Vicarious trauma: protecting your spirit when doing trauma work

by Jenny Winfield

Recently I’ve been listening to an audiobook of Bullshit Jobs by anthropologist David Graeber. Despite the flippant title, the book’s message is gravely serious. It “postulates the existence of meaningless jobs and analyses their societal harm.” Graeber says that:

“A bullshit job is a form of paid employment that is so completely pointless, unnecessary, or pernicious that even the employee cannot justify its existence.

A lot of bullshit jobs are just manufactured middle-management positions with no real utility in the world, but they exist anyway in order to justify the careers of the people performing them. If they went away tomorrow, it would make no difference at all.”

His findings were deeply provocative. According to Graeber, up to 40% of people – particularly those working in the administration, legal, and financial professions – admit feeling that they contribute nothing of value to the world. And that because of this, they’re experiencing a kind of “spiritual violence.” His message is that we need our lives and our work to have meaning. So much so that engaging in a charade of purpose can be “corrosive” to the soul.

“Oof,” I thought, listening along, and feeling a rising wave of gratitude for the work that I do. “Imagine a job so exceedingly unnecessary that, were it to disappear tomorrow, it would not matter in the slightest. Imagine doing a job that is so pointless, that just by logging on every day, it actually becomes damaging to your spirit.”

Alongside many of the other authors of this book, I practise trauma-informed design, and I believe that our work is fully necessary. But my wave of gratitude was quickly tempered by another reflection: our work can cause us spiritual harm, too.

Not because it’s meaningless, but the opposite: because we value its meaning so highly. Our dedication to our design work, and the practice of sitting with the pain of others as a part of that work, makes us at risk for vicarious trauma.

In this chapter, I’ll share some thinking on how and why we, as trauma-informed designers, need to protect our spirits. I’ll draw on my own experience as a researcher and designer, having explored trauma almost exclusively for the last 7 or 8 years of my practice. In that time, I've researched with people in recovery from addiction, folks in prison, and those deep in grief from a suicide. I regularly do research with people who have experienced traumas like domestic violence, sexual assault, and tech abuse. I don't mind sharing that some of the stories I've heard have percolated into my soul, and not always positively. I’ve had my share of secondary traumatic stress (STS) and teetered on the edge of vicarious trauma (VT), too.

I'll also share some guidance from experts on how to spot the signs of secondary traumatic stress and vicarious trauma. I'll leave you with some questions to reflect on, and a sincere invitation to explore your capacity to rest. My goal is to help you stay committed to this important work – and to stay hopeful as you do it.

What are secondary trauma and vicarious trauma?

Secondary traumatic stress (STS) was a term coined by trauma specialist Charles Figley and colleagues in the 1990s. It refers to our own experience when we witness an event that is highly stressful.

Take, for example, seeing a car accident on your way home from work. The crash happened to someone else (hence the “secondary”), yet it causes a stress response in you. Anxiety, distress, and even anger are all common reactions. You might have symptoms similar to post traumatic stress disorder (PTSD). The things that you saw, heard, felt, or smelled that day might return as flashbacks or intrusive thoughts. Over time, though, your nervous system will recover with the right kind of care and rest. The event causes you stress, but it doesn’t have a long term effect on your body or your views about the world.

Around the same time that Figley and colleagues introduced the term “secondary traumatic stress,” researchers Laurie Ann Pearlman and Lisa McCann popularised the term “vicarious trauma” (VT). They explored how, over time, therapists and other first responders to crises would internalise the trauma of their clients. They helped us to understand that VT can be an occupational hazard for professionals who are exposed to other people’s trauma over long periods. They said:

"Vicarious trauma is the transformation that occurs within the therapist (or other trauma worker) as a result of empathic engagement with clients' trauma experiences.”

So vicarious trauma is also about indirectly bearing witness to hardships, but the difference is that some rest and relaxation alone won't set you right. That’s because, as Pearlman and McCann said, you are transformed by what you’ve experienced, even at one step removed. In bearing witness, you actually experience a kind of trauma. (Note the difference between the word “stress” in “secondary traumatic stress” and the word “trauma” in “vicarious trauma.”)

