HJNO Sep/Oct 2024

HEALTHCARE JOURNAL OF NEW ORLEANS I  SEP / OCT 2024 25 trauma sufferers. 4,48 Compassion fatigue is a negative cognitive and emotional consequence for the empathizer of feeling empathy. These consequences include feeling sad, inadequate, exhausted, and so forth. 4 There is a significant overlap between compassion fatigue and the con- cept of emotional exhaustion. 4,49 While both com- passion fatigue and emotional exhaustion stem from overwhelming demands, they have two key differences: Compassion fatigue is triggered by interactions with others, while emotional exhaus- tion may arise from various sources, and compas- sion fatigue can manifest from a single encounter with someone in need, whereas emotional exhaus- tion typically develops over time. 4 Compassion Satisfaction Compassion satisfaction is a positive cognitive and emotional consequence of feeling empa- thy. 4 Compassion satisfaction may involve feeling empowered by providing assistance, contentment with one's own circumstances, personal growth, and so on. Compassion satisfaction is a positive consequence to feeling empathy, while compas- sion fatigue is a negative consequence. Profes- sionals who work with traumatized individuals may experience both when working with traumatized or suffering individuals. 50,51 Although compassion fatigue is often associated with healthcare pro- fessionals, anyone can experience it even after brief interactions with people not even considered known at the level of acquaintance. 4,51,52 Responses to a Partner’s Positive Behavior When individuals have experienced repeated behaviors that enhance their sense of security in a relationship, they are more likely to react with joy and gratitude to their partner's gener- ous behavior. Recognizing the good intentions of others can lead to feelings of gratitude, foster- ing positive views and appreciation for the kind- ness of those around them. 2 Positive behaviors repeated over time reinforce trust in the relation- ship and the partner. For an individual who has experienced abuse and has a predisposition for negative attachment, repeated positive behav- iors from a partner are the foundation for a new and congruent with, the perceived welfare of a person in need, including feelings of compassion, tenderness, warmth, and the like. 36,37,38 Empathy enables the sharing of experiences, needs, and desires between individuals and pro- vides the emotional bridge that upholds prosocial behaviors. Empathy is an “antecedent to attach- ment.” 39 Empathy is bidirectional in its relation- ship with attachment — i.e., influence bonding/ attachment and at the same time, be influenced by bonding/attachment. 40 Empathy has also been portrayed by professionals and laypeople as a positive behavior in individuals who have endured difficult violence and those individuals’ capacity to empathize with others. Additionally, it is pos- ited that empathy born of violence can, surpris- ingly, motivate helping behavior across group boundaries. 24,41,42 Research on empathy and trauma typically focuses on how trauma impacts the develop- ment of empathy, rather than the reverse. Stud- ies on childhood trauma have shown that indi- viduals who have experienced childhood trauma tend to exhibit higher levels of empathy com- pared to those who have not experienced such events, and that a higher severity of past adversity is associated with elevated levels of empathy. 43 This increased empathy, in turn, is connected to a consistent inclination toward feeling compas- sion for others in need. 44 Compassion Fatigue Other empathy research highlights empathy in the day-to-day machinations of paramed- ics and other trauma workers. 45 Regehr and co- contributors explored the relationship between and trauma in ambulance paramedics and found that paramedics with a higher ability to empathize with patients were more susceptible to develop- ing more complex coping conditions, including compassion fatigue. 4,46 MacRitchie and Leibowitz observed that empathy was a consistent modera- tor between previous experience of trauma and a secondary form of trauma, similarly to traumatic bonding. 24,47 Figley used the term “compassion fatigue” to describe the emotional, cognitive, and behav- ioral changes in professionals working with attachment style and a more enriched life. Repeated positive behaviors in relationships generate gratitude and become the narratives of what is referred to as relationship capitaliza- tion, or “the process of informing another per- son about the occurrence of a personal positive event and thereby deriving additional benefit from it.” 53 Sofer-Roth found that attachment insecu- rities inhibit relationship capitalization through demoralizing behaviors, and secure attachments made individuals more likely to express happiness in response to a partner’s happiness and less likely to express envy, criticism, and jealousy. 2,54 Strong attachment security leads to better rela- tionship quality, higher levels of sexual satisfac- tion, more positive feelings during sex, higher sexual self-esteem, more open communications about sex and sexual issues, and a zeal to grat- ify one’s sexual needs. 2,26,55 Attachment insecu- rity conversely influences sexual motivations and attitudes. An attachment anxiety coping mecha- nism is to rely heavily on sex as a means of satis- fying an unmet and strong need for security and love. 56 Anxiously attached individuals may engage in sexual activities for various attachment-related reasons, such as enhancing feelings of closeness, maintaining their partner's presence in the rela- tionship, seeking intense sexual arousal during times of insecurity or relationship challenges, and prioritizing their partner's sexual desires to ensure their partner's satisfaction. On the other hand, avoidant individuals often struggle with the inherent intimacy of sexual inter- actions, leading them to separate sexuality from emotional closeness, even when engaged in com- mitted romantic relationships. 57 Avoidant individu- als tend to prefer detached sexual experiences, such as one-night stands and mate poaching, to prioritize self-enhancement over relational close- ness, leading to uncomfortable feelings during sex and a tendency to distance themselves emotion- ally in sexual relationships. 2,55,57,58,59,60 In addition to influencing sexual motives and experiences, attachment insecurities can impede the positive impact of sexual feelings and activi- ties on a relationship, as attachment anxiety inten- sifies the effects of sexual experiences on rela- tionship quality. 2,55,57,58,59,60