Applying the Sara Vignette
In the case of Sara, exhaustion was her biggest battle. Sara was tested by her client Anne, who was very aggressive and manipulative. She is experiencing traumatic stress reaction often termed compassion fatigue (Figley, 2002). In the sessions with Anne, Sara was confronted with so many emotions but felt she had to suppress them so she could be able to go forward helping Anne. Anne's aggressive behavior was taking its toll on Sarah and she started to experience exhaustion. Arledge and Wolfson explained that, "a clinician's ability to stay grounded in a strong sense of self, even in the face of strong feelings, is weakened when his or her inner resources are depleted. Changes can occur in the clinician's ability to tolerate, maintain a positive sense of self, and maintain an inner sense of connection (p. 93)." This is exactly what happened to Sara when working with Anne. Her resources were fading and her work was struggling because of the impact of exhaustion. This can also lead the helper down a self medicating path of substance abuse, which is not a practice of self-care.
Utilizing the model of compassion fatigue can help to predict onset of compassion fatigue as well as prevent and mitigate this fatigue. It is evident that Sara sympathized with Anne and was concerned about her depressive condition. Hence Sara found the need to help her with her expertise. Being exposed to Anne, Sara experienced an emotional energy of Anne's suffering and empathized with her. In her demand to relieve the suffering of Anne, Sara suppressed her emotions. Hence she responded to Anne's call of wanting to see her on a daily basis which contributed to compassion stress. Being aware of her situation would have helped Sara to prevent this kind of stress.
It is obvious that Sara was not satisfied with her efforts to help Anne. Having a sense of achievement, Sara would have made a conscious effort to rationalize where her responsibilities ends and to distance herself from Anne's misery. Thus being disengaged from the thoughts, feelings, and sensations associated with the sessions with Anne, Sara would have recognized the need for self-care.
Sara's prolonged exposure to Anne and daily contacts also heightened Sara's stress. Sara felt that she was responsible for the care of Anne and so responded to her call to daily contacts and saw her for several months. In this case taking a longer time between breaks from Anne would have helped in giving a pause to being compassionate and over empathetic. It would also have been important for Sara to have sort social support.
Utilizing the model of self-care (Eckstein, 2001) will help Sara make meaning of supportive relationships, and social support in identifying sources of stress which will enhance her overall well being. By identifying and recording behaviors in each of the dimensions (physical, mental, spiritual, emotional and social), she will be informed on where she was lacking and can create a healthy balance. Balancing the five different aspects of self is crucial.
Refusing to seek help often keeps you off the balance and in the case of Sara she had to deal with the personal exhaustion and stress. This may have serious repercussions in both her personal and professional life. Perhaps if she had sought help and practiced self-care, she would have been satisfied with her achievement. It is really the issue of balance-having a passion for the profession and at the same time being protective of your well being.