Mindful Self-Compassion and Clinician Resilience: Managing the Empathy-Burnout Cycle

Mindfulness and Clinician Resilience

Abstract

Psychologists experience an occupational conflict that is central to their profession; they are required to be empathetic in order to provide the most effective therapy for patients but are at the same time exposed to increased risk of developing compassion fatigue due to this very same empathetic nature. The purpose of this narrative review was to gather current empirical evidence regarding the processes through which the long-term expression of empathy in clinical relationships can contribute to occupational impairment as well as evaluate whether or not mindful self-compassion could function as a protective factor against compassion fatigue in therapists. Through conducting a systematic review of the literature on the mechanisms by which therapist's expressions of empathy develop into compassion fatigue across multiple professional fields, researchers were able to identify several mechanistic pathways—cognitive intrusion, affective contagion, and boundary erosion—that can facilitate the transformation of therapeutic empathy into compassion fatigue. Additionally, cross sectional and mediation studies demonstrate significant associations between self-compassion and decreased levels of burnout. While preliminary studies have indicated that mindfulness-based interventions using mindful self-compassion, compassion focused therapy, and digital applications have shown promise in decreasing stress and burnout in therapists, there are currently limitations to the breadth of generalizability due to the small sample sizes and lack of longitudinal data. Therefore, if psychologists are to utilize self-compassion as a mechanism to promote sustainability and effectiveness in providing mental health services, it would be beneficial to recognize and integrate self-compassion as a professional competence rather than as an adjunctive self-care activity. Future research will need to utilize both longitudinal study designs and culturally representative samples to further elucidate the causal mechanisms underlying these processes and to develop optimal intervention strategies.