Help for the Helper: The Psychophysiology of Compassion Fatigue and Vicarious Trauma

by Babette Rothschild MSW LCSW, Marjorie Rand (Primary Contributor)

How empathy can jeopardize a therapist's well-being. Therapist burnout is a pressing issue, and self-care is possible only when therapists actively help themselves. The authors examine the literature from neurobiology, social psychology, and folk psychology in order to explain how therapists suffer from an excess of empathy for their clients, and then they present strategies for dealing with burnout and stress.

Genres: Psychology, Social Work, Nonfiction, Professional Development, Counselling, Mental Health, Self Help

272 pages, Hardcover

First published March 1, 2006

Reviews

[Meg · Rating 5 out of 5]

This should be required reading for everyone in a helping profession (in the broadest sense). I was shocked to realize how much I *hadn't* been taught in graduate school (or the 5-6 years since) on the physiology of how we "catch" other people's emotions. I also found it (strangely) unusual and refreshing for Rothschild to assert that (1) it's not good to catch your clients' emotions, as this can make you "the prisoner of someone else's nervous system" (I love this phrase); and (2) it's actually possible to DO something about it. Unlike other books on vicarious trauma, which focus on how you should get your own therapy or take a lot of soothing baths, Rothschild offers a lot of very specific and practical techniques (most of which are things you can do *in the session*) for "unmirroring" and generally being able to untangle your own feelings from your client's feelings.

I also was really surprised by - and appreciative of - her questioning of the whole concept of "projective identification." I had never questioned this idea before, but her critique is so sensible and spot-on. I loved when she pointed out the client-blaming aspect of claiming that a client "makes us feel" a certain way. Although interpersonal relationships have a mysterious quality (that perhaps can't entirely be pinned down to physiology), knowing about the physiology makes the whole process seem more clear and understandable, and less ominous and overpowering.

[Erica · Rating 5 out of 5]

When I purchased and began reading this book, I already knew I was suffering compassion fatigue and burnout. I hoped for, at a minimum, a new take on the standard therapist self-care tips, but found this book to be so much more. After 12+ years of studying and practicing psychotherapy, I was fascinated to learn how my brain, body, emotions, and energy are being impacted by this work.

The author is straight-forward while also compassionate, and efficient while also providing plenty of case examples. Most importantly, she is honest and direct.

This is not a self-help book. This is a "how to continue being a whole person while doing the work of empathy" manual. My only regret is that I didn't read it sooner.

[Janet Ferguson · Rating 5 out of 5]

I HIGHLY recommend this book to any therapist or care-giver who wants to be effective and empathetic without taking on clients' trauma or intense emotions. I am looking forward to implementing the author's strategies to stop having nightmares and allowing my clients' stories to negatively affect my own life. In order to help THEM, I have to be able to avoid "catching" some of the more intense emotions. I am confident the lessons learned from this book will help me be a better therapist in this way.

[A · Rating 4 out of 5]

Hyvä sisältö. Valitettavasti suomennettu psykologian alan kirjallisuus vaikuttaa vilisevän anglismeja, kankeita virkkeitä ja jopa puuttuvia sanoja ja lyöntivirheitä. Tämä käännös ei sentään ole pahimmasta päästä, mutta hankin omaan hyllyyni silti mieluummin alkukielisen.

[clove · Rating 5 out of 5]

Nothing in grad school taught me about this- the importance of learning how to /not/ empathize, ways that empathy can be damaging to a therapeutic relationship and clinician care. This should be required reading for all new therapists.

[Matthew · Rating 5 out of 5]

I read this book as a part of my Master's degree and research for my capstone (thesis) paper.

Rothschild has managed to write detailed and organized descriptions of some of the latest neurological research on how humans react to each others' emotions both consciously and unconsciously, especially as helping professionals. Much of the information was new to me about how we have a tendency to mirror the feelings, emotions, and posture around us. As I read, it made so much sense. The film industry must know at a fundamental level that humans resonate emotionally with just about anyone.

I approached this book with my lens as a teacher and aspiring school administrator and was not put off or overwhelmed by the neurology and science in the book. I LOVED how practical and on point Rothschild is in reducing vicarious traumatization, compassion fatigue and burnout. This book will be cited repeatedly in my research.

[Amy · Rating 3 out of 5]

Although, this book was designed for therapists and psychologists, I think it is a good for anyone in a major care taker role (teachers, nurses, etc.), or anyone who has a hard time watching the news (or Oprah) without crying. It explains effectively how anxiety and depression can be "catching", and gives tips on how to avoid it.

[Rachel Brown · Rating 4 out of 5]

This book explains the physiology and psychology of empathy, mirroring, and vicarious trauma. Most usefully, it has a set of detailed exercises that therapists can do to avoid or recover from vicarious trauma.

[Kayla Anderson · Rating 4 out of 5]

A lot of relevant information. It could be a great tool for clinical supervision as well.

