Compassion fatigue: Psychotherapists’ chronic lack of self care.

“Some researchers argue health professionals are at higher risk of being traumatised because they are in caring, empathetic and emotionally invested roles (Figley, 2002; Wilson & Thomas, 2004; Sheen, Slade, & Spiby, 2014).”

“Being a therapist can be extremely challenging and stressful, which could lead to burn-out (e.g., Baker, 2003; Figley, 2002).”

“A related concept is that of compassion fatigue, a state of physical, mental, and emotional exhaustion and pain experienced by those who practice compassion work (Figley, 1995, 2002a, 2002b).”

“, Irving & Dickson, 2004; Klimecki, Leiberg, Ricard, & Singer, 2014), it can also lead to negative consequences as a result of the costs involved for the one who empathizes (Craig & Sprang, 2010; Figley, 2002).”

“…distress that can be experienced by caregivers who have ongoing contact with patients distressed or traumatized, which seriously affects helpers’ physical and mental health and reduces their interest of empathizing with others, thereby impairing their willingness to help others (Figley, 2002).”

“Compassion fatigue was first explored in nurses and, as other caring professions, such as social work and psychology, later adopted the concept, its definition was adapted to focus on prolonged exposure to suffering as one of its primary causes (Figley, 1995; Figley, 2002; McHolm, 2006; Sabo, 2006).”

“APS social workers who work with the traumatized elderly are also vulnerable to experiencing compassion fatigue during their careers, due to providing in-depth services to clients experiencing a crisis (Adams et al., 2001; Boscarino et al., 2004; Figley, 2002a).”

“…and impairment (Emerson & Markos, 1996; Lawson et al., 2007; Venart et al., 2007), additional potential consequences of not engaging in self-care include vicarious trauma (Pearlman, 1999; Pearlman & Saakvitne, 1995), compassion fatigue (Figley, 2002), and secondary traumatic stress (Valent, 2002).”

“Radey and Figley (2007) developed a model for understanding STS and compassion fatigue that posits that social workers also experience compassion satisfaction from trauma work; thus, rather than focusing only on the negatives, the field should begin to study “the factors that lead clinical social workers toward human…”

“Secondary traumatic stress (STS) is defined as the problematic behaviors and emotions that result from the knowledge of a traumatic event experienced by another (Figley, 2002).”

“Research suggests individuals who are close with a person who has experienced trauma may also experience stress (Figley, 1998, 2002; Pearlman & Mac Ian, 1995; Rothschild, 2006).”

“Also, Figley (2002) has shown that compassion toward self and others is more dominant in women than in men.”

“When emotional and cognitive resources are mobilized as part of the everyday tasks of care, it becomes even harder to offer care outside of work tasks (Figley, 2002).”

“With ongoing emotional, physical, or mental exhaustion, compassion fatigue can impede feelings of empathy and concern for others (Figley, 2002).”

“Figley’s differentiation of countertransference and compassion fatigue is illustrated by a clinical vignette in an article written for psychotherapists ( Figley 2002 ).”

“…traumatisation (VT) (Brady, Guy, Poelstra, & Brokaw, 1999; Pearlman & Mac Ian, 1995; Pearlman & Saakvitne, 1995a), secondary traumatic stress (STS) (Figley, 2002; Pearlman & Saakvitne, 1995b), and burnout (Freudenberger, 1989; Lee, Cho, Kissinger, & Ogle, 2010; Lee, Lim, Yang, & Lee, 2011;…”

“, 2004), receipt of personal counseling or therapy (Bell, 2003; Figley, 2002; Salston & Figley, 2003), utilizing ones strengths (Bell, 2003; Salston & Figley, 2003; Thorpe et”

“According to the Webster Encyclopedic Unabridged Dictionary of the English Language (cited by Figley) [17], empathy fatigue is “a feeling of deep empathy and sorrow for someone who is suffering”.”

“Figley (2002 ) noted that compassion fatigue can lead to the helper becoming tense, preoccupied, anxious, and avoidant.”

“…understood as a critical factor in providing effective support, but it has also been considered a primary path of vulnerability to develop stress disorders secondary to the profession, such as compassion fatigue and professional exhaustion (Decety & Lamm, 2006; Figley, 2002; Rothschild, 2006).”

“This continuous exposure to the traumatic events of others may contribute to compassion fatigue (Figley, 1995), which refers to a worker’s reduced ability to be empathetic to clients’ suffering due to the prolonged demands of caring for others (Figley, 1995, 2002; Figley & Roop, 2006).”

“Although the terms secondary traumatic stress and compassion fatigue are used interchangeably in the literature, these two conditions appear to occur independently of one another (Figley, 1995, 2002b; Stamm, 2005, 2008).”

“STS presents itself as a preoccupation with others‟ traumatic experiences by re-experiencing the events, avoiding or numbing of reminders of the event and/or persistent arousal (Figley 2002a, McHolm 2006).”

“For example, secondary trauma and compassion fatigue have been identified as staff-related concerns for those helping consumers with high levels of trauma (Figley 2002).”

“…state and trait empathy, self-awareness and ability to regulate one’s emotions, whether one has down-regulated responsiveness due to repetitive exposure to others’ pain and suffering or whether one is suffering from burnout or compassion fatigue (Figley, 2002; Lown, 2016; Maslach et al., 2001).”

“Within the caring professions self-care is associated with resilience and burnout prevention, whilst a lack of self-care has been linked to compassion fatigue (Skovholt, 2001; Figley, 2002).”

“Social work scholars believe that regular contact with trauma-exposed clients can have a negative effect on the well-being of mental health professionals (Collins & Long, 2003; Bride, 2007; Figley, 2002; Cieslak et al., 2014; Harrington, 2007; Hensel et al., 2015; Kanno, 2010).”

