Secondary trauma (ST) refers to the impact of indirect exposure to traumatic experiences; effects which can be ‘disruptive and painful’ and can ‘persist for months or years’ (McCann and Pearlman 1990). The effects, as described by McCann, in relation to working directly with clients, are considered to be a usual response which results from witnessing a distressing traumatic event or from knowledge about such an event, particularly if the person is connected with the victim-survivor (Figley 1998). ST is one of a number of terms used somewhat interchangeably (including vicarious trauma, burnout, compassion fatigue) to convey ideas about the transference, or rippling-out effects, of trauma from the original incident and the original victim-survivor. Burnout is more usually related to the demands of work (including caregiving and studying) and its contextual components, such as long hours, insufficient support or control, and heavy workload, than the specific nature of work involved, and thus may be different, if overlapping, with the topic we are looking at (Freudenberger 1974). Brown (2017) refers to the Maslach Burnout Inventory (2015), which differentiates burnout from other forms of exhaustion or depression, due to its inclusion of an element of compassion fatigue. It is this aspect which those with caring responsibilities find particularly difficult to acknowledge and address. Because this previous research has often focused on front line workers rather than researchers and we know collectively very little about the impacts of studying trauma on this group, we use the term ST within this paper as a more descriptive term which doesn’t imply an outcome or particular impacts, yet can include a similar range of impacts found in the phenomena of burnout or compassion fatigue. The term secondary trauma is not ideal but it is important to recognise where this paper sits in relation to the wider literature on the impacts of working with trauma as the focus of ones work. We also use the term ‘emotional safety’ to recognise ways in which the potential for ST can be acknowledged.
The American Counselling Association describes ST as the ‘emotional residue of exposure’, explaining that it results from people witnessing trauma (by direct exposure or by hearing narratives about it), and thus becoming ‘witnesses to the pain, fear, and terror that trauma survivors have endured’ (American Counselling Association 2010). The idea that front-line emergency responders, and people working therapeutically with those who have experienced trauma, might experience vicarious impacts is not new (Maslach 2015). Professionals considered to be at potential risk of traumatisation have historically included: rescue workers, police officers, military personnel, emergency healthcare staff, and counsellors/therapists (Brown (2017); McCann and Pearlman 1990; Ursano et al. 1999). Increasingly, it has become recognised that there are many more groups of people who might experience ST, particularly those in a range of ‘helping professions’, who may assist trauma survivors, including: humanitarian workers, social workers, suicide helpline workers, a wide range of healthcare professionals, justice system professionals, journalists, and faith leaders (Rafferty 2004; Figley 1998; Day et al. 2006; Pryce et al. 2007; Shah et al. 2007; Sansbury et al. 2015).
So, where do researchers fit in this picture? We intuitively understand that front-line professionals exposed to the traumatic and sometimes horrific experiences of others might be affected, but the shift towards acknowledging the impacts on researchers working with information about traumatic events or with traumatised individuals has been slower (Dickson-Swift et al. 2008, 2009). Is that because researchers, on the whole, do not experience these affects? Or because it is not considered or acknowledged? Or is it because, as considered below, this type of impact can be cumulative?
In the past, we might have considered researchers outside of the ‘at-risk’ groups for ST for a number of reasons: they rarely see the traumatic events that people experience, they rarely interact with people who have experienced trauma for more than a handful of occasions, and they do not have an explicit helping role in the situation. In addition, part of the reticence about recognising the potential for researcher ST may be, in part, due to traditional views of academic scientific endeavour as objective, detached and neutral, where researchers are not supposed to feel anything (other than perhaps satisfied or frustrated) about the work they undertake. In reality, research is rarely an entirely neutral process, and researchers are often neither impassive nor unaffected by the research they conduct (Hallowell et al. 2005). This is particularly true for research using qualitative methods, where people may narrate their experiences in depth, though we would argue that it can also be the case for studies using a quantitative paradigm.
The topic of the research is, perhaps, most crucial in terms of risk of ST. This paper focuses on the field of Gender Based Violence (GBV). The World Health Organisation (WHO) identifies the most common risk for fieldworkers in this area as the ‘emotional toll of listening to women’sFootnote 1 repeated stories of despair, physical pain and degradation’ (Ellsberg and Heise 2005), with interviewers describing the imprint that bearing witness to violent narratives had had on them:
When I heard stories about women [sic] being beaten and tied up, I would leave there feeling desperate… I would be a wreck, and my supervisor would tell me “get a hold of yourself, you cry for every little thing.” But how could I control myself? I couldn’t stand it… I would try, but sometimes it was impossible, and I would burst into tears during the next interview… (Ellsberg and Heise 2005: 42).
