Counsellors and carers can become the victims of their ability to empathise with suffering. Conferences today and tomorrow will highlight the deceptive phenomenon of Compassion Fatigue, reports Padraig O'Morain, Healthand Children Correspondent
'I had started getting what I would describe as anxiety attacks which were acute signs of stress," says counsellor Ann Frey. "I felt as if I was running on empty. I felt worn down and lacking in any kind of joy. The fun had gone out of my work."
Like many others who listen to the stories of traumatised people, Ann Frey was experiencing Compassion Fatigue, a condition which most people, including most counsellors, have never heard of - but which has the capacity to wreck working lives and relationships.
A conference being held at Whiteabbey, near Belfast, today, and repeated in Dublin tomorrow, will hear of counsellors who worked with victims of atrocities in Northern Ireland who have had to give up one-to-one work, and of damaged professional and personal relationships among workers caring for children in residential homes. Aircraft crashes, bombings, kidnappings and other destructive events all leave traumatised helpers - as well as victims - in their wake, the conference will be told. It is organised jointly by the British Psychological Society, the Psychological Society of Ireland, the University of Ulster and the Staff Care Services section of the South and East Belfast Health and Social Services Trust. The main speaker is Prof Charles Figley, director of Florida State University Traumatology Institute.
Listening repeatedly to stories of human suffering, whether in war zones, the home or the workplace, threatens to traumatise counsellors and other members of the caring professions.
In Frey's case it was listening, on behalf of Trinity College Dublin's Anti-Bullying Research and Resource Centre, to the suffering of adults bullied at work that brought her to a halt about a month ago.
"They usually come when they are at the end of their tether, when they are experiencing acute stress and anxiety and don't really know which way to turn or what to do," she says of her clients.
"You are hearing a lot of pain. Their job, their health, their mortgage is under threat. Family life suffers. There is a possibility of not being able to obtain a reference if they leave. Their pension rights are under threat. Their own identity is under threat, they feel valueless." About three months ago her feelings of exhaustion, stress and acute anxiety began and continued to grow. Like many affected by Compassion Fatigue, she kept working. "Somehow we think we are invincible, that we can just keep going," she says. "I think that's a difficulty with carers: we don't look after ourselves." By Easter, "I was feeling very tired. I felt I really needed to get away. It was 'stop the world I really want to get off, and fast'." She went to a quiet place she knew in the country.
"I was only going to go away for a couple of days and thought that would be sufficient - then I started crying uncontrollably . . . I felt I was under the weight of a huge rock which was on top of me. This oppressive weight was bearing down on me." She felt she just could not take any more of man's inhumanity to man.
She extended her stay and spoke about her feelings to a trusted confidant. "To recharge my batteries, I went for long walks and drew energy from my surroundings: trees, fields, plants and flowers. I am seeing clients again now, and feeling a lot better. But I need to be careful."
Had she not heeded the wake-up call, the consequences could have been dire indeed. Selwyn Black, of the Department of Psychology at the University of Ulster, lists just some of the effects of Compassion Fatigue: a sense of unreality, emotional numbness, and a feeling of isolation from others at work and at home.
The person with Compassion Fatigue can go from "being warm, empathic, optimistic, and compassionate, to being cold, alienated, pessimistic and dispassionate," he says.
Black left his post as a minister in Rathgar Methodist Church, Dublin, in 1987 to spend 10 years as a chaplain with the RAF.
There he saw the effects on helpers of a catalogue of traumatic events including military air accidents. "I was involved with burying seven close colleagues or friends who were killed in an air accident at the Toronto air show on September 2nd, 1995."
In the weeks and months following an air accident, "I would wonder why pilots who were good at their job would not want to do this anymore and why very good permanent relationships were breaking down." In his study of counsellors listening to the victims of atrocities - including Omagh - in Northern Ireland, he has found the same effect. Compassion Fatigue has led two people who worked with the victims of the Omagh bomb to give up one-to-one counselling in favour of group work.
Prof Peter Weinreich of the University of Ulster has identified Compassion Fatigue in residential child care workers "whose work with demanding children made them prone to emotional exhaustion". Those most affected become prone to conflict with colleagues and alienation from family and friends. And, with that inability to let go, which appears to be a feature of Compassion Fatigue, they identify more and more strongly with their work, becoming, as he puts it, "enmeshed" in their work.
As the main organiser of the conference - at which the speakers include Dr Marion Gibson, who has substantial experience of working with traumatised people in Northern Ireland - Prof Weinreich says he wants to redress an imbalance in the way in which the effect of the conflict in Northern Ireland is seen: "There is general acknowledgement that there have been many people in the community in Northern Ireland who have been directly afflicted by the Troubles, but less recognition of the toll on those working with and caring for them," he says.
'COMPASSION Fatigue is when helping hurts, when the suffering of others becomes toxic to those of us who listen to and care for them," says Prof Figley, who developed his interest in Compassion Fatigue in the wake of the bombing of the federal building in Oklahoma City in 1995. Working with the traumatised, he says, "shatters our assumptions about the world, a world that is safe and full of caring, civilised people".
In tackling her Compassion Fatigue as she did, Frey is, he says, "a wise woman. To restore our world view, to effectively adopt to a new one, we must find our centre, our sense of self, whereby we both feel satisfied that our helping has actually done some good." Helpers must also "become successful in caring for ourselves, like she did". And boundaries are of enormous importance.
"We must at least create boundaries to allow us to shut off our work when we are away from it and experience the joy of living," he says. "Unless we are able to feel a sense of satisfaction for the work of helping others we will fail them and ourselves."