Monday, November 09, 2009

I Am Not 'One Of Them'

Since the Fort Hood shooting I've been hearing and reading a lot in the media about 'compassion fatigue' and 'vicarious trauma'. I feel compelled to blog after reading yesterday's New York Times article on the topic, which I'm sure won't be the last.

The idea is that any mental health professional who spends their days listening to patients tell their stories of traumatic events will eventually end up having emotional difficulties from it as well. The other term for this is 'compassion fatigue', in other words losing the ability to empathize with others or becoming numb to trauma due to exposure to patients' traumatic stories. The Times article is careful to point out that vicarious trauma and compassion fatigue will not automatically lead one to become a killer.

Well, I'm relieved to hear that.

Over the years as both a forensic and correctional psychiatrist I've heard plenty of trauma-related stories. I've reviewed autopsy photos and crime scene photos and read police reports of violent offenses and watched videotapes of violent offenses. I've heard people talk about
their crimes and talked to victims of violent crimes (if they survived). People who have read my "What I Learned" posts know that the annual conference of the American Academy of Psychiatry and Law regularly features presentations about serial murderers, psychotic killers, crime scene investigation techniques and other topics that can be a bit gruesome.

If all 1700 forensic psychiatrists in this country are exposed to this regularly that's a whole lot of vicarious trauma. It's good to know I won't automatically become a spree killer.

Frankly, I wasn't worried.

7 comments:

Dinah said...

Arg!!!! So I have to find you a picture AGAIN??? What do you want?

I keep thinking about these 'battle fatigue' stories and what's the point? Work gets stressful for lots of people. We go into this profession because we like hearing patient's stories, even the painful ones. If it gets too bad, there's vacation, or you quit. This is not the story, but I guess the NYTimes is looking to get stories out of it.

Anonymous said...

I'm surprised to hear you say this -- I typically hear from friends of mine in mental health that compassion fatigue and secondary traumatization (different things) are very real dangers. That's not to say that all over everywhere mental health professionals are on the edge of going postal, but these are very important concerns to be aware of and on guard against.

Dinah said...

It's not that burnout (in any field) is not important, it's the implication by the media that it plays any role in explaining the Fort Hood psychiatrist's behavior. Perhaps it does for him, but I don't think any of us want to propagate the idea that if it gets too tough, we could turn into mass murderers. Like I said, if it gets to be too tough, I'll go on vacation and get some rest.

Anonymous said...

I have a twisted feeling of glee to see you responding to this story...

Having a diagnosis helping professionals may suffer from, which could then also turn them into a mass murder, is probably on par with...

What about the people that keep their illnesses hidden, because of the same societal backlash you are now experiencing?

This, excellent website, itself has asked how a city could have a mayor who suffers from depression, has commented on not wanting pilots to have depression,

This site comments regularly about how people need help, yet question them in positions, that might be, on par to their own.

The hands-on experience psychiatrists have with mental illness, are the mentally ill who enter the system, or get caught by the system of psychiatry, or after the fact analysis, based on said people...

Not the many who manage to live successfully and in professional positions themselves...

Lockup Doc said...

Dinah, I agree with your take on this. The point is not to minimize the fact that "battle fatigue" as you call it can be a significant issue for anyone (including us psychiatrists) but that the media seems to be drawing a loose connection between this phenomenon and spree killing. Seems like a stretch to me...

itsjustme said...

Hey, Clinkshrink. Wouldn't it be kinda difficult to talk to victims of violent crimes that didn't survive?!?! LOL Sorry. I couldn't resist!

Deirdre said...

I find it interesting that people are using compassion fatigue to explain the Ford Hood tragedy and avoiding the reports that the shooter had problems for years and should have never graduated from med school to begin with.