Drowning in Empathy – Exploring Vicarious Trauma with Susan Zinn

Once you’re conscious of that, you want to change your life and then there become you can start to look at that future avatar of the life that you want to live. Then the action step starts coming into play and not being afraid to reaching out to get support and asking your community to support you because everyone has been through something or everyone will go through something. So I think having that vulnerability of saying you need help, that is one of the most important and questions that we can ask in our lives. Hi everyone, welcome back to another episode of The Mindful Space. Today we are here to talk about trauma and vicarious trauma with Susan. How are you today? Good. So glad to see you in Los Angeles. Yes, I know. I usually welcome people and the whole time people have been welcoming me to La. So it’s nice for a change. We’re glad to have you here and have your podcast here. It’s really special for us. So for those who might not know, you probably not in La. What is your full name, what do you do, your profession? You can say your personal background, anything you want to share with us. Okay, great. My name is Susan Zinn. I’m a board certified national clinical counselor. I’m a licensed psychotherapist certified trauma and eating disorder specialist, author and I’m a founder of the Westside Counseling Center. So many titles. I love it. It’s empowering and personally you’ve been here, how long have you been I’ve been in Los Angeles for seven years. I’m originally from New York City and I’m a mom of two teenagers and lots of dogs. So I’m a big advocate on animals. And right now we have a full house with lots of fosters as well. Really? That’s great. Yes, because I know you have a dog too. Yes, and I used to foster when I didn’t have a dog to satisfy my need as well of having a dog until I finally gave in and got one. But no, I love it. I love fostering. And you have two teens, so you are full of patients. Yes, and I actually have a high performance athlete too, so that’s actually been a really amazing journey and oftentimes working with patients that are in the sports or following a sports path has been really interesting. Having my own teenager going through that experience as well right now. Wow, so interesting. So we’re going to jump right into our subject, which is trauma. Let’s start with trauma in general. How would you define what trauma is? Trauma is the emotional response and the inability to cope as the result of a distressing event. And it really is the hopelessness and the face of fear. The problem with trauma right now is that we are experiencing a global mental health crisis and so many times people are sort of focusing on that distressing event and that title with trauma rather than really focusing on the effect that it has on us and the inside the wound that we experience from the distressing event. So oftentimes people will be focusing on, well, that wasn’t a big t, that wasn’t a catastrophic event, therefore you can’t really be experiencing trauma or it shouldn’t be distressing enough. And so people are not getting the support that they need because so many people have gone through so many things that they’re dismissing things like a heartbreak or what we kind of term as a small t or maybe it was a car accident, and then it starts to snowball in people’s lives. And that’s really when we start to see trauma really taking over their lives and causing a lot of distress in their everyday living. I heard you mentioned a big t and a little t. I know what that means, but for those who might not know what it means, do you mind give an example so they get the bigger picture? Sure. So the way that we’ve sort of looked at trauma when we’re looking at diagnostics is really looking at the amount of distress something causes someone. So a little t would be something like I mentioned, like a heartbreak or maybe it’s a car accident versus a big t would be something like a catastrophic event. But we’ve all been through a catastrophic event now with a pandemic on a global scale, and so I think we have to start looking at that very differently. And so while in the future, I know that we’re going to hopefully have biomarkers that we can measure in our body to sort of explore whether or not someone’s been traumatized, to really get them the support they need, right now, it’s really up to self reporting, and we really need to do a better job with people to start to let them know. Trauma is really the wound that you experience. It doesn’t matter what the event was. It doesn’t matter if it was a big t or a little t or if it was something catastrophic or if it was something that feels like it should be small. If it has an effect on you and it’s a wound, then you need the support. And we really need to start thinking about how to kind of get you the support that you need in order for you to live your joyful life, because no one needs to be suffering. Yeah, and my trauma might be different than your trauma. So why? To say that your event is not traumatic for you? Absolutely. And I think that’s such a valid point too, Michelle, because I think that so many times people will dismiss what’s happened to them or dismiss what’s happened to other people and be like, oh, you’ll be fine. And that can even be more traumatic because you feel like there’s something wrong with you or you’re defective or faulty or that you can’t somehow do what other people can, which causes even more trauma. And so I think we’ve got to start getting away from those labels and really just talking about the emotional impact this has on you as a wound and how you’re going to heal from that. Exactly. Now, somebody that might have trauma, whether it’s big T, little T, what symptoms would they present? How would they know if they have the trauma? Well, trauma really causes havoc in our everyday life, and sometimes it can start off with things like maybe disordered eating, sleep issues, either sleeping too much or not enough difficulty concentrating, and then it can go all the way up to things like having