Mini Class: Prevention of Vicarious Trauma & Empathic Distress in Today’s Challenging Work Spaces

Greetings friends & colleagues,
I am writing to invite you to learn more about my program of vicarious trauma prevention in today’s challenging work spaces complicated by COVID-19. The program is designed for anyone working on the front lines during these unprecedented times such as: mental health professionals, human service providers, healthcare workers, first-responders, attorneys, teachers, and online trust and safety teams.
I am offering these courses over zoom; tailor-made to suit your team’s specific needs. I also provide the option to include confidential pre- and post-test measures to evaluate your team’s progress in increasing its sense of well being and satisfaction for the work. Please feel free to contact me to learn more.

No-Cost Trauma Treatment for Veterans

I will be conducting a pilot study examining the potential benefits of providing four sessions of Trauma-Focused Mindfulness-Based Cognitive Therapy to veterans with post-trauma symptoms; as such, I am asking for referrals for vets who are interested in receiving four individual therapy sessions of trauma therapy at no-cost to them. The sessions can be conducted either online or in-person in my private practice office in Los Angeles. I will be conducting the sessions as well as a female Air Force veteran MSW who I am supervising. I have attached a flyer that explains more. Please let me know if you have any questions. Thank you so much for your consideration!

Click here to download the flyer:



Online Workshop: Making Peace with Anxiety in Uncertain Times


This online seminar will equip you with a powerful set of practical tools from a research-based form of talk therapy called Mindfulness-Based Cognitive Therapy or MBCT, which may be helpful to you during this time of extraordinary stress and uncertainty. Studies have shown that MBCT is effective at helping people actively manage their symptoms of anxiety and other mood symptoms while improving quality-of-life.

What is more, your instructor will help you understand the neurobiology of anxiety; what triggers it; the role that stress hormones play in emotional dysregulation, and what can be done to calm anxiety from the level of the body up-to-the brain and from the brain down-throughout-the-body. Finally, your instructor will introduce you to a set of Self-Compassion techniques that can help you calm the nervous system when confronted with overwhelming fear and panic. This workshop will include guided meditation practices led by your instructor.


  • Practical skills to actively manage symptoms of anxiety and panic
  • New ways of relating to difficult emotions and disturbing body sensations
  • Tools to promote positive and lasting physical changes in the brain
  • Helpful information about creating a daily MBCT practice for enhanced emotional and physical health.


  1. Instructor-led exercises designed to teach you practical MBCT tools for everyday use
  2. MBCT-based resources to help you manage anxiety and panic
  3. Helpful information about how to create a daily wellness program that you can use at home or wherever you may be
  4. Individualized answers to your specific anxiety-related questions


Understanding Post-Traumatic Stress & the Best Treatments for Relief


This workshop will equip you with an in-depth understanding of the stress that happens to many people following a traumatic event. Your workshop instructor will review the various forms of post-traumatic stress including Classic PTSD, Complex PTSD, and sub-clinical PTSD to help you better understand what you, or a loved one, may be experiencing.

Studies have shown that some individuals who are experiencing active PTSD symptoms are misdiagnosed or have trouble finding the right treatment due to a lack of knowledge of the symptoms of trauma as well as a lack of clarity about the best available trauma treatments within the field of behavioral health.

In addition, your workshop instructor will provide you with a basic understanding of the how trauma effects the brain as well as a review of the psychological and body-focused treatments that have been shown through research to have to the best outcomes for people suffering from the negative effects of trauma.


  • Practical knowledge about psychological trauma and its effects on the brain, body, and mind.
  • Research-based information about the best treatments for psychological trauma.
  • How to determine which trauma treatment may be most helpful to you.
  • Helpful information about accessing behavioral health resources.


  1. Instructor-led presentation on up-to-date and research-based information about psychological trauma and its effects on the brain, body, and mind.
  2. Information about effective treatments for trauma based upon recent research.
  3. Information that may help you determine which trauma treatment may best suit your individual needs.
  4. Q & A at the end of the workshop.



  • There is three-hour free parking across the street at the West Hollywood Library, which requires that you obtain validation from the library (the library closes at 6).
  • There is metered parking along Melrose Ave. and San Vicente Blvd. ($2 for 2 hours).
  • You may also park in Pacific Design Center’s parking lot for a fee. The first 20 minutes are free; thereafter, you will be charged $1.50 per 12 minutes with a maximum charge of $16.50.

The workshop does not validate for parking in the Pacific Design Center.

