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Jan./Feb. 2007

The New Face of Compassion Fatigue
By Karl LaRowe, MA, LCSW

Compassion fatigue is a term traditionally reserved for professional care providers—doctors, nurses, social workers, and counselors who experience a type of burnout providing care and treatment for people suffering from physical, mental, or emotional trauma. It has also been called secondary traumatic stress and vicarious trauma because the symptoms of compassion fatigue mirror some symptoms of posttraumatic stress disorder (PTSD), including restlessness, anxiety, sleeplessness, difficulties concentrating and focusing attention, problems controlling emotions, particularly anger, intrusive images, thoughts, memories, emotions and sensations, social withdrawal, increased use of drugs and alcohol, and with some people, depression and suicidal thoughts.

The hallmark of compassion fatigue is physical, emotional, and spiritual exhaustion—it is literally being “tired from caring” and “tired of caring.” Vicarious trauma is believed to be the result of a caregiver’s empathy for his or her patient and the degree of exposure to another person’s suffering. More recently, it has also begun to include the physical and emotional responses non-professional caregivers—i.e., family members—experience while caring for a loved one with a chronic condition—most notably, Alzheimer’s disease.

Vicarious Terror
Since the terrorist attacks of September 11, 2001, the war in Afghanistan and Iraq, and the ongoing war on terror, compassion fatigue may be redefined to include vicarious terror. Vicarious terror may be understood much the same as vicarious trauma, except the method of transmission is the media rather than face-to-face contact. Vicarious terror relies on the repetitive barrage of images and sound bites crafted specifically to induce the physical, mental, and emotional response of vicarious trauma, especially dissociation. Dissociation is another word for feeling separated, isolated, and disconnected from yourself and others—it is a state of emotional and even physical numbing. It is the result of a continual and repetitive barrage of noxious stimuli that slips below our mental radar while registering and accumulating subconsciously as a condition I call “wired and tired.”

Wired and Tired
When vicarious terror is experienced as repetitive shocks to the mind and body, the sympathetic nervous system is hyperactivated, secreting large amounts of adrenaline into the bloodstream in preparation for fight or flight; heart rate increases, breathing becomes short and shallow, blood vessels constrict, muscles tighten and the neocortex, the thinking brain begins to shut down in favor of automatic responses of the more primitive, reactive limbic system (or emotional brain). Because the terror is experienced vicariously through the media and especially when it occurs under the radar of conscious awareness, there is no specific mechanism to fight or flee the terror; all the body can do is freeze. The freeze response is the psychological mechanism most associated with PTSD and is comparable to gunning your car engine in gear while stomping on the brakes. Repeatedly, over time, your body will suffer the same fate as your car—mechanical breakdown and eventually, complete systems failure.

Awareness and Action
The most effective way to combat vicarious terror is through awareness and action. Make a conscious effort to become more aware of what you see and hear on the television and what you read in the news. Remind yourself that you are not getting the whole and complete picture at best, you are getting someone else’s version of what they want you to see and experience. Understand that shock and awe is in networks’ own interest to keep you glued to their station and sponsors. Continually question the reason, motivation, and validity of reports you hear and see: “Believe none of what you hear and only half of what you see.”

Take action. One interesting finding in the studies on PTSD is, when potential victims are able to take some kind of action to have a direct influence on their experience of the trauma, their symptoms were either reduced or nullified. Question the accuracy and authority of the news. It is far too often that we passively sit and accept whatever is shown and told to us on the television.

Try talking back at the television and call “bull” when you see it. Write, send an e-mail, or contact your network news station, and tell them you want more balanced and complete news coverage. Ratings are king in the media world—flex your muscles as a consumer. Switch stations to one that provides a less biased and sensationalized version of the news. Be cautious about sticking with a station simply because its bias is in alignment with your own.

Learn to turn the television off. Monitor the quality and quantity of information you can digest at one time. Like spoiled food, spoiled information can give you a bellyache.

— Karl LaRowe, MA, LCSW, is an international speaker, an author, and a workshop presenter. He travels the world offering workshops to health professionals and organizations wanting to find their center of balance and transform burnout and depression into energy and engagement.