Clinical Social Work Journal

, Volume 38, Issue 3, pp 341–349 | Cite as

Compassion Fatigue and Countertransference: Two Different Concepts

  • Joan BerzoffEmail author
  • Elizabeth Kita
Original paper


There has been considerable conceptual confusion about the differences between compassion fatigue and countertransference. This often results in them being treated as the same phenomena, both in the literature and clinically. This paper maintains that these are, in fact, two different concepts that derive from different sources and serve different functions. Each of these two concepts requires different kinds of interventions as well.


Compassion fatigue Countertransference Enactment Projective identification Intersubjectivity Self-care 


  1. Adams, R. E., Boscarino, J. A., & Figley, C. R. (2006). Compassion fatigue and psychological distress among social workers: A validation study. American Journal of Orthopsychiatry, 76(1), 103–108.CrossRefPubMedGoogle Scholar
  2. Aron, L. (1996). A meeting of the minds: Mutuality in psychoanalysis. Hillsdale, NJ: Analytic Press.Google Scholar
  3. Basham, K., & Miehls, D. (2004). Transforming the legacy: Couple therapy with survivors of childhood trauma. NY: Columbia University Press.Google Scholar
  4. Bollas, C. (1989). The shadow of the object: Psychoanalysis of the unthought known. NY: Columbia University Press.Google Scholar
  5. Browning, D. (2004). Fragments of love: Explorations in the ethnography of suffering and professional caregiving. In J. Berzoff & P. Silverman (Eds.), Living with dying: A handbook for end of life practitioners (pp. 21–55). NY: Columbia University Press.Google Scholar
  6. Collins, S., & Long, A. (2003). Too tired to care? The psychological effects of working with trauma. Journal of Psychiatric Health Nursing, l0, 17–27.CrossRefGoogle Scholar
  7. Figley, C. R. (1995). Compassion fatigue as secondary traumatic stress disorder: An overview. In C. R. Figley (Ed.), Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized (pp. 1–20). NY: Brunner-Mazel.Google Scholar
  8. Figley, C. R. (2002a). Compassion fatigue: Psychotherapists’ chronic lack of self care. Journal of Clinical Psychology, 58(11), 1433–1441.CrossRefPubMedGoogle Scholar
  9. Figley, C. R. (2002b). Treating compassion fatigue. NY: Brunner-Routledge.Google Scholar
  10. Freud, S. (1905). Fragment of an analysis of a case of hysteria. In standard edition, 7 (pp. 1–22). London: Hogarth Press.Google Scholar
  11. Freud, S. (1926). Inhibitions, symptoms and anxiety. Psychoanalytic Quarterly, 4, 616–625.Google Scholar
  12. Friedman, M. J. (1996). PTSD diagnosis and mental health clinicians. Community Mental Health Journal, 32(2), l13–l189.CrossRefGoogle Scholar
  13. Fromm, K., Andrykowski, M. A., & Hunt, J. (2005). Positive and negative sequelae of bone marrow transplants: Implications for quality of life. Journal of Behavioral Medicine, 19(3), 221–240.CrossRefGoogle Scholar
  14. Gabbard, G. O. (1995). An overview of countertransference: Theory and technique. In J. M. Oldham, M. B. Reba, & G. O. Gabbard (Eds.), Introduction to the review of psychiatry: Vol. 18. Countertransference issues in psychiatric treatment (pp. 1–17). Washington DC: American Psychiatric Press.Google Scholar
  15. Hafkenscheid, A. (2005). Event countertransference and vicarious traumatization: Theoretically valid and clinically useful concepts? European Journal of Psychotherapy, Counselling and Health, 7(3), 159–168.CrossRefGoogle Scholar
  16. Herman, J. (1997). Trauma and recovery. NY: Basic Books.Google Scholar
  17. Hoffman, I. Z. (1983). The patient as interpreter of the analyst’s experience. Contemporary Psychoanalysis, 19, 389–422.Google Scholar
