"We have to be honest with ourselves.  We have to have an early warning system. We have to protect against our own denial  and we have to give ourselves permission to be human beings.  Because if we don't do that, we are, I think, at a greater risk than other people.  I think we need to understand that the work we do is extremely difficult.  To have the courage to listen empathetically and to struggle to come up with some kinds of helpful therapeutic measures, tools for these people that are in such extreme states of suffering, bewilderment , hopelessness, etc. This is hard work and we don't have an unlimited reservoir of resources to help them and if we think we do, we're not only fooling ourselves, but I think we become dangerous.  I think that one needs to approach this work with a profound sense of one's own vulnerability, fallibility, and how easy it is to lose one's objectivity when one becomes immersed in this kind of work.  So we really have to have all kinds of safety valves, fail safe systems so that we can have a knowledgeable colleague or group of colleagues with whom we can do our own integration, processing, debriefing, call it what you will, and we will be open to the possibility that we have lost our way and maybe we need to stop the music as therapists until we have taken care of our own stuff so that we can then proceed as the kind of professionals that we want to be."

Mathew J. Friedman, MD, Ph.D., Executive Director, National Center for Post-Traumatic Stress Disorder.