PDF Summary:Trauma Stewardship, by Laura van Dernoot Lipsky

In Trauma Stewardship, Laura van Dernoot Lipsky writes that we can better care for others who have gone through trauma by learning to care for ourselves—a practice she calls trauma stewardship. Trauma, loss, and suffering are everyday realities, damaging not only to those who suffer from these challenges directly, but also to the caregivers who witness and tend to others’ trauma. Lipsky argues that to be fully present and emotionally available to others, we must address the impact of secondary trauma (the harm we experience when exposed to others’ trauma). Lipsky's trauma stewardship framework addresses how to manage secondary trauma, create a better work-life balance, and practice mindful self-care so you can support others to your fullest capacity.

In this guide, we’ll explain Lipsky’s concept of trauma stewardship, discuss the warning signs of secondary trauma, and provide ways you can replenish your energy for healthy caregiving. Along the way, we’ll provide additional psychological insights about trauma exposure and other experts’ advice on self-care and compassion.

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• Work becomes your source of self-worth: You become obsessed with your work because helping others and making a difference makes you feel like you’re important.
• You avoid everything: When work becomes so draining, some people grow to dread it and try to avoid it entirely. You might wish an excuse would come up so you don’t have to show up to work. Lipsky argues that avoidance can become a habit: You might feel like your personal life is just as draining as your work and start to isolate yourself from family, friends, and positive activities.

How Struggling to Detach From Work Harms Your Health and Relationships

Trauma work is often very stressful, and if you struggle to detach from your work, the excessive stress can take a serious toll on your health. In Mind Over Medicine, Lissa Rankin argues that when you don’t give your body the time to rest and repair, stress can affect your health in a number of ways: It can damage your blood vessels, increase your risk of heart attacks, weaken your immune system, and lead to muscle strain and stiffness. In fact, she cites a study revealing that people who don’t take annual vacations had a 21% higher risk of dying from any cause and an increased risk of cancer.

Additionally, the symptoms of overwork are similar to the symptoms of trauma. In The Body Keeps the Score, Bessel van der Kolk describes some common symptoms of trauma, and by examining them, we can get a better understanding of how overwork affects trauma workers.

Hypervigilance: Van der Kolk argues that trauma causes hypervigilance because it’s so overwhelming that the brain separates the event into pieces—into sounds, sights, emotions, or sensations. After the event is over, your brain remains hypersensitive to threats, and a particular and otherwise harmless sound might trigger your brain. This can make it hard to relax and connect with other people.

Dissociation: People exposed to trauma dissociate to protect themselves from negative feelings and sensations. This becomes a problem, van der Kolk argues, as regularly tuning out can cause you to lose a sense of self and make it harder to manage your emotions. For example, you might struggle to relieve tension in your body if you don’t recognize that it’s your stress that’s causing it.

Obsession: People who have suffered trauma (and likely those exposed to it) sometimes become addicted to it, actively seeking out stress to crowd out other feelings like boredom or anxiety. Repeating or engaging with that trauma, however, only leads to more feelings of pain and fixation.

Avoidance: While Lipsky discusses avoidance as a result of feeling overwhelmed by work, van der Kolk adds that people who have experienced trauma also avoid social settings because they feel unable to be understood. Interacting with others, then, becomes exhausting as they constantly view others as threats.

Sign #6: Struggling to See Nuance

Lipsky writes that trauma exposure can cause people to view people and situations in simplistic ways and develop polarized opinions. When trauma work leaves you drained mentally and physically, you lack the capacity to consider things deeply and from different perspectives. This might lead you to see things only in black-and-white or label things and people as “good” or “bad.” Lipsky explains that while some trauma sufferers adopt this generalized way of thinking to feel a sense of certainty and security about themselves and their environment, this way of thinking can prevent you, as a caregiver, from navigating situations with sensitivity and without judgment.

Beyond diminishing your capacity for complex thought, secondary trauma reduces your ability to think creatively, which in turn impacts your ability to come up with innovative solutions and make good decisions. According to Lipsky, this is because you can only be creative and entertain many possible options when you’re relaxed. However, the more you get wound up in the trauma of others, the harder it is to relax.

