Secondary Trauma and Compassion Fatigue

help for compassion fatigur and secondary trauma

14 Steps That Help

by Steve B. Reed, LPC, LMSW, LMFT

Secondary trauma (vicarious trauma), compassion fatigue, stress, and PTSD represent a serious group of related problems for people who care for, hear about, or witness the intense suffering of others.  Ultimately, this can lead to burnout.  Several professions are at high risk for compassion fatigue and burnout including physicians, attorneys, nurses, psychologists, counselors, social workers, ministers, hospice workers, adult, and child protective service workers.  Those who care for people in nursing homes and those who care for patients at home are also at risk.  Families who care for suffering relatives are particularly vulnerable to these problems.

One study suggested that the average E. R. physician will hit burnout within 10 years.  Another recent study estimated that 47% of currently practicing physicians are already experiencing burnout.  However, one problem with such studies is the varying definitions of burnout that are used in the research.  A meta-study on the topic found burnout ranging from 0% to as high as 80% (1).  Even though the lack of a precise definition of burnout causes a lot of statistical variances, it is clear that a major problem exists for those in the caring professions.

Years ago, I treated a minister who was two months from retirement.  He reported that the emotional wear and tear of his career had become so overwhelming that he had even lost his faith.  His goal was to coast across the finish line of retirement and recoil from religion.  He had given so much of himself that he had lost his compassion and a part of himself in the process.

When I was in my mid-twenties, a close friend was hired as a child protective services social worker.  After he had spent a year dealing with the traumatic experiences of the children he hoped to help, he was emotionally exhausted.  He began to experience secondary trauma.

One evening at dusk, I stopped by his house.  His front door was open and but no lights were on.  I called out his name, eventually, he emerged from the back of his house. He was wearing a bathrobe and carrying a half-drunk bottle of whiskey.  However, even alcohol could not quell his pain.  He had hit compassion fatigue and burnout.  Within a month, he quit his job and enrolled in graduate school.  He was done with human services.  He had enrolled in an engineering program and he never looked back.  This is what can happen to people in the helping profession who can not find a means of regulating the cumulative stress build-up.

However, almost anyone can be vulnerable to the impact of secondary trauma (vicarious trauma).  Anyone who owns a television can tune in to the unending stream of disasters.  For years, I have advised my clients against the negative mental health effects of sensational TV reporting.  This recommendation is a direct result of seeing the adverse effect that such stories and images have on the people I treat.

For example, in the years since the 9-11 terrorist attacks on the World Trade Center, I have treated one person who was actually in New York at the time and a couple of people who had been in the twin towers just the day before they came down.  This is about what I would have expected since my office is in the Dallas area.  However, I have treated many people for the secondary trauma of watching hours upon hours of broadcasts of the pain and suffering of the people who were there.  I continue to treat people for vicarious trauma related to that event many years after the fact.

This information outlines 14 steps that can be taken to increase resilience to this form of stress.  Two effective approaches are underscored for desensitizing traumatic stress and calming the emotional midbrain.  The video below demonstrates one of the two effective treatment approaches outlined in the "14 steps that help" slide presentation.  It is the use of the REMAP process to treat secondary trauma and sadness.

Treating Grief and Secondary Trauma with REMAP - Dallas, Plano, Allen, Murphy TX

By Steve Reed at the Psychotherapy Center

The slide presentation below provides links to information that explains the nature of PTSD, stress, secondary trauma, and compassion fatigue problem and offers practical self-help interventions.  Please review the slides now to discover how this information can be of help to you.


