Episode 109: Self Care Is More Than Walks On The Beach: Vicarious Trauma 101 [featuring Jenny Hughes]
Self-care is so much more than bubble baths and long walks on the beach. As helping professionals, we so often put our needs second, leaving us to pour from an empty cup.
During this episode of the All Things Private Practice Podcast, I speak with Jenny Hughes, psychologist and vicarious trauma specialist.
We talk about how...
- Vicarious trauma is an inevitable part of our work as therapists, helpers, and healers. We are empathic beings who soak up the stress and trauma of our clients. Without effective strategies to "wring out the sponge," this can lead to difficulties such as compassion fatigue, secondary traumatic stress, and burnout.
- It's disheartening to see the high rate of mental health professionals leaving the field due to burnout. However, there's nothing wrong with leaving any profession. The crucial aspect is making an informed decision with intentionality. By exploring realistic and sustainable ways to manage burnout, you can find a path that aligns with your well-being and professional aspirations.
- Self-care goes beyond bubble baths and beach walks. While these activities bring temporary relief, they don't address the root causes of burnout. It's essential for therapists to give themselves permission to acknowledge their struggles and imperfections. By implementing effective self-care strategies and seeking support, we can recharge and bring our best selves to our clients.
More about Jenny:
Jenny Hughes is a licensed clinical psychologist specializing in the treatment of trauma and PTSD. As a clinician, she practices EMDR, Cognitive Processing Therapy, and Prolonged Exposure therapy. Jenny has published a workbook designed for clients to use on their own or with their therapist called the PTSD Recovery Workbook, which can be found on Amazon.
Through her clinical work, Jenny has been able to also support helpers and healers through the common experience of vicarious trauma. As the founder of The BRAVE Trauma Therapist Collective, Jenny helps trauma therapists go from feeling drained and demoralized to energized and empowered. Members of BRAVE work with Jenny to become more aware of how to identify and overcome vicarious trauma, allowing them to thrive in their professional and personal lives.
Check out Jenny's free resource - The BRAVE Vicarious Trauma Tracker with BONUS Mini-Course, which is designed to help therapists better understand how vicarious trauma shows up for them so they can get the support they deserve! Visit: braveproviders.com/vttracker
A Thanks to Our Sponsors: The Receptionist for iPad, Alma, & Therapy Notes!
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I would also like to thank Alma for sponsoring this episode.
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I would also like to thank Therapy Notes for sponsoring this episode.
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PATRICK CASALE: Hey there, everyone, you are listening to another episode of the All Things Private Practice Podcast. I'm your host, Patrick Casale. I'm joined today by Jenny Hughes, who is a trauma psychologist and has a lot to talk about today in terms of vicarious trauma, burnout, and how it impacts the profession, how it impacts you as an entrepreneur, as a human, and strategies, as well. So, thanks, Jenny, for coming on and making the time.
JENNY HUGHES: Thank you so much for having me. I'm looking forward to it.
PATRICK CASALE: So, it sounds like, you know vicarious trauma or VT as you refer to it as your jam. And for the listeners who maybe aren't mental health professionals, can you kind of briefly describe what vicarious trauma is and how that shows up for people?
JENNY HUGHES: Yeah, definitely. So, vicarious trauma is, honestly, I talk about it as an inevitable part of our work as therapists, helpers, and healers. Because we come into these professions as empathic humans, we want to help other people. And so that means that we're at risk of soaking up the stress and trauma that we are helping them with. And that is the vicarious trauma.
So, I think of us as like sponges, and we're kind of soaking up our client's stress their trauma. And when we don't have ways to wring out the sponge, then that kind of inevitable experience of it, vicarious trauma, can turn into things that are really, really difficult, not that VT isn't tough, but it can turn into like compassion fatigue, secondary traumatic stress, and then burnout, where we kind of jump ship for that life raft because we feel like we don't have anything else to do.