recurring dreams or being triggered because trauma impacts on our senses. And so sometimes you might smell something or hear something or see something, and then it’ll come back and it comes straight back to you. Exactly. And so that could look very different than someone who may have other kind of other symptoms. And so what I would really always say is if whatever happened is impacting your life in any capacity, it’s time to sort of get present and really explore, all right, how am I going to heal this wound versus just allowing things to kind of snowball? Because food can all of a sudden be getting triggered and be your enemy. Exactly. And then that causes even more trauma, and then that starts to kind of just compound over time. Trauma, I think you mentioned it. It affects your nervous system. How does it affect, and what are the long term effects? So we have two parts of a nervous system. We have one that’s connected with our brain, which in our brain, we have the nervous system connection with our brain, but we also have one in neurocardiology, which is we also have a nervous system in our heart. So it’s really important to sort of be talking about the brain body connection whenever we’re talking about nervous system, but the heart and brain connection as well, that 18 inches. And so what happens with trauma and with the nervous system is that it stores in our body, and our body doesn’t know that it’s a past occurrence the way that our brain logically can. Our brain can go, this happened in the past, therefore I should be over it. But our body starts to store that in our nervous system, and our nervous system’s job is to keep us alive and to survive. It’s its only job. So in the amygdala, which is that almond shape that you might have heard before, all it’s doing is signaling constantly whether or not you’re in danger, but it doesn’t care if you’re happy. And so when trauma stores in our nervous system, that’s what we can start to have. Those symptoms which can cause all kinds of things, like chronic illness. They can cause mental issues, it can cause learning issues. It can cause so many different things that inhibits our ability to live. Our best lives is that when everybody is just like in the fight or flight mode, everything’s just alert. And really the biggest because fight or flight, the nervous system wants to do something or say something, to run away from whatever it’s scared of or whatever it needs to survive from. But the biggest one we’re always concerned about is freeze. And that’s the most primal self defense mechanism when we actually freeze up because our body is so terrified that it actually kind of plays dead, like a NepalA in a sub Saharan region of Africa. And it plays dead so the lions don’t actually come eat it. It thinks that it’s dead already. And so that’s what we do oftentimes when we’ve been so traumatized or something’s impact us so much that we go to the freeze response. And that can be so traumatic for people because they feel like, well, why didn’t I run away? Why didn’t I fight? Why didn’t I do something? And there’s so much shame around people that have experienced trauma because people will ask, well, why did it take you so long to come to court and get a restraining order? Or why did it take you so long to come and get a rape kit from the hospital? And so that shame can really keep us in that spiral that causes even more damage for us and causes a more impact on our bodies as well, which, as I said, can lead to things like chronic illness. How can someone start the journey to repair the nervous system? Or what are some of the treatment options? I think that there’s so many. But the most amazing thing is for us to actually really start to think about being present, because what happens with our nervous system is that the heart is going to beat faster, kind of signaling that we’re in danger and is communicating to the brain that we need to do something to survive. And we go off to the races of kind of taking a past occurrence and flipping it to the future, when we can actually allow our body to stay in rest and settle and actually be present in the now. That’s when we can start to restore our nervous system, when we can be curious about what’s going on, when we can allow our bodies to kind of feel the impact of the emotions and allow us to sort of put the brakes on, so to say. And so I always like to say start small because if we start to kind of get onto these really big approaches, we can overload our nervous system and then we’re going to go back to default because we’re not going to trust ourselves. And so things that can be really small, number one is we always need to work on our foundation, which is our nutrition, sleep, hydration, healthy Lifestyle, healthy Lifestyle 100%. But then we can start to add in things like going for a walk in nature and really being present. Doing something like color therapy where you could be naming all the colors that you see right there in that moment in the beautiful forest in order to allow your body to really feel like what it feels to be calm and communicating that it feels safe. I do something every day. Everyday practice is always going putting my hands on my heart super simple and simply saying I am safe, I can keep myself safe. And allowing me to actually just breathe through that as if the only place I could breathe is through my heart and just allowing my heart to start to calm down into a state of rest so that I can actually start to connect more with my body as if I’m in the present right now. Exactly. And everyday practice will make you perfect. We’re almost but you install it in you so then the more you do it every day then you learn to believe whatever you’re saying to yourself. That helps a lot. It becomes a habit. Yeah. And I think that habits actually breed on habits. So whenever we’re wanting to create change we always talk about attaching an existing habit that we have that’s really concrete and it’s really good for us with attaching it with something new. So that’s also a great way. If we start with something like taking a walk every