As front-line healthcare workers face increased pressures, burnout, exhaustion, secondary trauma and empathic strain, it is important to try and understand the definitions, causes and ways to heal.
The term ‘burnout’ is used a lot when referring to a person’s feeling of decreased motivation, and physical exhaustion, often brought on feelings of overwork or being overwhelmed. Burnout syndrome can happen at any time in any profession, and is not necessarily tied to a traumatic experience. Typically reversible ,with time and effort which might involve lifestyle changes, setting boundaries, or professional therapy/counselling burnout .
Vicarious trauma, (VT) sometimes referred to as secondary traumatic stress, is a process of change that results from the impact of hearing or witnessing other’s trauma experiences or reviewing challenging case files. Most commonly diagnosed in those who engage empathetically with survivors of traumatic incidents – typically those who work in fire, law enforcement, EMS, doctors, social service and health professionals and media professionals, VT can lead to feelings of loss of control and self-esteem, feeling unsafe and loss of intimacy. It change the beliefs and world views of people who experience it and can result in increased anxiety and/or fear in a manner that affects daily functioning.
What to look for
Common signs include getting overly involved rather than supplying patients with the tools to help themselves, continued feelings of anger, rage or sadness or bystander guilt or shame, loss of hope, numbing or distancing. While VT isn’t easy to live with coping skills include charting your stressors, engaging is relaxing, self-care activities and maintaining a realistic work-life balance with a mix of cases and regular opportunities to de-brief. Taking time off when needed and seeking support and additional training is also recommended.
Empathy is the ability to understand the root cause of a situation from another’s point of view. This Empathic strain is the deep physical and emotional exhaustion experienced by professionals that can, over time, cause an underreaction along with a decreased ability to relate to another’s experience.
Empathic strain is usually caused by extreme exposure to occupational stress. This high intensity exposure can be caused by decreased autonomy, significantly increased workload or insufficient funding for required staffing and resources. When someone feels burnout and vicarious trauma at the same time, there is an increased risk of empathic strain.
Serious impacts
Empathic strain not only affects those professionals who are experiencing it but also those in their care. It can often involve:
• Increased use of alcohol and drugs
• Absenteeism or attrition
• Anger and irritability
• Impaired ability to make decisions
• Problems in personal relationships
• Compromised care for clients/patients
• Reduced ability to feel sympathy and empathy
• Cynicism or Resentment
• Dread of or avoiding certain clients/patients
• Feeling professional helplessness
• Diminished sense of enjoyment or career satisfaction
• Depersonalization
• Intrusive imagery
• Hypersensitivity or insensitivity to emotional material
• Insensitivity to emotional material
• Difficulty separating personal and professional lives
• Failure to nurture and develop non-work-related aspects of life
Contributors to an individual’s empathic strain are usually environmentally related or a result of “on the job” experiences. Workers who experience longer working hours, intense caseloads, limited or cut-back resources and a lack of a reliable work support system are especially susceptible. Geopolitical issues such as pandemics or wars, can also affect workers. In addition, those individuals who are experiencing considerable amounts of personal stress, or who have their own personal trauma to deal with can be at risk of empathic strain. It is also more common in individuals who already possess a high affliction for empathy on their own.
Increasing awareness: Overcoming empathic strain starts by increased awareness and education on both personal and organizational levels. Healing starts with recognition and understanding which includes “naming” it and being preprepared to accept and address it.
According to experts, speaking about it, validating it as well as releasing any shame or guilt without judgement is key. Releasing the stigma associated with professional carers who are living with empathic strain is the first step to creating a culture where everyone feels free to express their feelings.
Providing supports
This needs to happen at a systematic level as well as a social one. Creating a workplace team that is collaborative and supportive will increase the psychological safety needed to prevent empathic strain. When employees feel supported by clear goals, open communication and effective leadership they will be able to leverage these factors to reduce some of the risk factors that lead to empathic strain.
Workplace culture: Additional factors to consider include adding structure to the workday, reducing environmental stressors such as noise, lighting and chaos in the general work environment can help. Often in high-stress, fast paced environments skipping breaks, conversations and regular debriefs can become the norm. Ensuring regular consultation from a colleague or manager can not only increase psychological safety in the workplace, but improve short and long-term mental health.
Personal prevention: Due to the nature of empathic strain, a big part of prevention has to do with individual elf-care in the wake of a stressful and taxing professional life. While lives can be busy especially for those working with families, redirecting your attention to self-care interventions that can be worked into the daily routine include:
• Meditation – practice deep breathing and stillness
• Exercise – regular exercise practices show huge benefits for mood boosting
• Journaling –express gratitude or vent
• Connect with nature – take a walk, or explore someplace new
• Engage in a creative activity – drawing, painting, cooking a fun meal or even adult colouring.
Lessening risk
The most effective way to reduce risk and increase the ability for elf-care is to set boundaries. In a personal or professional situation, limits should be set in a clear, non-confrontational way based on needs at the time. This can reduce anger, feelings of being taken advantage of, resentfulness and frustration—all emotions that can to, or prevent, healing from empathic strain.
Anjolina Rankin-West is an editorial assistant with an interest in family caregiving.
Source: Center for Innovation in Campus Mental Health: Empathic Strain Infosheet Photos: CanStock
Compassion Fatigue vs. Empathic Strain?
In the late 90s the term compassion fatigue was coined to explain the phenomenon of empathic strain. While many online resources still utilize the term Compassion Fatigue in some circles it has fallen to disuse as it doesn’t accurately reflect the experience of empathic fatigue.
Research shows that the ability to feel compassion and empathy have different neural pathways, hence the need for a shift in terminology. Like love, humans are said to have endless supplies of compassion that they can give. However, research has shown that there is a limit to the amount of empathy someone can give without it coming under strain.
Photos: CanStock