“A tiredness deep in your soul”

Laura Van Dernoot Lipsky, who wrote the brilliant Trauma Stewardship; An everyday guide to caring for self while caring for others, says that one of the signs of VT is “a tiredness deep in your soul.” I think many of us working to support traumatised people (often while dealing with our own traumas) can relate to that. Laura works with caregivers, activists, and professionals in the trauma and social justice space. She shares some other signs of VT; for example, we might feel unable to support the people who are actually experiencing that “primary” trauma, even if we try our very best. No matter how many hours we put in, or extra miles we go, we may feel as though we have never done enough. Feeling overwhelmed is also common. The immediate systems that we’re operating within can create infuriating blockers to good service outcomes – and that’s before we factor in the relentless grind culture and trauma of capitalism and white supremacy.

What I love about Laura’s work is that when she shares the signs of VT, she normalises how contradictory they may seem. Since VT is a type of trauma, responses look different for everyone. I might totally withdraw because that’s my trauma response – whereas someone else might become combative at work (not to mention at home). I might feel helpless; you may feel persecuted. I might minimise the experiences I’m having (“Oh, it's nothing”), while my colleague might start to have an inflated sense of importance. This makes it vital to be conscious about the risks and signs of VT not just in ourselves, but in our colleagues, too.

A change in your worldview

With VT, instead of your nervous system flaring up and then resettling (as it does with secondary traumatic stress), it actually becomes altered. This means that you remain in a state of “dysregulation,” and you might feel anxious or depressed for long periods. Not only that – your worldview changes negatively, too. You may begin to see the potential for trauma and harm everywhere. You might move from having a healthy awareness of risk (particularly in relation to the field that you work in) towards having a heightened belief in that risk.

For example, as someone who identifies as a woman and supports survivors of sexual violence, I have a strong awareness of the gendered risks posed to our bodies. I’ll see a young woman taking a train late at night and, knowing that predators may be around, feel concerned for her safety. But if I were vicariously traumatised by my work, I might feel sure that there were potential predators everywhere and feel angry that no woman can ever enjoy her freedom to travel alone.

In their episode of The Cancer Professionals Podcast by MacMillan on VT, Dr Karen Campbell and Lisa Nell note that “one of the defining features of VT is that it can really, over time, not just affect our psychological well-being and our physical well-being but also our spiritual wellbeing.” To me, this spirit means the way we approach the world, the values that guide us, and the way we direct our energies to what we believe matters. To others, it might mean something more religious.

Campbell and Nell go on to reassure us that the positive thing about our nervous systems (and our worldviews) is that they can adapt. So even if you have experienced VT, it’s possible to feel healthy and happy in yourself (and your work) again. You can adjust the lens of your worldview back to a healthy awareness of risk.

So what has all this got to do with designers?

Historically, discussions about secondary trauma stress (STS) and vicarious trauma (VT) have been focused on workers who offer direct support to traumatised individuals. For example, people working in:

  • death care,
  • palliative care,
  • social work,
  • mental health care,
  • sexual assault response,
  • emergency response roles such as firefighters, police, or aid workers in war zones.

These roles are often called “frontline” services, and we’d do well to recognise the reference to warfare within that term.

These folks are at high risk for vicarious trauma because they are continually exposed to the trauma of others. It’s literally their job to support people through some of the most challenging human experiences there are. Because of this, there are training programs on STS and VT that you’re likely to go through if you decide that this is your career path. You’ll be warned that the work can start to feel weighty, especially if you’re an empath.

What’s been happening in the last decade or so is that designers have also been given a seat at the table for trauma work. Designers, however, are only just starting to seek and receive education about how to conduct this work with the due care (for self and others) that it deserves. Social worker and designer Rachael Dietkus discusses this in her paper “Transforming Trauma-Informed Design: Ethical Practices, Lifelong Learning, and Collective Responsibility.” She writes that it can feel as concerning as it is encouraging for those with clinical backgrounds in trauma to see designers being granted access to this kind of work. Often it’s taking place without a code of ethics, a scope of practice, or even basic training in place.

The rise of trauma-informed design

A growing number of decision-makers in organisations and governments recognise that, in order to be effective, our services need to be well-designed. This doesn't just refer to how usable a service is. It means that the service should be designed with a deeper thoughtfulness and sensitivity for its users, many of whom are survivors of trauma. The need for trauma-informed service design and delivery has therefore been recognised not just in emergency services and mental health care, but across many contexts where everyday service provision happens; for example, in housing, education, and food systems. Frankly, I can’t think of people more deserving of good design (that is, access to services and support that actually works) than people who have endured trauma.

