Recently, I ran across a gem of a book that helped me understand the toll of a cancer diagnosis on our mental health and what to do to get healthy called "Healing Secondary Trauma" by Trudy Gilbert-Eliot. The book is written for caregivers, therapists, and health care professionals.

As a cancer survivor, I understand the mental toll cancer takes, but the book also helped me see the toll cancer takes on us when we're surrounding the patients with care and support. I could relate to several of Gilbert-Eliot's examples and I liked how she visually outlines practical thinking patterns and how these can lead to compassion fatigue or secondary trauma. I loved that the book was practical, it even had checklists and guided questions.

Here are some of my key takeaways:

Secondary Trauma

Secondary trauma, also known as vicarious trauma or secondary traumatic stress, refers to the emotional duress that results from witnessing or learning about another individual's traumatic experiences. It can gently unfold through our empathetic engagement and close emotional connections with the experiences of our loved ones. Those who support or care for individuals going through distressing events, such as illness, accidents, or loss, are particularly susceptible.

What does it look like?

It can manifest in symptoms similar to Post-Traumatic Stress Disorder (PTSD), such as heightened anxiety, intrusive thoughts, emotional numbness, or avoidance of reminders related to the trauma experienced by the person they are supporting.

Who does it affect?

Health care professionals, therapists, caregivers, and close family members are among those who commonly experience secondary trauma.

Secondary Trauma Checklist

• Intrusive Thoughts or Imagery: Do you find thoughts or images related to your loved one’s experiences intruding your mind unexpectedly? Is there a replaying of distressing moments in your thoughts?
• Avoidance: Are you avoiding conversations or situations that remind you of your loved one’s trauma? Is there a tendency to emotionally disconnect when exposed to related triggers?
• Hyperarousal: Do you feel heightened levels of anxiety or stress when exposed to reminders of the trauma? Is there an increase in irritability or heightened sensitivity to sudden sounds or movements?
• Mood Fluctuations: Are you noticing significant shifts in your mood, such as heightened sadness, anger, or anxiety? Is there a presence of emotional numbness or disconnect?

Compassion Fatigue

Compassion fatigue is a concept that refers to the physical and mental exhaustion and emotional withdrawal experienced by those who care for or support individuals in distress. It may evolve over time due to the cumulative effect of being emotionally tuned into others’ suffering.

What does it look like?

Symptoms may include feelings of hopelessness, a decrease in experiences of pleasure, constant stress and anxiety, sleep disturbances, and a pervasive negative attitude.

Who does it affect?

It often affects individuals in caregiving professions, such as nurses, doctors, and therapists, but can also affect anyone deeply involved in supporting someone going through hardship, like family members or close friends of a person dealing with illness or trauma.

Compassion Fatigue Checklist

• Emotional Exhaustion: Do you often feel emotionally drained or overwhelmed? Is there a sense of heaviness or numbness in your emotions
• Reduced Sense of Personal Accomplishment: Do you feel less satisfied or accomplished in your role as a caregiver? Is it challenging to celebrate small wins or feel a sense of purpose?
• Physical Symptoms: Are you experiencing physical tiredness more frequently? Do you notice any changes in sleep patterns or appetite?
• Reduced Empathy: Is it harder to feel empathy or connect emotionally with others? Do you find yourself distancing from the emotional aspects of caregiving?

What can you do?

I loved this book because it offered ways to take practical steps if you're experiencing secondary trauma and/or compassion fatigue:

• Acknowledge with Compassion: Allow yourself to feel and express your emotions without judgment. Recognize the impact of the journey on your feelings and relationships, holding them with understanding and care.
• View Seeking Help as a Strength: There's no shame in reaching out for professional mental health support. It’s a courageous step towards healing and finding strategies that resonate with your well-being.
• Nurture Relationships: It’s completely valid to acknowledge the effects of this journey on your relationships. Embrace the changes with openness, communication, and mutual support, nurturing the bonds with tenderness.
• Find Supportive Communities: Finding healing and insight in support groups or communities who share similar experiences can be a heartwarming space of mutual understanding and guidance.

Feeling compassion fatigue does not make you weak or a bad person. Gilbert-Eliot’s book helped me see that if you think you are feeling compassion fatigue and secondary trauma, you can regroup and reenergize. But you must stop doing what you are doing and put self-care practices into place.

I don’t mean spa days, but really work at what you need to do to reenergize and maintain your mental health.

A hypothetical example: Sarah and Michael

To apply what I read, I created two characters, Sarah and Michael, who are navigating life after Michael's cancer diagnosis two years ago and feeling compassion fatigue and secondary trauma. This is how I saw the book's recommendations and tools playing out.

Sarah’s caregiving journey

Sarah shares her heart and life with her husband, Michael, accompanying him through the nuances of colorectal cancer. Together, they have already navigated medical routines, emotions, and everyday adjustments.

Sarah noticed the silent footprints of compassion fatigue and secondary trauma. Feelings of emotional overwhelm, moments steeped in tears, and a soft veil of sadness seemed to accompany her all day, indicating a deep connection with and empathy for Michael over the course of two years.

After recognizing the signs of secondary trauma and compassion fatigue in herself, Sarah committed the time and space to seek mental health support. She learned strategies like mindful breathing, journaling, and participation in a caregivers' support group. She began to find solace and understanding. She wasn’t alone, and she wasn’t the only person feeling this way.

Sounds easy, but was hard stuff. The first step was being open enough to seek help. She had to stop fixing and planning. It required her to grieve and process her feelings about seeing Michael go through treatment and surgery.

Michael’s resilient path

It's been two years since Michael was diagnosed with stage III colorectal cancer, and he is still unpacking a wide range of emotions and experiences. Layered on top, he starts to feel the effects of secondary trauma. It manifested as emotional exhaustion, a heart heavy with unprocessed feelings, and that not-so-great mixture of vulnerability and fatigue. His body and his mind were worn down by cancer.

Michael had his own signs of compassion fatigue and secondary trauma. Realizing the impact of hearing "you have cancer," having his colon removed, and undergoing chemo plus radiation left him a different man. Watching Sarah work day and night to help care for him was also complicated. The guilt and sadness wouldn’t go away.

Michael needed professional advice, exploring therapeutic ways to regain his identity and sense of self. He had to make some radical changes and learn new coping strategies by embracing practices like meditation and expressive arts, allowing space for his emotions and experiences to flow and find expression. He had to find a healthy way to grieve and communicate his feelings and his needs to Sarah. He stopped bottling things up.

In this hypothetical example, secondary trauma and compassion fatigue didn't topple Michael and Sarah, but instead, they grew stronger and healed.

It’s okay to seek help and support

The journey toward mental wellbeing is continuous, and it takes time. Don’t rush it—big or small, each step you take toward mental wellness counts. Remember: if you're feeling the impact of secondary trauma and compassion fatigue, you are not crazy and you certainly aren't alone.