How Our Threat Response Affects Complex and Creative Thinking

Psychologists refer to the inability to view situations and people in a nuanced way as dichotomous thinking and suggest that it emerged as a part of our fight or flight response. In early human history, we had to be able to quickly label something as threatening or nonthreatening so that we could launch into an appropriate response. People who have gone through trauma, Bessel van der Kolk explains, have brains that are hypersensitive to threats, and they tend to misjudge things as immediate threats. Given this, it’s all the more important for caregivers to avoid dichotomous thinking and approach situations with nuance so they can better help trauma sufferers.

In terms of creative ability, some psychologists paint a more nuanced picture, arguing that trauma can make some people unable to access their creativity, but others can use their creativity as a way of healing. While trauma can affect creativity in different ways, it ultimately prevents people from expressing themselves with authenticity and vulnerability, which is why healing trauma is an important step to restoring their authentic creativity.

Sign #7: Struggling to Be Compassionate

According to Lipsky, people who regularly work with suffering and loss become desensitized to it. They no longer feel emotionally moved by the pain experienced by others. This desensitization makes it harder for them to be compassionate listeners. Instead of listening with an open mind, they might compare the hardships of different people and minimize those that are less severe. This subconscious act prevents them from giving the same compassion and attention to all people in need of support.

(Shortform note: Beyond desensitization, another symptom of secondary trauma, the silencing response, also hinders a caregiver’s ability to show compassion. This occurs when caregivers try to avoid feeling distressing emotions by unintentionally silencing those they’re caring for. Rather than being unaffected by other people’s painful experiences, they feel overwhelmed by them and close off their ability to listen as a coping mechanism. This response manifests in different ways, causing trauma workers to change topics, minimize situations with humor, and struggle to pay attention.)

Sign #8: Struggling With Addiction

Lipsky explains that many people experiencing secondary trauma also struggle with addictions. She elaborates that trauma workers often turn to drinking alcohol, playing video games, or overworking themselves to avoid coping with difficult feelings they’ve developed from their trauma work. These distractions, however, are only temporary and, over time, deplete their ability to cope with emotions and be present when helping others.

(Shortform note: In Dopamine Nation, Anna Lembke explains why addiction is a common coping mechanism: Your brain uses the same parts to process both pain and pleasure, so you can only feel one or the other at a time. As a result, when people do immediately pleasurable activities (like drinking or video games), they don’t feel pain. However, Lembke argues that the brain is always seeking balance, so each time you repeat that pleasurable experience, it brings you less pleasure because your suppressed pain has been building up. When you stop doing that pleasurable activity, you experience discomfort that drives you to resume it. When you keep relying on an activity to relieve pain, you become addicted to it.)

Practice Self-Care to Practice Trauma Stewardship

Now that we’ve discussed the signs of secondary trauma, let’s discuss how you can practice trauma stewardship to manage this type of trauma. To be more reliable, accessible, and effective for the people, animals, or environment that you’re tending to, Lipsky says you must practice self-reflection and self-care. Since secondary trauma results from you internalizing or “taking on” the pain of others, you must focus on healing yourself from within—by addressing your own needs, feelings, and intentions with mindfulness.

(Shortform note: While Lipsky argues for the importance of self-care for trauma workers specifically, Steven Covey argues that people of all professions should take care of themselves to maintain their capacity to do good work. In The 7 Habits of Highly Effective People, Covey says you must take care of your well-being in four ways: physically (by eating well, exercising, and sleeping enough); spiritually (by meditating or spending time in nature); mentally (by learning new information); as well as socially and emotionally (by seeking mutually-beneficial relationships and collaborating with others). He adds that maintaining your health allows you to improve your efficiency and grow not only in your work, but in your overall life.)

Lipsky provides five strategies for practicing self-care to be a better trauma steward:

Strategy #1: Make Time for Reflection

According to Lipsky, the first step of embracing a more mindful approach to trauma care is to regularly reflect on your needs, motivations, and emotions. You can do this by setting aside a small window of time in the morning for reflection. You can also practice meditation and breathing exercises.

Lipsky explains that understanding ourselves is key to processing the effects that secondary trauma has on us. Often, we get so caught up in our daily routines and work stresses that we lose connection to our personal needs and the reasons why we wanted to help others in the first place. This can cause us to feel like we have no control or options in our lives when we really do.

