity, you need to decide, on a case-by-case basis, what you are able to offer when it comes to support. Do you have the capacity to take on and care well for two new cases of prenatal terminal diagnoses at the same time? Are you able to take on a client for intense, long-term grief therapy right now? Is your home life so stressful that it is affecting your work?
It is okay to recognize and honor your capacity. You are human, and there is no shame in needing to prioritize your own mental health. If you know you don’t have the capacity to provide the standard of care you would like to, refer your patient or client to someone you know and trust. Offer your colleague any support you feel capable of giving, and let them care well for the patient or client.
If you are in the process of providing care for a patient or client who has chosen to carry to term, and you find that you’re beginning to experience compassion fatigue, reach out. Reach out to a colleague and process with them. Debrief with any other members of the patient or client’s care team. If you need more support beyond talking with a colleague, seek out counseling with a therapist. There is no shame in needing to check in with a therapist. The work you do is hard, and frankly, too important to not care well for yourself.
Additionally, you can practice professional self-care by attending specialized conferences and continuing education courses. Utilize these opportunities to learn, hone your skills, and network with other professionals who likely have similar work experiences as you. The expertise and support you are able to provide to parents facing a prenatal terminal diagnosis is incredibly valuable. The care you give helps parents feel informed, prepared, and supported as they make decisions and experience loss. Supporting families as they carry to term and grieve the loss of their baby or babies is intense, emotionally difficult work. So, take the time to cultivate a self-care practice, both at home and at work, because the work that you do is essential.