Put Your Oxygen Mask on First

Written by Dr. Becca C. Johnson

I used to feel uncomfortable every time a flight attendant instructed passengers, “be sure to put your oxygen mask on first before assisting others.” It seemed so selfish, so against our God-given mandate to be selfless and to help others. 

Then, a pilot explained to me what happens in those first few moments when the plane’s passenger cabin loses pressure. We have only a short time to respond before we become unconscious. It is faster, more efficient and effective to put your oxygen mask on first. If not, the chances of success are slim for you and anyone near you needing help.

This same thinking is necessary for those serving in or supporting intense ministries working with the severely traumatized. As we hear story after story of tragedies we need to make sure we’ve taken care of ourselves first. Working day in and day out with victims of abuse, rape, prostitution, sexual exploitation, violence, labor trafficking and more takes a toll on our emotional and physical health as well as our faith. 

Unfortunately, far too many Christians believe that self-care is selfish. Or, they incorrectly think they are immune to vicarious trauma if they are serving God wholeheartedly. We must be sure to take time to get away and pray, as Jesus did, and to rest on the Sabbath. We must take care of ourselves or we cannot take care of others.

Vicarious trauma is the term used to describe the trauma experienced by those working with the traumatized. It is the subtle and gradual accumulation of trauma that slowly creeps into the caregiver’s souls. It’s victims are big-hearted, good-intentioned , compassionate servants, who don’t understand the necessity and importance of self-care. “Experiencing and listening to the pain, hurt, difficulties, frustrations, and trauma of others gets transferred to the victim service provider… Vicarious trauma isn’t an issue of ‘IF’ but rather, ‘When’. (COVA, 2005)

Additionally, secondary trauma is experienced by those who witnessed, heard about, or watched media in which trauma took place or who know someone who has experienced a trauma. Many of us experienced this on September 11th, 2001 when news coverage showed the catastrophe and aftermath. Additionally, parents or family of children who have experienced a trauma such as rape or abuse would experience secondary trauma. We can apply this term to those who are consistently hearing about and aware of the gravity of human trafficking and its effect on others.

Compassion Fatigue is the emotional and physical exhaustion that can affect helping professionals and caregivers over time. 

It is associated with:

• A gradual desensitization to (victims’) stories
• A decrease in quality care for (victims) and an increase in… errors
• Higher rates of depression and anxiety disorders among helpers
• Helpers’ empathy and ability to connect with their loved ones and friends is (adversely) impacted 
• Increased rates of stress in the household, divorce (relationship difficulties), and social isolation. 

Mathieu, F. (2012). Compassion Fatigue. In CR Figley (Ed.) Encyclopedia of Trauma. Sage Publications

Those studying vicarious trauma report that the common symptoms are increased feelings of hopelessness (apathy), a negative view of humanity, and a growing sense of the world as unsafe. How can we help others if we are struggling with discouragement, powerlessness, sadness and an overwhelming sense of grief? 

“[Compassion Fatigue] is an inevitable and normal response to working with traumatized people.  Very empathetic individuals are at a higher risk of being frequently and negatively impacted.”

Charles Figley, Compassion Fatigue, 1995

Vicarious trauma happens because you care.

Left untreated, this leads to personal and ministry burnout which can easily lead to departure from service. While burnout refers to too much work, vicarious trauma refers to too much trauma. When we experience both burnout (too much to do and/or with insufficient resources and staff) AND vicarious trauma at the same time, we are in what I call the Danger Zone (illustrated here).

“What is crucial to remember is that working with the traumatized is very taxing to one’s psychological defenses, after all, the helper keeps seeing a steady stream of trafficked persons, each one of them carrying his/her tragic narrative, and the helper must remain professional and available.” (Helping the Helpers: Tips to Avoid Burnout Reactions and to Remain Professionally Effective, Jaffe, in The Mental Health Aspects of Trafficking in Human Beings, IOM, 2004, Ch 5, page 137)

If you have been aware of the issue of human trafficking, and continue to educate yourself and advocate for survivors, the constant information provided through social media and other avenues can create similar feelings of hopelessness, fatigue, and burnout experienced by those working directly with vulnerable populations. Because of this, it’s important for all of us who have a heart for ending human trafficking and supporting survivors to be aware of this secondary trauma and how to mitigate the effects. 

While Vicarious Trauma focuses on the negative effects of working with the severely traumatized, the term Vicarious Resilience is used to describe the potential benefits. It is a wonderful term that focuses on what we gain personally and professionally. Personally, we may gain more sympathy, awareness, and a greater thankfulness and appreciation for our lives. Professionally, we may develop better empathy skills, greater understanding of trauma and its effects, and an improved ability to help victims and assist them on the road to recovery. Working with the traumatized can make us stronger and better.

How to put your oxygen mask on

Vicarious and secondary trauma is minimized when you are able to:

• Remind yourself of the importance and value of what you do
• Allow yourself to feel rather than numb or deny the pain
• Take time to rest and to reflect (journal, read, prayer, write) rather than keep on going
• Identify and challenge any cynical (negative) thoughts and doubts
• Engage in helpful, hopeful and healthy activities 
• Minimize negative input such as news, exposure to trauma, sad movies,…
• Have fun, be spontaneous and laugh out loud often (it has healing power)
• Nurture your faith/spirituality, pray 
• Take care of yourself: sleeping, nutrition, activity (exercise)
• Maintain a vital support system (family, friends, co-workers,…)
• Make sure you have an enjoyable life apart from work: hobbies, recreation, outings,…
• Focus on God’s hope, goodness, love, mercy, forgiveness, peace, patience, grace,… and be thankful.

Summary

“Probably the most important recommendation we make to our colleagues about their personal lives is to have one.” (Pearlman and Saakvitne, 1995, p. 393 or Saakvitne, KW, Pearlman, LA, Transforming the Pain: A Workbook on Vicarious Traumatization. Norton, 1996) Remember, “Helping others is noble. Helping yourself is essential.”  And, don’t forget to put your oxygen mask on first!

About the Writer

Dr. Becca C. Johnson  –  Serving the Sexually Abused and Exploited

Dr. Johnson, a licensed psychologist for 30 years, has served as trainer, counselor, consulting psychologist, clinical director, aftercare director and international program director for numerous anti-trafficking and child abuse organizations. Becca has provided support, training and consultation on child abuse, human trafficking, trauma recovery and self-care to numerous NGOs and restoration programs around the world (in over 30 countries).

Dr. Johnson developed the counseling program for AIM’s Agape Restoration Home in 2006 and has continued to serve as Consulting Psychologist ever since. When in Cambodia, she provides training on trauma recovery, vicarious trauma and aftercare. She has also served on the AIM board for the past 10 years.