(Shortform note: In Who Will Cry When You Die?, Robin Sharma recommends you reflect on your purpose every morning and at the end of each day to be more connected to your personal needs, purpose, and motivations. He argues that thinking about your purpose every morning allows you to eliminate unnecessary obligations from your schedule. Every night, Sharma suggests you reflect on your purpose by writing about any lessons and experiences you had during the day. This helps you assess whether you’re living according to your purpose so that you can better adjust your mindset and actions tomorrow.)

When you practice reflection, ask yourself: “What is my reason for doing what I’m doing?” This question helps you realize that trauma doesn’t control you and that you have a choice in what to focus on when working with trauma. Lipsky recommends you discuss your reasons with people you trust or write them down as a reminder for the future. As you reflect on your reasons, consider whether continuing in your current work is good for your health. It’s possible that the work you do may no longer be in your best interest if it’s negatively impacting your well-being.

(Shortform note: Beyond posing yourself questions or discussing your reasons with others, consider visualizing a personal wellness meter to regularly assess your needs and determine whether your work has become harmful to your well-being. Imagine your meter has a green zone, a yellow zone, and a red zone, with green meaning you’re at your best and red meaning you’re distressed and overwhelmed. Picture in detail how it might look and imagine putting it on a dock that tells you how much stress and trauma you experienced during the entire workday.)

One reason many people engage in trauma work, Lipsky explains, is a desire for trauma mastery—a coping mechanism to recapture a sense of control that they didn’t have during a past traumatic experience. For example, you might work in the medical field if you had lost a loved one to illness when you were younger.

If trauma mastery is part of the reason you pursue your line of work, Lipsky advises that you seek support and healing for your original trauma so you don’t use your work as the main way to cope with your trauma. People with personal stakes tied to their work, she argues, might put an unhealthy amount of pressure on themselves. One way you can better understand how to manage your desire for trauma mastery while working with the trauma of others is by studying how others have dealt with their personal trauma while involved in trauma work.

(Shortform note: The urge to reengage with your past trauma is called repetition compulsion. According to psychologists, this compulsion happens when you’re unable to resolve or heal your former trauma. This causes some trauma survivors to want to repeat similar situations and causes others to engage in trauma work as a way to regain a sense of control. Pursuing trauma mastery can be damaging because repeating traumatic events rarely leads to a feeling of mastery and only increases your exposure to trauma. However, certain variations of reenactment, like telling stories about a deceased loved one, may have positive effects for coping with the trauma of the loss.)

Strategy #2: Focus on the Positives

When exposed to trauma, you might feel overwhelmed by how bad situations seem and how little control you have over them. However, Lipsky argues that you can restore your sense of agency by deliberately choosing to focus on the positives rather than negatives—on what you can do instead of what you can't. This practice reminds you that you have a choice in every moment and allows you to reframe situations in healthier ways and take productive action. When you regularly choose to focus on positive things, it becomes easier to notice the positives. Lipsky cautions, though, that reframing situations to see their upsides doesn’t mean suppressing your negative emotions.

(Shortform note: In The Happiness Advantage, Shawn Achor writes that learning to see the positives during challenging moments allows you to grow and become more resilient. Seeing the positives doesn’t mean ignoring problems or your feelings; rather, you’re choosing to notice the good that’s there alongside the problems. To do this, Achor recommends making a short list of what makes you happy or grateful every day or writing about a positive experience.)

To take control of your focus, Lipsky offers a few suggestions:

Focus on your resources. When you feel overwhelmed or distressed, think about the sources of support and comfort you have in your life—the memories you’ve had, the people you know, or the places you’ve visited that you associate with peace and calm. For example, you might imagine your favorite reading nook or your pet. When you direct your awareness to your resources, you draw your attention away from what’s distressing you. This allows you to snap yourself out of your panic and calm your nervous system.

(Shortform note: While Lipsky advises you to think about the resources you have in your life, you can also think about anything that makes you happy—what Rhonda Byrne calls “thought lifters.” In The Secret, Byrne adds a layer of specificity to Lipsky’s suggestions on how to redirect your focus in stressful moments: First, make a list of thought lifters, such as cute animals or a beautiful sunset. When you’re feeling negative emotions, close your eyes and smile for at least a minute. Then, concentrate on a thought lifter and how it makes you feel, and move down the list until you’re feeling better.)

