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In this chapter, we discuss the role of empathy as the main precursor for prosocial behavior, taking perspectives that span from social and developmental psychology to social neuroscience. We begin by introducing compassion fatigue in caregivers as a form of pathological altruism. We move on to introduce such relevant concepts as empathy, compassion, empathic concern, and distress; we then review relevant empirical findings from social and developmental psychology and social neuroscience. Finally, we propose a new integrative model that suggests that the term compassion fatigue should be replaced by the term empathic distress fatigue to more accurately account for symptoms of withdrawal and burnout. We conclude by outlining potential ways to circumvent the downside of too much empathy.

This chapter investigates the emergence, evolution, and performance of the concept of “compassion fatigue” in the humanitarian context. It tracks the uses made by humanitarians of bodily responses to their work or representations of their work from a discourse on a danger of humanitarian excess to its redefinition as the embodiment of caregivers’ dilemmas and, finally, as a metaphor for understanding the potential for public disengagement with fundraising campaigns. This chapter seeks to determine how compassion fatigue has been embodied, represented, addressed, and politically used in humanitarian contexts. Its focus points are the social and political organizations that have framed the emotions of humanitarian actors and spectators as “compassion fatigue” as well as the effects that this categorization has had in both the understanding of the humanitarian work and of its political agenda.

An increasing body of literature examines the presence and nature of vicarious traumatization in health professionals. This phenomenon, also known as compassion fatigue and secondary traumatic stress although there appear to be some differences between these three constructs, is increasingly being acknowledged as a possible consequence of witnessing the suffering of others. This chapter examines these constructs as well as those of burnout and compassion satisfaction, and places them within the daily routine of a physician. The possible “positive” aspects of such experiences are discussed, including compassion satisfaction and vicarious transformation or growth, as well as possible ways of measuring these constructs. The chapter concludes by reporting research that identified the presence of compassion fatigue, burnout, and compassion satisfaction in a group of resident physicians and linked these findings with the levels of resilience, spirituality, empathy, and emotional competence in the same group.

In this chapter we reflect on the role of physicians, the pressures they endure, potential negative outcomes, and a promising treatment for encouraging self-awareness and self-care. We conceptualize this process of exhaustion as compassion fatigue, which incorporates burnout and the silencing response, which may lead to negative behaviors such as substance abuse and even suicidality. We propose and discuss a new term, “the overcoper” as an identity that many is be emphasized. The Accelerated Recovery Program for treatment of physicians and other health care professionals who are experiencing compassion fatigue is also described.

This chapter will explore the emerging issue of judicial stress, through a review of relevant research, policies, and procedures, and provide recommendations for future research and policy. Existing research suggests that judges experience stress from safety concerns, secondary traumatic stress, and occupational burnout. Gaps in the literature are delineated to identify some specific areas of focus for future researchers. Interventions designed to prevent and/or assuage judge stress are also outlined and ideas for future research are proposed to fill specific gaps in the literature. Finally, recommendations for policy and practice are provided, based on logic, anecdotes, and research findings. The dearth of recommendations based on empirical findings underscores the need for further research on the topic.

This chapter discusses the correlation between empathic response and therapeutic outcome, along with the therapeutic alliance factors between the patient and the practitioner. The drawbacks for practitioners imparting regular empathic responses include depression and despair, and it is therefore important for them to keep their emotions in check. The chapter discusses residual compassion fatigue, which is a state where the practitioner takes the position of the patient, hence becoming vulnerable to emotional stress. Methods including limiting exposure to the patients’ traumas through distractions and exercising self-regulation by controlling one’s emotions are discussed for practitioners to keep themselves distant from their work pressure.

This chapter discusses the components of empathy, including affective arousal and empathic concern, in relation to clinical practice, as well as the negative effects of excessive empathic arousal, including a lack of prosocial behavior and an increase of personal distress in physicians. It explores professional distress, burnout, and compassion fatigue resulting from poor emotion regulation, along with the methods to regulate empathy, including emotion suppression, framing, and exposure control. The chapter discusses the importance of developing empathy-training programs for physicians while keeping in mind the features of the empathic process, and concludes with the importance of physicians maintaining a balance regarding their empathic responses for successful patient interactions.

The author discusses his career as a psychiatrist in this chapter. He notes that throughout his career he has seen the problems of physicians placing their work ahead of family and friends and having a life, even though some saw themselves as role models. Psychiatrists, like other physicians working in the Hippocratic tradition, place their patients first. Sometimes physicians act on emotions they do not fully understand, and this is a reflection of their need to rescue, not just treat, patients. As a result physicians experience a sense of failure when their patient's illness goes unaffected by their treatment program. These physicians often feel powerlessness, a sense of loss, grief, and fear of becoming ill themselves, or they make efforts to wall themselves off from patients and their families, thereby reducing their effectiveness. The author offers some suggestions to avoid this and other pitfalls.

This chapter considers the interplay of gender, nationality, powers, and vocations in the character of Molly “Shamrock” Fitzgerald, one of the most fascinating superheroines to appear in the Marvel Universe. A reluctant superhero, Shamrock served as a voice for the voiceless: women, children, workers, and the dead. Spiritually connected to a war she disavowed, she stayed modestly in the background when possible and took on maternal responsibilities of educator and caretaker – low-profile, emotionally-draining roles that would necessitate her working odd jobs through retirement. With strengths found through feminine agency, Shamrock’s intermittent appearances throughout the Marvel Universe between 1982 and 2015 are strikingly representative of the complicated history of women in society, war, and work.