It must be said, though, that culturally we’re talking about trauma a lot at the moment. And with that growing awareness comes an addressable market for products. There are many private sector (often tech) companies attempting to cash in by designing for trauma experiences. Many superficial digital products are springing up which do exactly that (another mental health app, anyone?). This trend goes to show that some design work in the trauma space is going to be “bullshit work” (if we go back to Graeber’s definition – offering nothing of value to the world). We’d be wise to assess the values and motivations of such companies, and these design roles, critically.

However, most of the great work I’ve seen in trauma-informed design is coming from the public and non-profit sector, and it’s heartening. These organisations are more likely to protect their staff from STS and VT because they understand trauma, not just tech.

They know that people who have endured chronic traumatic stress have needs that must be heard and understood by designers. They see trauma as a community sickness rather than an individual issue. They want their designers to commit to understanding the root causes of trauma on a social and political level, and explore their own positionality within that.

Equity-centred user researcher Alba Villamil recently wrote about this, referring to Jamie Willer-Kherbaoui’s 2019 paper “Working through the smog.” She invites us to notice and challenge the ways in which white saviorism in particular is damaging to communities who are encouraged to engage in design processes or are considered the beneficiaries of them. One of Alba’s reflections is that, in the design industry, we often see issues being de-contextualised or depoliticized. This is evident in:

“The refusal to acknowledge how slavery, colonisation, public policy, and other harmful interventions have impacted and continue to impact communities, which has implications for the research questions we ask and the problems we wrongly try to solve for.”

Engaging in this kind of critique is vital for designers working in the trauma space. Being willing to unlearn what you may have been taught about what good design is can bring deep discomfort. It can result in designers (especially those who haven’t been formally or informally educated about the social, political, and historical context of trauma) feeling in over their heads. It is a lot to go from working on purely commercial design projects to working with trauma survivors (believe me, I’ve done it). This only adds to the feeling of overwhelm that can creep in as part of VT when doing the trauma work itself. To engage properly in the wider narrative of your work, and also to know when to process and rest, is a lifelong skill to learn.

Overexposed and underprepared

Kate Every, Rachael Dietkus, and I ran a study in 2024 that explores the idea of being overexposed and underprepared for trauma as design practitioners. Our survey of designers and researchers found that out of 95 respondents, 51% had experienced secondary traumatic stress in their work, with a further 24% “not sure” whether they had. Considering that many of these people don’t actually work on trauma in an official capacity, these are noteworthy numbers.

Designers described being appointed as stand-in user researchers for organisations who don’t employ a dedicated researcher. Some shared that they’d been underprepared for situations they found themselves in; for example, wanting to have done more to support a participant during or after a distressing research interview. Practitioners said they were well-meaning and caring, but that these attributes only go so far towards helping them to avoid being harmed or causing harm to others. 70% wanted more training, and 66% wanted more opportunities to work directly with and learn from trauma specialists from other disciplines (for example, social workers and other clinical practitioners).

Many survey respondents were frustrated at their senior leadership or organisations for failing to proactively put more structural support and policies in place to support them. 65% wanted their leaders to have more education about trauma-informed practice.

Are designers at risk for STS and VT?

In user research (my professional discipline), it’s pretty well known that if you work on a trauma-related project, you’ll be at risk of STS, and possibly VT, too. But what about if you’re a content designer working on that same project? Does that mean you’re not at risk of STS or vicarious trauma? Of course not. In fact, I think that content designers have different risk factors of their own.

One reason lies in who does the user research. If we’re going to do justice to trauma-informed design work, we need to conduct excellent research as part of our design work. But who gets involved in this, and who receives the benefit of training and safeguarding? Often, it’s not designers.

When we’re working on design projects that touch on trauma, there are usually a limited number of places to join research interviews. Rightly so, because we don’t want to outnumber the participant. We also don’t rely on being able to make recordings of interviews that team members can listen back to, as participants may not want to consent to this.

So, as a content designer, you might be far less exposed to live research interviews than your team members are. The thing is, you’re still responsible for putting yourself in the shoes of the user. Being a dedicated and curious person, you know there is insight out there, waiting to be uncovered. You might well turn to doing your own secondary user research without any safeguards in place.

