Compassion Fatigue and its impact on addiction treatment providers.

The following is a guest post by Charlene Richard, B.S.W, M.S.W. Charlene is a registered Social Worker and Compassion Fatigue expert in Waterloo, Ontario. Having studied with The Traumatology Institute in Toronto, Ontario, in 2008, to become a Compassion Fatigue Specialist, she has since regularly provided Compassion Fatigue counseling, coaching and workshops for organizational wellness.  You can find her at @alliancecounsel on twitter where she regularly tweets about self-care and Compassion Fatigue or at www.thecompassionfatiguecoach.com where she maintains a “Confessions of a Social Worker” blog sharing how she succeeds (and struggles) to maintain awareness and management of Compassion Fatigue.  You can contact her at charlene@thecompassionfatiguecoach.com if you have any questions or comments about this post.

Compassion Fatigue and Addiction Treatment Providers – The Cost of Caring  by Charlene Richard

Compassion Fatigue, Burnout and Vicarious Trauma are all terms that are used within the helping profession.  I have provided many workshops for addiction treatment center staff and know that everyone who works in the addictions field is at risk of Compassion Fatigue and Vicarious Trauma.  People in treatment share their stories and experiences of pain and trauma with a variety of helping professionals including; intake workers, clinicians, therapists, resident managers, support workers, case managers and so on.   At the end of my Compassion Fatigue workshops I give participants a feedback form to fill out, you know…….what did they like, what could be better, what is their biggest take away?

On numerous occasions I have received the feedback that being able to differentiate between burnout, vicarious trauma and Compassion Fatigue was quite helpful. Having language for one’s experience fosters awareness and we need awareness in order to create change.  Often Compassion Fatigue is confused with Burnout and I think it’s important that Helping Professionals understand the difference….. so here it is!

Burnout: Burnout refers to the physical and emotional exhaustion that comes from prolonged stress and frustration.  When we feel we have too many demands, and not enough resources, we begin to feel powerless to reach our goals.  This can lead to a reduced feeling of personal accomplishment and diminished self-care.  Burnout can happen in any field/job.  It results in significant negative impacts on health and outlook on life.

Vicarious Trauma: When a person is continuously exposed to other people’s traumatic experiences through witnessing and/or hearing others’ stories, vicarious trauma can be experienced. Vicarious trauma (VT) means that you have not been the direct victim of a trauma, but you have experienced it second hand from clients through their stories of pain.  Clinicians may begin to experience posttraumatic stress symptoms similar to the person who experienced it.  This can include intrusive imagery (images of trauma popping into your head) dreaming about the traumatic situation or avoiding certain activities and so on.

Ongoing vicarious trauma can result in a shift in the helper’s world view and sense of meaning, for example, someone who may regularly feel safe can begin to doubt their safety if they work with victims of crime and hear numerous stories of crimes and trauma.  If a helper has a previous history of trauma (and many have as more than 70% of the population has experienced one or more event significant enough to be traumatic) that is unresolved, then you are more likely to experience VT. Vicarious trauma is something that people experience on a continuum, you may leave the job but you will still have that foundation of VT within you.

Compassion Fatigue:  Compassion Fatigue is applied to people who suffer as a result of being in the helping profession.  If helpers experience both burnout and VT they are more vulnerable to developing Compassion Fatigue (CF). Compassion Fatigue is when someone who regularly hears/witnesses very difficult and traumatic stories begins to lose their ability to feel empathy for their clients, loved ones and co-workers.  This deep physical and emotional exhaustion has been described as “having nothing left to give” and “an occupational hazard”.  Compassion Fatigue can show as a variety of symptoms presenting behaviorally, emotionally, relationally, physically and spiritually.  Sometimes CF is misdiagnosed as depression.

Compassion Fatigue is developed because of the helper’s strong ability to care for their clients in the first place.  It is the most caring individuals who are most likely to develop CF. The best helping professionals are able to connect with their clients because of their strong ability to empathize with them.  It is this gift of empathy that can also lead them to develop CF. By learning about CF and developing ways to manage it, these helpers can continue to do the work they love, and are good at, while still being able to thrive personally.  Simply leaving one helping job and moving into another will not reduce one’s CF.

So how do we remain in the helping profession while limiting our Compassion Fatigue?  One strategy is to Empathize With Care!  One way to manage Compassion Fatigue is to be aware of the affects of empathizing.  We empathize with our clients so that we can connect with them and help them in their suffering and struggles.  In her book, Help for the Helper, Babette Rothschild explains the neuroscience behind empathy and discusses emotional contagion.  In order to do our jobs well, we need to be able to maintain awareness of what feelings are ours and what feelings belong to the people we are working with.

One way to ensure we maintain awareness is to be mindful about our own internal experiences while we are hearing our client’s stories.  We can do this by picking up on sensations in our bodies, noticing images or sounds that come into our minds, note our breath and muscle tension, as well as any emotions that arise or any thoughts that occur. This will enable us to ensure that we engage in conscious empathy, thereby, allowing us to empathize while still caring for ourselves, managing our own internal experience and being the best helper we can be. The next time you are working with a client who is sharing a difficult story, take a moment to check in with your whole self and ensure you are empathizing with care!