Vicarious trauma

“Men ought to know that from nothing else but the brain come joys, delights, laughter and sports, and sorrows, griefs, despondency, and lamentations” — Hippocrates

THE message from the patient was distressing. She wanted an urgent appointment as she could not stop crying, thinking about the victims of the Gul Plaza fire in Karachi. She said she felt dep­r­e­s­­sed and had feelings of hopelessness. More worryingly, she was getting frequent thoughts of suicide as the images of the fire-ravaged building kept playing in her mind. What the lady was exhibiting was ‘vicarious trauma’ — trauma experienced not directly through a traumatic event, but by witnessing, hearing about, reading or seeing images of traumatic events repeatedly. Origi­nally identified in professionals exposed to others’ suffering — such as therapists, first responders and humanitarian workers — vicarious trauma occurs when individuals absorb the emotional and psychological toll of traumatic events indirectly.

The Gul Plaza fire tragedy is only one of many such events we’ve been exposed to regularly. Over the last two years, we witnessed the genocide in Gaza, which has now been overtaken by the conflict in the Middle East. Images coming out of Gaza and Tehran have been nothing short of apocalyptic, including those from the Minab bombing in Iran in which at least 160 schoolgirls were killed. These, along with events in Pakistan, are leaving deep scars on the collective psyche.

In today’s age of instant communication, almost everyone is exposed to images and narratives of suffering. At the population level, the psychological consequences of vicarious trauma are significant. Exposure to ongoing reports of violence triggers the body’s stress response, leading to hypervigilance and chronic anxiety. This results in a host of physical and mental health problems. Ord­i­­­nary life feels fraught and unpredictable, with a pervasive sense of uncertainty. Paradoxically, re­­peated exposure can lead to emotional blunting and people disengaging themselves as a self-protective mechanism. While this may shield individuals in the short term, over time, it can blunt em­­pathy, weaken social cohesion and diminish our collective capacity for a compassionate response.

Apocalyptic images and events, both at home and abroad, are leaving deep scars on the collective psyche.

Whether through social media videos, TV news or personal accounts of family and friends, Pakistanis are living trauma by proxy. Over the past few years, Pakistan has undergone intense political upheaval: the stand-off between political actors and state institutions, violent security crackdowns and incidents of lawlessness and terrorism have become fixtures of daily life. Pakis­tan’s sociopolitical landscape amplifies the risk of vicarious trauma. Deep divisions across political, ethnic and regional lines mean that crises are not merely political disagreements but existential threats to identity and belonging. That is what we are seeing in Balochistan and the country’s northern areas. When people see ‘the other side’ as dangerous or illegitimate, conflict narratives become personalised and emotionally charged.

Deteriorating economic conditions compound psychological stress. The recent high increase in petrol prices has broken the back of an already suffering population trying to meet their basic needs. Psychological resilience is further eroded, making the impact of vicarious trauma even more pronounced. For many, it is no longer safe to express political views openly. Public forums have become battlegrounds where the stakes are one’s liberty and sometimes even one’s life. Even for those who avoid protests physically, television, mobile phones and social media perpetually replay crises and conflict. This constant exposure conditions the psyche to remain in a heightened state of alertness, stress and emotional fatigue.

But perhaps the most serious outcome is a profound sense of helplessness. When every news cycle brings fresh distress that our leaders seem incapable of addressing, people begin to feel change is impossible and start losing hope. This collective despondency affects our interactions, further undermines our already low faith in institutions, and fosters apathy at a time when democratic participation is most needed.

How do we address vicarious trauma? It is not easy, given that many of the events are beyond our control. However, we need to do everything we can to survive these terrible times. The first step is recognising that psychological distress is a societal issue, not an individual failing. We need open conversations in public forums, media, educational institutions, social media and workplaces — without fear of retaliation by state authorities, which need to show restraint. People must be allowed to protest peacefully about an issue they feel particularly strongly about. It is in the government’s interest that people have outlets to vent their pent-up frustration and anger.

The media — both print and electronic — has a potent influence on public opinion. It has a responsibility to report the news without sensationalism and avoid repetitive graphic content that can exacerbate trauma. Educational institutions can play a role by building psychological literacy, ie, teaching young people about stress, coping mechanisms, emotional regulation and media literacy. Resilience is not innate; it can be cultivated through supportive environments and intentional practice. At an individual level, we need to control the time we spent on social media, particularly on content that show graphic images and videos. Many of these are not verified and the effect on the psyche of vulnerable people can be extremely damaging.

We may not be able to influence policymakers in Washington, Tel Aviv and Moscow when they decide to bomb another country and unleash terror and suffering, but we should never stop raising our voices against injustice, oppression and inhumane behaviour. That is one of the most potent ways to process vicarious trauma, which may be invisible, but whose effects are real. Since its independence, which itself was a traumatic event, Pakistan’s citizens are carrying the psychological imprint of chronic crisis. Ignoring these wounds will not make them disappear as unattended emotional harm undermines social cohesion, democratic engagement and long-term stability. Our people cannot afford this.

The writer is a consultant psychiatrist.

mmkarticle@gmail.com

Published in Dawn, March 28th, 2026

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