Last year, I was fortunate to have a piece published in Counseling Today with my co-author, Adrian Warren. The article, which appeared in the June 2021 issue, encapsulated our research on adult male survivors’ lived experiences of disclosing child sexual abuse.
Necessary to this research was the interview process in which I listened to the stories of men who had experienced horrific child sexual abuse, some by multiple perpetrators. These interviews took place over the course of about six weeks. I was bombarded with horror stories of emotional betrayal and sexual violence.
Then the nightmares started.
I can’t recall the exact date of my first nightmare, but I remember waking up angry and in a cold sweat after having dreamed that my youngest, 8 years old at the time, had been molested by a friend’s father. A few nights later, I dreamed I was beside my oldest son’s hospital bed after he was found beaten on a playground at school. In my dream, he was too ashamed to tell us who the perpetrator was or what exactly had happened. I woke up again in a cold sweat with a deep feeling of guilt that my son had been victimized. It took a minute for me to realize it was just a dream.
A few weeks after the nightmares started, my daughter, our middle child, announced she was planning to go to a sleepover at a friend’s house that weekend. “No, you’re not,” I blurted out without thinking.
My wife gave me an inquisitive look and asked, “Why not? We don’t have anything planned this weekend, do we?”
I couldn’t respond. I honestly didn’t know why I had suddenly become defensive, maybe even a little angry, about the thought of my daughter spending the night at a friend’s house. She had done it before many times, and we knew the family she would be staying with. My wife and I had been friends with this family since before our children were born. Why did I suddenly feel sick to my stomach at the thought of our daughter going to their home?
My wife made the arrangements. My daughter would go straight from school on Friday to her friend’s house with her friend’s parents, and we would pick her up around lunchtime on Saturday.
Friday loomed. The knot in the pit of my stomach grew heavier. Friday morning, I woke up in a cold sweat. Before getting in the car to take our daughter to school, I made sure she had her cell phone, a portable charger and her charging cable. I went over with her what numbers to call “if anything happened” and she needed us. I harped on it.
“Dad, chill out,” she said that morning. “You’re freaking me out a little.”
I was freaking myself out a lot. I checked my phone about every two minutes to see if she had called. When 9:30 p.m. rolled around, I called her. She didn’t answer. I was over the edge. I texted her and asked what she was doing. “Hanging out,” came the reply. She had just finished watching a movie, and they were getting ready to play some games. I spent that night in a state of near panic. I slept for maybe an hour and made sure my phone was on full volume and by my side the whole time.
Saturday morning came, and I couldn’t wait to go get our daughter. I was crawling out of my skin waiting. I almost called her at 6:30 a.m. to make sure she was OK. I sat that morning in a state of uncontrolled fear until we picked her up and she was safe with me again.
Mindfulness in action
The next day, as I nursed my cup of coffee, I realized I had not spent time in my mindfulness exercises all week. I have practiced mindfulness for more than 20 years. It was first introduced to me by Benedictine monks at a college I attended. Mindfulness exercises helped me manage depression and anxiety. When I became a counselor, I started integrating mindfulness into my own work with clients.
I put my coffee aside and went to my meditation chair. I have a specific place where I practice mindfulness exercises. The chair is comfortable but not so much that I fall asleep. It helps me sit up straight. I can put my feet on the floor or cross them underneath me depending on what is most comfortable on any given day. I went to my chair and began a mindfulness body scan.
I could feel how my feet rested on the floor with my ankles crossed. I could feel the bend of my knees and how my legs felt as I focused on each part of them. I could feel the pressure of my forearms resting on my thighs as my hands were placed in my lap, cupped in each other.
My attention moved up my hips and to my abdomen. Fear. There it was. Intense fear. The fear filled my stomach and rose up my chest like I was gagging on it. As I got in touch with that fear, I could feel my heart pounding and the tension in my shoulders, arms and neck. I noticed for the first time the stutter of my breath as I exhaled. I sat with this fear, recognizing the emotion of it. I accepted that I was afraid of something. I noted the physical sensations of fear and moved on with my body scan.
