What is the difference between burn out, compassion fatigue and vicarious trauma?
Let's begin by defining the different terms.
Burnout: Burnout is a term that began in the 1980’s as a description for the physical and emotional exhaustion that you may experience when you have low job satisfaction and feel powerless and overwhelmed at work, particularly in work that exposes you to trauma. However, burnout does not mean that your view of the world and the people in it has changed.
Compassion Fatigue: describes the profound physical and emotional erosion you may feel as a worker when you are unable to renew or regenerate your ‘batteries’. Compassion fatigue can reduce your ability to feel empathy and compassion for your clients, but does not include a change to world view.
Vicarious trauma: “A transformation of the helper’s inner experience, resulting from empathic engagement with clients’ trauma material.” (From the earliest vicarious trauma research by Pearlman & Saakvitne, 1995. The definition is little changed today.) You increasingly view the world as an unsafe place for you and your loved ones, and you increasingly see others as untrustworthy.
Vicarious trauma can create conflict in your deepest values.
In the early stages of developing any of the trauma responses above you may experience symptoms similar across all three. Each symptom will gradually increase over time, almost imperceptibly.
All three of these issues have symptoms in common. These fall into a few domains.
Psychological / emotional:
Anxiety
Depression
Feeling overwhelmed by negative emotions such as grief, despair, shame or guilt.
Increased irritability
Procrastination
Reduced sense of personal accomplishment
Reduced self-esteem
De-personalisation (where you feel like you’re living on auto-pilot)
Reduced time and energy for yourself and the people close to you
Increased cynicism or seriousness
Increased sensitivity to violence – for example in the movies or tv
Disruptions in personal relationships, including your relationship with yourself
Physical
Disrupted sleeping patterns
Increasing substance use/abuse
Avoiding situations perceived as potentially dangerous
Trauma responses:
Intrusive reactions which include dreams and nightmares, flashbacks, persistent re-experiencing of a trauma event, obsessive thoughts or rumination.
Avoidant reactions which include avoiding any material that might be seen as traumatic, and a general numbing
Hyper-arousal reactions such as hyper-vigilance and difficulty in concentrating.
In addition to these, if you are impacted by vicarious trauma, you may also experience changes in your cognitive schemas (your beliefs about yourself, the world and other people):
Increasing view of the world and other people as unsafe and untrustworthy
Feeling helpless about your abilities to take care of yourself and others.
Increasing belief that your freedom is limited
Increasingly feel alienated from friends and family, that our work sets you apart from other people.
A reducing sense of self-esteem.
A reduced sense of empowerment
An increasingly closed mindset.
Vicarious Trauma is much more complicated than just being tired, stressed or overworked. It can also create conflict between your deepest values and the work you have chosen to do; leading you to question your ability to do the work you love.
Vicarious trauma is more than burn out or compassion fatigue.
The symptoms of compassion fatigue, burnout and vicarious trauma may start with similar, equally debilitating symptoms; however only vicarious trauma causes changes to your cognitive schemas, ie: your beliefs about yourself, the world and other people. Over the past thirty years the research into vicarious trauma hasn’t shown much change in this definition.
These changes to your views on the self, world and others can lead to further distortions in your emotional regulation, interpersonal relationships and can contribute to mental wellbeing issues such as anxiety and depression. This is a serious issue with impacts across all areas of your life.
You can address the impacts of vicarious trauma, and prevent it developing with personal strategies such as reflexive practice, mindfulness and self care, and organisational level strategies like structured peer support, clinical supervision and awareness of vicarious trauma.
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