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Therapy for Compassion Fatigue

Ground & Heal Your Vicarious Trauma

Therapy for Vicarious Trauma

Compassion fatigue and vicarious trauma are terms often used interchangeably. Here's how I understand them in relationship to burnout and secondary trauma.

 

Compassion fatigue, or vicarious trauma, has been described as work-related burnout plus a secondary traumatization that creates a shift in one's attitude or worldview. That shift is significant, it's not just a passing emotion. While it is not an official mental health diagnosis, it is widely understood in psychological fields, as that is one of compassion fatigue's common occupational homes.

Not just burnout, compassion fatigue has the added element of a secondary trauma which can happen suddenly and create acute responses of the nervous system. This may happen when processing trauma with a therapy client, helping a medical patient during an emergency, seeing another person be abused, or witnessing an accident. Secondary trauma is commonly known to impact first responders of medical or mental health crises, but it can happen to anyone, especially those who work in people-facing support roles.

 

One instance of secondary trauma may or may not lead to compassion fatigue but certainly over time, chronic occurrences of it shift the sudden and acute experience into a long-term and all-encompassing change in how one sees the world and themselves in it. Signs of compassion fatigue include:

  • Feeling helpless in the face of another person's struggles

  • Reduced empathy and sensitivity to others

  • Feeling overwhelmed and exhausted by work demands, maybe even a bit agitated or resentful

  • Emotional disconnection and detachment in and outside of work

  • Mental exhaustion and decreased ability to focus, remember, or otherwise function typically

  • Isolation or withdrawing from others

  • Chronic physical and emotional exhaustion

  • Depersonalization

  • Dissatisfaction with work

  • Loss of interest in activities you once enjoyed  

Burnout is similar to compassion fatigue in that it results in exhaustion, loss of interest and motivation, and an overall desire to withdraw. But burnout is less about a worldview shift that stems from being an emotional support to others and more about the accumulated effects of not feeling supported enough yourself at work; long hours, lack of resources, too many responsibilities, no time for breaks, stress from job ambiguity, too many obligations that detract from the passion or purpose of the role, poor relationship with boss, etc.

Compassion Fatigue in Business Leadership

While secondary trauma happens often for first responders, it can also occur in non-emergency workplaces, as well. Being in a leadership role may task you with frequently having to hold the emotional reactions and needs of your employees, whether or not they may define some of these emotional experiences as traumatic. 

Charles R. Figley, PhD, founder of the Traumatology Institute at Tulane University says compassion fatigue is an occupational hazard of “any professionals who use their emotions, their heart.”

With current trends promoting the importance of EQ in leadership, managers are being asked to use their heart in their work. They're asked to be more sensitive to the needs and emotions of their employees, while not exactly growing in resources or support to do so. This sensitivity is needed and likely effective for the business, workplace culture, employee morale, collaboration, and our own humanness beyond the job description, but it puts business leaders on the list of people who may be likely to experience compassion fatigue, especially if they weren't trained on how to put boundaries around their empathy. 

COVID and Compassion Fatigue

The case for increased compassion fatigue in leadership, as well as medical and mental health care fields, is especially true when we consider the widespread mental and emotional impacts of the pandemic, a collective trauma that continues to reveal the ways in which it shapes us and went on to create additional unexpected issues.

A global pandemic created uncertainty about our health and the health of our loved ones, limitations in how we could engage in community and self-care practices, fears about our livelihood, stress about income and food supply (and the basics like toilet paper), and general anxiety about the future. In it, we were forced to confront emotions we may not have been equipped to confront. 

Therapists, healthcare workers, business leaders, and others who serve in support roles experienced an up-tick in compassion fatigue risk, as we were not only needing to hold the space for others' experiences of this collective trauma, their stories may have been directly poking at the very personal way that same or similar trauma lives inside of us. Triggers abound, resources diminished, world looking stranger and stranger every day. Hello, compassion fatigue.

Guilt and Compassion Fatigue

Personally, I experienced the impacts of vicarious trauma earlier in my therapy career after several years working in high levels of treatment with high-risk and highly traumatized individuals. I struggled to appropriately name my experiences of secondary trauma because I believed it would somehow invalidate the trauma of those I was supporting. Feeling guilty about having natural human responses is another way compassion fatigue can impact us, and it keeps us from seeking the kind of support we deserve in order to process and alchemize it into something meaningful and purposeful.

Because of this experience confronting vicarious trauma, I understand what it's like to perceive yourself no longer as a source of help, but as either a secondary source of harm, or at least a powerless witness to it. I can help you get unstuck from there. 

Depression, Anxiety, and Relationship Issues

Since vicarious trauma is not just about secondary exposure to traumatic events but how that changes your belief system, emotional expression, values, sense of self, and sense of belonging, over time you begin to feel numb, hopeless, alone, and unfamiliar to yourself. Left unaddressed, compassion fatigue can lead to depression, anxiety, and substance use disorders, as well as relational problems, which may only reinforce themselves over time.

 

As you can imagine, it's not only challenging to live in that space, but it makes helping other people seem impossible. And yet you still have to go to work, now burdened, perhaps even unconsciously, with this shift that makes everything harder.

What can help compassion fatigue? Some of the work includes:

  • Taking a break from the traumatic stimuli

  • Finding safety in your nervous system where the secondary trauma may now live

  • Processing the experiences of trauma or secondary trauma in a safe container with a trusted partner

  • Reflecting on (and maybe even updating) your values and priorities

  • Establishing firm boundaries around things not aligned with your values and priorities

  • Identifying where else you may need to assert boundaries in order to keep yourself emotionally and energetically safe with others

  • Increasing mindfulness around otherwise unconscious exchanges of energy with others

  • Developing a knob, so to speak, on your empathy dial so that you're in control of how much of it you give

  • Redirecting people-pleasing habits that keep you sacrificing your own wellbeing in order to cultivate or strengthen the wellbeing of others 

  • Exploring the narratives and beliefs adopted at the onset of compassion fatigue

  • Re-writing those narratives and self-soothing when the nervous system reacts to them anyway

  • Practicing self-compassion

  • Building community and other support structures

  • Setting reasonable expectations for what impact you're able to have on a struggling individual

You may be able to do this work alone, but often times when we incur a wound in relationship, that wound needs to be healed in relationship, too. Deciding that you're worthy of support, and that you're capable of meeting yourself in this work to build a better future, is where we begin.

If you have questions about compassion fatigue or want to begin working to heal yours, contact me at the link below. 

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