Change in terminology: 'empathic strain' rather than 'compassion fatigue'?

March 24, 2021

The concept of compassion fatigue has been around for twenty five years. Often closely linked (and at times incorrectly used interchangeably with) burnout, compassion fatigue has been a focus for researchers interested in mitigating the risks workers face with prolonged exposure to the suffering of others. Leading experts are calling for a change in terminology, suggesting that ‘empathic strain’ is a more accurate term due to the differing neural networks involved in empathy and compassion. See below for a brief overview of the discussion.

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What is compassion fatigue?

Other posts on this blog on compassion satisfaction, vicarious resilience and the upcoming post about the risks of connection, outline the inevitable impacts, both positive and negative, on workers in helping or caring roles.

‘Compassion fatigue’ refers to the physical, mental and emotional exhaustion that can arise as a result of engaging with the suffering of others for a prolonged period without adequate support.

The ensuing worker impairment and emotional depletion can result in workers shutting down and functioning on ‘autopilot’ due to a feeling that they have nothing left to give.


Implications

For clients, staff and organisations, the implications of ‘compassion fatigue’ can be enormous:

  • Individually, workers can lose a lot more than empathy, as they potentially lose hope, suffer personal and professional impacts, which can have consequences for career trajectories, personal mental health and family wellbeing.

  • For organisations, impacts may affect clients outcomes, workplace efficiency, staff morale resulting in absenteeism, presenteeism and high staff turnover.

  • Needless to say, none of this is good for patients, students or clients accessing services.

The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet.

‘Empathic strain’ rather than ‘compassion fatigue’

There has recently been some much needed debate by leading specialists regarding the relevance and value of the term ‘compassion fatigue’.

Only a month ago, experts from TEND and the Secondary Traumatic Stress Consortium held a panel discussion titled 'A Shift in Perspective. Why it’s time to stop using "compassion fatigue”', suggesting that ‘empathic strain’ may be a more accurate term, for the following reasons:

  • Empathy involves the ability to identify or feel with the feelings and perspectives of others, including pain and suffering. (For a more detailed look at empathy please see here).
  • Compassion entails “our ability to recognise the suffering of another without taking on that suffering as our own, combined with an authentic desire to alleviate the suffering of another” (Diana Tikasz).
  • The neural networks for empathy are shared with those that manage pain. In unconscious attempts to protect ourselves from feelings of distress we can withdraw and numb ourselves to the experience of others.
  • Over time, it is the strain of repeated interaction with another’s pain - that is, on our empathy circuitry - that can make us disengage, turn away or shut down from the suffering of others.
  • Compassion, on the other hand, does not get fatigued. Nor does this make sense from a biological point of view: compassion activates different neural circuitry from empathy, and can be energising both neurobiologically and behaviourally. Compassion releases the binding and connecting ‘feel-good hormones’, dopamine and oxytocin, that help to motivate us, connect us and promote pro-social behaviour.

Why is a change in terminology important?

The shift in terminology from ‘compassion fatigue’ to ‘empathic strain’ is important for several reasons:

  • As this area continues to grow in research, understanding and their practical applications, a shared understanding is important.

  • As these understandings evolve through research, we need definitions to reflect new meaning.

  • Knowledge is power. This is particularly the case when we differentiate what might be required. For example, approaches to addressing a reduced capacity for empathy are quite different from the neutral networks involved in fostering compassion.


After struggling with the crossover of terms in the area of secondary stress for some time, I welcome this shift in terminology.

For more information on how to combat empathic strain, and its cronies, vicarious trauma, burnout and secondary traumatic stress, stay tuned for the next blog or sign up for the newsletter here.

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Header image: Javier Allegue Barros