PATRICK CASALE: That's a great explanation and overview. And yeah, I think that's really true in this profession, in all helping professions, like you mentioned. And I think we're seeing an alarming rate of mental health professionals leaving the profession after the last couple of years who really have felt like they've gone through the wringer, and understandably so. And maybe they're thinking like, there's greener pastures out there, or the grass is greener, or like, I just need such a massive life shift that I am going to leave this career path.
And I know for a lot of people, that feeling and thought process alone can create a lot of shamefulness and a lot of grief because there was so much energy, and hard work, and emotion that went into obtaining licensure, becoming a professional, and starting a business, whatever the case may be. So, it's really disheartening to see what we're seeing. But I also think it makes a lot of sense in a lot of ways because of the way society is set up.
JENNY HUGHES: And there's nothing wrong with leaving any profession, right? And when we don't do it on our own terms, when we don't do it from a place of feeling like we're making a grounded and informed decision, that grief and anger is going to be so present. And then we're always going to be wondering what else?
And that's a big part of the work that I do with therapists, and helpers, and healers is give them all the options but even more so give them and work with them to find the ways that are realistic and sustainable to manage whatever it is that they want to be doing at that time.
PATRICK CASALE: Yeah, I think the intentionality and the intentionality behind the decision is really the most important piece. So, if you're leaving the profession or any profession because you just feel so burnt out, and you've experienced so much, and you just haven't been able to work through that to the best of your ability. I think that feels different than if you're saying like, "Hey, this is kind of boring to me, or this isn't really doing it for me anymore. I want to pursue this."
And I think that's what you see a lot of, right? Is like you mentioned, not being able to wring out the sponge. And that's a great imagery and a great analogy because that's really what it feels like as it starts to build up, and absorb, and get heavier, then it really does start to come out in problematic ways.
And do you want to talk a little bit about the problem areas that start to arise when this stuff isn't addressed?
JENNY HUGHES: Yeah, and it happens gradually, and then all of a sudden it feels like we get slapped across the face within. And I've been there too, I'm happy to share some of my own experiences. But when it starts to, like, seep out, unintentionally, some of the main kind of signs that people will talk about is feeling like really irritable. That's a big one, for me. Also isolating, those are my two big red flags. If I'm, like, super cranky, and don't want to talk to anyone, like whoever it is, it doesn't matter then I have to be in touch with myself and be like, "Okay, Jenny, what are you doing, you need to check in with your VT."
Other things, though, like a lot of times, it'll be those little things we do to avoid stuff in our work. So, like, avoiding emails or phone calls. Unfortunately, it can turn into like, dreading our work, and even dreading parts of our work that we have really loved, and that have felt really exciting and fulfilling. And then it can even kind of creep into, like, our sleep, our relationships. I often kind of break it into like emotional, physical, relational, and occupational effects because we have to think about ourselves as whole people within our systems and be aware of all the ways that could be showing up for us.
PATRICK CASALE: Yeah, absolutely. Irritability, and disconnection, and isolation, for me, are also two of my indications. And I know that I have like go-to coping skills when that's happened. And that means that, essentially, my capacity has been diminished so much that I need to do whatever feels most comforting to recharge.
And the problem, I think, for so many of us is that we don't acknowledge or recognize that until it's too late. And then all of a sudden, it's like, "Oh, shit, I am here. How do I get back?" And that's what I hear a lot when people start talking about burnout is like, and you mentioned this before in some of the stuff that you sent me before we started talking, was bubble baths, walks on the beach, whatever. Yeah, we love those things. But that's not the cure all and it's not really an option for a lot of people in terms of soothing, and grounding, and self-care strategy.
And a lot of the times I think we're starting to incorporate self-care or preventative measures when it's too late, when it's like, I am now living my life in a situation where I am constantly looking forward to the next experience that will take me away from my day-to-day. And that is just really challenging. And I understand why we get into that mindset as human beings, in general.
But like, I think, there's a difference between, like, looking forward to something on the horizon and having something on the horizon be the only way you can get through the day.