I spent the rest of the day paying attention to those physical cues of fear. I noticed how they intensified as my children talked about their activities. Every time my children mentioned their experiences of spending the night at a friend’s house or participating in some extracurricular activity, my stomach would knot up and my breath would quicken.
As I reflected on that fear in the coming days, I kept coming back to the same question: “What am I afraid of?”
“They’re going to hurt your children.” The voice was clear inside of me, although it felt a little alien.
“Who’s going to hurt my children?”
“Your friends. Your family. The abusers and manipulators. And you won’t know who they are until it’s too late.”
I had heard of vicarious traumatization in my academic studies, and it had always been an academic exercise: Identify the symptoms, prescribe intervention, promote prevention. I thought my academic understanding would be enough to insulate me from the threat.
Here I was though — nightmares, hypervigilance, intrusive thoughts, all underneath an anger that I didn’t understand. The worst part was the constant suspicion of everyone, even family members. As a counselor, I knew what these symptoms indicated. As a person, I wasn’t ready for the emotional toll they would take.
Support and self-care
I have always made it a point in my professional career to maintain a close-knit support group with other clinicians. Sometimes, I’ve been able to do this with co-workers in the same treatment organization. Other times, I’ve worked diligently to create my own professional support network. The iteration of my professional support network during this season of my life was a small group of three other counselors who met about every other week to talk and drink coffee. They were mindfulness practitioners too.
We visited with each other, and I let them know what was going on with me. Their response was more of a “Well, duh!” support than the kind of empathy that Brené Brown has spoken elegantly about, but that’s the kind of relationship we have. I told them I was kind of at a loss, and they helped me put together a plan and a series of exercises. They reminded me of the fundamental mindfulness concepts: radical acceptance, nonjudgment, compassion, patience, here-and-now focus. They reminded me to remain attuned to what I was paying attention to in my thoughts, to my emotions and to my body. They reminded me that the time to practice mindfulness is not when I’m in the grip of a vicarious trauma reaction or panic episode and most need to be mindful, but rather when I’m more relaxed.
Together, my support network and I worked out a plan of practice to address the experiences I was having. The first step was acceptance. I worked on accepting that the fears I was experiencing were not from my own lived experiences.
I found an image once of a woman walking down a darkened street. Her shadow was visible from a nearby street lamp, but behind her were the shadows of monsters clearly coming from a different source. This image summed up my understanding of vicarious trauma. Those of us in the helping professions can be haunted by the monsters that other people have faced.
We as counselors have many protective factors, including our knowledge, a developed self-awareness and strong support networks. While these protective factors may help us gain insight, they do not insulate us entirely from the vulnerabilities of our profession. Sometimes, we must accept the truth that we are not doing very well ourselves. The fear, nightmares, hypervigilance, suspicion and anger followed me but did not originate from my own experiences. Accepting that I was having these experiences was key to dismantling them.
The second step was to make sure I was engaging in my daily mindfulness practices. It has always been very easy for me to get busy and forget about the things that keep me well. I mentioned that I had not engaged in mindfulness practices the week prior to my daughter’s sleepover. That wasn’t because I deliberately chose to put these things on the back burner or to ignore my own needs. I just got busy.
Our practices for self-care are training for a marathon — training that needs to happen before the day of the race. We learn coping skills, just as our clients do, to make sure that we can manage our experiences as helpers. So many of the clients I have worked with through the years believe that they need to use the coping skills we review only when they are in the midst of dysregulation, be it panic, anger or addiction. We as counselors know that if a coping skill is not practiced before it is needed, it is not as effective as it could be when the time comes to use it.
The same is true of our own self-care. If the only time we engage in self-care is when we are on the edge of burnout, compassion fatigue or vicarious trauma, our self-care might stave off a crisis, but it won’t be very effective at keeping us well. So, I pledged to my support group that I would return to the daily practices that had helped me in the past. I made a commitment to them to practice mindfulness skills in meditation at least 30 minutes every morning, to exercise several times a week and to spend more time with my spouse and children. I committed to being mindful.