A content designer’s insight-gathering might look like getting lost in a Reddit thread about extreme poverty. They might dive into some survey data or social media content about the human experiences of war, displacement, and torture. They might spend a day forensically examining helpline call logs that have been passed over from a client partner working on child abuse. They may be exposed to a lot of harmful content, quite possibly more than a user researcher who is leading qualitative interviewing would be.

This type of secondary research isn’t always formally recognised as part of the research process, and it isn’t always guided or managed safely. Content designers might spend hours or days on these tasks without having any training in how to spot the signs of STS and VT. User researchers are more likely to be getting this (or at least aware that they need to be doing self-directed studying about it).

To make it worse, content designers are often doing this work alone. In qualitative research, we tend to work together with colleagues. We get to check in with participants, and sometimes we stay in touch. There’s a strongly relational aspect to it. But a content designer might engage with accounts of trauma after the fact. Reading data, call logs, and Reddit threads means you can’t reach out and connect with those who have shared their suffering to offer validation and support – it’s often way too late. You may also feel shame at asking colleagues for support after doing such desk-related activities. We shouldn’t forget secondary sources of research and how activating and risky these can be, too.

Content designers may be underserved when it comes to the safety practices of trauma-informed design, which very often centre on the needs of the user researcher and participant doing “live” research.

The cadence of design work

Trauma work should not be conducted at the same pace as “regular” design work. As a designer, it’s the norm to work intensely on projects that last a fairly short time (say 2-6 months) or to work across multiple projects at the same time. This means that you may be exposed to many stories of egregious trauma for a concentrated period, and then none at all. A mix of exposure can be a good thing, when we think about how vicarious trauma is something that builds in us cumulatively over time. But when we think about the potential for STS and VT, I think we’re starting to see that it’s risky to dip in and out of projects without having gotten training or access to safeguarding.

Yes, the chance to take a break is good, but these kinds of on/off project set-ups often miss the deep and soulful group work that is an essential component of navigating trauma work confidently. Moving on to work on another project that is not about trauma is not the same as resting. It is not the same as healing or doing reflective practices that enable you to process, and be fully present for, trauma work.

So what do we need to do?

We start by confronting the idea that, as designers, we don’t need any special measures – that we don’t need to be taken care of within our profession. We challenge the idea that STS and VT only happen to people working in those traditionally high-risk frontline jobs – because we can experience these things in our work, too.

Beware of hierarchical scales of suffering, which serve to minimise our experiences and elevate others’ as more “worthy” of proper care. If we find ourselves doing this, we’d do well to note that being cynical and minimising pain are, in fact, symptoms of VT.

Working in close collaboration with others is essential when your work touches on trauma. Judith Herman, renowned psychiatrist and trauma expert, talks about the isolation that trauma creates, both for survivors and for the workers supporting them. Note that the Substance Abuse and Mental Health Services Administration's (SAMHSA) trauma-informed care principles include peer support and collaboration, directly speaking to the necessity of collective care in trauma work.

We also have much to learn from the Black liberation movement, and its Black women leaders in particular, about resisting grind culture and learning how to rest. While reading Tricia Hersey’s book Rest is Resistance, I was struck by this line: “Rest is radical because it disrupts the lie that we are not doing enough.”

She discusses in detail how harmful it is to allow our bodies to be treated as machines, purely there to be economically productive under capitalism, and traces this back to chattel slavery. The idea of “never doing enough” is perpetuated by grind culture. It’s the modern day expression of those same white supremacist and capitalist ideals, and it’s pertinent to this chapter’s topic. The mindset that we are only “worthy” when we have worked and produced, that we are not enough in and of ourselves, is a massive risk factor for VT. Anyone who has grown up being taught that they are not enough will be more likely to experience VT because their natural instincts will be to pour in more energy, more of their spirit and soul, to gain approval in a system that is not designed to grant it.

Often it’s those supporting us, whether through formal supervision or more informal connecting, who help us to see that we are doing all we can. They share the load of helping us assess if and how we could do more.

Growing our consciousness

I work at Chayn, an organisation that works with survivors of gender-based violence (including domestic violence, sexual assault, and tech abuse). Although we apply the principles of trauma-informed design in our external services, we’re also constantly experimenting with applying them to our internal working practices.