JENNY HUGHES: Yeah, I totally agree. And honestly, I think that one of the big drivers of that are, as helpers and healers, we're not given permission to say when we're struggling, we're not given permission to say, like, I'm not okay, you know? And we, whether it's been said to us explicitly or not, internalize these messages of like, we have to be perfect. Do you know, everyone's like, "Oh, well, you're a therapist, you got it all together." No, I don't. You want to know the hot mess of stress that I'm on? Like, and it's okay that I am a hot mess at times because I'm an imperfect human. I started saying a lot I'm imperfectly perfect. No, perfectly imperfect, right? And working to really kind of embrace that for myself because certainly, I can be an overachiever, surprise, surprise to people who know me. I think a lot of us can be that go into these fields. And that can get you really far. But when we don't have realistic and sustainable ways to care for ourselves, then the bubble baths, and the chocolate, and the beach walks, they're not going to do it.
PATRICK CASALE: Now, those are like band-aid fixes at that time.
JENNY HUGHES: Right.
PATRICK CASALE: It's almost like your Zoom screen right now. You know, you're using a background to blur out the background, right? So, like, essentially, that's kind of what we see on the outside looking in for a lot of mental health and helping professionals of like, "Look how perfect this is." Because we're muting out everything that's going on in the background in our own lives.
And it's a challenging profession. You know, I don't work as a clinician anymore. I've kind of become a retired clinician since having throat surgery in October. And it's one of those professions where you're absorbing, you're absorbing, you're absorbing, you're listening, you're being empathic, empathetic, you are attuned, you're paying attention to everything that's tracking, and you're also hearing some pretty horrific stories, and you're in that with your client, and then you leave, and you can't talk about it to anybody, you can't tell your spouse like, "Hey, this is what I talked about at work today." It's like, your brain is just no longer really functioning optimally, your executive functioning goes down, and you're just kind of like, "Fuck, I don't know how I get back to where I felt like that sparked to be a helper or that sparked to make another schedule and feel really energized about what I'm doing."
And I think a lot of clinicians, right, like, especially over the last couple years with COVID have left community mental health jobs to start private practices or join group practices because it was kind of very apparent like, well, if people aren't going to take care of me during a pandemic, I'm going to have to figure it out myself. I applaud that 100 fucking percent.
What happens is like, that spark of excitement carries you through, but then you recreate your agency job setting, and you overload your schedule, and you can't say no, and you can't set boundaries, and you don't charge your clients, and all the things that starts piling up all of a sudden you're working for yourself, great, but you've created a culture for yourself that is not sustainable. And it becomes very challenging to dig out from that hole once you've created it.
And I think a struggle that I hear so often from people in my circles, is like, yeah, I went on this vacation for two weeks, and I thought it would recharge me, and I came back, and I'm right back to where I was before I left. And that just doesn't feel good when you're doing the heavy work that we're doing.
JENNY HUGHES: Yeah, I totally agree. And I think a lot of that, you know, comes again, to those internalized messages that we have to give more than we receive, that we have to even sacrifice ourselves, but we're also not taught how. I mean, you talk about this all the time, we're not taught how to be business owners and how to ethically, responsibly, healthfully, like, establish, and run our businesses.
And so, then, I mean, I also have made pivots to private practice, to other diversified incomes. And those have been on the heels of different times of burnout, vicarious trauma for me, and I've had to learn the hard way too that it's not a magic fix, that I have to make sure that I have my people that are my community and supporting me around me that I can really share these things with. And that I have spaces where I can be able to talk about the difficulties, not just of the clinical work, but of what it's like to be a business owner, to be a human, whatever it might be because isolation, and like you're saying, organizational factors are the greatest predictors of burnout. And when we work for ourselves, we are the organization. And so we have to be super aware. And, like, just really intentional about how we're setting up our organization. But we don't even think about that because it's like, it's just me, whatever.
