Trauma: Chaplain's Role in Working with Patients and Families

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Chaplain John Ehman

Chaplain John Ehman

9/21/17

This presentation will focus on working with patients and families at a

hospital after a significant blunt or penetrating injury (for example:

falls, gunshot or stab wounds, assaults, motor vehicle collisions and

pedestrian impacts) or a burn injury.

Such trauma patients tend to be initially unavailable to a chaplain,

because they are involved in medical assessment/treatment or are

unconscious or incoherent. Therefore, chaplains often work first with

families who have only just learned of the injury.

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•

Etymology

:  

from the Greek (

τραῦμα

 / 

τρῶμα

) for 

wound

.

•

Working Definition #1

:  A trauma is a serious physical injury

                 or psychological experience that overwhelms our capacity

                 to cope, not only evoking an acute reaction but 

indelibly

affecting our being and sense of well-being.

•

Working Definition #2

:  An instantly life-changing event for

                 a patient/family, requiring immediate trust in an unfamiliar

                 medical team in a moment when the world feels particularly

                 uncertain and unsafe.

•

Practical Emphasis for This Presentation

:  hours to days

                 after the traumatic event

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•

  Acute stress reaction (early on, often more of a practical

                   issue for chaplains working with families than with patients)

•

  Strong tendency to identify cause …and blame

•

  Potential for utterly shattering the sense of one’s world

                   and the struggle for meaning-making in sudden loss

•

  Seeds of Post-Traumatic Stress Disorder (PTSD)

                   and/or Post Traumatic Growth (PTG)

“Cataclysm”

By John Ehman

Acute Stress Reaction and Pastoral Response

Acute Stress Reaction and Pastoral Response

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“Fight or Flight”

Blood (and Sugar) 

to

Muscles and 

away

from Stomach

Sudden Change

in Heart Rate

Hyperventilation

and/or Fainting

Over-activity / Agitation

or

  Withdrawal /“Daze”

Narrowed Attention

Intrusive Rumination

Impaired Memory

and Comprehension

Strong, Labile Emotions

Heightened

Sense of Threat

—graphic: Agency for Toxic Substances and Disease Registry, 2005

Paying attention to the physiological dynamics

of an acute stress reaction is one way of

staying both objective 

and

 empathetic

toward a patient or family

…and to keep from being 

object

ifying

,

which leaves no room for empathy

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People experiencing acute stress reactions have reduced capacity to

take a constructive lead in pastoral interactions. This may require the

chaplain to take more of a lead than normal until the reaction subsides,

while always working to maximize the opportunity for patient-led pastoral

care by seeking to empower the patient or family member. However,

while some people in acute stress reactions may be passive and

suggestible, others may interpret a chaplain’s initiative as “pushy”; and

families may have a mix of these responses, requiring a balancing and

modulation of pastoral outreach.

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•  Normalization (i.e., manageability) of the extraordinary situation

•  Control of events; exertion of purpose

•  Information

•  Reduced stimuli (--and reduced pressure for cognitive processing)

•  Space

•  Sense of connection with others

•  Hopefulness

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•  Normalization (i.e., manageability) of the extraordinary situation

•  Control of events; exertion of purpose

•  Information

•  Reduced stimuli (--and reduced pressure for cognitive processing)

•  Space

•  Sense of connection with others

•  Hopefulness

How might chaplains help with these needs?

B

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•  Normalization (i.e., manageability) of the extraordinary situation

- Calmly name what is happening; orient people to processes and timing

•  Control of events; exertion of purpose

•  Information

•  Reduced stimuli (--and reduced pressure for cognitive processing)

•  Space

•  Sense of connection with others

•  Hopefulness

How might chaplains help with these needs?

B

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•  Normalization (i.e., manageability) of the extraordinary situation

- Calmly name what is happening; orient people to processes and timing

•  Control of events; exertion of purpose

- Allow the other to lead as much as feasible; show role of helper/advocate

•  Information

•  Reduced stimuli (--and reduced pressure for cognitive processing)

•  Space

•  Sense of connection with others

•  Hopefulness

How might chaplains help with these needs?

