“The Ugliness of It Seeps into Me”: Experiences of Vicarious Trauma among Female Psychologists Treating Survivors of Sexual Assault

Abstract

The current study explores the lived experiences of female psychologists who provide psychological treatment to women survivors of sexual assault. These practitioners are a population of special interest due to the frequency of their exposure to narratives and graphic images of sexual trauma. Semi-structured interviews were conducted with 15 female South African psychologists. The data, which were analyzed using an interpretative phenomenological approach, revealed experiences characteristic of vicarious traumatization. Participants reported having an enhanced sense of personal vulnerability to sexual assault and heightened awareness of the betrayals of trust that women experience from male figures, which has led to increased mistrust of men and hypervigilance regarding the safety of their daughters. Internalization of feelings of helplessness experienced by the victim evoked self-blame for practitioners and appraisals of being complicit in abuse. Practitioners also experienced survivor guilt about being spared from harm. Symptoms of intrusive re-experiencing of client trauma and cognitive and behavioral disengagement were evident. These findings have important implications for clinical practice and underscore the necessity for clinicians to cultivate an awareness of the impact of treating sexual trauma and working in ways that are self-protective.

“Holding the badness”: Therapists’ experiences of treating incestuous abuse continuing into adulthood.

“…Tanya, who moved into a different area of psychology said, "After working in complex trauma for six years, this was a breath of fresh air." Some therapists described adapting to the unique pressures of these cases in order to cope with them, in a process similar to that documented by Padmanabhanunni and Gqomfa (2022). Several therapists reported finding the close therapeutic relationship rewarding, sustaining them through the difficult and lengthy journey, something that appeared to be bidirectional.…”

“…However, there is no known published research investigating therapists’ experience of working with such clients, although therapists with complex, severely victimized clients are known to be at risk of vicarious trauma (VT), compassion fatigue, and burnout (Figley & Ludick, 2017). Therapists working with child sexual abuse survivors experience unique impacts, including being more likely to have negative cognitions about safety and the goodness of people; difficulties with sexual intimacy; and elevated levels of vulnerability, self-blame, withdrawal, and intrusive reexperiencing (Padmanabhanunni & Gqomfa, 2022; Rizkalla et al, 2021). Feeling unsafe and less trusting is more common among female therapists working with sexual abuse cases (Sui & Padmanabhanunni, 2016).…”

Review of Protective and Predisposing Factors in the Vicarious Traumatization of Psychotherapists

“…La muestra total de los 22 estudios analizados incluyó, 4064 psicoterapeutas del área de la psicología clínica y de la salud, con tamaños de muestra que variaron desde un mínimo de 6 (Sui y Padmanabhanunni, 2016) hasta un máximo de 931 participantes (Wozencroft et al, 2019). La edad media de la población, obtenida a partir de las medias muestrales especificadas en 12 de los estudios analizados, fue de 41.39 años (Aafjes-van Doorn et al, 2022;Barrington y Shakespeare, 2014;Cieslak et al, 2013;Cummings et al, 2021;Diehm et al, 2019;Foreman, 2018;Halevi e Idisis, 2018;Lakioti et al, 2020;Litam et al, 2021;Makadia et al, 2017;Martin-Cuellar et al, 2019;Padmanabhanunni y Gqomfa, 2022). El rango de edad osciló entre los 20 y los 79 años, ambas edades fueron recogidas en el estudio de Wozencroft et al (2019).…”

“…Por otra parte, se constata que existen discrepancias significativas en la prevalencia reportada para el EPS, mientras Cieslak et al (2013) identifican una prevalencia del 19.2%, Sodeke-Gregson et al ( 2013) elevan este riesgo al 70%, que contrastan con la evidencia previa informada por Bercier y Maynard (2015), quienes ofrecen una estimación de prevalencia más conservadora, situándola entre el 5% y el 15% incluso considerando conjuntamente EPS y TV. Más relevante es acreditar que cinco estudios identificaron que la mayoría de los psicoterapeutas manifestó síntomas combinados de TV y EPS (Barrington y Shakespeare, 2014;Hernandez-Wolfe et al, 2015;Padmanabhanunni y Gqomfa, 2022;Sui y Padmanabhanunni, 2016;Wang y Park-Taylor, 2021).…”

Vicarious trauma

“…For example, an individual may begin to view the world as an evil or unsafe place, question innate benevolence, or doubt their self-worth. 4 These shifts in the cognitive schemas are characteristic of vicarious trauma and contribute to the long-term sequela of symptoms including disturbances in spirituality, selfidentity, worldview, intimacy, and trust. 5,6 Sometimes the term vicarious trauma is used interchangeably with other related constructs including secondary traumatic stress (also known as compassion fatigue) and burnout.…”