Stress and Grief Reactions Among Rehabilitation Professionals: Dealing Effectively with Empathy Fatigue

Journal of Rehabilitation, Jan-March, 2000 by Mark A. Stebnicki

Countertransference

Countertransference, a term first described by Freud in 1910, is currently described as a reflection of the counselor's unresolved internal conflicts which encompasses reactions of thoughts, feelings, and emotions as it relates to his or her clients' experience (Corey & Corey, 1993). When this phenomenon occurs, the counselor may exhibit reduced feelings of warmth, acceptance, respect, or positive regard for their clients (Rogers, 1961). Rando (1984) addresses the phenomenon of countertransference that occurs among caregivers who work with persons that have chronic life-threatening disabilities. She suggests that dying persons touch us personally in at least three ways. They may: (a) make us painfully aware of our own losses, (b) contribute to our apprehension regarding our potential and feared losses, or (c) arouse existential anxiety in our personal death awareness. It is suspected that rehabilitation counselors, who are unaware of their unresolved personal issues during client-counselor interactions, experience increased levels of countertransference which may manifest as the experience of empathy fatigue.

Responding empathically to client concerns can either enhance or diminish countertransference within the therapist. Gelso and Hayes (1998) suggest that therapists who convey deep levels of empathy will occasionally experience an overidentification with their clients' issues. Accordingly, therapists who manage countertransference effectively are viewed as having an increased level of insight into their feelings and issues, as well as having a greater capacity for empathy and understanding (VanWagoner, Gelso, Hayes, & Diemer, 1991). The identification and awareness of one's emotional feelings and attitudes toward a client are important issues for rehabilitation professionals because having this information can contribute to an enriched client- counselor relationship (Marinelli & Dell Orto, 1999). Overall, the literature suggests that countertransference in helping relationships must be viewed as a natural by-product of caring for persons who have counseling needs. The rehabilitation professional who has an increased level of self-awareness and insight will likely deal more effectively with the phenomenon of empathy fatigue.

Secondary and Post-Traumatic Stress Disorders

Caring and serving persons with acquired chronic mental or physical disabilities can carry a significant emotional cost. Counselor stress that is associated with this process has been observed as a STS reaction. As Figely (1995) notes, "the process of empathizing with a traumatized person helps us to understand the person's experience of being traumatized, but, in the process, we may be traumatized as well" (p. 15). Thus, many rehabilitation professionals who maintain a high level of empathy or compassion while helping others who have experienced chronic pain, suffering, trauma, or loss may experience the secondary stressors or parallel feelings of the individuals they serve.