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Has your job given you ‘compassion stress injury’?

While supporting children in adversity can be satisfying, it can have serious effects on the mental health of school staff, writes Dr Rachel Briggs

Dr Rachel Briggs by Dr Rachel Briggs
June 13, 2022
in Heads & Governors, Human Resources, International Schools, Wellbeing
Reading Time: 7 mins read
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Teachers need to make sure they don't get compassion stress injury
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Schools have a significant role to play in supporting the welfare needs of their students, and this has become increasingly necessary due to adversity and/or trauma associated with, or exacerbated by, the pandemic. Challenges reported include higher levels of child mental health concerns, increased levels of domestic violence within families, financial hardship, health concerns, and bereavement.

Teachers and other school staff are regularly the first professionals that families turn to for support and advice when they experience adversity or trauma. This is particularly the case in international schools where families may be unfamiliar with support in the local community or may feel unable to access it due to cultural or language barriers. In addition, they may be away from their home country and their usual support networks, such as family and friends.

“Staff are regularly the first professionals that families turn to for support and advice.”

So, it’s not unusual for school staff to hear narratives of children who, for instance, have witnessed extreme violence, have suffered illness and bereavement, who have experienced neglect or abuse, or who are struggling to adapt to a new location and culture. It’s also common for school staff to be working with students who have additional learning and communication needs, social-emotional and mental health needs or physical disabilities unrelated to the pandemic.

This can leave school personnel, often with little or no specific training, and limited resources, trying to meet additional needs of the students and their families, whilst also trying to meet targets linked to academic progress.

Working with those who are living with adversity and trauma can be hugely satisfying, as it provides opportunities for experiencing compassion satisfaction, defined by Wolpow and colleagues as “the positive feeling we get when we realize that the compassion we put into working with others is resulting in some relief, growth or healing.”

“Working with those who are living with adversity and trauma can be hugely satisfying.”

However, in sectors such as health and social care, there is recognition that “dosage effects” from exposure to traumatic stimuli, rather than (or in addition to) dissatisfaction in the work environment, contribute to work-related stress. There are multiple terms used to express this detriment to practitioner wellbeing, with the most prevalent being:

Compassion fatigue – “the physical and mental exhaustion and emotional withdrawal experienced by those who care for sick or traumatized people over an extended period of time” (Merriam-Webster, 2021)

Vicarious trauma – “the process of change that happens because you care about other people who have been hurt and feel committed or responsible to help them. Over time this process can lead to changes in your psychological, physical and spiritual wellbeing” (Pearlman and MacKay, 2008)

Secondary traumatic stress – “the natural consequent behaviours and emotions resulting from knowing about a traumatizing event experienced by a significant other—the stress resulting from helping or wanting to help a traumatized or suffering person” (Figley, 1983).

The use of these terms is hotly contested, with some using the terms interchangeably, whilst others argue that this is unacceptable, as they are different concepts. To overcome this lack of consensus, Russell and Brickell suggest using an overarching term which acknowledges that there are nuances between these concepts whilst not seeing them as being sufficiently distinct to be considered separate phenomena.

They recommend using compassion stress injury (CSI) as a unifying term when referring to the emotional detriment from the second-hand experience of suffering, coupled with a desire to alleviate it, rather than a direct personal involvement in a traumatising or upsetting event. They also suggest that compassion stress injury more readily incorporates neuro-biological explanations for the related effects.

When talking to teachers about this concept, until recently, I’d rarely come across anyone who was familiar with it, regardless of the term used. However, once explained, the response is invariably an immediate recognition of CSI’s relevance to them in their teaching roles, often accompanied by statements such as, “Oh, there’s actually a name for that!”

This lack of vocabulary and understanding in educators (and those responsible for their wellbeing) needs to be addressed as research on CSI suggests that having a shared language for discussing related risks is an important first step towards protection against its effects.

So, how does compassion stress injury occur, what are the symptoms and what can be done about it? 

Russell and Brickell explain that CSI occurs because exposure to one person’s emotions can trigger a neurobiological response, creating congruent emotions in another. “Catching” others’ negative emotions in this way when we perceive that they are suffering, could therefore have detrimental emotional effects.

As humans, we are predisposed to find others’ distress aversive. If we can’t escape prolonged exposure, we can become overwhelmed by our own distress, moving the focus from another’s needs onto our own.

Alternatively, we can learn to override and regulate our emotional responses through suppression or reappraisal. Suppression enables us to reduce our awareness of others’ distress, but this is likely to prevent a compassionate response.