single morning, getting direct sunlight, breathing in the fresh air, staying focused and present in the now, not listening to a podcast or getting distracted or being on our phone, but really allowing us to kind of be really present, then we can attach to something later on. Maybe we’re going to attach a new habit like meditation for ten minutes or journaling after that. But I think starting with one and then allowing it to compound over time is really important. Exactly. And like you said, there’s so many different modalities and treatments out there that it is very essential and sounds basic but necessary to start with mindfulness and just be present in general. Now, I also wanted to talk about something called vicarious trauma where my Spanish gets in between how do you pronounce it? Vicarious trauma. Vicarious trauma. I’ve said enough in the show. They know I’m Hispanic, it’s fine, they don’t hate me for it. What is that? And can you give us some examples? So being in the helping profession like you and I are that oftentimes people, whether they’re physicians, doctors, there are clinicians, trauma therapists, first responders, no matter what it may be that you’re actually witnessing people’s stories and narratives in an empathetic way. Our brain doesn’t know the difference between reality and fiction and sometimes what we can experience is living their story as if it’s happening to us. And that’s what vicarious trauma is sort of that it all of a sudden impacts us and our mental health and well being based on the story that didn’t happen to us, we’re just witnessing it. And so it really is that cautionary care tale of sort of being in the helping profession that it’s something that we really have to kind of be very mindful of because if we’re not careful we can burn ourselves out or we can just get so overloaded. And I’m sure you’ve seen it as much as I have of people that no longer want to do this profession or want to change careers because they’re just too burnt out from experiencing so much trauma or sadness in people’s lives. And the amazing thing about trauma is just how that has an impact on us. So can vicarious transformation, which is actually listening to people’s stories and witnessing that of hope, can also impact us and actually make us more resilient. So it’s kind of this double edged sword that one side we can sort of experience vicarious trauma if we’re not careful. On the other side, we get this beautiful part of resilience and experience vicarious transformation through other people’s stories and strength which is really incredible about the work that we do. Exactly. It’s a very fine line. Have you ever felt that kind of way or treating your patients with trauma? Do you feel at any sessions or any point that you’re being a little too empathetic? Yeah, I think that the signs that you know that you’re getting in trouble would be really like if you find yourself being angry or over involved in their story or that you’re having trouble sleeping or that you are so invested in what’s going on with them that there’s sort of this line that gets crossed between what’s personal and what’s professional. And those are really the symptoms to kind of know that you’re getting into that. And I think it’s something every day when you’re a clinician, you really have to watch to make sure that you’re not getting over involved because oftentimes we can dream and think and wonder what’s going on with our clients and our own personal lives. So yes, the answer of course, that’s happened to me and I think that there’s been certain times that I found it harder. I think especially when people are starting off in their profession, it can be really challenging. I started my career off in the Er working as a rape crisis counselor and it’s a perfect example, right? And so I would get called in at 03:00 in the morning when maybe I wouldn’t have enough sleep, I would be on an eight hour shift working through victim services at the time, right after they had experienced a crime. And that was something that was really hard for me because I found myself becoming very hyper vigilant, kind of very concerned about other people’s safeties during that time. And I think that that’s often what a lot of people when they first start and especially when you’re doing really hardcore work like that, that it can have that impact on you as well. I mean we’re therapists but we’re also human beings, right? We’re allowed to feel. Absolutely. And I think that if we are not honest about that, then there also becomes this perception that somehow we’re supposed to have it all figured out and we never go through anything. And that’s what actually causes so much trauma for us is because we don’t feel like we’re allowed to be human. And that can really have a large impact in why sometimes people no longer want to do this job anymore. As a result too going to say that’s where people get burnout. Listen, a therapist needs a therapist. Absolutely. I always say that. Absolutely. And their tribe. You need to have the support system and really working on your own self care program is super important. That is part of the job that is a requirement to do this job. Exactly. Self care first so then you’re able to treat others. What are some of the most common treatments for someone that has been through any traumatic event? I know you mentioned the mindfulness. That would be the first step, very important step. But once they’ve reached that point where they want to continue and go into a larger extent, what do you recommend or how do you treat your clients, what do you do? I think that there’s so many modalities out there and they’re all amazing and they all kind of have the same sort of elements to them which I think are really important. So I’ll talk about that. But also there’s a whole other aspect which I think self healing is so important and we all have the ability to heal. So there’s a lot of things if you can’t afford treatment or if you don’t have access to it, there are a lot of things that you can do in order to heal yourself. But from a treatment perspective, when