Thematic Analysis of How Police Officers Perceive and Relate to Compassion Fatigue

“You have to be strong”: a thematic analysis of how police officers perceive and relate to compassion fatigue

Abstract

Compassion fatigue is equated to the ‘cost of caring’ and describes the behavioural and emotional responses associated with exposure to those who have experienced trauma. It is a significant problem in caregiving professions and contributes to poor outcomes, such as decreased health and poor employee retention. Professionals in healthcare and caregiving occupations find the term compelling and accurately representative of their experiences resulting from indirect exposure to trauma. The issue of compassion fatigue amongst police officers is rarely considered, yet research suggests they comprise an at-risk group. This study explores how police officers perceive and relate to compassion fatigue, using interviews with seven currently serving officers, who were thematically analysed. Findings suggest that the police culture and professional identity conflicts with the cultural meaning of compassion fatigue and that stigmatisation surrounding psychological illness is pervasive within the police organisation. Therefore, it is suggested that interventions are targeted at constabularies in creating changes in normative attitudes and minimising the power of stigma.

Introduction

The nature of policing

Police officers routinely attend critical and distressing incidents, including road traffic collisions, sudden deaths and domestic violence (Boulton et al, 2016). During these incidents, police are tasked with helping traumatised victims and dealing with emotional individuals. Studies have shown that officers experience high rates of depression, suicide and post-traumatic stress disorder (PTSD) compared with the general population and other emergency service personnel (Royal, 2014; Basinka & Wiciak, 2012). As previous research has focussed on police officers with more severe mental health conditions, such as PTSD, the experiences of officers who do not suffer from these conditions is less well understood.

Although police officers are trained to respond to critical incidents, this does not guarantee immunity to the detrimental effects of trauma (Popazoglou, 2013). Therefore, the unique nature of police work impacts on their mental and physical wellbeing and job performance. Furthermore, during recent periods of austerity and budget cuts, police forces have increasingly encountered resource and staff shortages (Boulton, 2016). This increases pressure on serving officers and can lead to reduced performance and significantly impact psychological functioning (Balmer, 2014).

As a highly stressful occupation, policing can negatively impact officers’ health and performance (Violanti, 2010). Severe stress symptoms have been found to potentially interfere with their judgment and decision-making abilities during critical incidents (Covey, 2013). Gilmartin (2002) describes the physiological exhaustion experienced by police officers and identifies this, in combination with other organisation stressors, as a significant risk factor for developing compassion fatigue.

Contemporary policing has seen a shift in the functions of officers’ operations, marked by an increase in neighbourhood policing, with greater contact between officers and the communities they serve (O’Neill, 2014; Bacon 2014). It has been suggested that community-oriented policing may challenge the values of the police service. Neighbourhood policing places officers are in closer proximity to, and thus scrutiny from the community they serve. This contextual shift has heightened the level of chronic stress police are experiencing, added to the traumatic stress they already endure (Violanti & Paton, 1999; Bacon 2014). The role of police officers is increasingly expansive and often overlaps into other job roles, particularly social work (O’Neill, 2014) where officers are expected to perform the duties attributed to these professionals when they are not available. As social workers have been identified as being at high risk of experiencing compassion fatigue (Bourassa, 2009; Adams, 2006; Kapoulitsas, 2015), this could contribute to the likelihood that police officers are also vulnerable.

Compassion fatigue

Compassion fatigue was a term originally used to describe increasing unresponsiveness in public appeals for aid, thought to be the result of factors including inundation and overwhelm of worldwide catastrophes and/or feelings of helplessness (Moeller, 1999). Figley (1995) developed the concept of compassion fatigue by shifting focus onto the distinct work of trauma and caregiving professionals and their indirect exposure to trauma. Researchers use numerous terms interchangeably to refer to the distress experienced by working with traumatised individuals, although others are keen to emphasise the distinctions between them. Secondary traumatic stress, vicarious traumatisation and compassion fatigue are all terms used to describe this phenomenon (Figley, 1995; Bocarino et al, 2004; Craig & Sprang, 2010). The commonality of these terms is their characterisation by emotional exhaustion, which has led to inconclusiveness as to whether compassion fatigue is distinct from similar concepts (Sabo, 2006; Jenkins & Baird, 2002; Stamm, 2002; Berzoff & Kita, 2010; Cicognani et al, 2009). Hofmann (2009) offers a well-established definition of compassion fatigue as a phenomenon present when an individual loses their ability to feel and express genuine empathy and support, which should be considered in conjunction with compassion fatigue as the result of depletion of internal emotional resources (Figley, 1995).

