Compassion Fatigue and Vicarious Trauma

Professionals in the fields of health care, mental health, community and social services, as well as caregivers and first responders, are at a higher risk for compassion fatigue (CF) and vicarious trauma (VT) than the general population. Regardless of the specific helping or healing profession you find yourself in, the act of caring for others can come at an unspoken cost.

Differences Between Compassion Fatigue, Vicarious Trauma and Burnout

These three terms are complementary and yet different from one another. While Compassion Fatigue (Figley, 1982) refers to the profound emotional and physical erosion that takes place when helpers are unable to refuel and regenerate, the term Vicarious Trauma was coined by Perlman & Saakvitne (1995) to describe the profound shift in world view that occurs in helping professionals when they work with clients who have experienced trauma: helpers notice that their fundamental beliefs about the world are altered and possibly damaged by being repeatedly exposed to traumatic material.

Burnout is a term that has been used since the early 1980s to describe the physical and emotional exhaustion that workers can experience when they have low job satisfaction and feel powerless and overwhelmed at work. However, burnout does not necessarily mean that our view of the world has been damaged or that we have lost the ability to feel compassion for others. Most importantly, burnout can be fairly easily resolved: changing jobs can provide immediate relief to someone suffering from job-related burnout. This is not the case for Compassion Fatigue and Vicarious Trauma.

-Françoise Mathieu, MEd, CCC

Physical Signs of CF and VT

  • Physical exhaustion and fatigue
  • Somatization: emotional stress that translates into physical symptoms, like getting sick more often, headaches, migraines, digestive issues, nausea, aches, tension, pain, etc.
  • Difficulty sleeping or settling at the end of the day (or wanting to sleep too much)
  • Reduced interest in sex due to feeling depleted

Psychological Signs of CF and VT

  • Emotional exhaustion, reduced empathy and low patience
  • More easily angry, irritable, cynical or resentful
  • Shifts in your ability to relate with compassion to clients or loved ones
  • Hypochondria (fear of developing severe physical ailments)
  • Hypervigilance (on guard, anxious, paranoid, irrational fears)
  • Problems in personal relationships outside of work due to reduced compassion
  • Doubting your competence/skill as a helper
  • Feeling helpless towards clients
  • Depression (feeling hopeless about yourself, clients or the future)
  • Suicidal thinking
  • Diminished sense of satisfaction or enjoyment in your career
  • Disruption of your worldview (e.g., difficulty trusting in people or viewing the world as unsafe as a result of hearing your clients’ experiences of trauma)
  • Intrusive imagery (often related to client stories)
  • Hypersensitivity (or insensitivity or numbness) to emotionally charged material
  • Loss or altered sense of self or reality

Behavioural Signs of CV and VT

  • Distancing and isolating yourself from others
  • Not engaging in activities you typically enjoy; low motivation
  • Difficulty making simple decisions or clinical decisions that affect clients
  • Missing work, or dreading or avoiding clients/patients
  • Frequently changing jobs or leaving your field altogether
  • Compromised care towards certain clients (disconnecting, merging/rescuing)
  • Disordered eating or addictions to cope
  • Difficulty separating work and personal life (impaired boundaries)
  • Being the caretaker in your personal life outside of work

“We can do good work with others and keep ourselves well and healthy. We can take care of ourselves first so we can then take care of others. Even Mother Teresa recognized the potential drain of helping and made it mandatory for her nuns to take extended periods of time off to heal from the effects of their care giving. While extended sabbaticals aren’t something most of us can enjoy, we can make self-care a priority.”
–Overcoming Compassion Fatigue, p. 118

Contact The Refuge to find out more about how integrative psychotherapy can support you to recognize the signs of overwhelm in your nervous system sooner, listen to the wisdom of your body, intervene with self-care and self-regulation strategies, and restore balance.

© 2013 –   The Refuge.