If we want to exude collective care, we know that we need to cultivate it in ourselves as individuals. We need to cultivate it in our culture, too. There is a strong awareness in the organisation that we do challenging work. We know that this can wear us down over time, and may well activate our own traumas. So why shouldn’t our day-to-day policies and practices be trauma-informed, too?

Our founder, Hera Hussain, adapted SAMHSA’s trauma-informed principles and created our own, tailored to the context that we work in: gendered violence. Both sets of principles are listed at the start of this book. Chayn’s are (currently):

  • safety,
  • power sharing,
  • agency,
  • privacy,
  • equity,
  • plurality,
  • accountability,
  • hope,

I use these as a framework below to share some questions that we tend to think about and ask ourselves in our work. Exploring some of these questions with your team could allow you to understand your needs and advocate for yourselves. Perhaps you might ask for the time and support that you need.

I’d always start with curiosity and seek to explore your experiences and feelings. The earlier on in your work that this happens, the better.

Safety

  • Do I feel safe enough to do this work?
  • If I begin to feel unsafe in my work, do I have options? What are they?
  • Do I know what will bring me back to a felt sense of safety?
  • If I feel unsafe during or after an experience at work, do I have a way of sharing this with colleagues and learning from it?
  • Is regular supervision (speaking with a therapist to discuss what comes up in my work) available to me, and if not, can I request this?
  • How can I share with my team what it looks, feels, and sounds like if I am not doing OK?

Power-sharing

  • How can we plan this work so that no one feels they’re “going it alone”?
  • Are we sharing the responsibility for a good research experience and good design outcomes with each other?
  • How are we planning to support each other and the participants that we meet?

Agency

  • Am I conscious of the choices that my team or I have to make changes in our work if we are feeling overwhelmed?
  • What are we practising to help ourselves?
  • What are the tools that we would like to try? How could we build them into our work?

Privacy

  • How might I enquire and explore topics with survivors while respecting their privacy and not overstepping?
  • How might we communicate our personal feelings with our colleagues, knowing that this can also bring discomfort?

Equity

  • Am I conscious of the elements of my history and identity that might make me feel particularly vulnerable to being harmed or harming others on this piece of work?
  • What are they and how might I manage and navigate them?
  • How might I share my experiences and support others?

Plurality

  • Are we remembering that coping and not coping looks different for everyone?
  • Am I aware of the different types of trauma responses that there are?
  • Have I thought about how my responses might change day-to-day or over time, depending on what else is going on?

Accountability

  • Am I in a position today to safely engage with survivors and show them the compassion and validation that they deserve?
  • Am I clear about what my responsibilities to survivors are and where the limit is?
  • Do I have clear professional boundaries, and have I communicated these with participants?
  • Do I know what is “mine” and what is “not mine” to respond to and solve?

Hope

  • Do I still feel hopeful?
  • If we feel a sense of hope slipping, do we know how to restore that faith in the work we’re doing? Who can we turn to to share our feelings?

How’s your spirit doing?

I hope this chapter will serve as an invitation to tune into your souls and spirits and curiously ask them how they’re doing. Committing to taking care of them is a hopeful and lifelong process.

If you and colleagues are already applying principles of trauma-informed design in your work, you’ve already done important work to create the support that survivors of trauma need. I’d encourage you to think about how you can also apply the same principles to your working practices. If your organisation doesn’t have a group that is already talking about STS and VT, try starting the conversation with a fellow researcher or designer. Ask for the space and resources that you need before you really need it. If connecting outside of your workplace feels right, there are lots of online groups that provide peer support. Whether it's advice, solidarity, or learning opportunities you're after, the many trauma-informed design spaces online are free to join and very welcoming.

I think the goal for many of us (doing jobs which we don’t believe are bullshit) is to continue to do this trauma work that we care about for a long time. We need those of us who are already doing this meaningful work to stick around; because if we’re working in trauma, we’re probably not addressing problems that will be solved by next week. We should remember, though, that it’s precisely because our work is full of knotty problems and has so much meaning for us that we are going to be at risk of VT.

If we are going to manage STS and VT when it comes knocking, we need to deeply nurture our capacity and confidence to define what the limits of our work are and hold boundaries around it. To keep going, we must decide to actively – and collectively – protect our spirits and our souls.

We must get to the work, while not letting the work get to us.

Reference and further reading

find the references of this chapter here