Figley (1995) equated compassion fatigue to the ‘cost of caring’, which describes the behavioural and emotional responses associated with exposure to those who have experienced trauma. It is assumed to result from stress activated by this exposure (Figley, 1995). Compassion fatigue is generally associated with disengagement and lack of empathy, although symptomology is vast in capturing the behavioural, emotional, cognitive and somatic impacts (Portnoy, 2011). Irritability and withdrawal are widely recognised behavioural signs of compassion fatigue and cognitive indicators often comprise difficulty in concentrating and apathy. Emotionally, individuals may feel powerless or depleted, or present somatic symptoms such as excessive sweating and breathing difficulties (Berzoff & Kita, 2010). Paralleling the obscurity in actual definition, the characteristics of compassion fatigue are similarly expansive and inconsistent (Gentry, 2002).

Compassion fatigue is widely considered an individual psychological phenomenon (Figley, 1995; Hoffman, 2009) but recognition should be given to the theory that it encompasses an environmental and cultural phenomenon brought about by environmental conditions (Mestrovic, 1997).  This explored the concept that Western societies are becoming ‘postemotional’, characterised by cynicism and disconnection from community, potentially linked to social and technological advances. Consequential to a ‘postemotional’ society is a suggested shift from compassion fatigue as an individual phenomenon to one largely affecting society (Watts, 2013). The higher incidence of compassion fatigue in smaller institutions, such as the healthcare system is, therefore thought to mimic wider cultural change.

Figley’s generic model of compassion fatigue (1995) draws on stress-process framework and was created to predict compassion fatigue. The model was validated for social workers (Adams et al, 2006), nurses (Abendross & Figley, 2014) and military personnel (Bride & Figley, 2009). The model suggests that if unattended to, the existence of residual stress from being compassionate and empathic may develop into compassion fatigue. If individuals are unable reduce compassion stress, the build-up will eventually lead to compassion fatigue. Attempts have been made to apply Figley’s model to police officers to explain their compassion fatigue (Violanti, 1999) and, despite lack of direct validation, appears to offer a feasible proposal. However, this model only provides predictions and estimations of compassion fatigue prevalent amongst offers based on the nature of the job, and does not explore how they perceive or relate to the concept.

However, Sabo (2011) highlights overemphasis on the linear direction of the model, suggesting this seems to contradict human behavioural responses, and identifies the possibility that compassion fatigue may be exhibited on a continuum of stress. Therefore, it may be insightful to investigate those without a specific compassion fatigue diagnosis, to explore the potential effects of traumatic interactions.

Research suggests that compassion fatigue is influenced by an individual’s empathic response (Portnoy, 2011), concurring with the idea that vulnerability to developing compassion fatigue is heightened when empathy is present during vicarious traumatic exposure (Figley, 1995). However, empathy has been conceptualised in various ways (Kunyk & Olson, 2001) and since Figley’s (1995) model fails to articulate to which definition it adheres, it is difficult to determine whether certain conceptualisations have more significance (Sabo, 2011).

Furthermore, Figley’s (1995) model appears to have an implicit premise that those caring for suffering individuals will inevitably develop compassion fatigue, although Valent (2002) states that manifestation of such symptoms is not guaranteed. Therefore, it appears intuitive to divert from quantitative measures, and to explore whether perceptions of compassion fatigue and professional identity may affect its prevalence. Kapoulitsas (2015) proposes a potential link between resilience and compassion fatigue, though emphasises that conceptualisations of resilience should be understood regarding the interaction between genetics, environment and risk (Rutter, 2007) and beyond the conventional personality trait. Organisational commitment, social support from colleagues and group cohesion have also been cited to protect against compassion fatigue (Berzoff & Kita, 2010).

Compassion fatigue within helping professions

Professionals working with those suffering from or having experienced trauma must be able to cope with the normal stress of work as well as their personal feelings and emotional responses. Previous research extensively studied the experience of compassion fatigue in healthcare professionals, (Yoder, 2010; Austin 2009; Watts, 2013; Sinclair, 2017) physicians (Pfifferling & Gilley, 2000; Hooper, 2010) and social workers (Bourassa, 2009; Adams, 2006; Kapoulitsas, 2015).

Herdman (2004) applied Mestrovic’s (1997) social (postemotional) analysis to current nursing practice, identifying problems in maintaining personal wellbeing due to changes, such as resource and staff shortages. These changes result in isolating legitimate emotion from work, leading to disengagement and empathy deficiency. Compassion fatigue correlates with lower employee retention, reduced patient safety and satisfaction and physical health (Halbesleben, 2008), suggesting the emotional demand of healthcare work has the potential to impact the professional’s psychological wellbeing and job performance (O’Connor, 2016).

Research suggests compassion fatigue may provide a more accurate description of the experiences of helping professionals than other similar terms (Figley, 1995). Due to this accurate representation, the compassion fatigue term promotes acceptance by professionals, where secondary traumatic stress may carry more negative connotations. Healthcare professionals seem to find the term compelling, as though it captures the frustration and distress they experience (Austin, 2009). The basic meanings of ‘compassion’ and ‘fatigue’ is thought to enhance the appeal to healthcare professionals (Austin, 2009). As research assumes that healthcare occupations are characterised by compassion and empathy, the link between these professionals and compassion fatigue is palpable.