PATRICK CASALE: And it's very easy when it's just you to say yes to more coming your way. Like, "Oh, I could take another client. Oh, I really resonate with this issue that they're calling about, I could fit them in somewhere. Oh, I do want to go on another podcast." So, well, you know, your schedule begins to look like a game of Tetris. And then you wake up and look at your calendar for the weekend, you're like, "I don't want to do any of this." And I think that's so demoralizing for those of us who are entrepreneurial, who have started our own ventures, and are pursuing our passions, and then to essentially create a system situation where it's no longer energizing or fun.
And our work can be fun, like the mental health profession can be enjoyable and really creative. And I think sometimes it's also about like, maybe it's taking a step back and looking at your calendar, and your schedule, and revisiting the hours that you see people, and that'll bring up some stuff for people where they're like, "God, I have to be really accessible. And I have to see people after 6:00 PM. And I have to do weekends." And it's like, no, you don't. Like…
JENNY HUGHES: You can choose to do that.
PATRICK CASALE: Right. You can strictly-
JENNY HUGHES: Right, you can make that choice, yeah.
PATRICK CASALE: But it should never feel like I have to. And I think for those of us who are business owners, or you are listening to this podcast, it's probably because you're a business owner or want to become one.
And I think when I pull people, like, and do market research, I'm like, why did you become an entrepreneur? Right? Like, really, the answers are the same. It's like autonomy, freedom, flexibility, the ability to make my own decisions, set my own hours. So, if you start straying away from that, if you start running your business from a point where it's no longer values-aligned, where it no longer makes sense for you, you become really resentful of your business, you become irritated by the decisions that you have made.
And that is challenging because that becomes a very introspective, like, personalized process of like, "I'm not happy with this and I am the one to blame." And that can feel really complicated and really challenging to work through.
JENNY HUGHES: And really scary. And you know, a great person and resource is Nicole Lewis-Keeber. Have you had her on here?
PATRICK CASALE: I haven't. I know the name, though.
JENNY HUGHES: So, I'm pulling her up right now, she wrote a book called that, let's see, she wrote a book, I'm trying to pull up the book, oh, here we go, books. But it's all about how our trauma shows up in our business and how to do that work. So, yeah, so Nicole Lewis-Keeber is called How to Love Your Business. And it is a trauma-informed approach to look at ourselves as business owners and to really examine how our trauma could be running our business instead of us running our business. And so that is a really, really great resource that I recommend to entrepreneurs.
PATRICK CASALE: That's a great resource. And a good friend and colleague of mine, Yunetta Smith also has a book, she has a lot of talks about trauma running your business. And I think so often, if we get into the helping profession, probably, gotten to the helping profession for a reason. And the odds are, you've experienced some trauma as, you know, most human beings have.
But it really can lead us astray when we're not working through it. And I don't just mean our own personal trauma histories, like our trauma narratives that then influence our business decisions and how it shows up when we're making decisions about whether to say yes to something, or whether we feel obligated, or whether we feel pressure to do A, B, and C, it really starts to play a role. And it can lead you down a path that is really challenging.
So, I think just having strategies to, one, catch it before it gets too late, right? Like, we want to have some awareness of this. Two, like, what can we start to put into place that are attainable, and tangible, and actionable in the moment, now, like, starting today. And three, like how to really keep some intentionality behind the decisions that you do. And then incorporating the skill sets that you talk about because I do think all of this stuff really ties in and intertwines with one another.
JENNY HUGHES: Yeah, and I'll go through each one of those. One of the VT sign that I do want to point out, though, is overworking. And it goes right back to trauma running our business. Because, especially, since a lot of us come into this profession because of the me search that you're talking about, that's the way I always refer to it as, and then being productive, helping, doing all these things, it feels good. We do love this work.
But overworking can then end up being a sign of vicarious trauma as well because it's like that distraction avoidance stuff. As long as I'm working, and I'm producing, I'm helping others, I have to deal with my own shit.
PATRICK CASALE: Right, exactly.
JENNY HUGHES: But like you're saying, so identifying it, what do we do? And how do we sustain that stuff, right? So, the first thing is naming our vicarious trauma. And I have a free tracker that I'll share with your audience that goes through these four different areas of emotional, physical, relational, and occupational functioning, basically. And kind of go through a checklist first of, like, are these things showing up for you in these different areas? And then I encourage people to track VT over the course of seven days to the best of their ability, doesn't have to be perfect to get a snapshot of what it looks like.
