As clinicians, we all say it: “We must take care of ourselves.”
We empower our colleagues, patients and families by repeating this mantra to them in times of stress. But, too often, we forget to take our own advice.
At some point, as humans, we therapists all fail to recognize our own limits. We take on another case, work another weekend, take another call, all under the premise that this workload is what we are built to do. But, what happens when we start to fall apart?
Compassion fatigue syndrome is a feeling of chronic stress, emotional exhaustion and tension often felt by therapists, counselors and anyone in the helping professions. It is common for clinicians to develop this syndrome at some point in their careers, given their close work with those experiencing and hearing stories of abuse, death and trauma. Central to this syndrome is a clinicians’ inability to engage in a productive therapeutic relationship with a patient (van Mol et al., 2015).
This phenomenon manifests itself in many ways and differs from one clinician to another. Some develop secondary trauma, which happens when a clinician is exposed indirectly to trauma through the voice of their patients. Other clinicians experience symptoms of anxiety and depression, perpetuating their emotional exhaustion. The overwhelming empathy we give our clients all leave us feeling depleted regardless of the stories when we experience compassion fatigue (Salston & Figley, 2003).
Compassion fatigue all has one common denominator: lack of self-care.
We know that we need to take time to care for ourselves and when we fail to do so as clinicians, we become more susceptible to poor coping mechanisms and harmful health risks. According to Norcross (2000), reflecting on professional practice, taking time to become aware of ourselves while providing treatment, case reviews and identifying positive client outcomes are all ways to help preserve our professional selves.
When we do not take the time to do so, we face many adverse physical and psychosocial symptoms. At times, our bodies can become so weak that we develop physical symptoms such as fevers, stomach aches and chest pains. In extreme cases, clinicians can develop symptoms related to PTSD despite the trauma resulting from an indirect source (Salston & Figley, 2003).
We begin to withdraw from friends and family, obsess about things we did not always fixate on and spend our nights tossing and turning. We become short or distant with our colleagues and find ourselves unable to focus on a task because our minds are running faster than we can comprehend. We find ourselves wondering how we got here.
When clinicians begin to feel this way, it’s important to seek support to validate our own emotions. We must empathize with ourselves the way we would with our clients. We must recognize our responsibility as helpers to first help ourselves to better serve those around us. We need to realize that we are allowed to have a human reaction to our patients’ stories but must work to process these stories to prevent them from interfering with our personal and professional lives. We must work to continually be self-aware and reflect so we do not dissociate from reality and become numb to those around us.
It is often encouraged that therapists seek out therapy or supervision to help us manage our own mental health, especially when we are dealing with our own health or family issues (Cerney, 1995). The issues our clients face can very easily become our own personal struggles and the support from therapy can help us stay on track as clinicians and maintain professional boundaries.
When we are dealing with our own loss, trauma or other life-altering circumstance, a supportive environment can offer us the validation we need to help us move forward, often times, the same validation we give our clients.
We have fears and insecurities and experience pain like all humans, and must treat ourselves with the same care and empathy. We must remember that there is a great deal of courage in seeking assistance to become healthier versions of ourselves and recognize our own strength. We are clinicians. We are human. We are no different than those we help. It is time we start practicing what we preach.
Cerney, M. S. (1995). Treating the “heroic treaters.” In C. R. Figley (Ed.), Compassion fatigue (pp. 131-148). New York Brunnerhlazel.
Norcross, J. C. (2000). Psychotherapist self-care: Practitioner-tested, research-informed strategies. Professional Psychology: Research and Practice, 31(6).
Salston, M.D., & Figley, C.R. (2003). Secondary Traumatic Stress Effects of Working With Survivors of Criminal Victimization. Journal of Traumatic Stress, (16)2.
van Mol M.M.C., Kompanje E.J.O., Benoit D.D., Bakker J., & Nijkamp M.D. (2015). The Prevalence of Compassion Fatigue and Burnout among Healthcare Professionals in Intensive Care Units: A Systematic Review. PLOS ONE, 10(8).