Compassion Fatigue & Impostor Syndrome

Compassion fatigue, also known as second-hand shock and secondary stress reaction, describes a type of stress that results from helping or wanting to help those who are traumatized or under significant emotional duress.


Although compassion fatigue is sometimes called burnout, it is a slightly different concept. Unlike burnout, compassion fatigue is highly treatable and may be less predictable. The onset of compassion fatigue can be sudden, whereas burnout usually emerges over time. Additionally, severe cases of burnout sometimes require the person experiencing it to change jobs or occupations, but often measures can be taken to prevent or treat compassion fatigue before a change in work environment is required.

Compassion fatigue can be a precursor or a symptom of other stressors. Because helpers are trained to utilize compassion and empathy in order for therapy to be effective, they are particularly vulnerable to emotional stress and compassion fatigue. For therapists, compassion fatigue can have ethical and legal implications if left untreated, especially if they are providing therapeutic services that are not benefiting those under their care in therapy.


Compassion fatigue can take a physical, mental, spiritual, and emotional toll on people who experience it. Common symptoms of compassion fatigue include:

  • Chronic physical and emotional exhaustion
  • Depersonalization
  • Feelings of inequity toward the therapeutic or caregiver relationship
  • Irritability
  • Feelings of self-contempt
  • Difficulty sleeping
  • Weight loss
  • Headaches
  • Poor job satisfaction


Therapists, for example, may experience compassion fatigue when the stories and experiences of the people they meet in therapy start to affect their lives outside of work.

Nurses, because empathy and compassion are demanded of them on a daily basis, may experience compassion fatigue when dealing with heavy workloads, excessive demands of patients, and long hours.

The American Bar Association says that even lawyers, especially those practicing in areas that may require them to visit accident scenes, view graphic evidence, or deal with reports of trauma, have a high susceptibility to compassion fatigue.

Several factors can put providers at higher risk for developing compassion fatigue:

  • Specializing in therapy that introduces them to extreme issues nearly every session.
  • Being physically threatened by a person under their therapeutic care.
  • A person under their care dying by suicide.
  • Providing therapeutic services to someone considered dangerous.
  • Working exclusively with people who experience depression and/or child abuse.
  • Specializing in treating death, and grief bereavement. 
  • Providing therapy for someone who has experienced the death of a child or who has a dying child.

What Is Impostor Syndrome?

Impostor syndrome refers to an internal experience of believing that you are not as competent as others perceive you to be. While this definition is usually narrowly applied to intelligence and achievement, it has links to perfectionism and the social context.

To put it simply, it is the experience of feeling like a phony—you feel as though at any moment you are going to be found out as a fraud—like you don't belong where you are, and you only got there through dumb luck.

Impostor Syndrome and Anxiety:

It's easy to see how impostor syndrome and social anxiety may overlap. A person with social anxiety disorder (SAD) may feel as though they don't belong in social or performance situations.

You might be in a conversation with someone and feel as though they are going to discover your social incompetence. You might be delivering a presentation and feel as though you just need to get through it before anyone realizes you really don't belong there.

While the symptoms of social anxiety can feed feelings of impostor syndrome, but this does not mean that everyone with impostor syndrome has social anxiety or vice versa. People without social anxiety can feel a lack of confidence and competence. Impostor syndrome often causes normally non-anxious people to experience a sense of anxiety when they are in situations where they feel inadequate.

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