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  • Compassion Fatigue, Secondary Trauma, and Burnout

    WITH APPRECIATION OF THE VERY INFORMATIVE WEBSITE   for much of the following information…

    Difference between Compassion Fatigue, Secondary (or Vicarious) Trauma, and Burnout

    These terms are complementary and yet different from one another; they all can be the result of working as a health care professional.

    Compassion Fatigue:  Refers to the profound physical, emotional, and even spiritual exhaustion that helping professionals and caregivers can develop over the course of their careers as a helper.  It is a gradual erosion of all the things that keep us connected to others in our caregiver role:  our hope, patience, and empathy–not only for the people we treat, but also for our loved ones.  When we suffer from Compassion Fatigue, we start seeing changes in both our personal and professional lives.  We can become dispirited and increasingly bitter at work; we may even contribute to a toxic work environment; we are more prone to work errors; we may violate confidentiality and lose a respectful stance toward our students and/or collegues; we may become short-tempered with our loved ones; and we feel constant guilt or resentment at the never-ending demands on our personal time.  Compassion Fatigue is cumulative over time– and, as mentioned above,  can be evident in both our professional and personal lives– and even with the relationship with ourselves.  Addiction to drugs, alcohol, or habits can become a part of one’s life– not to deliberately harm oneself or other, but to try to soothe the emotional pain and exhaustion within.  Compassion Fatigue is cumulative over time–and evident in both our professional and personal lives.  It is an occupational hazard of working in the the helping field (

    Compassion Fatigue is cumulative over time– and evident in both our personal and professional lives.  It is an occupational hazard of working in the helping field. (Saakvitne & Pearlman, 1996).  Helpers can simultaneously experience Compassion Fatigue and Secondary Trauma.


    Secondary Trauma (alias,Vicarious Trauma):   This condition was first noted in literature by Pearlman & Saakvitne (1995) to describe the profound shift in world view that helping professionals can experience when they work with clients who have experienced trauma– just by hearing their stories and/or seeing their emotional and physical pain.  Helpers sometimes notice that their fundamental beliefs about the world and beyond, (such as their sense of safety and spiritualty) may be altered and possibly damaged by being repeatedly exposed to traumatic material.  The result can be very similar to Post Traumatic Stress, though the individual himself or herself was not personally involved in the traumatic situation.  (One may even experience Secondary Trauma from repeatedly watching horrifiic suffering on TV and/or on the internet, as well.)


    Burnout:  This is a term you’ve probably heard over and over in your lifetime.  It was first coined in the early 1980s.   It describes the physical and emotional exhaustion that workers can experience when they have low job satisfaction; they may feel powerless and overwhelmed and/or overworked at their job.  Burnout can be found in any job or profession– not just the helping professions.  (Sidenote:  However, burnout does not necessarily mean that our view of the world has been damaged– or that we have lost the ability to feel compassion for others.  Therefore, it is different from both Compassion Fatigue and Secondary Trauma.

    Most importantly, Burnout can be fairly easily resolved.  A long and relaxing vacation or changing jobs can provide immediate relief to someone suffering from job-related Burnout.


    The more that we know about the problem, the more able we are to develop strategies to prevent/modulate the impact of what we experience. Gaining an understanding of where your personal compassion sits can be done using the Proqol Self Test(  Also found on Terrie’s  website… with permission from  🙂




    Is your job challenging because of the types of client situations you have to deal with?  Because of the volume of work or because of a toxic supervisor?  Or all of the above?  Read through the examples below from and notice if you recognize elements of these scenarios in yourself.



    If my job as an administrative assistant to a parole officer is to read the files of violent sex offenders, I may be secondarily traumatized and deeply disturbed by the content of what I read. This may, in turn, affect my sex life, my feelings of safety for my children or my ability to watch television (Secondary/Vicarious) Trauma).  However, I may not necessarily feel too tired to talk to my friend who is going through a difficult time at home, and I may not find that this has caused me to feel deeply exhausted in my interaction with colleagues. But then again I may experience all of the above (Compassion Fatigue and Secondary Trauma).

    If I work as a nurse in palliative care, helping patients who are dying of cancer, I may feel incredibly drained, fatigued, unable to give any more and/or unable to stop thinking about my patients when I go home (Compassion Fatigue) I may also find that I have become very preoccupied with death, dying and end of life issues. Over time, these may affect my world view and beliefs about aging, cancer or similar issues (Secondary Trauma).

     Compassion Fatigue and Secondary (Vicarious) Trauma are much more complicated than just being tired and overworked. They are often caused by a conflict between our deepest values and the work that we are required to do, a phenomenon which is called Moral Distress(



    What factors contribute to Compassion Fatigue, Secondary (or Vicarious) Trauma, and Burnout?

    There are many reasons for which helping professionals can develop Empathy Strain and Vicarious Trauma. These are described in Saakvitne and Pearlman’s book “Transforming the Pain” (1996):

    The Individual:

    Your current life circumstances, your history, your coping style, and your personality type all affect how Empathy Strain may impact you.

    Most helpers also have other life stressors to deal with. Many are in the “sandwich generation” – meaning that they take care of both young children and aging parents in addition to managing a heavy and complex workload. Helpers are not immune to pain in their own lives and, in fact, some studies show that they are more vulnerable to life changes (such as divorce and addictions) than people who do less stressful work.

    The Situation:

    Helpers often do work that other people don’t want to hear about. They spend their time caring for people who are not valued or understood in our society. This may include individuals who are homeless, abused, incarcerated or chronically ill.

    Furthermore, our working environments are often stressful and fraught with workplace negativity. This negativity is often a result of individual Empathic Strain, Burnout and general unhappiness. The work itself is also very stressful. Dealing with clients/patients who are experiencing chronic crises, who have difficulty controlling their emotions, and/or those who may not get better can be draining.  Finally, we live in a society that glamorizes violence and does not adequately fund efforts to reduce or prevent violence in our society.