Abstract
An integrative neurobehavioral model for “compassion stress injury” is offered to explain the “double-edge sword” of empathy and inherent vulnerability of helping professionals and care-givers. One of the most strikingly robust, yet largely invisible scientific findings to emerge over the past decade is identifying the neurophysiological mechanisms enabling human beings to understand and feel what another is feeling. The compelling convergence of evidence from multi-disciplinary lines of primary research and studies of paired-deficits has revealed that the phenomenon of human beings witnessing the pain and suffering of others is clearly associated with activation of neural structures used during first-hand experience. Moreover, it is now evident that a large part of the neural activation shared between self- and other-related experiences occurs automatically, outside the observer’s conscious awareness or control. However, it is also well established that full blown human empathic capacity and altruistic behavior is regulated by neural pathways responsible for flexible consciously controlled actions of the observer. We review the history, prevalence, and etiological models of “compassion stress injury” such as burnout, secondary traumatic stress, vicarious traumatization, compassion fatigue, and empathic distress fatigue, along with implications of the neurobehavioral approach in future research.
Highlights
On a clear summer night in 2006, an ambulance is urgently dispatched to the family residence of doctor “R”, a well-respected senior military psychologist and the only credentialed mental health provider for a U.S Marine base of 6000
This study aims to: (1) introduce the concept of compassion stress injury (CSI) and explore its relationship with other stress-related conditions; (2) review the universality of compassion stress across history and disciplines; (3) examine current etiological models of CSI; (4) review developmental, social psychological; and neuroscientific studies related to empathy; and (5) propose a unifying neurobehavioral theory of CSI
Figley adopted the term in his seminal text Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized, and elaborated compassion fatigue” (CF) as
Summary
On a clear summer night in 2006, an ambulance is urgently dispatched to the family residence of doctor “R”, a well-respected senior military psychologist and the only credentialed mental health provider for a U.S Marine base of 6000. Initial reports by Dr R’s frantic spouse indicated sudden paralysis, inability to speak, and unresponsiveness, suggesting possible seizure or stroke. Emergency personnel are greeted by a panic-stricken wife and two crying children. They enter the home to find the high-ranking patient sitting upright on a bed, conscious and breathing on his own, but immobilized, non-communicative, and with fixed gaze. Dr R. frequently expressed consternation, guilt, and moral outrage over his and the military’s inability to provide adequate treatment to the high volume of traumatized war veterans. Absent secondary gain and prior psychiatric or epileptic history, Dr R. concurred with his wife’s initial assessment-but how exactly can “caring too much” or empathy be a double-edge sword for helpers and caregivers?
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