[Tea]

Luin tämän harrastautuneena maallikkona. Kirjan ohjeet tuntuivat sekä tosi yksinkertaisilta että myös tehokkailta. Ne asettautuvat hyvin muuhun tietopohjaani aiheesta, enkä ainakaan huomannut mitään ristiriitaisuuksia.

Sattumalta luin rinnakkain myös vankilanjohtaja ja psykologi Kaisa Tammen Naisvankilan pomo -kirjaa, jossa hän kuvaa sekä oman sijaistraumatisoitumisen kokemuksensa ihmiskaupan uhrin kanssa työskennellessään. Olisipa hänenkin työyhteisöllään ollut tällaiset tiedot käytettävissään aiemmin.

[Kendra · Rating 4 out of 5]

Interesting perspective on how we unconsciously pick up on trauma and emotional distress in the therapeutic relationship and some practical ideas to reduce our susceptibility and maintain awareness of our empathy and joining.
"It is my hypothesis that many therapists suffer in their work as a result of unconscious empathy - that is, empathy processes that are outside of the therapists's awareness and therefore also outside of his control." (p11)

[Michał · Rating 2 out of 5]

Zawiodłem się szczerze mówiąc na tej książce. Autorka powołuje się na teorie, które nie mają oparcia we współczesnej nauce. Miałem także poczucie, że jest pisana jak luźne przemyślenia a nie na konkretny temat. Kilka rzeczy sobie z niej wziąłem ale wiele z fragmentów zwyczajnie pominąłem bo były nieciekawe.

[Paltia · Rating 4 out of 5]

May seem repetitive for those in practice over the long haul. However, if you do supervision or work as a consultant there are some entertaining and useful exercises sprinkled through the text. I don’t think Rothschild credits Bandler but there is a lot taken from NLP theories.

[Niamh Sullivan · Rating 4 out of 5]

I highly recommend it for new and experienced clinicians alike. It is a dense read, but entirely helpful and validating. The book offers both practical and philosophical teachings. It is a book I will go back to time and time again.

[Gato Negro · Rating 4 out of 5]

Some excellent practical advice here.

[Shoma · Rating 5 out of 5]

Such a valuable book with many insights and tools for those in the caring professions.

[CC · Rating 5 out of 5]

A very helpful book for professionals working with traumatized clients!

[Elissa Egan · Rating 5 out of 5]

Very good! Wonderful tools and exercises for empathy and anxiety and burnout. It’s for psychotherapists or people in the health field but I found it helpful as someone not working in those fields.

[Erika · Rating 3 out of 5]

Good for introduction, but that's it. You could probably Google most of the information in this book and get it for free.

[Bailey · Rating 1 out of 5]

Use common sense.. that’s the whole book. Terrible, reductive, and disappointing.

[Denis Gil Vega · Rating 3 out of 5]

Una interesante y útil herramienta para cualquier profesional de la ayuda, ya sea psicólogo, enfermera, terapeuta de cualquier tipo, asistente, etc. Aunque personalmente la introducción se me hizo tediosa por ya conocer los conceptos, puede resultar muy útil para quienes no estén familiarizado con los conceptos de neuronas espejo, reflejo, o empatía desde un punto de vista más profesional y serio, por lo que es, realmente, necesaria.
Sin embargo la gran utilidad del libro es su segundo mitad: ofrece un muy amplio abanico de técnicas y trucos para controlar tu propio estrés y tensión en la práctica profesional,para evitar el contagio emocional, y demás cargas que puede llegar a tener el profesional que se dedica a ayudar a los demás. Es muy fácil que nos quedemos con las cargas negativas de nuestros pacientes/clientes y es fundamental poder escudarnos contra ellas e incluso saber cómo liberarnos de forma sencilla para poder actuar de filtro sin retener esas cargas y así, al final, poder ser de más ayuda.

[Cyndi · Rating 5 out of 5]

Too much empathy - can that really be a problem? Yes it can! Particularly so, as the author explains, if it is not employed with conscious awareness. If it remains unconscious (and therefore unexamined,) this tendency can be very draining for the practitioner, leading to emotional and physical health problems as well as potential burnout. It can also be detrimental to the therapeutic relationship, and even to the client's well-being. For those who are highly sensitive and attuned to the emotions of others, particularly those working in helping professions, this book will be an excellent resource. It is the best I have read on emotional contagion, vicarious trauma, and compassion fatigue. The author's treatment of these topics is comprehensive, backed with research and physiological explanations, full of helpful anecdotes as well as practical suggestions.

[Alex · Rating 5 out of 5]

If you work in any of the helping professions, this should be required reading. More books are coming out about self-care, but this is one of the best I've read.

[Jenna · Rating 4 out of 5]

hyödyllinen kirja etenkin auttamistyötä tekeville. sisältää paljon keinoja oman hyvinvoinnin ylläpitoon ja työn rajaamiseen liittyen.

[Ana · Rating 3 out of 5]

No lo leí entero. Tiene partes interesantes

[Elio · Rating 5 out of 5]

Invaluable resource.

[Jenelle Cheetham · Rating 4 out of 5]

Recommended for health care workers and anyone in a helping profession