Dealing with the Compassion Fatigue of Psychotherapists

Many of us may have noticed that the various factors surrounding the pandemic (especially the lockdowns) have affected all sections of society, and that has significantly affected the practice of therapy and changed its nature. On the one hand the consequences for mental health and emotional well-being have been severe, making our profession more socially urgent and necessary than ever, but on the other hand it has made our work more difficult: the stresses that have always been intrinsic to our therapeutic practice have been intensified and with that also the risks for the therapist and the dangers of compassion fatigue and vicarious traumatization. At the same time the technological distancing inherent in online work via the screens has made the contact between client and therapist less immediate and therefore has made it more difficult to engage directly and effectively with the relational stresses in face-to-face contact.

Vicarious traumatisation arises when therapists absorb their clients’ traumatic states beyond the therapist's capacity to register, process and digest the intensity of the trauma they are exposed to session after session, day after day. However, this processing capacity - some call it the therapist’s capacity to metabolise relational vicissitudes - is not static or fixed: there are a multitude of factors which contribute to us getting overwhelmed, but there are also many helpful factors that can support and enlarge these capacities.

What can you expect from the course

In this experiential workshop we will address two areas:

1. Deriving from the traditional emphasis on verbal interaction across the talking therapies, there is pervasive in our discipline a naivete and lack of awareness around the non-verbal and pre-reflexive processes by which vicarious traumatisation flies under the radar of our attentional focus, and gets absorbed especially by the therapist’s body. There is little point in developing techniques for understanding and processing vicarious trauma if we remain unaware of how it gets inside us in the first place (because ever more will continue to keep coming in). We want to be deeply aware that being a therapist should carry a health warning, not just in principle as an idea, but in the particular detail of the relationship with each and every client.

2. Once we are aware how pervasive and ubiquitous the subliminal dynamics are by which “the client’s conflict becomes the therapist’s conflict” (this is one of the principles that Michael has been teaching for many years, and will clarify in the workshop), we can then think about helpful theories, tools and techniques for dealing with it, both in the session and afterwards.

Across the many different therapeutic approaches, what are the diverse factors which intensify the therapist’s exposure to vicarious trauma, and what are the factors which make therapists more prepared and resilient?

Michael has been thinking about the bodymind dynamics of the therapeutic relationship for many years, and in 2015 was asked by the BACP (British Association of Counseling and Psychotherapy) to write a series of articles on the ’Sustainability of Therapeutic Practice’. These writings will be available to participants of the workshop.

 POSSIBLE LEARNING OBJECTIVES

You will learn to:

• Recognise the exhausting and draining aspects of your regular working week
• Track your embodied response to particular clients, especially after a session, and connect it to ‘charged’ and conflictual moments during the session
• Make sense of these moments not merely in terms of the client's traumatised state or trauma narrative, but specifically in terms of the client's complex conflicted bodymind system, especially in terms of dissociated states and non-verbal processes outside of awareness which cannot be spoken about
• Recognise how the client's conflict is paralleled in the countertransference in the therapist's own bodymind system (whether we think about this in terms of mirror neurons, projective identification, embodied resonance or 'dreaming up’)
• Entertain - in your stream of consciousness as a therapist - the multiple levels of enactment of traumatic scenarios, without or before any explicit self-disclosure
• Feedback through your interventions fragmented aspects of the client's complex conflict whilst continuing to regulate the client's potential overwhelm/re-traumatisation
• Contain and metabolise the after-effects of sessions during the week before you see the client again