This chapter focuses on clinical empathy substituting emotional empathy in medical care. It discusses the reasons for avoiding emotional sympathy, including interference with the doctor’s objective mindset, effective care of the patient in trying circumstances, and burnout risk. The chapter explores the importance of developing trust through empathy, along with the challenges that physicians face while trying to be empathic toward patients, including emotional distress and compassion fatigue. It presents the arguments against the reasons for the avoidance of emotions in clinical sympathy, along with the methods through which physicians can engage with their patients on an emotional level in a very subtle manner, and explores the importance of curiosity for physicians to understand empathic accuracy.

As carers become fatigued, all sorts of things can so easily go wrong, including the carer becoming ill themselves. We argue that the professional should watch over the lay carer’s well-being as well as over the patient’s needs. The grind can affect the whole household. From this can grow a sense of guilt over recognised negative feelings, about a lack of confidence and about the constrictions of the home and life-style. The capacity to forgive can be strained in the struggle to keep going. Among other issues considered are the sense of loss of freedom, friends, personal time and the joys of the past. A major loss may be the mental change in the patient which brings new and unexpected stresses to the relationship. There are also positive consequences—more time together, rediscovered common interests, and a warming and deepening affection. The combination of family devotion and the skills of the professional can lead to a renewing and enriching situation.

Animal care in biomedical facilities has undergone major changes in the past few decades, including having dedicated and highly trained caretakers to oversee the physiological and psychological well-being of the animals in their charge. An important outcome of this high quality animal care is the close relationship that can develop between the caretaker and the animal. Once discouraged and considered a potential threat to scientific objectivity, such positive interactions are now encouraged by many facilities. This chapter summarises the current use of animals in scientific research, and the types of human–animal interactions that are typically found in the research environment. It then examines effects of such interactions and relationships on both the animal and the caretaker. Lastly, suggestions for facilitating positive interactions while reducing the potential costs, as well as directions for future research are provided.

This chapter discusses caring in different social roles and contexts. In education scholars have discussed and studied teachers’ caring, attachment processes in the teacher-student relationship, as well as caring in schools. In the workplace arena, people may choose caring as a profession (the helping professions), and this choice may reflect processes related to parentification in childhood and also the ”wounded healer” syndrome. Caring is also demonstrated in organizations through organizational citizenship behaviors (OCBs). Leadership and in particular transformational leaders have been associated with caring and nurturance and evolutionary accounts also attest to the connection between leadership and caring. As part of intergroup and interindividual transgressions, apology, forgiveness, and reconciliation reflect caring and empathic processes. Caring can also overtax the capacity for compassion and result in burnout and in compassion fatigue.

This chapter considers how the rights and interests of interrogators should shape interrogation ethics. What can States ask of their police and military interrogators, given that certain interrogation techniques may have lasting moral and psychological effects on practitioners? I reject a prominent theory advocating a complete separation between professional and nonprofessional moral spheres as well as a theory that expects professionals to martyr themselves by using expedient methods even if they are conventionally considered immoral. I develop a theory of professional ethics involving a triangulation among the rights and interests of professionals, their clients, and their “targets.” The chapter applies the preferred standard of professional ethics to different modern interrogation methods. It draws on interviews with over a dozen interrogators to highlight concerns about the emotional toll that certain techniques may have on the interrogator. I conclude with recommendations on how interrogators using modern rapport-based techniques can engage in self-care to avoid compassion fatigue and moral injury.

This chapter focuses on the reasons why empathy has not been successfully incorporated into medicine despite studies indicating its importance in medicine. The practitioners’ focus on objectivity in responding to a patient’s suffering, detaching themselves from personal feelings with patients, burnout, and compassion fatigue are some of the reasons listed that create a problem in the successful incorporation of empathy in medicine. The chapter explores the unintended consequences of incorporating empathy into the medical education curriculum, including the exercise of fake empathy by medical students to be successful in their examination, the lack of emotional engagement by students with patients with unfamiliar instances, and the devaluation of empathy. It presents methods for encouraging medical students to learn and exercise empathy.

This chapter considers some of the challenges experienced by professionals who care for the seriously ill and the dying. Itrecommends ‘patient-centred care’ and reviews its range and focus, and the working out of the contrast between empathy and sympathy. The mobile and transient nature of the professional carer is recognised and some of the demands arising from this are considered including the importance of effective communication and confidentiality in a multidisciplinary team and what contributes to it. Time and organisational pressures impact strongly on matters such as privacy, case conferences and mutual support. The range is diverse. Some styles and objectives of counselling are discussed. Flexibility, priority management and judgement ‘on the hoof’ are viewed as important for professional carers. The role is exhausting physically and emotionally, and comment is made on the contemporary care standard for professionals. The importance of self-care, available advice and corporate support is strongly advocated.

This chapter serves as the conclusion for the book. A summary of the book and its contents is included and general themes are highlighted. The unique contributions of SFBT with clients who have experienced trauma are discussed. In addition, the benefits (for both the client and the clinician) of this kind of work is discussed. A review of the literature related to resilience and vicarious resilience is included and integrated with the assumptions of the SFBT framework. The editors each share how SFBT has shaped their clinical work and teachings. This chapter serves as a hopeful conclusion to this book.