B

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•  Normalization (i.e., manageability) of the extraordinary situation

- Calmly name what is happening; orient people to processes and timing

•  Control of events; exertion of purpose

- Allow the other to lead as much as feasible; show role of helper/advocate

•  Information

- Listen actively; respond to questions; convey information quickly/clearly

•  Reduced stimuli (--and reduced pressure for cognitive processing)

•  Space

•  Sense of connection with others

•  Hopefulness

How might chaplains help with these needs?

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•  Normalization (i.e., manageability) of the extraordinary situation

- Calmly name what is happening; orient people to processes and timing

•  Control of events; exertion of purpose

- Allow the other to lead as much as feasible; show role of helper/advocate

•  Information

- Listen actively; respond to questions; convey information quickly/clearly

•  Reduced stimuli (--and reduced pressure for cognitive processing)

- Reduce extraneous noise/activity; buffer decision-making pressure

•  Space

•  Sense of connection with others

•  Hopefulness

How might chaplains help with these needs?

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•  Normalization (i.e., manageability) of the extraordinary situation

- Calmly name what is happening; orient people to processes and timing

•  Control of events; exertion of purpose

- Allow the other to lead as much as feasible; show role of helper/advocate

•  Information

- Listen actively; respond to questions; convey information quickly/clearly

•  Reduced stimuli (--and reduced pressure for cognitive processing)

- Reduce extraneous noise/activity; buffer decision-making pressure

•  Space

- Avoid “trapped” space; give “own” space, esp. for emotional expression

•  Sense of connection with others

•  Hopefulness

How might chaplains help with these needs?

B

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•  Normalization (i.e., manageability) of the extraordinary situation

- Calmly name what is happening; orient people to processes and timing

•  Control of events; exertion of purpose

- Allow the other to lead as much as feasible; show role of helper/advocate

•  Information

- Listen actively; respond to questions; convey information quickly/clearly

•  Reduced stimuli (--and reduced pressure for cognitive processing)

- Reduce extraneous noise/activity; buffer decision-making pressure

•  Space

- Avoid “trapped” space; give “own” space, esp. for emotional expression

•  Sense of connection with others

- Use the family’s own support system; facilitate getting people together

•  Hopefulness

How might chaplains help with these needs?

B

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•  Normalization (i.e., manageability) of the extraordinary situation

- Calmly name what is happening; orient people to processes and timing

•  Control of events; exertion of purpose

- Allow the other to lead as much as feasible; show role of helper/advocate

•  Information

- Listen actively; respond to questions; convey information quickly/clearly

•  Reduced stimuli (--and reduced pressure for cognitive processing)

- Reduce extraneous noise/activity; buffer decision-making pressure

•  Space

- Avoid “trapped” space; give “own” space, esp. for emotional expression

•  Sense of connection with others

- Use the family’s own support system; facilitate getting people together

•  Hopefulness

- Be attentive to “brittle” hope (i.e., 

wishing for highly specific things

)

How might chaplains help with these needs?

S

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.

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Originally proposed by psychologist Gerard Egan as a way to “make sure

you are physically present to a client,” the S.O.L.E.R. strategy has been

widely adopted by emergency responders and crisis counselors.

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See: Stickley, T., “From SOLER to SURETY for effective non-

verbal communication,” 

Nurse Education in Practice 

11, no. 6

(Nov 2011): 395-398; and Egan, G., 

The Skilled Helper, 

1975.

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In addition to normal cultural and interpersonal dynamics, a chaplain’s

touch during an acute stress reaction could potentially play into a

person’s heightened sense of 

threat

. In the context of a 

family

system

,

some people may even see a chaplain’s touch of another family member

as threatening to family roles. Chaplains should try to utilize the

immediate support resources within a family system as much as possible

-- e.g., family members’ roles for caretaking of others -- and consider

taking cues from family leaders regarding physical touch.