Literature identifies certain groups at greater risk of developing compassion fatigue. Caregiving professionals are considered particularly vulnerable due to the nature of their roles and proximity to patients (Joinson, 1992; Austin, 2009). Resource shortages and organisational stresses within nursing, in particular, have been associated with greater risk of encountering compassion fatigue (Caulfield, 2002) by undermining the engagement and nurse-patient relationship. As organisational cuts are also present within policing, (Boulton, 2016), police officers may also comprise an at-risk group. However, police culture may influence compassion fatigue development more than the actual nature of the job.

Police culture

Police culture can be described as occupational beliefs and values shared by officers, widely recognised in shaping their behaviours, enabling the establishment of a shared, organisational identity and group cohesion (Crank, 2015; Bayerl, 2014; Reisig, 2014; Bacon, 2014; Cornelissen & Haslam, 2007).  Their sense of belonging to a certain group and acceptance of the emotional and value significance of that group membership is known as social identity (Cornelissen & Haslam, 2007; Jetten, 2014). This theory suggests group categorisation leads to an individual’s sense of self being defined by their group membership (Cornelissen & Haslam, 2007; Turner, 1982). Social categorisation involves the assignment of stereotypical group characteristics to individual group members and initiates self-stereotyping, whereby individuals take on norms and values associated with their group (Haslam 2003; Cornelissen 2007). Social identity and categorisation theories may explain why officers often endorse the police culture and stereotype.

The perception of police culture as combining machismo, pragmatism and bravery is widely accepted in the media and academic literature and officers are thought to be aware of the necessity to adhere to organisational norms to optimally perform their job (Crank, 2015; Bayerl, 2014; Reisig, 2014; Atkinson, 2015). A shared understanding of what it means to be a police officer allows reliance on expectations and established roles to facilitate collaboration across professional groups, although assimilation into the ways of police culture is not automatic (Bayerl, 2014; Crank, 2015; Bacon 2014).

In the culture of police work, interdependence, the perception of mutual support, is an important requirement, although implicit cultural rules also mandate that officers should not expose their feelings or any sign of distress (Piper, 2003). ‘Emotive dissonance’ is the conflict between inner feelings and outward expression, in the context of police work, this describes how the organisationally mandated unemotional response interferes with the officer’s real feelings. Emotional dissonance is thought to lead to depression, cynicism and burnout, although psychological distress is minimalised when the individual has internalised organisational role expectations (Heuven, 2003; Tracy, 2007).

Police culture creates the expectation that officers are heroic, strong and invulnerable (Piper, 2003; Oulmokhtar, 2011). As the importance of social identity amongst police officers has been widely recognised in literature (Cornelissen & Haslam 2007; Piper, 2003; Bradford, 2014; Jetten & Haslam 2014), the police stereotype is often endorsed to promote resilience and conceal weakness. Bullock & Garland’s (2017) reference to the “spoiled identity” of an officer suffering mental health problems epitomises the police identity of strength. This organisational identity helps explain why police officers are notoriously reluctant to seek help when experiencing distress (Royal, 2014; Karaffa & Koch, 2016; Haslam, 2003).

When faced with mental health problems, stigma is often associated with the resistance amongst officers to seek support (Bullock & Garland, 2017), which can negatively impact on work performance and health (Gershon et al, 2009; Randall & Buys, 2013). Lack of research exploring police attitudes towards mental health and psychological wellbeing (Royal, 2014), means stigmatisation within police forces is not well understood (Bullock & Garland, 2017). Bullock & Garland (2017) brought the Modified labelling theory (Link, 1982) in line with the police organisation, which explains stigmatisation in relation to a series of dimensions. These include: labelling differences, associating the difference with negative attributes and stereotyping, the process of separation (us and them), status loss and discrimination (Link, 1982). This process of stigmatisation has been associated with the powerful stereotypes towards mental health within the police, which undermines help-seeking and recovery (Bullock & Garland, 2017). As a psychological phenomenon, it is important to determine whether compassion fatigue may also carry stigma within police, therefore affecting perceptions of this concept.

Suspicion and cynicism are also considered core characteristics of police culture due to the inherent stress and frustration (Bradford, 2014: Behrend, 1980). Cynicism has been associated with burnout and low job satisfaction and can contribute to officers’ lack of engagement in organisation support schemes, due to suspicion of the motives behind them (James, 2005).

Research has attempted to differentiate between typologies of police officers, and a review by Worden (1995) summarised previous findings to create five disparate types: professional, tough cop, clean-beat crime-fighter, problem-solver and avoider. However, there is disagreement as to whether these dimensions are accurate (Bayerl, 2014; Tait, 2011).

