Breaking the taboo: eight Swedish clinical psychologists’ experiences of compassion fatigue

Abstract

Purpose: The aim of the study was to investigate the participating psychologists' experiences with compassion fatigue, and to identify individual, interpersonal, and organizational factors and strategies perceived as contributing or protecting in relation to compassion fatigue. Methods: Semi-structured telephone interviews were conducted with eight psychologists (three men and five women) with more than five years of experience in clinical practice. The interviews were analyzed with thematic analysis, generating five themes. Results: These were organizational and task specific factors which the participants felt contributed to their compassion fatigue ("mission impossible" and "emotional strain"), experiences of compassion fatigue ("consequences"), interpersonal factors that were perceived as contributing or protecting ("interpersonal factors"), and individual factors that were perceived as protecting ("shielding and strengthening factors"). Conclusions: It was found that all of the participants had experienced negative impact of compassion fatigue on their personal lives. A large quantity of patients, and complex patient cases, as well as high expectations on the psychologists were experienced as contributing factors. Collegial support, an empathetic boss, a high degree of agency at work, and fulfiling activities outside of work were experienced as protecting against compassion fatigue.

Incorporating compassion into compassion fatigue: The development of a new scale

“…Some of the aspects of compassion fatigue, such as a lack of interest in or annoyance with patients, can be particularly difficult to address since they do not fit with the general image of health care professionals as compassionate and altruistic (Isdal, 2017). This theme was also found in the study by Norrman Harling et al (2020), where psychologists expressed concern regarding their own and others' expectations of psychologists as never failing to be compassionate towards others. Other contextual factors hindering compassion were physical and ethical stress due to a heavy workload and complex patient cases combined with hindering organizational factors such as lack of resources, time, and support from higher instances (Norrman Harling et al, 2020).…”

“…This theme was also found in the study by Norrman Harling et al (2020), where psychologists expressed concern regarding their own and others' expectations of psychologists as never failing to be compassionate towards others. Other contextual factors hindering compassion were physical and ethical stress due to a heavy workload and complex patient cases combined with hindering organizational factors such as lack of resources, time, and support from higher instances (Norrman Harling et al, 2020). Additionally, research by Åhlin (2015) has shown that health care personnel often experience stress due to a troubled conscience when they cannot provide the type of care they wish to provide.…”

“…A general review of studies connected to compassion fatigue was conducted and questionnaire items were based on the descriptions of compassion fatigue found in an integrative literature review by Coetzee and Laschinger (2018) and a concept analysis by Coetzee and Klopper (2010) which has a broad conceptualization of the construct including earlier theoretical and empirical research of compassion fatigue. The items were also based on a qualitative study examining Swedish psychologists' experiences of compassion fatigue (Norrman Harling et al, 2020). When designing the CFI, special care was taken to create items that were differentiated from items in questionnaires measuring burnout and STS.…”

“…However, feeling empathy, and compassion for others while experiencing high levels of stress can lead to compassion fatigue, leaving the carer unable to help their patients sufficiently (Coetzee & Klopper, 2010). In a qualitative study by Norrman Harling et al (2020), in which psychologists shared their personal experiences of compassion fatigue, the participants reported feeling emotionally affected by patients in a negative way and experienced a reduced capacity to feel and express compassion, both at work and in their personal lives. The psychologists also experienced some difficulties in mentalizing with the suffering of their patients, resulting in higher levels of annoyance which they felt had a negative impact on their work.…”

“…The psychologists also experienced some difficulties in mentalizing with the suffering of their patients, resulting in higher levels of annoyance which they felt had a negative impact on their work. Other unwanted effects were feelings of numbness, increased categorical thinking and a will to withdraw from social interaction (Norrman Harling et al, 2020).…”