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:

:

•

  Identify key family 

authorities

 and 

managers

     (--including information managers).

 •  

Feel free to ask for the help of key family members

     in caring for particularly needful  individuals and in

     managing the family as a whole.

•

  Family members’ roles tend to be resilient. (Acting in an

     established family role during a crisis is a way of coping

     with an acute stress reaction.)

•

  Imagine the family system’s response as somewhat

     analogous to an “immune system” response to an

     injury to the “body” of the family.

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Explicit Engagement and Honoring of Patient/Family Spirituality

Professional Connection to Community Clergy

Religious “Authority”

Representing the Presence of God

Wisdom/Experience of “Clergy” in Extraordinary Situations

Ritual Leadership (especially prayer)

Pastoral Ethic of Caring and Trustworthiness

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o

f

f

t

t

h

h

e

e

R

R

e

e

l

l

i

i

g

g

i

i

o

o

u

u

s

s

R

R

o

o

l

l

e

e

o

o

f

f

a

a

C

C

h

h

a

a

p

p

l

l

a

a

i

i

n

n

Explicit Engagement and Honoring of Patient/Family Spirituality

Professional Connection to Community Clergy

Religious “Authority”

Representing the Presence of God

Wisdom/Experience of “Clergy” in Extraordinary Situations

Ritual Leadership (especially prayer)

Pastoral Ethic of Caring and Trustworthiness

…but the religious role may be insignificant or even

dysfunctional if people aren’t able or willing to accept it

A

A

N

N

o

o

t

t

e

e

a

a

b

b

o

o

u

u

t

t

S

S

a

a

f

f

e

e

t

t

y

y

-

-

B

B

a

a

s

s

e

e

d

d

N

N

e

e

e

e

d

d

s

s

•

  Be prepared for falls and collapses; avoid cluttered spaces

•

  Reduce the presence of sharp, breakable, or throw-able objects

•

  Be attentive to warning signs of medical crises (e.g., cardiac, diabetic)

•

  Be attentive to effects of alcohol/drugs

A

A

N

N

o

o

t

t

e

e

a

a

b

b

o

o

u

u

t

t

S

S

a

a

f

f

e

e

t

t

y

y

-

-

B

B

a

a

s

s

e

e

d

d

N

N

e

e

e

e

d

d

s

s

•

  Be prepared for falls and collapses; avoid cluttered spaces

•

  Reduce the presence of sharp, breakable, or throw-able objects

•

  Be attentive to warning signs of medical crises (e.g., cardiac, diabetic)

•

  Be attentive to effects of alcohol/drugs

•

For the chaplain, personally:

        - 

prepare for how to avoid trapped space

        - have a 

measured

 plan for response to physical threat or medical crisis

        - help other responders to gain perspective on what is happening

        - be prepared for anger, and be mindful to 

de-escalate

 tensions

A

A

N

N

o

o

t

t

e

e

a

a

b

b

o

o

u

u

t

t

S

S

a

a

f

f

e

e

t

t

y

y

-

-

B

B

a

a

s

s

e

e

d

d

N

N

e

e

e

e

d

d

s

s

•

  Be prepared for falls and collapses; avoid cluttered spaces

•

  Reduce the presence of sharp, breakable, or throw-able objects

•

  Be attentive to warning signs of medical crises (e.g., cardiac, diabetic)

•

  Be attentive to effects of alcohol/drugs

•

For the chaplain, personally:

        - 

prepare for how to avoid trapped space

        - have a 

measured

 plan for response to physical threat or medical crisis

        - help other responders to gain perspective on what is happening

        - be prepared for anger, and be mindful to 

de-escalate

 tensions

        (

seek to minimize a need to compromise your non-anxious presence

)

H

H

o

o

w

w

m

m

i

i

g

g

h

h

t

t

y

y

o

o

u

u

–

–

t

t

h

h

e

e

c

c

h

h

a

a

p

p

l

l

a

a

i

i

n

n

–

–

m

m

i

i

n

n

i

i

m

m

i

i

z

z

e

e

y

y

o

o

u

u

r

r

o

o

w

w

n

n

a

a

c

c

u

u

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s

s

t

t

r

r

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s

s

s

s

r

r

e

e

a

a

c

c

t

t

i

i

o

o

n

n

?