Whilst the focus remains on social and organisation identity regarding the development of compassion fatigue, there is literature suggesting that individual differences may be influential (Blumstein et al, 2012; Carpenter, 1987). Research suggests individuals attracted to a career in policing may display particular traits, including low agreeableness and freedom from remorse (Blumenstein et al, 2012) which, if true, may make them less susceptible to experiencing compassion fatigue. However, it is unlikely the majority of police officers possess these characteristics, although there is evidence that serving officers and service applicants are generally psychologically healthier then the normal population (Carpenter, 1987).

Kapoulitsas (2015) explored how resilience is endorsed personally, professionally and organisationally amongst social workers. Findings showed organisations can be influential in strengthening worker capacity and resilience and suggested that, in the absence of causal explanation, resilience may protect workers from compassion fatigue. Adhering to police organisational culture, the promotion of resilience may generate a cohort of workers who are at less risk of suffering from compassion fatigue.  However, research has found that length of service predicted resilience within police officers, whereby longer serving officers experienced lower levels of resilience, attributed to the cumulative exposure to trauma which negatively impacts coping abilities (Balmer, 2013).

Policing and compassion fatigue

Caregiving and helping professions have been defined as those of a rewarding, although emotionally demanding nature (Collins, 2011) involving promoting welfare and providing support to survivors of trauma (Bride, 2007; Shweta, 2014). Adhering to this definition, police work should be categorised as a helping profession, as specified by Anderson (1970). Beaton and Murphy (1995) state that emergency workers absorb the traumatic stress of those they help, leaving them at risk of experiencing compassion fatigue.

Joinson (1992) recognised the high incidence of compassion fatigue within caregiving professions, though few studies have deviated from the investigation of nurses, therapist roles and social work, neglecting roles such as policing. Police officers are confronted daily with significant stress, which conceivably places them at risk of experiencing compassion fatigue.  However, Cocker (2016) conducted a systematic review of the effectiveness of interventions in reducing compassion fatigue in healthcare, emergency and community service workers, yet was unable to find any relevant studies targeting emergency service workers.  Similarly, Anderson’s (2015) research, specifically focussing on the police, was only able to identify three papers regarding compassion fatigue that included this professional group. Research identifies police officers as vulnerable to experiencing compassion fatigue and found those suffering had reduced personal relationship satisfaction and professional quality of life (Anderson, 2015). The neglect of study of compassion fatigue within police officers is evident despite research recognising that these individuals routinely face trauma and are in contact with traumatised civilians (Bell and Eski 2014).

Cases of police officers in the UK taking long-term sick leave for psychological reasons has risen by 35% over the last five years, despite forces decreasing in size (BBC). It is unknown whether compassion fatigue contributes to this statistic, although, as a form of psychological distress, it merits being investigated within the police. As compassion fatigue is associated with a multitude of cognitive and behavioural deficits, understanding whether police officers experience this and the consequent occupational detriments is vital. The police service provides an indispensable service to society in promoting and protecting public wellbeing, whilst risking their own safety. As the development of compassion fatigue can adversely affect job performance (Cacciatore et al, 2011) this can be detrimental for both officers and the communities they serve. The lack of research, which is also partly due to methodological limitations and renowned hesitancy among officers to collaborate with academics (Anderson, 2015) presents an obstacle to development of preventative measures to protect the psychological wellbeing of officers.

When reviewing literature, it is difficult to determine whether reported experiences relate to the same phenomena, as the lack of conceptual clarity makes it difficult to distinguish between compassion fatigue, burnout and secondary traumatic stress (Najjar et al, 2009), highlighting the need for well-developed concept analysis (Sorenson, 2016). Owing to these challenges, measures of compassion fatigue are considered screening tools in identifying the condition and guiding individual and organisational decisions to mitigate its development, rather than actual diagnostic measures (Stamm, 2002.)

Despite challenges to the measurement of compassion fatigue, much of the existing research has relied on quantitative methodology, using assessment instruments such as the Compassion Fatigue Scale (CFS-R) (Adams et al, 2008) and the Professional Quality of Life Scale (ProQOL) (Stamm, 2010). Whilst recognising the usefulness of these tools in exploring prevalence, they are limiting in the information they yield and greater understanding of current compassion fatigue research is required through narrative review (Sorenson, 2016). The current study employs a qualitative design to enable the extraction of experiential information and to enhance the understanding of how compassion fatigue is manifested in the police service. Qualitative methodology will allow a more in-depth understanding of how officers associate with compassion fatigue. Additionally, investigating compassion fatigue in police officers could allow for the development of preventative measures. This study aims to investigate police officers’ perceptions of compassion fatigue and how they relate to the phenomenon.