Make a Plan B. Create an alternative vision of your life, whether it involves a shift in your career, a move to a different location, or an entirely new lifestyle. When you consider alternative options, you recognize that you have a life outside of your work and that you always have the freedom to choose how you want to live it.

(Shortform note: In Designing Your Life, Bill Burnett and Dave Evans suggest you plan out three different lives to remind yourself that there are multiple paths to happiness and fulfillment. Your first plan should be the life you’re currently living. Your second plan should be what you would do if your current line of work disappeared. Your third plan should be what you’d do if money or the opinions of others didn’t matter. To create each plan, write a short title and a timeline containing the experiences and activities you’d like to enjoy. By having multiple plans, you might better recover a sense of control over your life.)

Strategy #3: Find a Supportive Community

According to Lipsky, a supportive community can help you rebuild your ability to be compassionate toward yourself and others. This community could be the members of your gardening club, your group of gaming friends, or your hiking partners—all that matters is that they support your growth and encourage you to be a better person.

A community helps you restore your compassion because its members validate your feelings and help you navigate your unhealthy habits. When others are nonjudgmental and supportive toward you, you begin to view your own feelings and struggles in the same light. This self-compassion, in turn, makes you more able to understand people you both agree and disagree with and treat them without judgment or malice. This compassionate approach, she argues, is necessary when working with people in pain or crisis.

The Components and Benefits of a Support System

Other experts weigh in on what makes a group supportive and what benefits can come from having a support system. In Burnout, Amelia and Emily Nagoski write that a supportive relationship should be one in which both parties display empathy and share attention equally. Beyond increasing your compassion, regularly connecting with and being close with others has additional benefits: It can lower your heart rate, blood pressure, and stress, while elevating your mood.

Lipsky points out that a supportive group can make you more compassionate, but the authors of Burnout offer a way you can practice self-compassion and be nonjudgmental of yourself when others aren’t around: Pretend an imaginary friend is telling you about the worries you’re having. This allows you to view and respond to your thoughts from a distance similarly to how the members of a supportive group might.

Strategy #4: Create a Healthy Work-Life Balance

While laboring until complete exhaustion and dedicating every second of time to your cause might feel like the best way to make a difference, Lipsky argues that this is not the case. To properly care for others, she argues, you must take a healthier approach to your work—one in which you give yourself time and space to rest and renew.

(Shortform note: While Lipsky encourages finding balance and establishing hard boundaries between yourself and your work, Kim Scott argues that you should integrate your work and life instead. In Radical Candor, she explains that a balance implies that work takes energy from your personal life while taking personal time drains the energy you devote to work. Integration, on the other hand, means that your work life and your personal life enhance one another—you devote yourself to work so you can better relax at home, and you relax at home so you can better devote yourself to your work.)

Lipsky offers several tips for how to create a healthier work-life balance:

Encourage healthier work habits. Reflect on whether your work schedule is reasonable and consider how you can better care for the well-being of you and your coworkers. For example, make commitments with your coworkers to take breaks for lunch instead of eating in front of your computers.

(Shortform note: To determine whether your work schedule is reasonable, pause and pay attention to your feelings. Often, trauma workers are so busy that they don’t have time to reflect on how overburdened they are. When you pause and tune into your emotions, any negative feelings that you have might point to what’s currently not working for you at your job, such as an unreasonable workload or schedule. Then, you can reconsider your priorities and implement changes to how you work.)

Take your mind off work. Reflect on your daily routine and identify times when you can disengage from work and check in with your needs and feelings—for example, while you’re boiling a cup of tea. Additionally, build up your life outside of work by engaging in new hobbies, interacting with supportive people, and making a conscious effort not to check your devices. By taking time to recharge your physical and emotional batteries, you’ll be more effective when you’re at work.

(Shortform note: To prevent your work from seeping into your personal life, experts suggest you create a starting and ending routine to help you transition into and out of work. Establish an activity to do every day before work, such as getting in a quick exercise or meditation session, that signals your brain that it’s time for work. Then, before you leave work, create a wrap-up routine, such as reviewing and closing your to-do list, that reminds you to intentionally detach from work once your routine is done.)