you’re looking at trauma, there’s sort of EMDR, somatic experiencing, somatic motor havening technique, internal family systems, there’s a lot of modalities that all have a common thread, which is they all focus on body work and releasing the trauma that’s been stored in the nervous system and in the body so that the memory then starts to put it into the correct order as a past occurrence. It’s no longer happening now, it’s actually happening in the past. And it doesn’t mean that you’re going to forget it and you’re not going to remember it happened, but it’s going to mean that it’s no longer triggering you and it’s no longer affecting you and your body. But on the same side of that, when I’m talking about self healing mindfulness, you don’t need to go to a teacher for that or a therapist. That is a practice that you could be doing. However, I do want to warn that some people when we discuss that freeze response when they are doing meditation or mindfulness, they can find that to be triggering because they’re too still. And so something like a walking meditation would be much better for someone who’s experienced trauma because the body can be in motion as they’re processing information and utilizing really the power of nature. Exactly. Connecting. Yeah. Things like faith are really important animals. We discussed from the beginning how therapeutic connecting with animals can be. And really oftentimes I find with so many people that have been through the unthinkable being of service is actually very cathartic for them to work through their own experiences. And probably why there’s a high percentage of people that are actually therapists that actually been through their own fire as well. Right, so having that ability to help someone else is so important to the healing process. And our ability to sort of connect and be human and be present with one another is really important to healing. Yeah. I know you can’t mention details, but do you mind sharing with us a successful story of yours, of a client maybe, or one of those stories that maybe you thought was too complex and the person was able to move on with their trauma? I think that one of my favorite things oftentimes is not only seeing people live their best lives, but I recently have had several patients that have actually become a therapist, particularly eating disorder patients. And so that’s always really cool to see that they really find the meaning making and sort of paying their story forward. And I think, again, talking about that transformational aspect that can happen where when we’re sort of witnessing someone that has really been through so much and then to see their lives be so beautiful, that is really the meaning making, I think, of doing this profession and what makes it so special as well. Yeah, we’re definitely in the industry of helping people because we want to. But also the magic of human beings, our ability to heal, our ability to overcome it so much and how strong we are to get to the other side and say, hey, there’s only really ever one question we have to ask every single day and it’s do I want to be happy? And so I think that when people are on that journey of saying, I’ve now chosen to no longer staying stuck in this pattern, I’m no longer allowing something to hold me back from my divine life, then they can just live these beautiful lives. But it takes a lot of work, it’s not magic and it takes a lot of effort too. Now, you mentioned people overcoming, but I know you also have a personal story of overcoming. Do you mind sharing? Yes, I’m like where to start. Back in 2000. Yeah, so I actually, in 2008, had three heart surgeries. My last heart surgery was 17 hours. I had 35 ablations to my heart and I pretty much had a near death experience is the only way I know how to describe it. So when I woke up. The word that I kept rolling around in my head over and over again was joy. And what I realized is, and exactly what we’re talking about is I lived way too close to burnout. I was at the time working on a lot of school shootings, natural disasters. It was post 911. I’m still working with a lot of survivors from that or first responders and my work was really focused so much around trauma and I didn’t have a lot of reprieve. I would work till 10:00 at night, had kids and I just was always the engine that was going and so I was sort of really depending on medical science to tell me oh well there’s something wrong with your heart and we can fix it. I was not really understanding the impacts of how I was living my life was having on my physiological body and how that was leading to chronic illness. And unfortunately, heart disease is the number one killer for women. And so it’s something that we really have to take seriously. That the impact that living with so much trauma and living in a dysregulated state for so long or burnout is going to impact our hearts. The amazing thing about it is that I discovered neurocardiology. And so, so much of my practice has now really been about teaching people about the power and the intelligence of the heart. And that when we actually allow ourselves to understand that we can shift our states whenever we want to and we listen to this higher intuition, everything in our lives change. It doesn’t mean that that wasn’t hard for me. And I went on this journey of self discovery myself but I don’t have a pacemaker. I was supposed to have a pacemaker and I’m no longer having any heart or health issues and so much of that is just to the choices that I’ve made and so I think that that’s also really important for people to know. Just because you have a diagnosis of a chronic illness or an issue like a heart issue does not mean that that is what you have to deal with for the rest of your life. There are choices of how you can heal yourself. Exactly. It doesn’t have to be your truth, at least not forever. Yes, don’t deny it either but it doesn’t have to be dragging you around forever. How can someone with trauma transform what they went through something negative into something positive? I think the amazing things about human beings is we’re