Method

Design

An analytic method was used in an attempt to construct a psychological understanding of compassion fatigue grounded in the experiences of police officers. The study set out to generate data which may develop an understanding of compassion fatigue, rather than attempting to test theory or prove/disprove hypotheses. Therefore, thematic analysis was selected as the most appropriate method of analysis in addressing the gaps in current literature, focussing on identifying themes across the participants understanding and allowing scope for further investigation. Thematic analysis offers an insight into how individuals make sense of experiences through active dialogue and interpretation of accounts. It aims to produce detailed analysis regarding experiences and perspectives, whilst maintaining the flexibility tied to its epistemological position (Braun & Clarke, 2006). Thematic analysis allows interpretation of different individual experiences surrounding the same specified phenomenon, currently compassion fatigue, which is analysed to identify recurrent themes. This method allows content of separate interviews to be combined to produce useful, common themes that are not instinctively apparent, enabling investigation into the importance and implications of the themes. This paper adopts a contextualist position, which lies between essentialism and constructionism, allowing consideration of the reality of compassion fatigue to the participants, through exploration of their experiences and their attached meanings, whilst also encompassing the wider role of society in contributing to the participants’ understanding (Willig, 2008).

Participants

An opportunity sample of seven participants, consisting of four males and three females aged between 25 and 55, with a mean of 43.3 years (SD=9.71) was recruited via a poster advertised in the participants local Police Station. Inclusion criteria meant participants must be currently serving police officers, with at least two years’ experience (experience ranged from 2.5-33 years).

Data collection

All participants, having read and signed an informed consent form, were interviewed and audio recorded at their Police Station. Qualitative data was collected via semi-structured interviews, which presented a standard set of questions asked in a specific order, facilitating comparison across participants, yet allowing for flexibility according to the demands of the individual context. The interview schedule was designed to be completed in 15 to 40 minutes, depending on participants’ responses. To promote rapport, a discrete Dictaphone was used to record the interviews, rather than the researcher making notes. On completion, participants were fully debriefed, with researcher contact details provided should they have further questions, and additional organisation contact details if they require extra support.

The interview schedule covered topics including participants’ understanding and potential experiences of compassion fatigue and how they relate to this phenomenon. The questions were constructed based on a review of previous literature regarding compassion fatigue, police culture and the nature of policing in order to produce detailed accounts.

With all self-report methodologies, data collection was limited to the information participants were willing to disclose, therefore there may have been a bias towards socially acceptable responses (Van de Mortel, 2008), in this case meaning answers with greater adherence to policing values. However, self-report measures are suggested to be appropriate for gaining perceptions of participants’ work environments and stressors (Spector & Jex, 1998).

Analytic Procedure

Data was transcribed verbatim from each of the seven interviews, each transcript being re-read to familiarise the researcher with the data.  Initial codes were generated for each transcript regarding the content of the data and what was interesting about it. Working systematically through the entire data set, with equal attention to each data item, allowed identification of interesting aspects of the data that occur repeatedly across transcripts. Once the data had been initially coded, the codes were sorted into potential themes by collating all relevant coded extracts within the identified themes. Extracts from the transcripts that exemplified each of the themes were identified according to participant pseudonym. Further analysis reviewed and refined the themes using a theoretical approach and similar themes were combined to cohere meaningfully, whilst ensuring clear distinctions between themes. Extracts for each theme were reviewed to ensure they form a coherent pattern, then viewed in relation to the entire data set. Themes were considered for validity and ensuring accurate reflection of the data set. Finally, themes were defined and appropriately named. Thematic analysis was used at the latent level in beginning to examine the underlying concepts that are theorised as shaping the semantic content of the data (Braun & Clarke, 2006).

Ethical considerations

Participants were given an information sheet enabling them to give informed consent to take part in the study. Due to the qualitative nature of the research, no deception was necessary and participants were reminded of their right to withdraw their data at any point during or after the interview. As qualitative research uses data extracts, confidentiality cannot be ensured, though the use of pseudonyms and disguising locations ensures anonymity. Participants were given a full debrief upon completion of the interview and were given the contact details of support organisations, due to the potential sensitivity of the interview topic. Similarly, participants were monitored throughout the interview to ensure they did not become distressed, and deflection techniques were employed in such instances. Data was kept in a secure file, with access only to the researcher and supervisor. The study was approved and compliant with the Social Sciences Research Ethics Committees guidelines.

Findings

Thematic analysis of the transcribed data yielded two overarching themes explaining how police officers perceive and relate to compassion fatigue. All accounts referenced the strength and professionalism police officers endorse and the negative connotations associated with compassion fatigue. The themes that emerged were the police organisational identity and the social burden of compassion fatigue.

The police organisational identity

This theme focuses on establishing how participants construct and assume the police identity. This encompasses the professionalism and strength characteristics instilled within police officers, which appears to conflict with the cultural meaning of compassion fatigue, connoting weakness and impotence (Crank, 2015; Bayerl, 2014; Bullock & Gardner, 2017).

This theme was developed from participants’ references to the stereotypical view of officers as tough and resilient to the detrimental effects of traumatic incidents (Reisig, 2014; Bacon, 2014).

