Help for the Helper: The Psychophysiology of Compassion Fatigue
and Vacarious Trauma
by Babette Rothschild
ISBN: 0-393-70422-X: (W. W.
Norton), 2006,
Hardback: pp: xiii, 253:
RRP: $30.00: £19.99
________________________
Rothschild, author
of ‘The Body Remembers’ and ‘The Body Remembers Casebook’,
addresses the topic of therapist burnout, from the only possible perspective,
that of informed self-help.
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Not is this just a ‘good book’ for therapists of all sorts, but it beautifully illustrates the importance and significance of Body-Psychotherapy. The book addresses a ‘sort of’ taboo topic in therapy: that there are natural physiological and emotional limits to our compassion. Therapists often feel guilty or inadequate if they ‘burnout’ or develop negative feelings towards their ‘difficult’ clients. There are actually dangers and risks of ‘compassion fatigue’ and ‘vicarious traumatisation’. Therapists are physically and emotionally affected by the work they do, and this is an important aspect of their work, and yet they can also be affected negatively by this work. This is not just counter-transference, it has a demonstrable psycho-physiological basis: it is a real risk.
In addressing this topic, Rothschild is excellent in weaving her points in and out of advanced neurophysiology, making this relatively new topic both understandable and relevant. Her writing is firmly based on her ‘grounded’ commonsense and her clear mind-body basis. Her main focus is how we, as therapists, can – and must – help ourselves. There is a level of simplicity that runs through the book. This is balanced with a clear understanding and helpful application of the underlying physiology.
She starts off in her preface with “Using Common Sense”, and other chapters include: Psychotherapists at Risk, Counter-transference, Projective Identification, Empathy, Managing the Ties that Bind, The Neurophysiology of Empathy, Somatic Empathy, Mirroring and Mimicry, Skill Building, Facial and Postural Awareness, Conscious Postural Mirroring, Un-mirroring, Keeping Calm, The Neurophysiology of Arousal, Arousal Awareness, Therapist’s Brakes - Relaxed vs. Calm, How Close is too Close? - Thickening the Skin, Controlling Empathetic Imagery, Thinking Clearly, The Neurophysiology of Clear-thinking, Know Thyself, Strengthening the Observer, Controlling Self-Talk, Nurturing Your Workspace, and Structured Self-Care, Evaluating the Risks of, and Reversing the Effects of, Vicarious Trauma.
There are many case-history vignettes, therapist-supervisor exchanges, and useful self-help exercises scattered throughout the book, in a nice mix between theory and ‘skill-building’. She concludes by challenging and re-interpreting the psychoanalytical concept of ‘projective identification and suggesting ways around some of these dilemmas.
What I particularly like about this book (especially from my present perspective) is that this takes us in a ‘second wave’ of Body-Psychotherapy writings. We are being informed about a dilemma or an issue common to all therapeutic modalities, not even just psychotherapeutic ones, from a well-known author and group leader, published by a mainstream publisher, and based on a solid Body-Psychotherapeutic awareness. What I miss is an essence of compassion itself: compassion for the client who provokes this ‘burn-out’ in the therapist and compassion for the therapist who has been really trying and, in so doing, has given too much,
A review by Courtenay Young, President EABP.
Reviews of other Body-Psychotherapy books are available on the EABP website: www.eabp.org
Other Reviews:
Help for the He/per is a gift to psychotherapists and others who open their hearts and minds to the pain of traumatized clients. It is the first publication to integrate contemporary research on the neurobiology of empathy into a broader understanding of the origins of vicarious traumatisation and compassion fatigue. Babette Rothschild enlivens this highly readable, scholarly overview of the research with her conversational tone, clinical applications, examples, and exercises for therapists who want to address therapy’s negative effects on themselves. The book will be a valuable resource for seasoned clinicians and trainees alike. Rothschild provides guidance for working with trauma survivors in a way that enhances the therapist’s well-being while contributing to the client’s recovery. Laurie Anne Pearlman (from book cover)
Babette Rothschild has done a masterful job in laying out important principles and strategies to avoid compassion fatigue, vicarious trauma, and burnout. She integrates several core psychological concepts—countertransference, projective identification, and empathy—with recent research on mirror neurons, emotional contagion, and neurobiology. Help for the Helper, so clearly written and well organized, will benefit any practitioner who wants to avoid the fatigue that interferes with treatment of the people who are most in need of our help. Reading this book and following the exercises Rothschild provides will be of value for both new and experienced therapists. Marion F. Solomon (from book cover).
With this book, Babette Rothschild establishes herself as a pre-eminent science writer, able to translate abstruse scientific concepts into practical clinical advice for helpers. Elaine Hatfield (from book cover)
This book provides underpinning scientific knowledge on why the work of helping others affects the helper. It shows how to recognise the signs of therapist burnout and offers a range of skills to minimise the impact of working with clients in a therapeutic way. Much of the work focuses on "listening" to your body and skill-building a self-care toolbox which feels right for you as an individual. The author is a great fan of common sense, and it is SO refreshing to see this in print. The style is easily accessible, and robust in content - a real "must" for all therapists to have (well thumbed) on their bookshelves!! Aileen Ferguson, Scotland (on Amazon.co.uk)
I read Help for the Helper cover to cover as soon as it arrived and all I can say is WOW and THANK YOU!! This is a book that addresses the needs of helping professionals--all sorts! Babette Rothschild begins the book with a preface on "Common Sense;" something we all need for taking care of ourselves (and our clients, for that matter). She's become a kind of champion of Common Sense in psychology and I'm glad to see her apply this important life-tool to the self-care of professionals. Her three central chapters begin with theory of neurophysiology: on Empathy, Arousal and Clear Thinking. She then goes on to outline things we can easily do to combat the consequences of our work and avoid burnout, vicarious trauma and compassion fatigue. Though the book examples are pointed to psychotherapists, the theory and the exercises will be useful to anyone (like me) in the helping professions. One thing that stands out is that she underscores us each finding the tools that help us best. She offers expert advice without having to be "the" expert. Consistent with her advocacy of common sense, she knows that each professional has to find his or her optimal combination of resources. For those who are interested in neurophysiology, this book covers cutting edge theories and research, including the recent discovery of mirror neurons. For the psychotherapist, sections on countertransference and projective identification offer a fresh view on these core concepts. I believe that anyone in the helping professions, including those who pitch in following disasters, will find this book to be a huge help for their own well-being. ‘helpingprofessional’ (on Amazon.co.uk)