Early this year, as the country reeled under shock after a 23-year-old New Delhi resident was gang-raped, and died of her injuries, Powaibased trauma therapist Hvovi Bhagwagar noticed her women clients were rescheduling their late evening appointments.
"Several said they didn't feel safe visiting the clinic that 'late at night'," says Bhagwagar, about appointments scheduled post . This despite the fact that her clinic sits inside a busy mall. Another patient, a 17-year-old girl, stopped coming to the clinic altogether. "When I inquired, her mother asked me how could I expected the young girl to drive down alone to Powai when newspapers were buzzing with news of sexual assault," adds Bhagwagar, who has been practising for 13 years. It's no different this time around, after news of a 22-year-old photojournalist's gang rape last week.
While an increased sense of caution following news of this sort is normal, Bhagwagar says the behaviour her patients exhibited was linked to Vicarious Trauma (VT).
The empathy overdose
Dr Siddharth Ashvin Shah, medical director of Washington DC metrobased Greenleaf Integrative Strategies, says VT is a phenomenon in which people develop symptoms of trauma (numbing, hyper-vigilance, nightmares) when exposed to information concerning someone else's trauma.
While this is commonly seen in care-givers, social workers and counsellors, even those exposed to tragic news in the media are susceptible to it.
Dr Shah adds that the psychological reason for VT's occurrence is not completely understood. "Still, it would not be speculative to suggest that the following contribute to VT: the human capacity for empathy, the brain's mirror neurons and exposure." Empathy conveys the content of the exposure - people react because they imagine the suffering as if it were happening to them. Mirror neurons in specific regions of the brain fire as if an activity were being done physically (even though a person is aware of it happening to another). Exposure refers to the duration, frequency and depth of contact with the traumatic story.
Speaking about last week's incident, Bhagwagar says that those who identify with the girl - young working women or those who come from the same profession as her - are at higher risk. But even men can show signs. "Typically, husbands and fathers could become overprotective of women in their lives. They might suggest they take a different route back home from work, even if the road they walk on is busy and well-lit," adds Bhagwagar.
In 2008, Bhagwagar says, there were reports that students at city schools seemed withdrawn, and lacked focus in class. "This was after the 26/11 attacks in Mumbai, and we realised that the children had been exposed to terror via television for three days, and didn't know how to process their feelings," she adds. The parents had to be advised to stop watching news 24x7, or watch it on their laptops.
Immediately after witnessing a traumatic event vicariously, it's natural to suffer anxious moments. But if the symptoms persist for more than a month after the event, it's a sign that Post-Traumatic Stress Disorder (PTSD) is setting in. Shah and Bhagwagar say it's best to consult a therapist in this case.
Interestingly, there are enough people, who after exposure to news about war, natural disasters, accidents, terror attacks and sexual assault, don't react the same way.
Trauma can be layered one on top of another. Those who have faced a similar trauma in the past find themselves vulnerable to similar attacks - in the case 26/11, those who frequented the areas and hotels that were targeted by the terrorists - can experience both a retriggering of past trauma plus VT.
Dr Shah says, "For instance, journalists covering the 9/11 attacks experienced a triple layering of trauma. As journalists, they were present during the attacks and primarily affected; those who had experienced prior trauma faced a re-trigger; and those who continued to report on it found themselves vicariously traumatised by stories they were covering."
Dealing with it
While one would argue that after attacks like last week's, it would be normal for any woman in the city to be anxious and alert, Bhagwagar points out there's a difference between the two. "Alertness results in problem-solving behaviour, whereas anxiety leads to avoidance behaviour."
Reaching out for help is important. Speak to your friends and family about your emotions, and reach out for professional help if symptoms last longer than usual.
SIGNS YOU MAY BE SUFFERING FROM VT
» Hyper-vigilance (anticipating that something horrible will happen; increased obsession with bad news)
» Exaggerated startle response
» Emotional instability
» Flashbacks (visual, auditory or olfactory memories intruding the consciousness)
» Physiologic instability (racing heartbeat)
» Distorted thinking (confusion)
» Avoidance (staying away from reminders of the event; memory gaps; occupationally, this could mean extreme discomfort continuing to cover violent events)
» Loss of hope (believing that no one can make a positive difference)
» Emotional numbing (not enjoying socialising with others)
» Dissociation (decreased awareness of one's surroundings)
» Maladaptive behaviours (excessive alcohol use, over/under eating)