“Relationships among the nurse, patients, and family members, as well as the nurse being a witness to suffering, are common factors examined in studies of the meaning of oncology nursing (Cohen, Ferrell, Vrabel, Visovsky, & Schaefer, 2010; Figley, 2002; Lewin, 1996).”

“Figley[22] (2002), empati kurma becerisi, empatik endişe, hastanın travmasına maruz kalma, empatik davranış, merhamet stresi, başarı duygusu, uzun süreli hasta bireye bakım verme, travmatik anılar, hastadan uzaklaşma ve hayatın sekteye uğraması gibi değişkenlerin etkileşerek merhamet yorgunluğunun ortaya çıkmasına yol…”

“Compassion satisfaction refers to a sense of pleasure that an individual may get from feeling that they have helped their clients in their recovery (Figley, 2002).”

“Compassion is the regard and respect for fellow humans, including the bearing of another’s suffering and a desire to relieve it (Figley, 2002).”

“Vicarious traumatization is a term that describes the undesirable outcomes of working directly with traumatized populations, including negative interactions with patients and colleagues, and deleterious personal consequences [48, 49].”

“In this sense, these professionals will be exposed to what is known as secondary traumatic stress, a set of psychological symptoms that a professional acquires due to exposure to people who have experienced a trauma ( Figley, 2002 ; Kelly, 2020 ; Wang et al., 2020 ).”

“Burnout reflects exhaustion in the context of work demands (Freudenberger, 1974), whereas compassion fatigue has been used to identify the personal costs over time of caring for others who are suffering (Figley, 2002; Joinson, 1992).”

“CF is a general term applied to anyone who suffers due to being a formal caregiver in health, psychology, and social fields and refers to the natural emotional behaviors and reactions derived from knowing about a significant traumatic event [16].”

“Compassion fatigue can be defined as a state of tension and preoccupation with traumatized patients through re-experiencing traumatic events, resulting in a desire to avoid patients and reminders of their trauma, and a reduced capacity or interest in bearing the suffering of others [5].”

“Secondary trauma or STS describes the emotional and psychological impact of empathetically listening to clients’ experiences of trauma (Figley, 2002).”

“Figley (2002) and Stamm (2009) have suggested that the term " compassion fatigue " be used to describe secondary stress reactions among helping professionals who work with traumatized and suffering populations, as it may be a less stigmatizing term than " secondary traumatic stress disorder.”

“Continuous selfawareness and self-care may reduce stress and distress among social-service professionals, thereby enhancing work satisfaction and quality of care in the institution [29, 30] .”

“For instance, coping strategies (Lazarus & Folkman, 1984) have been discussed as a relevant factor in predicting work-related stress in social professions (Figley, 2002; Udipi et al., 2008).”

“Compassion fatigue is an extreme state of tension and preoccupation with the suffering of those being helped to the degree that it is traumatizing for the helper (Figley 2002a).”

“Empathy is a prerequisite for compassion fatigue according to the Compassion Stress and Fatigue Model [3], and nurses are at a high risk of compassion fatigue when they face patients with severe physical and psychological distress or when those who are dying have strong demands for empathic care.”

“The negative symptoms we have observed in these organizations in relation to bearing excessive responsibilities are in line with the empirical findings on compassion fatigue (Figley 2002; Slatten et al. 2011), role overload (Bolino and Turnley 2005), and burnout (Cordes and Dougherty 1993).”

“Previous scholarship shows that more time spent listening to trauma tends to be related to greater degrees of distress (e.g., Figley, 2002).”

“The negative mental and physical impact on care providers has been described under a variety of terms including “STS,” “vicarious traumatization,” “BO,” “CF,” and “PTSD” (Figley, 1995a, 2002b).”

“Compassion fatigue can affect patient care (Figley, 2002); therefore, greater understanding of compassion fatigue may foster interventions that can reduce compassion fatigue among hospice nurses.”

“” The types of self-care activities that are frequently discussed in the STS literature include healthy eating, sufficient sleep, exercise, leisure activities, meditation, mindfulness, spiritual practices, stress management, and self-soothing techniques (Berceli & Napoli, 2006; Brady, 2017; Caringi et al., 2017; Figle…”

“Sequelae include emotional exhaustion (McCormack et al., 2018), depersonalisation (Ackerley, Burnell, Holder & Kurdek, 1988), and compassion fatigue (Figley, 2002), and the impact of these symptoms extends beyond the practitioner well-being by negatively influencing work quality and client care…”

“Compassion fatigue is described as being preoccupied with or re-experiencing the patient’s traumatic events thus reducing the caregivers’ aptitude or interest in bearing the suffering of other people (Figley 2002:1435).”

“…and includes the related concepts of vicarious traumatization (Pearlman & Mac Ian, 1995), secondary traumatic stress (Figley, 1999), compassion fatigue (Figley, 2002), trauma exposure response (van Dernoot Lipsky, 2009), burnout (Maslach, 1982), and moral distress (Jameton, 1984).”

“Compassion fatigue may have numerous implications for care-giving professionals’ health and wellbeing (e.g., behavioral, cognitive, physical health, emotional) (Bride et al., 2007; Figley, 2002).”

“This phenomenon was termed as compassion fatigue (CF) by Joinson in 1992, which refers to the formal caregiver’s re‐ duced capacity or interest in being empathic and is considered as the natural consequence of constantly witnessing the traumatizing events suffered by other people [4].”

“It is believed to result from the constant empathy, caring, and emotional investment that helping professionals put into their work in order to be genuine and empathic to clients (Figley, 2002).”