  • 1. PTSD Stress Secondary Trauma Compassion Fatigue 14 Steps That Help 14 Steps That Help Steve B. Reed, LPC, LMSW, LMFT 1
  • 2. Stress Level Limit Stress Goes Here Psychological Coping Container Whether your capacity for containing stress is small, medium, or large, everyone has their limit. 2
  • 3. Two Types of Stress Routine Stress Both Adversely Effect Functioning 0--------------6---------10 Traumatic Stress 0-----------------7------10 3
  • 4. Traumatic Stress Is too Intense To Handle Routed Into the Bottom of the Coping Container 0-----------------7------10 4
  • 5. Traumatic Stress Compartmentalized for Long-Term Storage Does Not Heal Remains Painful 0-----------------7------10 5
  • 6. Routine Stress 0--------------6---------10 With Enough Time, It Can Evaporate, Work its way out 0-----------------7------10 6
  • 7. Routine Stress 0--------------6---------10 Too Much, Too Soon Leads to Spillover Loss of Containment Overwhelm – Panic It Feels Traumatic Video – 2 min. 0-----------------7------10 7
  • 8. Emotional Midbrain • When traumatized or when we • Hit cumulative stress overwhelm • The midbrain (amygdala) is imprinted • With threatening and benign data • The alarm is then set and • Triggered by any trauma remainder • Causing a fight, flight or freeze reflex Midbrain Intro Video # 5 on the Midbrain – 11 min. PTSD Symptoms 8
  • 9. Secondary Trauma Viewers of 9-11 Media Coverage Develop Secondary PTSD Trauma resulting from caring for, hearing about, or witnessing the intense suffering of others. Over time, the cumulative effect can result in an internalization of trauma, leading to compassion fatigue or burnout. 9
  • 10. 12 Ways to Increase Resilience to Stress & Secondary Trauma 10
  • 11. Boost Coping Capacity Speed Up Offloading Stress 11
  • 12. Walk Laugh Sleep Recreation Social Support Media Diet TV 6 Healthy Habits 12
  • 13. 3 Ways to Manage the Mind Change Your Expectations Expect = Get Expect = Get Develop a Positive Filter Look for What’s to Like – Attitude of Gratitude Let the ANTs Go Automatic Negative Thoughts 13
  • 14. 3 Daily Mind-Body Practices Stress-Relieving Breathing Video # 1 – 11 min. Intro. Video # 2 – 6.5 min. Exercise Mindfulness Video # 3 – 7 min. Intro. Video # 4 – 7.5 min. Exercise Quick REMAP Video # 6 – 11 min. 14
  • 15. Professional Help – 2 Ways To Heal Trauma Clean Out the Container 15
  • 16. Effective PTSD Treatment  EMDR  REMAP Useful in Healing the Midbrain 16
  • 17. More Links to Info. & Articles Article: Overcoming a Firefighter’s Trauma Case Study SlideShare: PTSD War Trauma Treatment Case Studies SlideShare: Treating Domestic Violence PTSD Case Study Article: Soothing the Sympathetic Nervous System – REMAP Research 17
  • 18. Steve B. Reed, LPC, LMSW, LMFT Please Share & Like On Social Media 18

Quick REMAP can be effectively used to treat compassion fatigue and secondary trauma.  An article by Dr. David Santoro discussed the use of Quick REMAP in helping a medical social worker who suffered from burnout.

Help for secondary trauma, compassion fatigue, and burnout.

If you are suffering from burnout, compassion fatigue, or secondary trauma, help is available.

Steve B. Reed, LPC, LMSW, LMFT is available to provide therapy, treatment, and counseling to help you neutralize the stress that leads to burnout.

Appointments are available by phone or video (e.g. Zoom, for people worldwide.

To Schedule an Appointment – Call 972-997-9955.

Treatment is frequently provided to people in major US cities including Albuquerque, Atlanta, Austin, Boston, Charlotte, Chicago, Cleveland, Columbus, Dallas, Denver, Fort Worth, Houston, Indianapolis, Jacksonville, Kansas City, Las Vegas, Los Angeles, Oklahoma City, Phoenix, Philadelphia, Portland, New Orleans, New York, San Antonio, San Diego, San Jose, San Francisco, Seattle, Tampa, and Washington DC.

Steve's local practice serves the Dallas, Fort Worth, DFW metroplex, including Addison, Allen, Arlington, Bedford, Carrollton, Colleyville, Denton, Euless, Fairview, Flower Mound, Frisco, Garland, Grand Prairie, Grapevine, Highland Park, Hurst, Irving, Keller, Lake Highlands, Lewisville, McKinney, Mesquite, Murphy, Plano, Richardson, Rockwall, Rowlett, South Lake, University Park, and Wylie. He provides therapy at his office in Richardson, Texas.


  1. Rotenstein LS, Torre M, Ramos MA, et al. Prevalence of Burnout Among PhysiciansA Systematic ReviewJAMA. 2018;320(11):1131–1150. doi:10.1001/jama.2018.12777
Share This: