How are we worse for the wear? What can be done about it?

"Constructivist self-development theory is interactive in that it view's the therapist's unique responses to client material as shaped by both characteristics of the situation and the therapist's unique psychological needs and cognitive schemas."

"The effects on therapists are pervasive, that is, potentially affecting all realms of the therapist's life; cumulative, in that each client's story can reinforce the therapists gradually changing schemas; and likely permanent, even if worked through completely."

In 1966, Carl Jung "originally conceived that an 'unconscious infection' may result from working with the mentally ill."

In 1976, English described this process: "As the emotional needs and distresses of people in difficulty were presented to me, I not only felt them through the process of empathy, but I also found I tended to absorb them within myself as well."

In 1978, Chessick hypothesized that "conditions of depression and despair in one's clients (which he calls 'soul sadness') can be contagious."

In 1985, Farber cited "evidence that the client can transfer his or her pathology to the therapist."

In 1987, Guy cited "research which supports the notion that doing psychotherapy can be dangerous to the psyche of the therapist."

In 1990, McCann presents her "notion of vicarious traumatization...implies that much of the therapist's cognitive world will be altered by hearing traumatic client material."


In 1999, Figley described secondary traumatic stress and compassion fatigue as "a reaction from indirect exposure to a traumatic event...as a result of the therapist's own empathy towards a traumatized client in addition to the therapist's own secondary experience fo the traumatic material."


In 2007, Hernandez formulates "a new concept: vicarious resilience. It addresses the question of how psychotherapists who work with survivors of political violence or kidnapping are affected by their clients' stories of resilience. It focuses on the psychotherapists' interpretations of their clients' stories and how they make sense of the impact that these stories have had on their lives."

In 2007, Radey and Figley, coin the construct "compassion satisfaction" in the "broader context of positive social work...a paradigm shift towards identifying the factors that lead clinical social workers toward human flourishing in their field...compassions satisfaction or feelings of fulfillment with clients, rooted in positive psychology and expanded to incorporate the social work perspective. The model suggests that affect, work resources, and self-care influence clinicians' positivity-negativity ratio, which in turn can result in compassion satisfaction. To maximize compassion satisfaction, research, education, and training should consider how classroom instruction and workplace policies can promote the most success among clinical social workers."

There is energy exchange between client and therapist. What do we know about this exchange and how can we manage it in the best interest of both parties?

I frequently get massages for health maintenance and self-care. I forego other treats in favor of this one. I have had massages by practitioners up and down the State of California. On a few occassions, I walked in congested and by the end of the hour, walked out breathing easy. On both occassions, I heard my masseuse walking out with those sniffles. I wondered if there had been an exchange of energy and wondered how it had been transfered. After this experience, I asked two different practitioners about what they were taught and how they deal with their clients' release of toxins and energy. They both said that they set their intention at the outset of the massage to release the energy that no longer serves the client, but not take it on.

What are mental health professionals taught about this? We are taught about setting limits and boundaries. Understanding where we begin and end. Empathizing but not becoming responsible for our clients problems. But it appears that empathizing is both a vehicle for the clients' healing and a potential risk hazard for the therapist.

I remember working in South Los Angeles as a beginning social worker and feeling overwhelmed by the sense of hopelessness and despair that is "in the air." I remember thinking that it tapped into my own experience growing up in East Los Angeles and the air of hopelessness that can linger there. I remember wondering if this pre-existing vulnerability made it difficult for me to work in this environment and with this population. That is when the concept of resiliency saved my life. It reminded me of the other side of the story. The truth that despite the risks, most of my classmates were indeed living, loving and working well in adulthood. There is hope, despite the risks.

Early on in my career as a school social worker, I used to get weekly massages for $40. That gifted healer taught me that rather than release the energy accumulated at work throughout the week (my massages were on Friday evening), I could notice the energy coming towards me and shunt or redirect it away from me and not allow it to enter and be processed by my own body. She was like that. She spoke metaphysically and I usually only half-understood. But over time, I practiced this somehow. The visual metaphor helped to give meaning or grounding to the experience - like a guided visualization.

Because of neuroscience research, we now know about mirror neurons and how two people can sync up, right-brainwise, that is. Reevah called this, in the tradition of psychodynamic psychotherapy, knowing a lot about a person by how they make you feel when you are with them for five minutes. In Eastern medicine, this might be called energy or chi/qi. If this is happening between us, it would seem beneficial to explore this further, for all our sakes.

I am fascinated by what we can learn about this transfer of energy, how to manage it and what purpose it serves.

References:
Radey & Figley. (2007). The Social Psychology of Compassion,
Hernandez, Gangsei, & Engstrom. (2007). Vicarious Resilience: A New Concept in Work With Those Who Survive Trauma
McCann & Pearlman. (1990). Vicarious Traumatization: A Framework for Understanding the Psychological Effects of Working with Victims.