The practical guide produced by the WHO for researchers of GBV clearly describes the ethical responsibilities within research; not only to keep all parties physically safe, and to minimise participant distress, but also to consider the impact that this work has on researchers’ wellbeing (Ellsberg and Heise 2005). Of course, these are not unique considerations for those researching GBV, researchers working with trauma in other fields may encounter similar. In fact, a brief scoping of the literature indicates that secondary distress has been raised as an issue in recent years by researchers working in a number of fields, including suicide (McKenzie et al. 2016), cancer (Benoot and Bilsen 2016;), and bereavement (Butler et al. 2017), in addition to those working on topics relating to violence and abuse (Nikischer 2019). These topics have risk of serious harm or death in common and, as a recent revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) also indicates, extend the populations seen as potentially vulnerable to developing ST to include anyone with indirect exposure to aversive details of events where a person has been ‘exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence’ (APA 2013). Some may consider this definition too broad, as it includes the potential for anyone to be defined as vulnerable and therefore any researcher engaging with humans to be traumatised as a result. However, we would argue that there are sensitive areas of research where this risk of negative impacts on researchers is judged to be high, where additional support measures ought to be considered. These additional measures might include Ethics Committees reviewing the emotional safety of research in protocols (as suggested by McKenzie et al. 2016) or clinical supervision as we suggest in this article.
For GBV researchers, there may be potential compounding factors relating either to exposure to traumatic information, or to the people who have experienced the trauma. The first is that the trauma has resulted from the actions of another person, most often someone close to the victim-survivor. This person has intentionally chosen to inflict pain, harm, violence, and/or abuse, and Herman describes how this brings those studying in this field face-to-face with ‘the capacity for evil in human nature’ (Herman 2015). This invariably challenges the way we see the world and humanity, and can potentially impact on both our sense of safety, and the way we might relate to others (Biruski et al. 2014). The second dynamic is that because stigma, embarrassment, shame and guilt often exist around the experiences of abuse, participants may not have communicated their experiences previously. Klein (2012) describes the possibility of participants making their first-ever disclosure of sexual violence in response to questioning by an interviewer. Consequently, when given an opportunity to speak in a safe environment, with someone independent of their situation who is empathetic, people may share material which is raw and unprocessed, finding a release of expression, and pour out detailed descriptions of events and incidents, also allowing themselves to feel, at depth, their emotions (Ellsberg and Heise 2005). This is often experienced as an empowering, cathartic and purging encounter for participants, (Smith 2000; Moch and Cameron 2000; Hutchinson et al. 1994) but can leave a researcher reeling from the deluge, and feeling besieged and unsteadied (Klein 2012). A third factor which might amplify experiences of ST is personal experience. It is not uncommon for people who have experienced GBV in their own life to gravitate towards an active role in this topic of research, including undertaking related research. This ‘insider view’ is incredibly valuable and may, through enhanced empathy with participants, lead to more in-depth and nuanced research findings. However, for researcher protection and self-care, the possibility that exposure to other people’s experiences may trigger memories relating to personal trauma, or may increase cumulative effects of exposure, needs to be considered (Ellsberg and Heise 2002).
In addition to the topic area, the types of research conducted and the models used may unintentionally amplify secondary distress for researchers. Qualitative methods are frequently used, which not only bring researchers face-to-face with people who have experienced trauma, but also require researchers to remain immersed in the data over lengthy periods, through the iterative processes of data collection, transcription, coding, analysis and paper writing. In addition, research in this field tends to attempt to conduct with people rather than on people, and to incorporate feminist ideals around reducing power imbalances between researcher and participant (Legard et al. 2012). There are bodies of work relating to Participatory Action Research (Burke et al. 2017) and Indigenous Knowledge Research (Marzano 2009) which would critique whether such approaches achieve genuine collaboration, and these criticisms are acknowledged. However, attempting to conduct research in this way requires researchers to be fully present and fully congruent, with a shared sense of humanity with participants, honouring emotional connectedness with people (Williamson et al, 2019a). When done successfully, this certainly enhances the research, but it can also increase the risk of ST due to, what Figley describes as, the ‘cost of caring’ for others in emotional pain (Figley 1982).
The aim of this paper is to explore reflexively the impact of research on the lives of GBV researchers, and the ways in which they guard against ST. We draw on the experiences of a team of researchers who recently completed a large study looking at GBV, although we believe that this paper can contribute to wider discussions about the wellbeing of researchers working in a range of subjects.