CLINICAL EDITOR’S COMMENTS:
The authors provide helpful tips for preventing compassion fatigue.
A
nother day, another ten clients with stories of trauma, abuse, divorce, heartbreak, and despair told and re- enacted before one highly trained, very caring, and
often overwhelmed play therapist. How can s/he continue to watch little hearts shatter and bear witness to the unimaginable horrors enacted upon small bodies, minds, and spirits, then go home to his/her own children and respond with calmness, kindness, and compassion, after pouring out so much for other people’s children? How does s/he cope with the stories of predators in the community knowing his/her children live in that same community?
The play therapist’s job can be emotionally charged and intense, and oftentimes involves empathic engagement in the pain of precious children. All counselors are taught to evaluate clients objectively, put aside personal feelings, and maintain a degree of professional distance (Abendroth & Figley, 2013; Figley, 2002). However, play therapists can be deeply impacted by others’ experiences (Copley, 2013), such as participating in children’s emotional lives. Therefore, it especially to traumatic events played out by vulnerable and fragile children.
Although empathy and compassion are requirements of the counseling profession,
they are also the very factors that make counselors
vulnerable to compassion fatigue, sometimes referred to as vicarious trauma, and its negative effects (Figley, 1995). Play therapists need to be aware of these impacts and to be familiar with ways to prevent or ameliorate compassion fatigue.
Compassion Fatigue Compassion fatigue refers to the “cost of caring” for others in fatigue as a secondary traumatic stress reaction that results from helping or wanting to help people suffering from traumatic events. Compassion fatigue, a function of bearing witness to the suffering of others, is associated with a sense of helplessness and isolation (Figley, “a transformation of the helper’s inner experience, resulting from empathic engagement with client’s trauma material”
(p. 40). Both
phenomena share similar symptomology involving the counselor’s preoccupation with traumatized patients by reexperiencing their traumatic events, and symptoms such as the avoidance of reminders, numbing in response to reminders, anxiety, and persistent or increased arousal (Abendroth & Figley, 2013; Figley, 2002). Over time, the terms
“compassion fatigue,” “secondary traumatic stress,” and “vicarious trauma” have been used interchangeably (Figley, 1995). However, more recent literature distinguished them from one another. While secondary traumatic stress may be applied to many populations, compassion fatigue refers exclusively to those in helping professions (Elwood, Mott, Lohr, & Galovski, 2011).
Signs and symptoms. It is important for play therapists to be aware of their mental, emotional, and physical states, because neglecting personal self-care needs can lead to compassion fatigue. Preventing or attenuating compassion fatigue requires being aware of and recognizing the signs and symptoms of its emergence (Abendroth & Figley, 2013), then implementing strategies quickly before the symptoms and effects worsen (Mathieu, 2007). According to Mathieu (2007), some signs and symptoms of compassion fatigue are: • Physical and mental exhaustion • Reduced ability to sympathize and empathize with others • Anger/irritability • Dreading working with certain clients • Diminished sense of career enjoyment/satisfaction • Heightened anxiety or irrationality about the world
• Impaired ability to make decisions and care for clients • Problems with intimacy in personal relationships
Causes. The fundamental components of effective counseling are the very factors that can lead to compassion fatigue (e.g., empathy, compassion, and engagement). Simply being exposed to another person’s painful narrative can be enough to induce compassion fatigue (Portnoy, 2011). Some causes of compassion fatigue include: unresolved past trauma, unrealistic expectations (of self or others), caregiver stress, neglected self-care, disregarded healthy coping skills, and the loosening of personal or professional boundaries (Figley, 1995; Hayden, Williams, Canto, & Finklea, 2015). According to Figley (1995), counselors are most susceptible to compassion fatigue when dealing with children’s pain or suffering.
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