?

•

  Pay attention to cues from your own body, and

                         acknowledge a need to break the stress cycle.

•

  When you feel “out on a limb,” remember that

                         you are part of a 

team.

•

  Look for small opportunities to “catch your breath”

                         and refocus on the situation.

•

  Make intentional use of “down time” between

                         events to relax, refocus, and debrief  (--you are

                         more susceptible to an acute stress reaction if

                         you are tired, “wired,” or in need of food/water).

Offering

Offering

Emotional

Emotional

Engagement

Engagement

as Vital to

as Vital to

Pastoral

Pastoral

Practice

Practice

Keeping

Keeping

Objective

Objective

Perspective

Perspective

as Part of a

as Part of a

Professional

Professional

Care Team

Care Team



Managing

Managing

One’s Own

One’s Own

Personal

Personal

Stress

Stress

Reaction to

Reaction to

the Situation

the Situation



Challenge for the Chaplain During a Trauma Response

Challenge for the Chaplain During a Trauma Response

“Light in a

Fractured

World”

By John Ehman

I

I

n

n

t

t

h

h

e

e

S

S

p

p

e

e

c

c

i

i

a

a

l

l

C

C

a

a

s

s

e

e

o

o

f

f

a

a

P

P

a

a

t

t

i

i

e

e

n

n

t

t

’

’

s

s

D

D

e

e

a

a

t

t

h

h

S

S

o

o

o

o

n

n

a

a

f

f

t

t

e

e

r

r

H

H

o

o

s

s

p

p

i

i

t

t

a

a

l

l

i

i

z

z

a

a

t

t

i

i

o

o

n

n

There is a limited opportunity for the chaplain to make an

impact on the family’s subsequent journey of healing, by

taking advantage of last interactions with family members.

“

“

S

S

o

o

w

w

i

i

n

n

g

g

S

S

e

e

e

e

d

d

s

s

f

f

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r

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H

H

e

e

a

a

l

l

i

i

n

n

g

g

”

”

i

i

n

n

t

t

h

h

e

e

G

G

r

r

i

i

e

e

v

v

i

i

n

n

g

g

F

F

a

a

m

m

i

i

l

l

y

y

    •

Express sorrow specifically for the loss (as opposed to an open-ended

        statement of “I’m sorry”). Speak eye-level to eye-level and, unless

        contraindicated, let the family know that you’ll keep them and their

        loved one in your thoughts/prayers that night. Look for opportunities

        to make small 

gestures

 of compassion, as families in shock may

        not remember what has been 

said

 as much as what has been 

done

.

    •

Encourage the family to talk about their loss in the days ahead, but

        acknowledge that everyone in the family will be moving through

        grief in their own way, and some people outside of the family may

        have a hard time hearing and understand their traumatic feelings.

        (This may be a specific message for the family member who

        appears to be taking the lead in overseeing the family’s needs.)

    •

Plant the idea of a bereavement support group or formal counseling.

        State that many people find this helpful.

    •

If practical, walk the family to the door. Let them leave 

you

 instead

        of you leaving 

them

. Be receptive to the family’s hugs.

Strong Tendency to Identify Cause …and Blame

Strong Tendency to Identify Cause …and Blame

A

A

t

t

t

t

r

r

i

i

b

b

u

u

t

t

i

i

o

o

n

n

o

o

f

f

C

C

a

a

u

u

s

s

e

e

/

/

B

B

l

l

a

a

m

m

e

e

i

i

n

n

T

T

r

r

a

a

u

u

m

m

a

a

•

   Easy for people to “connect the dots” regarding the trauma,

           resulting in 

taking

 responsibility or 

attributing

 responsibility

•

   A meaning-making/coping response that simplifies the sense

           of overwhelming chaos and pain

•

   Blame may be re-directed when an identified cause is

           unacceptable (e.g., self, sacrosanct family member, God)