Finally, I used my support network. I have been to counseling in the past. It helped me immeasurably and put me on the path of becoming one myself. I am not opposed to seeing a counselor for my own individual therapy. Just as I encourage my clients, however, I decided to use my natural support network first.
These are friends in the profession with whom I have bonded. We meet regularly and speak openly to one another about our personal challenges. Sometimes we complain about our employers. Sometimes we complain about our employees. Most of the time we challenge one another to make sure we are taking care of ourselves, our families and our clients. I knew that I could sit down with them and say, “I think I’m having a vicarious trauma reaction.” I knew that they would hear me and help me recenter and get through it. Each time that we met afterward, I shared with them how I was doing on my plan to address these experiences.
Having this professional support is invaluable to me. We gather often to challenge, support and educate one another. This small group of clinicians is an important element of my self-care and ongoing professional competence.
Along with this professional network of support, I have natural supports in my life. I belong to a group of men that meets every Saturday morning for breakfast to share our stories of personal faith and to hold one another accountable as spouses and fathers. I shared with this group what was happening. They expressed understanding.
I also told my wife what was going on. She asked me if I wanted to stop letting our kids spend the night with friends for a while. I said just the opposite. I felt we needed to proceed as normal with our children’s activities, and I needed her to remind me that it would be OK.
This sharing of my experiences with my natural supports helped in the acceptance process. Talking about it with them and having to explain it at times helped me accept that it was happening.
I wish I could say that the nightmares, discomfort and anxiety stopped after a period of time. Word spread through my professional network that I had expertise in working with men who were survivors of child sexual abuse. This led to me getting more referrals of this particular client population than I had before. I have heard many more stories of abuse and betrayal since then. So, I continue with the regimen I established:
- Regular meetings with my professional support network
- Daily training in mindfulness practices that prepare me for the moments of panic I sometimes feel
- Honesty with my natural supports in life, which helps with the acceptance that I have this vulnerability
The symptoms of vicarious trauma have not gone away, but I am managing better. I still wake up occasionally from a nightmare, but the nightmares are less intense. I still experience bouts of anxiety when my children attend sleepovers and other activities. I was out of my mind this past summer when my kids went to a swim party at a friend’s house. I practice deliberately shifting my attention to other things until they are home and remind myself constantly that my wife and I have done our due diligence regarding who our children are spending time with.
I caution counselors-in-training against acting as their own counselors. In this spirit, I continue contact with my support network of other counselors. I am radically honest with them about my self-care. These supportive colleagues helped me create a list of things I need to watch for as indicators that I should seek individual counseling myself.
In the final analysis, my experience of vicarious trauma did not affect my work with clients. Based on the feedback I receive from them, they continue to feel that I am present and empathic, compassionate and helpful.
No, this experience primarily affected my life at home and my relationship with my children. It wasn’t just that I wanted to crawl into a hole but rather that I also wanted to put my kids in a hole where I thought they would be safe. My fear was closing in around my children, making me want to shrink their world and experiences. It threatened their well-being as they continue developing into their outstanding selves.
Through this experience, I have learned that self-care for me means that I wrestle with other people’s monsters so that my children, wife and friends don’t have to wrestle with mine.
James M. Smith is a licensed professional counselor, national certified counselor, approved clinical supervisor and board certified telemental health provider. In addition, he is a contributing faculty member with Walden University, a husband, a father, and a friend to a golden retriever. To contact him, email email@example.com.
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Hello Mr. Smith,
Your letter was validation for my dissertation research. I am currently in a Ph.D. program at Walden University writing my dissertation on vicarious trauma’s (otherwise called: Secondary Traumatic Stress), effects on Substance Use Disorder Counselors. Thank you for sharing your personal experience.
Barbara Stewart, CAC-AD
Good article James Smith.
I think that is A GOOD IDEA TO MEET ONCE A WEEK WITH COLLEAUGES ,
I wasn’t shouting ,sometimes my pinky finger hits the caps lock when I’m typing.
I need to get back to my mindfulness practice also.
Thanks for sharing.
Bill Livigni, LPC-S, LMFT,LRC,