  18. Kanter, J. (2007). Compassion fatigue and secondary traumatization: A second look. Clinical Social Work Journal, 35(4), 289–293.CrossRefGoogle Scholar
  19. Kernberg, O. F. (1992). Aggression and personality disorders and perversions. New Haven, CT: Yale University Press.Google Scholar
  20. Klein, M. (1975). Envy and gratitude and other works 1946–1963. New York: Delacorte Press.Google Scholar
  21. Linley, P. A., & Joseph, S. (2007). Therapy work and therapists’ positive and negative well-being. Journal of Social and Clinical Psychology, 26(3), 385–403.CrossRefGoogle Scholar
  22. McGlaughlin, J. T. (1991). Clinical and theoretical aspects of enactment. Journal of the American Psychological Association, 39, 595–614.CrossRefGoogle Scholar
  23. Mitchell, S. A. (1993). Hope and dread in psychoanalysis. New York: Basic Books.Google Scholar
  24. Munroe, J. F., Shay, J., Fisher, L., Makary, C., Rapperport, K., & Zimering, R. (1995). Preventing compassion fatigue: A team treatment model. In C. R. Figley (Ed.), Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized (pp. 209–231). NY: Brunner Mazel.Google Scholar
  25. Nelson-Gardell, D., & Harris, D. (2003). Childhood abuse history, secondary traumatic stress, and child welfare workers. Child Welfare Journal, 82(1), 5–26.Google Scholar
  26. Neumann, D.A., & Gamble, S.J. (1995). Issues in the professional development of psychotherapists: Countertransference and vicarious traumatization in the new trauma therapist. In Psychotherapy: Theory, research, practice, training, 32(2), pp 341-347. Retrieved January 23, 2009, doi: 10.1037/0033-3204.32.2.341.
  27. Ogden, T. H. (1979). On projective identification. International Journal of Psychoanalysis, 60, 357–373.PubMedGoogle Scholar
  28. Ogden, T. H. (1994). Subjects of analysis. Northvale NJ: Jason Aronson Press.Google Scholar
  29. Odgen, T. H. (1994). The analytic third: Working with intersubjective clinical facts. In B. Rothschild & M. Rand (Eds.), Help for the helper: The psychophysiology of compassion fatigue, vicarious traumatization and self care. NY: W.W. Norton.Google Scholar
  30. Racker, H. (1988). Transference and countertransference. The International Psychoanalytical Library, 73, 1–196.Google Scholar
  31. Rasmussen, B. (2005). An intersubjective perspective on vicarious trauma and its impact on the clinical process. Journal of Social Work Practice, 19(1), 19–30.CrossRefGoogle Scholar
  32. Renik, O. (1993). Analytic interaction: conceptualizing technique in light of the analyst’s irreducible subjectivity. Psychoanalytic Quarterly, 62, 553–571.PubMedGoogle Scholar
  33. Saakvitne, K. W. (2002). Shared trauma: The therapist’s increased vulnerability. Psychoanalytic Dialogues, 12(3), 443–449.CrossRefGoogle Scholar
  34. Shubs, C. (2008). Countertransference issues in the assessment and treatment of trauma recovery with victims of violent crime. Psychoanalytic Psychology, 25(1), 156–180.CrossRefGoogle Scholar
  35. Tansey, M. H., & Burke, W. F. (1985). Projective identification and the empathic process: Interactional communications. Contemporary Psychoanalysis, 21, 42–69.Google Scholar
  36. Trippany, R. L., Kress, V. E. W., & Wilcoxon, S. A. (2004). Preventing vicarious trauma: What counselors should know when working with trauma survivors. Journal of Counseling and Development, 82(1), 31–37.Google Scholar
  37. Ulman, K. H. (2008). Helping the helpless. Group, 32(3), 209–221.Google Scholar
  38. Winnicott, D. W. (1947). Hate in the countertransference. International Journal of Psychoanalysis, 30, 69–74.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Smith College, School for Social Work, Lilly HallNorthamptonUSA
  2. 2.Smith CollegeSan FranciscoUSA

Personalised recommendations