The concept of compassion fatigue is used to describe a secondary post-traumatic stress response, especially in helper work. It is an emotional state of exhaustion caused by repeated exposure to stimuli that cause sadness and anxiety, as well as an empathic interaction with a person in crisis. It involves emotional mirroring and somatic or bodily empathy.
In practice, in work that involves helping people for example, the suffering of the patient is transmitted to the caregiver both at the conscious level and at the unconscious level, including the somatic level. The intensity of identification is influenced by a person's own experiences and life situation. It is important to understand that this is a natural and normal reaction for an empathetic person, but at the same time a significant work-related risk that can lead to incapacity for work, reduced work capacity and difficulties in private life. The onset of symptoms is individual, but includes, for example, the experience that what has happened fills the mind, sadness and depression “catch on”, the worldview and human image can become pessimistic, internal numbness, irritability, loss of meaningfulness of work, weakening of professional self-esteem, loss of appetite, and insomnia. In addition to the care professions, people can be exposed to compassion fatigue in police work, in social work, in the judiciary, as a journalist, as accident investigator, etc.
This blog post deals with the treatment of compassion fatigue in the work of a journalist. I call my client Venla here. She is a well-experienced journalist specializing in crisis reporting and investigative journalism. She had been working for a long time on a case involving a criminal investigation involving several plaintiffs who had suffered significant psychological symptoms as a result of the crime. Venla had been in contact with several plaintiffs and instructed them to file criminal reports. To Venla's disappointment, however, the police had treated the plaintiffs' reports contemptuously and questioned their veracity. Gradually, this work situation began to cause Venla sleep problems, experience of lack of control, feelings of guilt, and anxiety attacks.
Venla chose a telephone conversation she had had with a plaintiff as a target memory. During the conversation, the plaintiff had told Venla about the contemptuous attitude of the police towards them and how it had affected them. The worst point in her memory was when she heard how the police had treated the plaintiff. Venla chose “I am powerless” as negative cognition and “I did my best” as positive cognition. The truthfulness of positive cognition on an emotional scale of 1 to 7 (not true at all — completely true) was two. The memory evoked feelings of pain, dismay, powerlessness, guilt, sadness and despair in Venla, which externalized as chest anxiety and crying among other things. The disruptiveness of the event was eight on a scale of 0-10 at the start of treatment.
Mutual stimulation with visual stimulus remotely via video was initiated with Venla focusing on the target memory and attaching a negative thought of herself to it. The stepwise processing of Venla's mind as bilateral stimulation (BLS) progresses and lasts approximately 20-30 seconds at a time is described below. To reduce the length of the text, each step of the bilateral stimulation is not marked, but after the feedback given by Venla, they always repeat at relatively the same duration:
V1: The tears keep falling.
V2: It’s tough, I can't say… I find that I've loaded a lot of emotion into it. I myself wasn’t aware of this.
V3: I couldn't have known that the police would take it that way… I've been listening to him for a very long time. More than what a journalist would need to.
V4: All I remember is that he has said many times that it has been very helpful that I have listened. Now I think it’s being present, even though there’s nothing you can do about it.
V5: I feel calmer. I can't really say. I can't treat people otherwise.
V6: In a way, I do more than I should, so I don't just write a story. I am not responsible for how the police handle things. I'm just doing my own job.
V7: Less anxious.
V8: Really much less anxious.
(me) Going back to the target, what do you notice now?
V9: There no longer this terrible feeling.
(me) How disturbing is the target memory now on a scale of 0-10?
V10: Three. Will I ever get over the fact that I feel responsible for someone else’s doings?
(me, cognitive intervention): Are you responsible for police action?
A12: I don't really know. Maybe I’m actually responsible as I can use my stuff to influence how they work.
(me, cognitive intervention): Have you ever written a story that would have an impact on how the police would work?
A14: I think I haven't really written one. I can't be blamed.
A15: I feel even less anxious.
(me) When you get back to your target, how disturbing does that event feel now?
(me) Let’s check for positive cognition. Is that “I did my best” good here?
A17: Yeah, I did my best and the distress of that plaintiff is not my responsibility.
(me): Great, let's root it in that event. How real it feels now on a scale of 1-7 (not at all — completely).
Eventually, with repetitions the positive cognition rose to a six and the person felt relieved and well. She herself was surprised by how emotionally charged the experience had really been.
As in this case, the use of the EMDR method is ideal for professional guidance situations. This way the method can be used to process memory traces related to the client's work, work community and own work role by neutralizing the negative and disturbing feelings associated with them, as well as negative thoughts and beliefs about oneself. So far, I have used the EMDR method successfully to process negative experiences caused by, among other things, difficult customer situations, challenging interaction situations, redundancy situations, performance stress and collective bargaining. The BLS4 Online Help application I developed, which provides work guidance to a group via video, has been used to unravel difficult customer experiences. Professional guidance promotes the identification of professional abilities, promotes development at work, and identifies and solves work challenges and increases self-awareness. The goal of professional guidance is always professional growth, as in this case study.
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