Compassion Fatigue
Compassion fatigue can present as emotional, physical, and psychological symptoms that develop slowly over the course of a life or career. A few physical signs that are associated with compassion fatigue are prolonged periods of exhaustion, insomnia, headaches, and somatization (Mathieu, 2012). Behavioral signs of increasing compassion fatigue can include the increased use of alcohol and drugs, anger and/or irritability, absenteeism, avoidance, and having an impaired ability to make decisions. Psychological signs can include depression, negative self-image, cynicism, resentment, problems with intimacy, hypervigilance, and failure to nurture and develop non-work-related aspects of life (Skovolt & Trotter-Mathison, 2016). Compassion fatigue gradually diminishes many elements of the individual, including their empathy, hope, and compassion for others and the self (Mathieu, 2012).
Vicarious Trauma
This term describes the shift that helping professionals can experience in their fundamental beliefs about the world. These beliefs can be altered and possibly damaged by being repeatedly exposed to traumatic material. When those who work to hold space for others in pain are exposed to traumatic stories, whether they are heard, seen, felt, or otherwise experienced, a type of transference can occur where the caregiver becomes traumatized by the images and details shared, even though they were not experienced firsthand (Pearlman & Saakvitne, 1995).
Trauma Exposure Responses
Trauma exposure responses can manifest within oneself but are often expressed outwardly. These reactions can include feeling hopeless, having a sense that one can never do enough, diminished creativity, inability to embrace complexity, minimizing, physical ailments, dissociative moments, developing an inability to listen fully, deliberate avoidance of potentially painful situations, a sense of persecution, guilt, fear, anger and cynicism, a tendency towards numbing or addictions, and grandiosity (Van Dernoot Lipsky & Burk, 2009). Some of these trauma exposure responses are born out of pre-existing personal and organizational factors, as well as the ongoing engagement with the suffering of others. These can include a personal history of trauma, a lack of hobbies and support groups, and geographical and social isolation (Phoenix, 2014).
Trauma Stewardship
Laura Van Dernoot Lipsky and Connie Burk (2009) coined the term “trauma stewardship"- an all encompassing term that continually calls into conversation the way in which people are affected by the interactions they have with others, and how people can process trauma stories in healthy, non-harmful ways. It is active, not passive, and can also be described as an intentional daily practice through which individuals, organizations, and societies tend and react to hardship, pain or trauma and create space for growth and healing (Van Dernoot Lipsky & Burk, 2009).
Self-Efficacy
Self-efficacy refers to an individual's belief in their capacity to execute behaviors necessary to produce specific performance attainments (Bandura, 1977, 1986, 1997). Self-efficacy reflects confidence in the ability to exert control over one's own motivation, behavior, and social environment. These cognitive self-evaluations influence all manner of human experience, including the goals for which people strive, the amount of energy expended toward goal achievement, and likelihood of attaining particular levels of behavioral performance. Compassion fatigue and vicarious trauma can impact feelings of self-efficacy.
Resilience
Resilience involves behaviors, thoughts, and actions that promote personal wellbeing and mental health. People can develop the ability to withstand, adapt to, and recover from stress and adversity—and maintain or return to a state of mental health wellbeing—by using effective coping strategies. Other contributing factors to building resilience include social support and close relationship, the ability to manage strong feelings and impulses, problem-solving skills, feeling in control (self-efficacy), asking for help and seeking resources, coping with stress in healthy ways,
helping others, and practicing gratitude.
Social Capital
Social capital broadly refers to those factors of effectively functioning social groups that include such things as interpersonal relationships, a shared sense of identity, a shared understanding, shared norms, shared values, trust, cooperation, and reciprocity.
The Professional Quality of Life: Compassion Satisfaction and Fatigue Scale was created by B. Hudnall Stamm and is the most commonly used measure of the negative and positive affects of helping others who experience suffering and trauma. The ProQOL has sub-scales for compassion satisfaction, burnout and compassion fatigue.
Often, the health and well-being of professional caregivers goes overlooked. In order to understand some of the consequences of caring and how to mitigate those consequences, a few key concepts are defined here.