347As Peters (2010) notes, “...genetic counselors clearly do witness much pain and
suffering, and may fall prey to compassion fatigue” (p. 314). Compassion fatigue is
a type of distress that comes from repeated exposure to patient suffering (Benoit
et al. 2007 ; Bernhardt et al. 2010 ; Injeyan et al. 2011 ; Udipi et al. 2008 ). When you
experience compassion fatigue, you feel overwhelmed by patient suffering and feel
as if you have cared to the point where you are “drained of empathy.” You may feel
depressed, tired, disillusioned, and worthless regarding your ability to care for your
patients (Zeidner et al. 2013 ). Compassion fatigue is believed to be caused either by
feeling and expressing empathy without being able to “let go” of the “emotional
residue” that stays with you (Figley 1995 , 2002 ) or by fear and avoidance of
empathic engagement with patients that cause you to expend a great deal of effort
pretending to empathize (Miller and Sprang 2017 ). In either case, lack of effective
coping strategies compounds compassion fatigue’s effects (Miller and Sprang 2017 ;
Udipi et al. 2008 ; Zeidner et al. 2013 ).
The risk for compassion fatigue is prevalent among genetic counselors. As many
as 39–57% of genetic counselors may be at moderate risk, and 26–61% at high risk
(Lee et al. 2015 ; Udipi et al. 2008 ). This risk is not surprising, as “Genetic counsel-
ing sessions across settings are often brimming with intense emotion: fear, worry,
anger, sadness, and frustration about the limits of information. Witnessing such
intensity, and working with it in a concentrated time frame, takes a toll on provid-
ers” (Werner-Lin et al. 2016 , p. 865).
Although compassion fatigue may be an inevitable part of caring for patients, it
only becomes problematic when it is not recognized and managed effectively.
Unchecked compassion fatigue can compromise patient care, damage one’s profes-
sional self-confidence, and even lead to leaving the profession (Lee et al. 2015 ).
12.3.1 Differences Between Compassion Fatigue and Distress
and Burnout
Before describing compassion fatigue in greater detail, it may be helpful to distin-
guish it from distress and burnout. Although compassion fatigue and distress share
similar signs and symptoms and certain coping strategies, distress can arise from all
aspects of your genetic counseling roles and responsibilities, whereas compassion
fatigue is exclusive to empathy for patient suffering. Burnout is a reaction to exces-
sive amounts of work and feeling disempowered to make positive work-related
changes. Burnout can occur in any type of work, and it involves a gradual “wearing
out” physically and emotionally. In contrast, compassion fatigue is prompted by
intense interactions with distressed patients and grieving for the tragedies that occur
in their lives. Compassion fatigue is unique to individuals in human services profes-
sions, and it can come on suddenly in response to a single intense experience, or
from multiple exposures (Figley 1995 , 2002 ). Any of these three phenomena (i.e.,
distress, burnout, compassion fatigue), however, can place you at risk of experienc-
ing the others (Lee et al. 2015 ; Udipi et al. 2008 ).
12.3 Compassion Fatigue