Melting the Effects of Trauma through Everyday Self-Assertion

By Tony Madril, LCSW, BCD

Making a conscious choice to assert yourself in a stressful situation may help you to reprocess past psychological trauma and counteract its long-term effects on the body and mind. We know from scientific research that most people automatically respond to traumatic experiences by preparing to fight a potential perpetrator, by fleeing a dangerous situation, or by physically freezing in the moment. If your body reacted to past trauma with some form of freezing, it is possible that you are unusually sensitive to situations that are reminiscent of past traumatic events and that you may respond to minor threats in your daily life by momentarily regressing to a state of immobility, especially if you have not processed your injury with a trauma specialist. For instance, while being confronted by a demanding co-worker, alone, would not qualify as a traumatic event, this minor threat can nevertheless activate the brain’s release of stress hormones in your body if the trauma you experienced involved some sort of intimidation against you. The “post-trauma brain” is wired to notice and quickly respond to situations that appear similar to the traumatic event of the past. This is its primary form of defense, of keeping you safe from further harm.

While it may not have been humanly possible for you to have taken action to escape the traumatic event of your past, it is now possible for you to take action by asserting your needs when faced with situations that threaten your sense of integrity or emotional wellbeing. How? I have written a set of three questions that, in conjunction with therapy, you can ask yourself during moments of distress to help clarify: (1) whether the situation you’re in may be linked to past trauma; (2) how practicing self-assertion may help to counteract the feeling of immobility.

The first question: What am I feeling in my body? By using your concentration to quickly scan the body from head-to-toe like a copy scanner, you can gather important information about how the body is physiologically reacting to your immediate situation. Whereas uncomfortable or unusual body sensations such as a rapid heartbeat, shallow breathing, or a sense that you cannot move (or act as you would like) may suggest that something about your situation may be linked to past trauma, neutral or pleasant body sensations may suggest that you are experiencing an ordinary day-to-day stressor with no particular ties to past critical events.

The second question: Does this situation threaten my sense of safety or cause me fear? Defining what makes you feel unsafe or fearful is something only you can determine. Simply put, if you answer “yes” to this question, it would be important for you to determine a clear course of action to take care of yourself in the moment; answering the next question may help you do this.

The third question: Would asserting myself help restore my sense of safety? If you answer yes, you might consider the choices you have to assert yourself in your moment of distress. Returning to the example of the demanding co-worker, asserting yourself may come in the form of taking any of the following actions: making a request, saying no, resisting pressure from the person, or maintaining a particular position or personal point-of-view. On the other hand, if you notice that you are feeling oddly frozen to act, self-assertiveness may be that you walk away from the situation or simply acknowledge that “feeling frozen is happening” and soothe yourself with kind words of self-compassion such as: “I’ve got you sweetheart” “This is temporary” “Don’t worry, you will have more chances to assert yourself in the future.”

Over time, this ongoing practice of asserting yourself in challenging situations may improve the effects of past trauma by helping you develop new core beliefs about your ability to take care of yourself in the world. Gradually, you may begin to think (and believe): “I can do this!” “I can learn to do whatever it is necessary to take care of myself.” Feeling frozen to act may, therefore, become less and less of a problem as your ability to assert yourself and your sense of personal safety increase. When you feel safe, there is little need to fight, to flee, or to freeze.

Working with Traumatic Imagery

Working with traumatic imagery in whatever your profession has the potential to cause a significant amount of stress and may even lead to secondary trauma if you are not careful. In addition to the articles I have written about how to prevent vicarious trauma in the workplace, I recommend reading an article written by the Dart Center for Journalism and Trauma for helpful information about working with traumatic imagery. Follow the link to read…

6 Things Online Trust & Safety Teams Can Do to Reduce the Stress of Working with Traumatic Imagery

By Tony Madril Therapy & Training, LCSW, PC

For many Trust & Safety teams whose responsibility it is to investigate potential violations to the rules of the online communities they serve, the “daily grind” often involves inspecting multiple images that have the potential to trigger highly distressing emotions such as horror, disgust, and fear due to the traumatic nature of the photographs and videos posted by sickly users of the online platform. A video showing a live beheading of another human being is one example of such traumatic images. Research suggests that repeated exposure to traumatic material creates a certain vulnerability for developing vicarious trauma or some form of traumatic stress[1]; therefore, it is imperative to the health and wellbeing of online Trust and Safety teams to have ready various practical tools and techniques to help mitigate the emotional burden of regularly working with traumatic imagery. Here are six tools I have developed for online Trust and Safety teams to help prevent vicarious trauma and other forms of work-related stress:

  1. Reconnect to the highest purpose of the job. Perhaps the highest purpose of the job for online Trust and Safety teams is to protect others from various types of harm. Remembering this when feeling discouraged by the number of people who are psychologically or financially harmed by online perpetrators may help to refocus the mind onto the positive impact you are having as a valuable member of a Trust and Safety team. Repeating a mantra such as: “Each day, I am doing my part to prevent traumatic material from spreading and causing more harm to others” may help to balance your perspective and settle your emotions.