Practice gratitude. Even during routine tasks like microwaving a meal, recognize opportunities to express your gratitude. Negative emotions like irritation and disappointment are natural when you're exposed to suffering. While valid, harboring these emotions can harm your well-being and hinder your work. By practicing more gratitude, you can increase your resilience and make work feel more fulfilling rather than draining.

(Shortform note: While Lipsky writes that you can always identify something to be grateful for, some say it's perfectly acceptable not to be grateful all the time. If you suppress your negative emotions and force yourself to be grateful, you succumb to toxic positivity—the belief that you should be positive no matter what. Some studies show that gratitude reduces depressive and anxious symptoms less than once believed. Experts suggest you practice gratitude if it works for you, but focus on improving your well-being in other ways if it doesn't.)

Process your pain and emotions. To approach your work in a healthier way, acknowledge and find a way to process your negative emotions. Lipsky explains that people who do trauma work often absorb the pain and suffering of others. However, if you hold on to these feelings, your mental, emotional, and physical health will suffer. To process your emotions, Lipsky recommends you practice mindful activities—ones in which you’re focused on the present moment—such as meditation, physical exercise, creative hobbies, or going out into nature. When you practice mindful activities, you allow yourself space to think about, acknowledge, and release negative energy instead of letting them build up inside you.

(Shortform note: Repressing negative emotions may be just as harmful as holding onto them. Both approaches result in greater emotional pain. According to physician Gabor Maté, when we repress our emotions, we prevent ourselves from being able to recognize how much stress we’re under. In When the Body Says No, he elaborates that stress causes various diseases including cancer, and if we’re unable to recognize the stress we’re under, we remain susceptible to more illnesses. Like Lipsky, Maté advises you to acknowledge all feelings, not just positive ones, and tune in to your body for signs of stress such as a fast heart rate, excessive sweating, headaches or back pain, or digestion problems.)

Strategy #5: Create a Daily Practice

To engage in sustainable and fulfilling trauma work in the long term, make mindfulness a daily habit and regularly practice the four strategies for self-care. According to Lipsky, the more you connect with yourself, the more aware you become of your resources and autonomy, and the more motivation you have to do the work that you do.

(Shortform note: Mindfulness offers health and work benefits that support Lipsky's suggestion to make it a daily practice. Some researchers suggest that mindfulness reduces your stress, improves your immune functioning, enhances your working memory and focus, and helps you better manage fear and other emotions. Some studies on therapists have shown that mindfulness increased their ability to empathize, show compassion to themselves and others, and practice more effective counseling.)

To make mindful self-care a regular practice, Lipsky offers two suggestions:

Set a daily goal. At the start of each day, identify a small goal you want to accomplish, such as eating healthier snack options or practicing more conscious breathing. According to Lipsky, identifying a daily goal gives you a sense of control, reminding you that the stress or the situations you encounter at work don’t determine your day—you do.

(Shortform note: If you decide you want to do one of your daily goals every day, turn it into a tiny habit: a small behavior that you work into your routine. In Tiny Habits, BJ Fogg writes that to make a tiny habit, you need an anchor (a behavior you already do regularly, like refilling your water bottle), a small behavior you will do after your anchor, and then a celebration to complete it. For example, if your daily goal is to practice more conscious breathing, your tiny habit might be: After I sit down at my desk, I will take five mindful breaths and then give myself a thumbs up. Fogg explains that the ideal tiny habit should take less than 30 seconds to do.)

Set mindfulness reminders. Consider setting alarms on your phone, scheduling small parts of your day, or creating specific triggers to be mindful (like every time you enter a new location). Lipsky explains that being present in our daily activities can be difficult to achieve—urgent deadlines might make us irritated at a slower team member or you might be distracted by an upcoming social outing with friends. By setting reminders, you can be mindful more regularly, which allows you to think and approach your work with intentionality and control.

(Shortform note: If you find yourself ignoring the reminders you set for yourself, consider partnering up with a self-care buddy at work who can hold you accountable to your mindfulness goals. Arrange for specific times you will check in with each other, share your feelings, talk about your challenges, and celebrate your successes.)