By: Tracy C. Wharton, M.Ed., MFT
When I was a young counselor just out of school, I took a job at an alternative school. I provided crisis intervention and behavioral therapy to children who were unable to succeed in normal educational environments. One of my clients was a six-year-old girl who had been repeatedly sexually abused and had been bounced around foster homes with her aggressive outbursts. After one particularly bad day of her active flashbacks, I found myself sitting in my clinical supervisor’s office in tears.
“How do you do it?” I asked. “I can’t sleep without thinking about her, about all of them. How do you deal with it?” He turned around and slammed his briefcase shut. “Like that,” he said, latching the locks shut. “You just have to learn to walk away. If you can’t do it, maybe you’re in the wrong field.” I hated him at that moment, and suddenly I felt as if all my teachers had betrayed me for not letting me in on this little secret. Why hadn’t anyone told me that this job would hurt so much sometimes?
The truth is that he was wrong. He may be able to shut it all off at the end of each day, but research tells us that most of us cannot and do not. In fact, about 48% of the total social work workforce in the United States experiences high levels of personal distress as a result of their work (Strozier & Evans, 1998).
Personal distress can look like a lot of things, such as relationship problems at home, feelings of no longer being effective at work, depression, or more noticeable things like nightmares or hypervigilance. Researchers make the case that there is a strong connection between the helping professions and what they call Secondary Traumatic Stress (STS). There is a lot of literature out there that talks about the high incidence of suicide rates in social workers, high turnover rates in employment, high rates of burnout, and disruptive symptoms to personal lives resulting from traumatic stress (Figley, 2002; McCann & Pearlman, 1990; Meyers & Cornille, 2002; Pryce, Shackleford, & Pryce, 2007; Valent, 2002). We often are willing to write it all off as fatigue, or tell ourselves (or others) to “buck up,” or “learn to deal,” or even worse—to get out of the profession, as my supervisor had done with me. Can you imagine what would happen if every young social worker took such advice? There’d be no one left to help our clients. It took me less than six months to learn about the strains of the job, but it would be nearly a decade before I would find out that reactions like mine are common, and more importantly—normal.
Exposure to stressors is not necessarily a guarantee that there will be development of clinically significant symptoms. Job satisfaction and personal gratification protect us (this is that notion that we love what we do, even if it’s very rough some days). We know that these things are true for our clients. What makes us think that our training makes us something other than human?
Burnout, Trauma, and Compassion Satisfaction
Burnout, secondary trauma, and compassion fatigue are not exactly the same things, and it’s helpful to be able to distinguish among them. Secondary trauma is the reaction to dealing with other people’s situations, such as my reaction to my six-year-old client. Burnout is related to the job environments in which we work, and the stresses attached to those jobs and requirements, like paperwork or poor supervision or support. When burnout and STS are both present, an individual is said to be experiencing compassion fatigue (CF). There is also a third factor in CF—something called compassion satisfaction (CS). Stamm explains this phenomenon as “being satisfied with doing the work of caring” (2002, p. 110). In other words, the gratification of helping others makes the strains of the work worth it. It is not uncommon to see social workers continue in their jobs after physical or psychological injury, or to find them reluctant to leave the field despite personal stress. The caring that we give to the world is both the greatest risk and the greatest protective factor from long-term trauma (Figley, 2002; Saakvitne & Pearlman, 1996; Stamm, 2002).