  1. Release judgment. Feeling resentment toward a single identifiable perpetrator of harm, although understandable, may entangle you in a web of negative emotions, which may intensify over time. It may help you “let go” of this distress by viewing the images with a mindful sense of curiosity rather than judgment; recognizing the fact that there were likely multiple factors that ultimately led to the creation and perpetuation of these online images such as technology-related security flaws, the perpetrator’s own history of abuse, societal problems as well as those factors which may never be fully explained.


  1. Practice dual concentration. Refocusing a significant part of your attention away from the distressing image and onto a neutral point of focus such as the sensation created by caressing a polished stone or squeezing a stress ball. It might help to apply what I call the 60:40 rule to the situation where 60% of your focus is dedicated to examining the distressing image and 40% is dedicated to exploring the neutral object.


  1. Dis-identify with traumatic material. It might help to make it a conscious practice to regularly create a mental boundary between what you are personally responsible for causing and what you are not. For example, while reviewing traumatic material to complete a work assignment you might make it a point to say to yourself: “I did not create or cause this, this is not mine!” For some, it may even be helpful to accompany this comment with a specific type of behavioral ritual to further separate who you are from what you do, such as nodding your head or waving your hands as if to non-verbally say “no.”


  1. Practice self-compassion. You can practice self-compassion at work by making a personal decision not to become entangled with the traumatic images by using the tools mentioned above and by refraining from getting involved in the case beyond what is required. You might compassionately say to yourself: “This is not worth the harm it will cause me in the form of stress, fatigue, and physical ailments.”


  1. Create an end-of-the-day ritual. Creating tangible end-of-the-day rituals like immediately changing your clothes after you have signed-off from your work computer may help you to better separate your professional life from your personal life. In addition, it may help you accept and appreciate what it is you were able to accomplish for the day and “let go” of the rest like those things about your work that are outside of your control.


If you are interested in learning more about these tools or about the process of preventing vicarious trauma within online Trust and Safety teams, please feel free to contact me @ (323) 315-2598 or

1Cieslak, R., Shoji, K., Douglas, A., Melville, E., Luszczynska, A., & Benight, C. C. (2014). A meta-analysis of the relationship between job burnout and secondary traumatic stress among workers with indirect exposure to trauma. Psychological services11(1), 75.


What is CPT Really Like? How Can It Help Me with My Trauma?

Cognitive Processing Therapy or CPT is an evidence-based talk therapy for working through psychological trauma. It is a technique that I regularly offer my clients and one that I’ve found it to be very effective in resolving troublesome trauma-related symptoms like anxiety, depression, and panic-like sensations in the body. If you are curious about CPT or about the process of working through trauma, I invite you to listen to the podcast (accessible by clicking on the link) that lets you listen in on an entire course of CPT with a real client who wanted to share with others her journey through trauma therapy…

Protecting the Protector: How Mindfulness Can Help Shield Trust & Safety Teams from the Harmful Effects of Online Vicarious Trauma

Vicarious Trauma and the Online Guardian

Vicarious trauma is a by-product of engaging in work that includes ongoing exposure to distressing images, sights and sounds as well as exposure to personal stories of trauma. Web-based professionals whose job it is to “protect” online communities from inappropriate material are regularly subjected to obscene, toxic, and exceptionally disturbing pictures, videos, online postings, distressing virtual conversations, and cyberspace crimes. Research suggests that repeated vicarious exposure to traumatic material creates a vulnerability for developing vicarious trauma or some form of secondary traumatic stress. This “vulnerability” may have deleterious effects upon the well-being of the online guardian’s personal and emotional life as well as their ability to deliver quality services to their clients over time. The following is a list of stressors often encountered by online trust and safety teams:

Stressors Unique to the Role of Online Guardian

  • Repeated exposure to emotionally distressing online content
  • Pressure to address a high number of cases due to the guardian’s unique skillset and the number of cases identified for investigation
  • Lack of understanding and support of the guardian’s work by the larger organization, and others, due to the novelty of the role
  • Inability to control the actions of online rule-violators and perpetrators
  • The constantly changing online landscape
  • The unusual time demands of online work


How Mindfulness Can Help. Mindfulness is a meditative practice that involves training one’s ability to pay attention to what is happening in the moment without reacting to elaborate mental stories about the experience and without reacting to distressing thoughts or emotions that may be present; instead, the experience is accepted without judgment or avoidance (Baer, Smith, Hopkins et al., 2006; Carmody, 2009; Dimidjian & Linehan, 2003). Similarly, mindfulness is associated with improvements in concentration and awareness of thoughts and feelings as transient mental and physical events rather than factual representations of reality that demand a response (Chiesa & Serretti, 2009; Garland, Gaylord, & Park, 2009; Segal, Williams, & Teasdale, 2002). In this way, online guardians trained in mindfulness can learn to witness traumatic material from a more distanced and less personal perspective that, overtime, allows for more reflective, intentional action and less impulsive “automatic” reactivity to the online traumatic material.