And I work with people to do this on a regular basis. In my community, we track VT every three months together, so that we're continuously on top of it because it'll get sneaky, it's a chameleon, it'll kind of sneak up on you. But once you have that snapshot, it can show you both like the things that are working for you, and those areas where you want to maybe make some shifts.
And so looking at that snapshot, my first thing is don't do anything new. You don't have to go and learn a new thing. Like just go back to basics, re-ignite those things that you know are helpful. So, like, for me, my go-to's are like walking my dog, making sure I'm doing yoga, at least, you know, once or twice a week, and connecting with people in different areas of my life for different reasons. Those are the things that I know help me.
Sure I could go in, like, I can't even tell you how many times I bought a new pair of running shoes and said I was going to start to be a runner. I'm not going to be a runner. Like, why I'm I running? I'm not going to add that on to help me, like, manage my VT, right?
And then sustaining it. So, it's much easier said than done. And I think the greatest resource for sustaining these things is having other folks who are doing it with you. So, whether that be people who practicing, like, in your group practice, or in your consultation group, or online communities, whatever it might be. But we need different kinds of people in our life for different things.
And when it comes to vicarious trauma because it happens because of our clinical work, it really is good to have other clinicians surrounding you that get what it's like, that you can talk to you about this work. Because like for me as a trauma therapist, HIPAA, of course, but I can't talk to people about my work. I did sign up for that. Like I did, I chose to sign up for that. And so I can talk to other trauma therapists about it, or other therapist friends who've given me permission to talk about it, but not everyone can or wants to.
And so finding those people where you guys can support each other, you can share together, you can come together, and community, again, in imperfect ways because there's going to be times that we fuck up and we stop going to yoga, or we stop walking the dog, or whatever it is, and having a space where people are going to catch you and hold you until you're ready to start doing those things again.
PATRICK CASALE: Yeah, I love that. And I love the example of like, not adding new stuff in because you're not going to do it. And that just creates like this guilty, shameful reaction of like, "Oh, man, I bought this exercise bike and now it haunts me from the corner of my office for some reason."
And, you know, when you only have the capacity to do certain things, do the things that you're already doing, that you enjoy doing, that you know are good for you. And I do agree, yeah, community, community, community, and intentional community, I think that's really important, as well. Who you spend time with, who you share with, who you communicate with, who you're kind of in constant connection with. So, really good tips that I think our audience will really resonate with today.
Tell the audience a little bit about where they can find what you're offering and what you've got going on.
JENNY HUGHES: Yeah, so to get their tracker, you can go to braveproviders.com/vttracker and we can put that in the show notes. And that'll get you the tracker. And I also have actually added, it's as a free tracker, like a little bonus video course that walks people through it because I felt like it was important to have some of that guidance because just like you're saying, with the ways that VT and stress can affect our brain and our executive functioning is that that you're not doing anything well enough, it's just good to have all those supports there. And so that's how you can get the tracker.
You can also find me on Facebook. I have a free group called The BRAVE Vicarious Trauma Community. And then I also run The BRAVE Trauma Therapist Collective, which is my online membership for trauma therapists where we do all these things that we're talking about both kind of in our online private space, and through live calls, and things like that to get come together as a group of people who believe in supporting our imperfections.
PATRICK CASALE: Love it. All of that information will be in the show notes that all of you have access to Jenny's information. I want to just thank you for coming on and sharing these tips that, hopefully, some of you can start putting into life and action immediately. I think it's important to be proactive about this stuff and not to let it linger.
And to all the people who are listening to the All Things Private Practice Podcast, new episodes are out every single week on all major podcast platforms and YouTube. You can like, download, subscribe, and share. Doubt yourself, do it anyway. We'll see you next week. Thanks, Jenny.
JENNY HUGHES: Thank you.
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