Recently, researchers have begun to reach beyond burnout and explore the impact of Vicarious Trauma on professionals in the field of human service. What is Vicarious Trauma? The technical definition of Vicarious Trauma is a permanent transformation in the helper’s inner experience resulting from empathic engagement with the client’s traumatic material (Pearlman, Saakvitne, & Figley, 1995). Those who work in family law and other related fields need to understand one of Vicarious Trauma’s paramount underpinnings, Controlled Empathy, so that they may remain aware of this pervasive occupational hazard.

All of us are secondary witnesses to trauma nearly every day. All one needs to do is watch television, listen to or read the news. A traumatic response in any one individual is the result of a number of processes, some of them biological, some of them psychological (Weingarten, 2003). It is also important to remember that any experience of trauma is in the “eye” of the beholder. There are cultural, historical and childhood frames of reference that may help one person go into a trauma response when it will not affect another in quite the same way (International Trauma Consultants, 2006).

Vicarious Trauma is more than secondary trauma. It is estimated there are more than one hundred million helpers worldwide (Izzo & Carpel Miller, 2008). Vicarious Trauma is a syndrome that anyone in the helping position can experience. It is characterized by a painful set of symptoms that result from utilizing Controlled Empathy while listening to or seeing traumatic narrative content (Wilson & Thomas, 2004). This article will discuss the activity call Controlled Empathy as a vehicle to raise awareness around a key neurological process that significantly contributes to the risk of becoming vicariously traumatized.

Controlled Empathy is a vigorous neurological activity. When a helping person is listening to the shocking, sad, or awful stories of another, it may look like he or she is calmly sitting and listening. But the activity going on inside the listener’s brain and body looks anything but calm. Not only is the helper absorbing the shocking story, he or she must respond to the content in a constrained manner that is geared to aid the suffering person.

Controlled Empathy and Automatic Empathy are not the same. Neurologically, they travel in different circuitries in your brain (International Trauma Consultants, 2006). Because Controlled Empathy is Automatic Empathy interrupted, it casts a much greater strain on the professional’s physiology, cognitions, emotions and spiritual well being.
Let’s start with and explanation of Automatic Empathy. The neurological activity of Automatic Empathy involves a specific system of neurons called mirror neurons. The process forms a neurological loop originating from the mirror neurons in the pre-frontal cortices of the brain, traveling throughout different regions of the brain, creating a full body sensation as if the listener was actually experiencing the event. These neurons form a specific brain circuitry that underlies the empathic impulse and ultimately helps the individual to adopt another’s point of view. This circuitry sets the stage of the human imagination: it is a right brain activity and the helper imagines the event as if it were happening to him/her (Wilson & Thomas, 2004).

Researchers studied the empathic response by locating the neurons in the anterior cingulae of the brain that respond to a patient being poked with a needle. These neurons are referred to as sensory neurons. Remarkably, these researchers have also found that some of these neurons will fire equally as strong when the patient watches someone else being poked. When this type of sensory neuron is fired, changes take place throughout the body as if the witness is having the pain. New brain scan techniques have enabled scientists to prove that our ability to empathize is an intrinsic part of our brain. Empathy neurons dissolve the barrier between the self and the other (Kramer, 2007).

Empathy, the ability to share another’s emotions, is rooted in infancy. For example, newborn babies will cry in response to the cries of another infant (Kramer 2007). Early in life, we learn to imitate matching emotions to expressions and events. We use that information to predict each other’s emotions and act altruistically or vicariously, depending on the situation.
A pattern of the brain strain associated with the technical skill of Controlled Empathy is observed starting with the activation of the visual cortex. As the listener hears a horrible story he/she begins to visualize it in the mind, as if it is actually happening. The brain is struggling with another’s upset. In this process called Controlled Empathy, the helper has to now rev up his or her own internal resources to remain composed (International Trauma Consultants, 2006). This taxes the right hemisphere of the brain because the activated mirror neurons want to automatically surge from it and travel to the left brain, but the helper has to “hold them back” because professionally, he or she needs to remain calm, cool, and collected. Imagine first setting a top spinning, and then immediately interrupting its gyrations; it’s like going against a force of nature.

When a person engages in Automatic Empathy, he or she can let out the tension freely. This process has a preferable physiological impact on the brain. The right brain and left brain work together to resolve the process of Automatic Empathy. The brain activity of a person experiencing Automatic Empathy, a healthy neurological process, is much like the top, spinning until it slows down and then stopping on its own.
It is only after the left and right brain has once again achieved a calm balance or homeostasis that the empathic person has the ability to respond to the story and more easily access higher mind or high- left brain dynamics for helping (Begley, 2007). These dynamics might include forgiveness, hope, faith, and courage. These are considered spiritually-based dynamics and are important to utilize in traumatic situations so that the other’s legitimate suffering can be effectively addressed (Izzo, 2008).

Empathy plays a critical role in many facets of life. It leads the way to compassion, moral awareness and spiritual well-being. When the taxing neurological activity of Controlled Empathy is coupled with the neurological strain of traumatic content, one is faced with the probability of suffering Vicarious Traumatization, or as we call it, Second-Hand Shock™. (Izzo & Carpel Miller, 2008).

Untreated Vicarious Trauma can adversely affect the ethical judgment of the helping professional by mitigating their ability to set professional-to -client boundaries and diminished levels of competence. Therefore, awareness of this major contributing factor, Controlled Empathy, empowers the helping professional to protect him/herself from the negative effects of internalizing trauma.

Begley, S. (2007). Train Your Mind, Change Your Brain. NY:

Izzo, Ellie. (2007). The Bridge to I Am. NY: iUniverse.

Izzo, Ellie & Carpel Miller, Vicki. (2008). Day After Day The Price
You Pay; Managing Your Second-Hand ShockTM. CA: Janis

Kramer, P. (2007). Empathy. The Infinite Mind. Online. Google.

International Trauma Consultants. (2006). Online. Google. 6 Mar.
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Pearlman, L.A, Saakvitne, K.W. (1995). Treating therapists with
Vicarious Traumatization and secondary traumatic stress
disorders. in Figley, C.(Ed).Compassion Fatigue: Coping with secondary-traumatic stress disorder in those who treat the traumatized. pp. 150-177. NY: Brunner

Weingarten, K. (2003). Common Shock: Witnessing Violence Every
Day: How We Are Harmed, How We Can Heal. NY: Dutton.

Wilson, J. & Thomas, R. (2004). Empathy and the Treatment of
Trauma and PTSD. NY: Brunner Mazel.

Author's Bio: 

Ellie Izzo and Vicki Carpel Miller are Co-Directors of the Vicarious Trauma Institute in Scottsdale, AZ and co-authors of the book Day after Day The Price You Pay: Managing Your Second-Hand Shock™. They present extensively on this subject. Please visit their website at