The weight of "emotional overload
Emotional overload describes the cumulative weight of distress absorbed by professionals. This model, supported by Figley's work, highlights how repeated exposure to traumatic stories can erode caregivers' emotional boundaries, leading to compassion fatigue. Brillon stresses the importance of maintaining an empathic posture while avoiding the trap of excessive sympathy, which can undermine the necessary professional distance. Sympathy" should not be confused with "empathy", says Pascale Brillon: "Unlike empathy, a sympathetic stance is a sign of excessive commitment to the person being helped. Sympathy hinders the helping relationship and makes us vulnerable to vicarious trauma or compassion fatigue".
This professional vulnerability is also accompanied by an involuntary physical response: the phenomenon of body mimicry. Involving the activity of mirror neurons, their involvement was discussed in 2006; in the context of Rothschild & Rand's discoveries. These authors illustrate how professionals can, without being aware of it, absorb their patients' distress through physical and emotional imitation, underlining the need for awareness and strategies to manage these subtle effects.
Influence of "fear structures" on professional sensitivity
Exploring how professionals can integrate their patients' fear structures, this model builds on the work of Foa, Steketee, & Rothbaum. It reveals that constant exposure to traumatic narratives can lead the professional to react hypersensitively to stimuli associated with patients' traumatic experiences, requiring vigilance and active management of these influences.
Confronting core beliefs and moral wounds
This conceptualization addresses the disruption of personal beliefs in the face of trauma exposure. It reveals how professionals can be shaken in their fundamental beliefs about life, human nature and justice, leading to heightened vulnerability to vicarious trauma and requiring reflective work and psychological support.
The crucial importance of self-care strategies
Highlighting the neglect of self-care practices among professionals, this model links back to earlier work that criticizes a professional culture often focused on self-sacrifice. This work supports the need to balance dedication to others with attention to oneself as a central pillar in preventing vicarious trauma.
The combination of disruptive events and vulnerability
Based on numerous studies, this fifth conceptualization presented by Pascale Brillon examines how a disruptive event, in combination with accumulated risk factors, can make helping professionals vulnerable. These triggering events, such as a conflict with a patient or a patient's suicide, occur against a backdrop of pre-existing stress and vulnerabilities, influencing the professional's reaction. Pre- and post-event conditions, including the professional's psychological and physical state, as well as personality traits and experienced stresses, thus play a crucial role in managing the event, and can either reduce or exacerbate its impact.