•

   The Care Team members may be available options for

           blame unless perceived as the patient’s champions

•

   Caregivers should avoid taking sides in a blame game,

           and continually emphasize a focus on the 

care and dignity

           of the patient

A

A

t

t

t

t

r

r

i

i

b

b

u

u

t

t

i

i

o

o

n

n

s

s

o

o

f

f

R

R

e

e

s

s

p

p

o

o

n

n

s

s

i

i

b

b

i

i

l

l

i

i

t

t

y

y

Research into the blaming of self or others after traumatic events

has produced mixed findings but suggests that attributions of

responsibility are complex and may potentially affect health

outcomes.

If attributions of responsibility involve a person’s religious beliefs

(e.g., “God is testing me” or “the devil did this to me”), they play

into the particular dynamic of 

religious coping 

and may signal

spiritual distress.

Shattering the Sense of One’s World

Shattering the Sense of One’s World

A

A

n

n

O

O

v

v

e

e

r

r

w

w

h

h

e

e

l

l

m

m

i

i

n

n

g

g

S

S

e

e

n

n

s

s

e

e

o

o

f

f

L

L

o

o

s

s

s

s

In trauma, immediate loss and anticipatory loss (usually

rooted in past loss) flood together and can overwhelm a

sense of perspective. One’s entire world may feel utterly

shattered, in the present moment, which can seem unmoored

from what has given life order and meaning.

In such a time, how might we regain the moorings of order

and meaning for our lives? How might we find our way to

feeling more than just loss and chaos?

M

M

a

a

i

i

n

n

t

t

a

a

i

i

n

n

i

i

n

n

g

g

/

/

R

R

e

e

g

g

a

a

i

i

n

n

i

i

n

n

g

g

a

a

S

S

e

e

n

n

s

s

e

e

o

o

f

f

M

M

e

e

a

a

n

n

i

i

n

n

g

g

a

a

f

f

t

t

e

e

r

r

T

T

r

r

a

a

u

u

m

m

a

a

A classic model of coping after trauma turns on the alignment or

realignment of one’s interpretation of a traumatic event with one’s

larger worldview.

Some research suggests that religious beliefs, as a part of a person’s

religious life, can be an especially strong factor in maintaining or

regaining congruence between an understanding of a trauma and a

sense of global meaning.

B

B

a

a

s

s

i

i

c

c

M

M

o

o

d

d

e

e

l

l

o

o

f

f

C

C

o

o

p

p

i

i

n

n

g

g

w

w

i

i

t

t

h

h

T

T

r

r

a

a

u

u

m

m

a

a

t

t

i

i

c

c

S

S

t

t

r

r

e

e

s

s

s

s

o

o

r

r

s

s

Worldview

Assumptions

/ Beliefs

B

B

a

a

s

s

i

i

c

c

M

M

o

o

d

d

e

e

l

l

o

o

f

f

C

C

o

o

p

p

i

i

n

n

g

g

w

w

i

i

t

t

h

h

T

T

r

r

a

a

u

u

m

m

a

a

t

t

i

i

c

c

S

S

t

t

r

r

e

e

s

s

s

s

o

o

r

r

s

s

Traumatic

Stressor

Worldview

Assumptions

/ Beliefs

B

B

a

a

s

s

i

i

c

c

M

M

o

o

d

d

e

e

l

l

o

o

f

f

C

C

o

o

p

p

i

i

n

n

g

g

w

w

i

i

t

t

h

h

T

T

r

r

a

a

u

u

m

m

a

a

t

t

i

i

c

c

S

S

t

t

r

r

e

e

s

s

s

s

o

o

r

r

s

s

Traumatic

Stressor

Appraised

Meaning of

the Stressor

Worldview

Assumptions

/ Beliefs

B

B

a

a

s

s

i

i

c

c

M

M

o

o

d

d

e

e

l

l

o

o

f

f

C

C

o

o

p

p

i

i

n

n

g

g

w

w

i

i

t

t

h

h

T

T

r

r

a

a

u

u

m

m

a

a

t

t

i

i

c

c

S

S

t

t

r

r

e

e

s

s

s

s

o

o

r

r

s

s

Traumatic

Stressor

Appraised

Meaning of

the Stressor

Worldview

Assumptions

/ Beliefs

Discrepancy?