Ben

I think you kind of step into the police officer role, which means you have to be strong, you can’t really show if you’re upset or anything. You’re dealing with people who are very varied in their emotions and it can be a stressful job, there’s no doubt about it, you have to be a strong character to deal with it

This demonstrates the perception that officers must be strong, robust and able to cope with the demands of the job, with participants tending to adopt the established qualities of a police officer (Reisig, 2014; Crank, 2014). “Step(ping) into the police officer role” acknowledges the difference between their personal and professional identity.  In recognising that they should not display emotion when dealing with the public, this reflects the implicit cultural rules that mandate that officers should not engage in behaviours that could portray weakness, reinforcing the self-perception that they are strong (Crank, 2015)

The strength of character and resistance to appearing as weak is also evident through participants’ engagement in coping strategies.

Rachel

By managing, just by managing…getting my life work role balance, you know, and I exercise too, I don’t need extra help or support from work or anything like that

Helen

I talk to my, sort of colleagues, you know. I don’t particularly need support from each other, but it’s nice to have a friendly bunch to work with, and there is like other support within the police service, but I’m quite resilient so I’ve not used it, and I don’t think I would anyway

This highlights participants’ reluctance to admit they require support, which may suppress any potential struggles or distress they may be experiencing (Bullock & Gardener, 2017). This resistance may be representative of the masculine, ‘macho’ organisational culture (Reisig, 2014; Bacon 2014; Crank, 2015), making it difficult for officers to acknowledge their feelings, owing to their ability to conceal emotion.

It also demonstrates how participants tend to endorse informal coping strategies and rely on individual coping abilities, in preference to organisational support. Participants frequently reported the use of exercise, humour and camaraderie as effective coping mechanisms, which may reflect their need to appear tough.

“I’m quite resilient so I’ve not used it” suggests that requiring support implies weakness, which conflicts with the organisational identity (Reisig, 2014; Bacon 2014; Crank, 2015). Helen’s assurance that she is “resilient” highlights that strength of character is imperative to the organisational identity and participants’ sense of professionalism.

Amy

We’re only human and it’s an emotional situation to be in but over time you kind of become used to it and you’re just doing your job and trying to do it in the best way you can to help those families and staying professional and not getting emotional is more efficient in my opinion, showing you’re upset wouldn’t be professional

Here, the participant appears to try to justify any emotional response on the grounds that she is “only human”, rationalising any emotional effect as a normal response to particular incidents. However, Amy also indicates that through the normalisation and “getting used to” certain types of incidents, police officers tend to become more detached and impassive (Bayerl, 2014; Crank 2015). The participants recognised that police culture does not allow for emotional, human responses as this would indicate lack of professionalism, hence the rationalisation and justification. The excerpt distinguishes between the appropriate “human” and police response, suggesting a dichotomy between police and non-police expectations and implying that compassion fatigue does not fit within the response of police officers.

The excerpt also exemplifies how revealing emotion is contradictory to the professionalism concomitant with the police identity (Bacon, 2014; Crank 2015). All participants referenced the criticality of remaining “professional” which is consistent with police values of proficiency and competence, whereas emotional responses undermine efficiency (Crank, 2015). Participants tended to construct their organisational identity around efficiency and professionalism, rather than being considered compassionate or empathetic.

Furthermore, participants repeatedly identified that cynicism is inherent within police organisational culture (Bradford, 2014).

Pete

I may well have suffered from compassion fatigue at some point, but I am a lot more cynical or suspicious than I was when I joined

The propensity to be distrustful of particular motives is embedded within the policing organisational attitude (Bradford, 2014). Participants often appeared sceptical towards the concept of compassion fatigue. This cynicism seems to represent a significant part of the police identity, tending to grow with experience.

The social burden of compassion fatigue

This theme represents both the resistance of participants to identify with compassion fatigue and the social and psychological impact of the label, which collectively demonstrates the concept of compassion fatigue as a social burden. The reluctance to relate to the ‘compassion fatigue’ term seems to be reinforced by stigmatisation of individuals with psychological illnesses (Royal 2014; Bullock & Garland, 2017). There was consensus across the interviews that compassion fatigue carried many negative connotations, particularly of weakness. Participants were keen to defy these assumptions and resist such categorisation.

Sam

I understand compassion fatigue to be a tiredness or stress related to dealing with an incident which may require you to use a lot of emotional energy and leaves you feeling tired and fatigued

Despite a general lack of awareness of compassion fatigue, interviewees generally associated it with tiredness, emotional exhaustion and a lack of patience or empathy. Each of these perceptions connote ineffectiveness and adverse attributes, where “feeling tired and fatigued” implies performance is undermined.

Rachel

I think there are a lot of officers that probably are on the periphery maybe, or even currently experiencing compassion fatigue, but you know, for whatever reason they don’t want to recognise it or they won’t recognise it for fear of it having some sort of negative effect potentially on their working career or that they’d be looked on or disapproved on, which shouldn’t be the case

Here, the participant reports that even recognising the symptoms of compassion fatigue evokes concern regarding the consequent response from colleagues and the organisation. The onset of stigmatisation is immediate and assumes discrimination is inevitable. The anticipated reactions from colleagues are acknowledged as irrational and inappropriate yet still seem to contribute to officers’ fears of admitting distress.

