Why Counselors Lose Their Empathy

Stressors in the Business of Counseling

As a counselor, you need to stay abreast of the constantly changing standards and requirements of the business. This can include agency policies and personalities, documentation, insurance authorization claims, and the occasional legal concern.

If a counselor is in private practice, you need to develop ongoing business plans, take on the responsibilities of marketing yourself, deal with the financial concerns of running a business, in addition to the above-mentioned work tasks. 

These occupational stressors can cause vulnerabilities and decrease a counselor’s empathy.

Challenges Working With Clients with Personality Disorders

It is challenging to maintain empathy in the face of some personality disorder features such as manipulation, high resistance, defensiveness, emotional reactivity, and inflexibility. When a client with a personality disorder commits to the counseling process progress can be slow. 

It is important for counselors to be mindful of these factors and notice their own internal overwhelm. If not kept in check, the counselor may do more therapeutic work and effort than is necessary, leading to a loss of empathy. 

Working with personality-disordered clients who have post-traumatic stress disorder can lead to fatigue, burnout, and a possible loss of empathy. Garcia et al. (2015), in the journal Psychology and Psychotherapy: Theory, Research and Practice, stated: 

“Treating patients with personality disorders and suspected malingering predicted burnout in PTSD Clinical Team providers. High numbers (77%) reported perceiving that emotional exhaustion impacted the quality of care they provided.”

What are Compassion Fatigue, Vicarious Trauma, and Burnout?

All counselors are vulnerable to compassion fatigue, vicarious trauma, and burnout. 

Compassion fatigue is known as caring too much. When you are empathic, your energetic boundaries are at risk from absorbing too much of your client’s feelings, thoughts, and experiences. The result is you end up feeling overwhelmed and exhausted. These symptoms can prevent you from empathizing or having compassion towards others and even yourself. In an article by Cocker and Joss (2016), Compassion Fatigue among Healthcare, Emergency and Community Service Work A Systematic Review, it was found: 

“The compassion and empathy shown by healthcare, emergency, and community service professionals can prove psychically, mentally and economically costly. In short, exposure to patients or clients experiencing trauma or stress can negatively impact a professional’s mental and physical health, safety and wellbeing, as well as that of their families, the people they care for, and their employing organizations.”

Vicarious trauma can develop from compassion fatigue and occur when you work with clients who have experienced trauma. When you lack professional personal boundaries, over time, your fundamental beliefs about the world can change from repeated exposure to traumatic material. It can be traumatizing to hear another’s trauma or too much traumatic material throughout the day. Below is a list of symptoms you could experience.

Symptoms of Posttraumatic Stress Disorder from the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM–5; American Psychiatric Association, 2013) include:

• A. Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:
  • Directly witnessing the traumatic event(s).
  • Witnessing, in person, the event(s) as it occurred to others.
  • Learning that a traumatic event(s) occurred to a close family member or close friend.
  • Experiencing repeated or extreme exposure to aversive details of the traumatic event(s).
• B. Presence of one or more of the following intrusion symptoms associated with the traumatic event(s).
  • Recurrent, involuntary, and intrusive memories of the traumatic event(s)
  • Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s).
  • Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring.
  • Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).
  • Marked physiological reactions to internal or external cues that symbolize an aspect of the traumatic event(s).
• C. Persistent avoidance of stimuli associated with the traumatic event(s) (one or both required):
  • Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event.
  • Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, or situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
• D: Negative alterations in cognitions and mood associated with the traumatic event(s) (two or more required):
  • Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs)
  • Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world. (e.g., “No one can be trusted” The world is completely dangerous”)
  • Persistent distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others
  • Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame)
  • Markedly diminished interest or participation in significant activities
  • Feelings of detachment or estrangement from others
  • Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings).
• E. Marked alterations in arousal and reactivity associated with the traumatic event(s). 2 or more of the following:
  • Irritable behavior and angry outbursts
  • Reckless or self-destructive behavior
  • Hypervigilance
  • Exaggerated Startle Response
  • Problems with concentration
  • Sleep Disturbances

Burnout is the physical and emotional exhaustion counselors experience when they have low job satisfaction. This experience leaves counselors feeling powerless and overwhelmed at work. You may have too much of a workload or are not receiving adequate support from your work environment. Another piece of burnout is having unrealistic work expectations, which can drive you to do too much.