Practical Tools for Trust & Safety Staff

Enhancing Mindful Self-Awareness. As a specialist in vicarious trauma prevention and mindfulness coach, I have found that one of the first steps of preventing vicarious trauma in trust and safety teams is to help them begin to understand how they are relating to the traumatic imagery. The supportive team meetings I’ve facilitated and the individual supervision sessions with caring team leads have provided a safe space for team members to identify and reflect upon their automatic cognitive and emotional responses to witnessing traumatic imagery.
I’ve also found that offering team members opportunities to practice mindful sitting meditations designed to promote greater awareness of the thoughts, feelings, and body sensations can uncover unhelpful thoughts that create undue stress and impede work performance such as the stream of distressing thoughts that can occur (for some) when investigating a video containing scenes of child abuse: “If this could happen to this child…this could happen to my child…What if it does happen?” “Is my child in danger?”

Practicing Dual-Concentration. Being skilled at refocusing a significant part of one’s attention away from distressing images and onto a neutral point of focus can help to promote resilience and a greater sense of ease when trust and safety team members review cases involving traumatic imagery. This is called practicing “dual concentration.” Dual concentration is a mindfulness technique that a team member can practice simply by caressing a polished stone or squeezing a stress ball while working with a traumatic image. I suggest to team members that they apply what I call the “60:40 rule” to the situation where 60% of their focus is dedicated to examining the distressing image and 40% is dedicated to exploring the neutral or pleasurable object.

These are just two of the many tools and techniques I have adapted and designed to help trust and safety teams reduce work-related stress and prevent online vicarious trauma. If you are interested in learning more about how mindfulness and related techniques may help prevent vicarious trauma in your team, you may contact Tony via e-mail @ or by telephone, (323) 315-2598.

Written by Tony Madril Therapy & Training, LCSW, PC

What are anxiety disorders and how are they be treated?

There are several types of anxiety disorders that a person may experience, which may cause any level of emotional discomfort and, in some cases, may become an obstacle to accomplishing daily tasks necessary for living. For example, the fear of being trapped in a public space where help may not be available, characteristic of Agoraphobia, may cause someone to become social isolated over time as a result of avoiding public spaces. The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) lists seven other anxiety disorders, including:

  • Separation Anxiety Disorder
  • Selective Mutism
  • Specific Phobia
  • Social Anxiety Disorder
  • Panic Disorder
  • Generalized Anxiety Disorder
  • Substance/Medication-induced Anxiety Disorder

Some of these disorders may be more recognizable to you than others such as Generalized Anxiety Disorder characterized by uncontrollable worry about a number of situations and Panic disorder, which involves surges of intense emotion often accompanied by body sensations like heart palpitations, dizziness, and sweating. While each of the disorders listed above have trait symptoms unique to the specific disorder, they are all unified by intense worry and extreme focus on anxiety-related thoughts. For example, people suffering from anxiety may have rigid thoughts about the future that they can’t seem to get out of their heads such as: “What if I have a serious medical condition and die?” “What if I’m rejected?” “I’m a complete failure!” As such, first-line treatment for any anxiety disorder necessarily involves addressing these types of distorted thoughts with tools and techniques from Cognitive Behavioral Therapy (CBT), a heavily researched type of talk therapy proven useful in working with these types of thinking errors. A psychotherapist trained in CBT will help you work through your anxiety by teaching you how to identify and challenge thoughts that typically trigger feelings of anxiety. CBT sessions are designed to help you develop the skills to successfully build resilience to acute anxiety in about 12-14 sessions.  Depending upon the severity of your anxiety symptoms, your CBT therapist may also recommend that you schedule a medication evaluation by a medical doctor to assess whether adding a psychotropic medication to your treatment plan may further help feel better!

I am a trained CBT-trained psychotherapist and having been using it to help hundreds of people successfully work through their anxiety over the 22 years I have been practicing in the field of behavioral health. Please feel free to call or e-mail me if you have any questions about CBT and how we might work together to resolve your anxiety-related problems.

Written by Tony Madril, LCSW, BCD