Multiple Exposure: Increased Risk

Image courtesy of Dr. Leslie Anne Ross, UCLA

This diagram presents the wide range of factors that can lead to a professional experiencing greater rates of stress and distress which can, over time, contribute to someone developing compassion fatigue and related symptoms.


Personal Vulnerabilities


The individual’s current life circumstance, their personal history, coping style and personality characteristics all affect how they are impacted by the work. In addition to working in a challenging profession, most helping professionals 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. 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 difficulties such as addictions than people who do less stressful work.


Work-related Traumatic Grief and Loss


Traumatic events in the workplace (death of a child or a colleague, critical incident and other distressing situations), loss of a colleague through retirement or other career changes, loss of a beloved leader, school closure, funding cuts, etc.


Direct Exposure


Direct exposure refers to traumatic events that happens directly to the individual in question. In the context of helping professionals, there are two kinds of direct exposures, also called “primary trauma”:


Primary trauma from personal life


History of childhood abuse, High ACES score, having escaped a war-torn country, a traumatic loss in their personal life, surviving a motor vehicle accident, etc. Research shows that over sixty percent of helping professionals have a trauma history of their own, which may be why they chose this field of work (to make a difference, to give back, to share their learnings with others.) That, in and of itself is not a problem. The challenge arises when helpers go into the field without having done their own trauma work and are not aware of the ways in which their trauma history negatively impacts the work they do. It can also make us more vulnerable to developing vicarious trauma when bearing witness to our clients' pain and suffering.

Primary trauma caused by work related exposure


This type of primary trauma exposure occurs in the line of duty: working as a firefighter, a search and rescue operator, being a first responder to an accident or a crime scene, being involved in a lock-down or negotiating a hostage taking, working in a war-torn country in unsafe conditions. What makes it primary is that it is happening to you. During this traumatic situation, you are potentially in harm's way and/or you are overwhelmed by the horror/terror of the situation.



Indirect Trauma


Secondary or Vicarious trauma is caused by an indirect exposure to trauma: you are not in actual danger, you are not at the scene of the traumatic event seeing first hand the results of a shooting rampage or an accident. Instead, those stories are described to you verbally, in writing or through audio or video recordings. Secondary traumatic exposure can happen through counselling a client who is retelling a story of abuse, reading case files, debriefing a colleague or a client, sitting in court and hearing graphic testimonies or watching a disturbing movie or traumatic news footage. Many first responders such as firefighters and paramedics are at risk of developing primary trauma in addition to the secondary trauma they are exposed to in the line of duty.



Empathic Strain (Compassion Fatigue)


Compassion fatigue, now more commonly referred to as Empathic Strain (ES) refers to the profound emotional and physical exhaustion that helping professionals and caregivers 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 empathy, our hope, and of course our empathy - not only for others but also for ourselves. When we are suffering from Empathic Strain, we start seeing changes in 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 towards our students and colleagues. We become short-tempered with our loved ones and feel constant guilt or resentment at the never-ending demands on our personal time.


A Shift in Perspective, Why It’s Time to Stop Using “Compassion Fatigue”. Panel discussion with F. Mathieu, D. Tikasz, G. Sprang and B. Bride:



Systems Failure


Grappling with roadblocks in the systems that we work with. Feeling angry and/or frustrated about a lack of resources, disagreeing about someone’s eligibility for a service, there are many examples of systems failure. One result of facing these numerous challenges is moral distress.

Moral distress occurs when we are told to do things that we fundamentally disagree with or are morally opposed to. When our values conflict with what is required by law or other rules and regulations.



Working Conditions


Working conditions are profoundly affected by our workplace relationships, sense of trust, quality of communication, perceptions of fairness, workload, who we directly report to, overall workplace climate, rewards, recognitions and many other factors.



Socio-Cultural Context


The socio-cultural context of the community, state or country that we live in can profoundly impact our daily levels of stress. Being a member of a minority group and having to navigate discrimination or safety concerns on our way to and from work and even in the workplace. The current political climate, media, being exposed to cyber bullying etc.