Vicarious trauma in doctors

What is vicarious trauma?

Like many other frontline workers, doctors and medical students are, by the nature of their work, routinely exposed to other people’s traumatic experiences. Vicarious trauma is when we experience trauma through indirect exposure to another person’s trauma.

For medics, this is particularly likely to be trauma encountered at work, but it can also occur with trauma at home, or even on the news. Anyone who engages empathetically with survivors of traumatic events such as major illness, violence, wars, natural disasters, or accidents can be affected by it.

Factors that may make some people more vulnerable to vicarious trauma include:

  • previous traumatic experiences
  • long-term exposure to trauma
  • limited opportunities to share and debrief

Doctors, especially those who have worked through the Covid pandemic, are likely to tick off all of those factors.

What are the signs of vicarious trauma?

When faced with difficult situations, it’s normal to experience feelings of anxiety, stress, anger, and/or sadness. However, if those feelings are particularly intense or prolonged, it could be a sign of vicarious trauma.

Someone who usually feels safe can begin to doubt their own safety. Some may find themselves increasingly pessimistic and cynical about the future. Others may stop seeing meaning in what they do.

Other symptoms may include feelings of guilt, feeling emotionally numb, feeling hopeless about the future, worrying excessively about safety, unwanted thoughts or imagery about the traumatic event, fatigue, exhaustion, problems with sleep, and physical health problems.

What’s the difference between secondary trauma and vicarious trauma?

These two terms were coined at different times by trauma specialists seeking to better understand people’s reaction to the trauma of others. They are often used interchangeably in literature, and there is also overlap with the concepts of burnout and compassion fatigue.

Ultimately, however we refer to it, the effect on a doctor’s wellbeing and the mitigation strategies required will be fairly similar.

Is vicarious trauma preventable?

Doctors cannot, in most roles, prevent themselves from encountering other people’s trauma. But as with many of the mental health challenges that doctors face, prevention is better than cure: by taking care of their own wellbeing, doctors can reduce the likelihood of being traumatised themselves.

Some strategies that can help are:

Open up to people you trust. This may help you to feel less alone, and put things into perspective. It can be particularly helpful to talk to those who have been through similar experiences, like fellow doctors. And there is no need to rush – you should open up when you feel ready to.

Practice self-care. Whether it’s taking a relaxing bath, dancing to a favourite song, cooking a favourite recipe, or walking in nature: make sure you intersperse your responsibilities with fun activities.

Ask for help. If you aren’t feeling better over time, it’s a good idea to speak to your GP, or see what support is available through your hospital, surgery or NHS trust.

What support is available?

If you’re a doctor facing financial hardship due to mental health issues caused by vicarious trauma, you may be eligible for financial support from the RMBF.

In partnership with the BMA, we offer confidential psychotherapeutic support to all UK doctors via DocHealth.

There may be support available through your workplace or your GP. The BMA offers free and confidential 24/7 counselling and peer support services to all doctors and medical students (regardless of BMA membership), plus their partners and dependents. The Royal Colleges and other professional organisations for doctors also offer a range of support programmes.

This article includes information from an article by Rightsteps, who also provide our specialist online wellbeing resource. It offers simple, practical advice on a range of issues around mental and physical health.

The Vital Signs is our series of guides for doctors facing stress and pressure at work, including how to recognise the signs that you or a colleague may be struggling.

More information on our advice hub


BMA: Vicarious trauma: signs and strategies for coping

Tend Academy: Defining Vicarious Trauma and Secondary Traumatic Stress