B

B

a

a

s

s

i

i

c

c

M

M

o

o

d

d

e

e

l

l

o

o

f

f

C

C

o

o

p

p

i

i

n

n

g

g

w

w

i

i

t

t

h

h

T

T

r

r

a

a

u

u

m

m

a

a

t

t

i

i

c

c

S

S

t

t

r

r

e

e

s

s

s

s

o

o

r

r

s

s

Traumatic

Stressor

Appraised

Meaning of

the Stressor

Worldview

Assumptions

/ Beliefs

Discrepancy?

Coping may involve a change in Worldview Assumptions /Beliefs

and/or reappraisal of the Stressor

B

B

a

a

s

s

i

i

c

c

M

M

o

o

d

d

e

e

l

l

o

o

f

f

C

C

o

o

p

p

i

i

n

n

g

g

w

w

i

i

t

t

h

h

T

T

r

r

a

a

u

u

m

m

a

a

t

t

i

i

c

c

S

S

t

t

r

r

e

e

s

s

s

s

o

o

r

r

s

s

Traumatic

Stressor

Appraised

Meaning of

the Stressor

Worldview

Assumptions

/ Beliefs

Discrepancy?

Coping may involve a change in Worldview Assumptions /Beliefs

and/or reappraisal of the Stressor

A

n

A

A

u

u

g

g

m

m

e

e

n

n

t

t

e

e

d

d

M

M

o

o

d

d

e

e

l

l

o

o

f

f

C

C

o

o

p

p

i

i

n

n

g

g

w

w

i

i

t

t

h

h

T

T

r

r

a

a

u

u

m

m

a

a

t

t

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i

c

c

S

S

t

t

r

r

e

e

s

s

s

s

o

o

r

r

s

s

Zukerman, G. and Korn, L., “Post-Traumatic Stress and World Assumptions: The Effects

of Religious Coping,” 

Journal of Religion  and Health 53, no. 6 

(Dec 2014): 1676-1690

Traumatic

Stressor

Appraised

Meaning of

the Stressor

Worldview

Assumptions

/ Beliefs

Discrepancy?

Coping may involve a change in Worldview Assumptions /Beliefs

and/or reappraisal of the Stressor

Religious  Beliefs

The Seeds of Post-Traumatic Stress Disorder 

The Seeds of Post-Traumatic Stress Disorder 

and Post-Traumatic 

and Post-Traumatic 

Growth

Growth

 for the Patient

 for the Patient

C

C

o

o

m

m

m

m

o

o

n

n

A

A

f

f

t

t

e

e

r

r

-

-

E

E

f

f

f

f

e

e

c

c

t

t

s

s

o

o

f

f

T

T

r

r

a

a

u

u

m

m

a

a

•

   Intrusive thoughts, including flashbacks to the traumatic event

•

   Desire to avoid people or conversations (esp. re: the event)

•

   Emotionally numb or emotionally overwhelmed at various times

•

   Negative mood; negative feelings toward self and/or others

•

   On edge; sensitive to little things as irritating or threatening

•

   Trouble concentrating of sleeping (including nightmares)

R

R

e

e

s

s

p

p

o

o

n

n

d

d

i

i

n

n

g

g

t

t

o

o

P

P

a

a

t

t

i

i

e

e

n

n

t

t

s

s

t

t

o

o

E

E

n

n

c

c

o

o

u

u

r

r

a

a

g

g

e

e

P

P

s

s

y

y

c

c

h

h

o

o

s

s

o

o

c

c

i

i

a

a

l

l

H

H

e

e

a

a

l

l

t

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h

h

    1)   

Listen attentively, actively, responsively.

