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  • Compassion Fatigue, Vicarious Trauma, and Burnout

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    Difference between Empathic Strain (formerly Compassion Fatigue), Vicarious Trauma, and Burnout

    These three terms are complementary and yet different from one another; two are occupational hazards only to the helping field.

    Empathic Strain (ES), formerly known as Compassion Fatigue:  refers to the profound emotional and physical exhaustion that helping professionals and caretakers can develop over the course of their career as helpers.  It is a gradual erosion of all the things that keep us connected to others in our caregiver role:  our hope and our empathy–not only for others but also for ourselves.  When we suffer from Empathic Strain, we start seeing changes in both our personal and professional lives.  We can become dispirited and increasingly bitter at work; we may 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 collegues; we become short-tempered with our loved ones; and we feel constant guilt or resentment at the never-ending demands on our personal time.

    Vicarious Trauma
    (VT):   This term was coined by Pearlman & Saakvitne (1995) to describe the profound shift in world view that occurs in helping professionals, when they work with clients who have experienced trauma. Helpers notice that their fundamental beliefs about the world are altered and possibly damaged by being repeatedly exposed to traumatic material.

    Empathic Strain and Vicarious Trauma are cumulative over time– and evident in both our personal and professional lives. They are also an occupational hazard of working in the helping field. (Saakvitne & Pearlman, 1996)  Helpers can simultaneously experience Empathic Strain and Vicarious Trauma..



    Burnout:  This term has been used since the early 1980s.   It describes the physical and emotional exhaustion that workers can experience when they have low job satisfaction, and feel powerless and overwhelmed at work.  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 Empathic Strain and Vicarious Trauma.

    Most importantly, Burnout can be fairly easily resolved.  Changing jobs can provide immediate relief to someone suffering from job-related Burnout. This is not the case for ES or VT.


    As a helping professional, the distinction described above may not be particularly important to make. It is only important in so far as it helps you understand the contributing factors that lead to developing ES or VT.  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.

    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 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 (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 (Vicarious Trauma and Empathic Strain).

    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 (Empathic Strain). 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 (Vicarious Trauma). 

    Empathic Strain and 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.

    Using our specialized course in Empathic Strain, TEND has worked with individuals who are not in the helping field but who still feel severe work-related Burnout (e.g. someone working as an administrative assistant in a toxic work environment).


    What are some of the signs of Empathic Strain and Vicarious Trauma?


    Researchers have discovered that helpers, when they are overtaxed by the nature of their work, begin to show symptoms that are very similar to their traumatized clients. These symptoms can negatively affect the workplace and create a toxic work environment.

    • Difficulty concentrating
    • Intrusive imagery
    • Feeling discouraged about the world
    • Hopelessness
    • Exhaustion and irritability
    • High attrition (helpers leaving the field)
    • Negative outcomes (dispirited, cynical workers remaining in the field, boundary violations)

    For more information, check out this article Warning signs of Vicarious Trauma/Secondary Traumatic Stress and Compassion Fatigue


    What factors contribute to ES/VT 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.