The awareness of stigma was apparent across the interviews, although not always explicitly. It appeared to characterise and influence participants’ interactions during their work, explored within the previous theme, regarding the preference to “just get on with it” rather than endorse any emotional reaction. The traditional view of police officers promotes masculinity and professionalism (Crank, 2015; Bayerl, 2014), which may enhance the likelihood of compassion fatigue being viewed in a highly stigmatising way.  Even when participants claimed not to have experienced compassion fatigue, the expectation of being negatively evaluated was evident.

Tom

I haven’t experienced any of the symptoms but I know some officers that have dealt with real life and death scenarios and I think they would have done and yeah, they obviously seeked counselling…I’ve never come across them because I’ve never needed them, but there are people you can go to

Here, Tom insists that he has not suffered from compassion fatigue or required further support, despite the lack of suggestion that he had. This excerpt also highlights the defensiveness portrayed by several interviewees at the mere suggestion of an encounter with compassion fatigue or requiring support. The emphasis on not requiring additional support is consistent with the police identity, of strength and resilience, and coincides with the resistance of participants to admit any experience of the condition.

The majority of participants overtly made reference to symptoms of compassion fatigue that they had experienced during their career, although only one readily identified with having experienced compassion fatigue in its entirety. A recurring approach included identification with symptoms, but denial of classification with compassion fatigue as a whole.

Helen

I don’t think there’s particularly a time when I could definitely turn around and say yeah I’ve had that but probably snippets of that sort of, throughout my career, I’ve definitely experienced stress though

This excerpt is typical of most interviewees’ association with compassion fatigue, whereby they recognise the symptoms but still do not think the term applies to them. They are reluctant to categorise themselves with this condition and are only comfortable identifying “in part” or “to an extent”. This resistance could be attributed to police officers not identifying with the label, preferring to use terms such as “burnout” and “stress”, even when describing symptoms of compassion fatigue that do not apply to a diagnosis of stress. Alternatively, the associated stigma may serve as a barrier to identification, as some participants avoided the term altogether, which may suggest that the label carries too much emotional baggage and negative connotations (Royal 2014; Bullock & Garland, 2017).

Despite a lack of adherence to the term, interviewees still recognised the prevalence of compassion fatigue within the police service. Participants readily recognised symptoms in colleagues, despite struggling to admit their own personal issues.

Ben

Compassion fatigue most definitely exists with some officers

Amy

I know officers that have dealt with situations and I won’t disclose what the incident was but I know of one not so long ago where you know, he had to deal with something and it emotionally affected him and of course you notice that because effectively your work colleagues become your family, you look after them and they look after you so you do understand and you do see it and you just have to be there to try and help them

The reference to “some officers” represents an attempt to divert attention away from the interviewee, whilst retaining the focus on compassion fatigue via deflection towards others. Similarly, Amy acknowledges the impact of attending critical incidents, through recognising the detrimental consequences in her colleagues. Whilst this suggests that it may be easier for participants to identify potential compassion fatigue symptoms in others, rather than in themselves, it also highlights a recurring theme whereby participants tend to deflect from attending to personal experiences and more readily disclose the situations of other officers. It seems participants accept the existence of compassion fatigue, but resist any exploration of the phenomenon other than through the experience of others. This again emphasises the issues surrounding personal identification with compassion fatigue, possibly explained by stigma consciousness (Bullock & Garland, 2017; Pinel, 1999).

Discussion

From listening to the participants involved in this study, police culture and the organisational identity emerge as universal and pervasive concepts that have the potential to influence the recognition and perception of compassion fatigue. Participants perceive compassion fatigue as signifying weakness and ineffectiveness, directly conflicting with their self-perception, which conforms to their professional identity. The dissonance between the perceived meaning of compassion fatigue and the traditional view of police officers suggests the police stereotype may interfere with the ability to relate to compassion fatigue. Police culture discourages expression of emotion which, coupled with the endorsement of the police stereotype of strength and stoicism (Crank, 2015; Bayerl, 2014; Reisig, 2014; Atkinson, 2015), emphasises the contrast between the participants’ views of themselves and what they consider to be compassion fatigue.  Stigmatisation surrounding compassion fatigue is also prevalent and offers another explanation for the apparent reluctance to accept the compassion fatigue label.

The resistance to identify with compassion fatigue among the participating officers is markedly different to the way the term seems appealing and compelling to healthcare professionals (Austin, 2009). This could be understood in relation to the characterisation of the respective professions, whereby nursing is epitomised by compassion and empathy (Austin 2009; Yoder, 2010; Sinclair, 2017) whilst policing is characterised by resilience and pragmatism (Crank, 2015; Bayerl, 2014; Atkinson, 2015). Alternatively, the differing reaction to the term’s appeal could reflect differences in the way the term is understood by different groups. Taking the words ‘compassion’ and ‘fatigue’ at face value, nurses may find the label synonymous with the relentless emotional energy and sympathy required in their daily work (Austin, 2009), whereas police officers may feel that ‘compassion’ is not integral to their identity, where ‘fatigue’ denotes tiredness and thus weakness.