    2)   

Acknowledge – generally, without taking a position

          on a patient’s questions/conclusions – statements

          of meaning-making and relationship.

    3)  

 Affirm how a traumatic event is an emotional event,

          which can hit us in waves of feeling overwhelmed.

    4)   

Encourage the patient not to be alone in thinking

          about what’s happened but rather to think things

          through with trained counselors, support groups,

          or at least trusted friends (–though not all friends

          will know how to be helpful).

P

P

o

o

s

s

t

t

-

-

T

T

r

r

a

a

u

u

m

m

a

a

t

t

i

i

c

c

G

G

r

r

o

o

w

w

t

t

h

h

(

(

P

P

T

T

G

G

)

)

The idea of PTG is that many people can recognize experiences of

personal “growth” emerging from a traumatic incident, even 

while

suffering such negative effects as Post-Traumatic Stress Disorder.

Research on PTG has focused on themes of:

•

   a greater appreciation for life in general

•

   a more enriching sense of relationships

•

   an awareness of one’s own strengths

•

   the perception of new possibilities

•

   a deepening sense of spirituality

P

P

o

o

s

s

t

t

-

-

T

T

r

r

a

a

u

u

m

m

a

a

t

t

i

i

c

c

G

G

r

r

o

o

w

w

t

t

h

h

(

(

P

P

T

T

G

G

)

)

The idea of PTG is that many people can recognize experiences of

personal “growth” emerging from a traumatic incident, even 

while

suffering such negative effects as Post-Traumatic Stress Disorder.

Research on PTG has focused on themes of:

•

   a greater appreciation for life in general

•

   a more enriching sense of relationships

•

   an awareness of one’s own strengths

•

   the perception of new possibilities

•

   a deepening sense of spirituality

Chaplains can acknowledge “growth” …but never at the

expense of acknowledging the deep injury of trauma.

“Horizon”

By John Ehman

Chaplains’ Experience and Self-Care:

Chaplains’ Experience and Self-Care:

Contending with Secondary Traumatic Stress (STS)

Contending with Secondary Traumatic Stress (STS)

and Vicarious Traumatization

and Vicarious Traumatization

Postscriptum

C

C

h

h

a

a

p

p

l

l

a

a

i

i

n

n

s

s

a

a

n

n

d

d

S

S

e

e

c

c

o

o

n

n

d

d

a

a

r

r

y

y

T

T

r

r

a

a

u

u

m

m

a

a

t

t

i

i

c

c

S

S

t

t

r

r

e

e

s

s

s

s

/

/

V

V

i

i

c

c

a

a

r

r

i

i

o

o

u

u

s

s

T

T

r

r

a

a

u

u

m

m

a

a

t

t

i

i

z

z

a

a

t

t

i

i

o

o

n

n

When we engage sufferers of trauma at an emotional and empathic

level, we can become susceptible to the effects of traumatic

experience. This often occurs after repeated exposures over time, but

the process can be exacerbated by our particular sensitivities from our

own stories.

C

C

h

h

a

a

p

p

l

l

a

a

i

i

n

n

s

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When we engage sufferers of trauma at an emotional and empathic

level, we can become susceptible to the effects of traumatic

experience. This often occurs after repeated exposures over time, but

the process can be exacerbated by our particular sensitivities from our

own stories.

Warning signs include:

•

  avoidance of topics or situations with patients

•

  difficulty empathizing or feeling compassion

•

  trouble attending to proper boundaries

•

  lack of interest in work / “going through the motions”

•

  sense of cynicism or disillusionment

•

  PTSD-like symptoms (for example: flashbacks)

Professional caregivers’ responsibility to stay

whole

 and 

able

 for those who look to us for help.

        •

  Self-care as a personal discipline

            (including attention to support from others)

        •

  Intentional use of professional experiences

            to advance one’s capacity for caregiving

        •

  Idea of 

vicarious resilience

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