However, through reappraisal, we can rationalise others’ actions/needs and be non-judgemental. This allows us to help, but helping can use up psychological and physical energy and repeatedly putting others’ needs first, whilst neglecting our own, can mean we ‘help until it hurts’, creating the conditions for CSI.

“We can become overwhelmed by our own distress, moving the focus from another’s needs onto our own. “

CSI has multiple symptoms including disturbing emotions (e.g., sadness, hopelessness, guilt and frustration), powerlessness, sleeplessness, hypervigilance, and intrusive thoughts or imagery related to events that have happened to others. Individuals experiencing CSI may find themselves re-experiencing personal trauma or notice an increase in arousal and avoidance reactions related to the second-hand trauma exposure. They may also experience changes in memory and perception; alterations in their sense of self-efficacy; and a depletion of personal resources.

In short, CSI disrupts our fundamental sense of who we are, who others are, and our sense of safety and security. My research found that, regardless of role, all participants had experienced symptoms of CSI; mostly this was from the cumulative effects of repeated exposure to their students’ adverse and traumatic experiences but occasionally it resulted from a single, highly traumatic event.

In addition to these second-hand dosage effects, teaching children who have been exposed to trauma and adversity often comes with first-hand experiences of distress and trauma for the teacher. Children living with trauma and adversity may have associated behaviour regulation issues which are often deemed inappropriate for the classroom, for example, they may be clingy and in need of attention, totally shut down and difficult to engage, or violent and disruptive.

Witnessing children violating others, or being attacked themselves, even when they know the circumstances of the child, can be immensely distressing.

“Individuals experiencing compassion stress injury may find themselves re-experiencing personal trauma.”

For teachers, children’s disruptive behaviour can also lead to feelings of incompetence and a lack of control, which can be particularly stressful when feeling pressures related to accountability practices. Added to this are the more commonly recognised stressors associated with work-related stress and burnout in teaching, such as: workload; lack of resources; seemingly constant scrutiny and high-stakes accountability practices; difficult workplace relationships; and little time to meet one’s own physical needs, such as eating or going to the toilet. It is perhaps no wonder therefore that there are issues with teacher wellbeing, recruitment and retention.

However, there are solutions.

Recognising CSI and normalising discussions about it and its causes and symptoms, coupled with the acknowledgement that it is a natural reaction and not a personal weakness, is vital to supporting educators’ wellbeing. So, as mentioned above, having a shared language and understanding of CSI as it applies to educators is vital.

Research has also shown that opportunities to experience compassion satisfaction and to reflect on achievements are important mitigators against CSI and work-related stress. Training which includes trauma-informed practice, and an explanation of CSI, can help with this; however, training on its own is insufficient and appropriate physical resources in schools are also required.

“Having a shared language and understanding of CSI as it applies to educators is vital.”

In the research that I’ve undertaken, to help them cope, in addition to self-care, teachers wanted someone to talk to who “gets it”, preferably from a teaching background but who wasn’t a colleague.

They wanted opportunities to: offload but also to process and make sense of their emotions; gain validation that what they’d done was reasonable in the circumstances; and to learn, for example through unpicking experiences and seeing them from another perspective; gaining understanding of what had worked and what might have been done differently; or by exploring how they might handle imminent/anticipated situations that they were concerned about.

This type of appraisal and emotional support, in the form of ‘supervision’ is part of the culture in many other “helping” sectors, such as health and social care. Supervision, as it is meant here, is not about being watched, controlled and judged but is about developing what Professor Peter Hawkins calls a “super form of vision” which facilitates a fresh and deeper look at experiences and the impact that they have on us, others and our work.

“Access to support has contributed to reducing sickness absence, presenteeism, feelings of isolation and resignation.”

Although interest in supervision is growing in schools, it is not widely available, particularly for class teachers and support staff who are usually the ones who work most closely with traumatised students. Whilst there is an additional cost to this, research suggests that where such support has been accessed, it has contributed to reducing sickness absence, presenteeism, feelings of isolation and resignation.

The financial costs therefore are offset, with added benefits to teacher/leader wellbeing as they feel cared for and supported. This is good news as there is an increasing body of research suggesting that happier teachers lead to higher academic attainment and healthier, happier students.

This article first appeared in the summer 2022 print edition of Wellbeing in International Schools Magazine, out now.

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Dr Rachel Briggs

Dr Rachel Briggs

Dr Rachel Briggs has more than 30 years’ experience in the education sector. She has worked in England, the USA, The Gambia and Egypt. She provides reflective supervision, coaching and training in educator wellbeing. Connect with Rachel on LinkedIn and Twitter @DrRachelBriggs.

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