Compassion Fatigue and Vicarious Trauma in Helping Professions

Compassion Fatigue and Vicarious or Secondary Trauma can have a huge impact on people in helping professions and a good understanding of these two conditions are very important in preventing them. However, to understand how compassion fatigue and vicarious trauma work, we first need to understand how empathy works.

One of the characteristics of the human nature (and not only human) is the capacity to feel empathy, without which we would probably not have survived as a species. Empathy is the ability to understand and feel what another person is experiencing. But how do we do it? Well, according to Neuroscience when we are in the presence of another the more we get attuned to them the more our body starts mimicking and getting in sync with theirs. Our body might mirror their posture, our breathing might get in sync, our heartbeat might change, and our Central Nervous System in general starts copying theirs. The physical mirroring triggers relevant emotions. We start experiencing the anxiety, the sadness, the anger, the emotional pain etc. And this is billiard and helpful for a mother who needs to understand why her young baby cries, but it can also lead to Vicarious Trauma and Secondary Traumatic Stress which is indirect trauma that can occur when we are exposed to difficult or disturbing images and stories second-hand.

Now imagine a nurse who works in A&E, a homicide detective or a psychotherapist. Due to the nature of their work they are constantly exposed to physical and emotional pain and trauma. The repeat exposure to emotional distress and traumatic situations can lead to deep emotional exhaustion which is called Compassion Fatigue. This exhaustion diminishes one’s ability to feel empathy for their clients, loved ones and co-workers. You might hear people describing it as “having nothing left to give”.

And it needs to be noted that Adoptive Parents can also be affected by these two conditions as they are exposed to the trauma their children might have experienced.

Now the important question is, how do we support ourselves so we can keep caring and helping others? And the answer is simple (at least in theory): we have to ‘have’ in order to give and self care is the key to this. We need to find ways to recharge emotionally without that becoming a chore on it’ s own. It could be a good meal, having a relaxing bath, watching a good movie, reading a book, making sure we take small breaks from our work during the day or even just allowing ourselves to do nothing for half an hour a day. Find the simple things that give you joy and treat yourself, especially on difficult days. And make sure you rest, emotionally and physically.

Another important element is finding support ourselves. For people in the caring professions, being the helper has become such a part of our identity that we often struggle to ask for help when things get difficult. It is ok to be human and it is vital for a good and ethical practice to accept our limits and be able to ask for support. This could be in the form of Supervision, talking to a colleague, discussing with your manager, getting advice from a professional etc.

Finally, for anyone interested in reading more about this I would recommend ‘Help for the Helper’ by Babette Rothschild. It is written for Psychotherapists and Counsellors, but there is useful information there for everyone.

Teaching children about equality.

Did you know that babies start recognising racial differences as early as 6 months old and that they start internalising ideas about race, gender etc as early as 2 years old?

When they are around 2 to 3 years old our little ones start processing all the messages, spoken and unspoken, that they receive from the world about what it means to be black, white, yellow, blue, girl, boy, tall, short etc. And unless we educate them differently, they will accept the ideas they receive as true.

Children will not naturally come to the conclusion that we are all equally important, as unfortunately this is not the world we live in and these are not the messages they receive. As parents we have to actively educate them about what the issues are and about how to be kind to everyone. I would even take it a step further and say we need to teach them that we should stand up (each one of us in our own way) to bullies, racists, discrimination and injustice when we come across it.

I wish for a future that all adults and children will leave in harmony, but the only way to get there is by educating the younger generations now.

On depression

There are a lot of information out there about depression. However, I think the following are not mentioned as often as they should:

-The first thing I would advise somebody who feels low or depressed is to do a blood test. A number of medical conditions like iron deficiency, lack of vitamin D, thyroid dysfunction and other, can cause low mood and can contribute to depression.

-Another very important element is sleep. From the Sleep Foundation ‘The relationship between sleep and depressive illness is complex – depression may cause sleep problems and sleep problems may cause or contribute to depressive disorders.’ Note that an adult that is sleeping less than 7 hours a day is considered sleep deprived, regardless if it is by choice.

-Brain development during adolescence can trigger depression as a side effect.

-Depression is not something that happens only to adults. Children as young as primary school age can experience depression and low mood.

-You don’t have to be traumatised or to have experienced something serious to end up with depression. You might have a lovely family and life, but still suffer from it. Depression is a complex condition and its causes are not fully understood yet.

-And the most important of all – If you think you or your child might be depressed ask your GP for help. It might not feel like it at the moment, but things can get better with help.

You don’t need to be perfect as a parent

You don’t need to be perfect as a parent, just ‘good enough’ IS enough.

Donald Woods Winnicott (1896–1971) was an English paediatrician and psychoanalyst, whose work and innovating for the time ideas had a great impact on psychoanalysis and the way children and parenthood are viewed today. One of the very important ideas that Winnicott introduce first, is that of the ‘good enough mother/caregiver’ (1953). According to Winnicott there is no such thing as a perfect parent as there is no such thing as a perfect human. The caregiver needs to be ‘good enough’ not perfect, and that is enough for a healthy baby and child development.
Specialists in Brain Development today take it one step further and advise that children learn from the mistakes of parents and that a parent being perfect, if such thing was possible, would actually not be good for their child’s development. Dr Daniel Siegel advises that children learn from the ‘rupture and repair’ in the relationship between parent and child, as long as parents are able to repair.
In a world where we are constantly bombarded with information and advice about ‘should and shouldn’t s’ in terms of parenting, and where many parents run themselves to the ground in order to be perfect for their children, I find great relief and hope in these ideas.