always becoming new versions of ourselves and that’s a choice. Again, as I said, it’s a choice every single day to wake up and decide if you want to be happy. But I think that we have to be okay with being uncomfortable with the transition because when we’ve been traumatized we oftentimes are so fearful that something in the future is going to be more painful than what we’re experiencing right now that we’re resistance change. And that’s really for anyone, not only just people that have been through trauma. So it’s letting go and having faith that what’s on the other side is going to be amazing. And so I find that when people are willing to take that brave step in order to heal themselves, they often will say it’s not the trauma that made them have this beautiful life or create meaning in their lives. It was the strength and the resilience that they realized that they had. And I don’t want to sugarcoat trauma is painful, it’s ugly. There’s nothing about it that actually is meaning making from that perspective. It’s the resilience that we find within ourselves to transform our own lives. And that’s what makes that post traumatic growth that oftentimes people discuss so incredible and where they find meaning and purpose. Even going back to where we mentioned maybe someone who experienced an eating disorder and then all of a sudden is becoming a therapist, helping other people or like you. I’m sure you have your own story of why you’re sitting here right now. There’s meaning making in your life as a result of you using your voice right now and helping so many people understand their mental wellness and live more beautiful lives. Well, I must say my story is not that interesting. Even since college, when they would ask, well, why do you want to become a therapist? My answer was always like, I just want to help people. And then everybody else had their own traumatic event and that’s why I connected. I was like, I’m like the 0.1% that does not have big trauma in their life, but I love to help people, that’s why I do it. Well, I’ve loved your conversation. It’s a heavy subject, but we have to talk about it in the trauma. And I love the way you were able to deliver the message of being hopeful and staying positive and be willing to make the change and the work so that it becomes a positive experience in your life. Ultimately, what would your last message be for someone that might be going through a traumatic event and they want to start their healing journey? I think the first is really accepting the fact that you do not have to survive in your life. You don’t have to be white knuckling. It just getting through day to day. You have a choice of whether or not you want to live a joyful life. And making that first step is everything. Because once you’re conscious of that, you want to change your life and then you can start to look at that future avatar of the life that you want to live. Then the action steps starts coming into play and not being afraid to reaching out to get support and asking your community to support you because everyone has been through something or everyone will go through something. So I think having that vulnerability of saying you. Need help. That is one of the most important questions that we can ask in our lives. So I think that rather than being hopeless is where we started with this conversation, that so much of it is hopeful for your future and the future life that you want to live. Yeah. Couldn’t have said it any better. One of those cases that you’re like, wow, oh, gosh, there’s, like, so many of us. I know about confidentiality, though. Of course. Yeah. Very general. You don’t even have to say if it’s female or male. Just the story. Well, I could talk about do you want okay, yeah, just jump right in. After 911, one of the reasons why I decided I want to become a trauma therapist was because I started spending a lot of time with the firefighters. And these were these heroes that were going down every single day to the pit, what was called at the time, where it was the rubble of what happened after 911. And they would come back and they had such hope and family and laughter and sharing meals. And I was so inspired by these people that were doing what was unthinkable. And so that really goes to the point that we’ve been talking about with that vicarious transformation of seeing people go through what is so unimaginable and then inspiring other people to do something and change their life. And that had a tremendous impact on me. And so much so that on the 20th anniversary, I contributed to and co authored a book called The Epiphanies Project. And I talked about that connection with the firefighters and how much they impacted me and my life. And that led me to then start working in the Er as a rape crisis counselor and then at Planned Parenthood soon afterwards. But it really started me on that journey of really seeing that vicarious transformation and how people could change their lives no matter what they had witnessed, no matter what they had gone through. And that I think oftentimes when you’re working this profession, people assume, well, how do you do that job? It just feels my gosh, it’s so sad every single day. And it’s actually the complete opposite. I want people to know that that’s the complete opposite. You finish the end of your day and you’re like, that was amazing. I’m so happy that person is actually doing better in their lives or that they’re recovering or they’re no longer in pain or they’re starting to heal or whatever it may be. That there’s so much hope in our career and our journey that we do in our profession that I never want people to feel like this isn’t something that they should choose. Because exactly, that vicarious transformation can be everything and it just makes so much meaning for us in our daily lives and what we’re doing in our profession as well. All yes. I completely agree with you. Thank you. Thank you so much. For coming. This was a wonderful interview. Thank you guys for listening or watching. Don’t forget to subscribe to our channel. We have new episodes every week. Bye.