The risk of developing compassion fatigue in healthcare professionals was attributed to their proximity to patients, vicarious exposure to trauma and resource shortages (Joinson, 1992; Austin, 2009; Caulfield, 2002), factors also present within police work (Boulton, 2016; Popazoglou, 2013; Violanti, 2010). This suggests the presence of either a mediating factor in police work, inhibiting the development of compassion fatigue, or that police officers are simply less likely to admit or recognise it.

The extent to which adherence to police culture governs and influences participants’ self-perceptions and behaviours is clear. Endorsement and adoption of the police identity and stereotype means participants consider themselves as strong and professional, paralleling the occupational values and shared identity highlighted in previous literature (Crank, 2015; Bayerl, 2014; Reisig, 2014; Bacon, 2014). The tendency to view psychological distress or mental health problems as an indicator of weakness is also embedded in police attitudes (Bullock & Garland, 2017). Combined, this juxtaposition of the police identity and perception of compassion fatigue generates conflict. Overall, officers perceive compassion fatigue as a sign of weakness and therefore, owing to their professional identity, do not readily identify with the phenomenon.

The cynicism prevalent within police culture, and discussed within most interviews, may explain officers’ resistance to relate to compassion fatigue, supporting research recognising the suspicious nature of police officers (James, 2005; Bradford, 2014). There is potential for this cynicism to result from emotive dissonance, created through the conflict between participants’ real feelings and the organisationally mandated emotional response (Piper, 2003). However, participants presented as having adopted their professional identity without being in conflict with it. Therefore, cynicism is likely due to organisational culture, which results in doubting the authenticity of compassion fatigue.

Organisational commitment, social support and group cohesion have been claimed to protect against compassion fatigue (Berzoff & Kita, 2010; Austin, 2009). Participants showed preference for the use of informal coping strategies, referencing the benefit of camaraderie and colleague support, which may serve to buffer the growth of compassion fatigue within police officers. This concurs with the concept of interdependence and validates findings of group cohesion within police culture (Crank, 2015; Bayerl, 2014; Piper, 2003). Similarly, the advocacy and adoption of the police identity could display participants’ inherent commitment to their profession, potentially mitigating any deterioration, coinciding with research referencing the shared police identity (Bacon 2014; Bayerl, 2014; Reisig, 2014). Assuming these factors protect against the development of compassion fatigue, police officers may struggle to identify with the phenomenon as they rarely experience it in its entirety.

Participants’ reluctance to accept the compassion fatigue label indicates social concerns, primarily focused around stigmatisation. This parallels the findings of previous literature investigating police officers’ attitudes towards mental health (Bullock & Garland, 2017; Royal, 2014). The stigma surrounding compassion fatigue is also likely to explain participants’ resistance to utilise organisational support (Bullock & Garland, 2017). The Modified Labelling Theory (Link, 1982) offers a feasible explanation of the participants’ reluctance to admit being affected by compassion fatigue. The dimensions of this model, including stereotyping, associating the label with negative attributes and the process of separation (between an individual suffering from compassion fatigue and typical police officers) are evident in participants’ indications of stigmatisation. The organisational environment shapes how psychological distress is understood and interpreted by officers, which often leads to the notion of a “spoiled identity” (Bullock & Garland, 2017). The participants implied that compassion fatigue contrasted with what they perceived to be culturally expected of a police officer, whilst anticipated rejection generated self-stigmatising tendencies (Bullock & Garland, 2017). Attention was also drawn to how categorisation with compassion fatigue might lead to concerns as to whether the officer is still able to fulfil their role efficiently, which only reinforces negative perceptions of compassion fatigue.

The police culture, encompassing professionalism and machismo, adheres to the notion of a ‘postemotional’ environment (Mestrovic, 1997), which could explain why participants recognise the existence of symptoms of compassion fatigue in a number of their colleagues. However, this fails to explain why it is not more widespread in the police force. Police officer typologies may offer an explanation for these differences, in that a ‘professional’ or ‘tough cop’ may be less susceptible to developing compassion fatigue (Worden, 1995; Bayerl, 2014). Resilience has been suggested to protect individuals from developing compassion fatigue (Kapoulitsas, 2015).  Whilst this could be attributed to the personal resilience levels of police officers, research also indicates that organisations can be influential in building resilience in employees (Balmer, 2014; Kapoulitsas, 2015; Cornelissen & Haslam, 2007). Social identity theory may explain why individuals become more resilient, as group membership and categorisation means officers adopt the characteristics and values of the police organisation (Cornelissen & Haslam, 2007; 2014). As police culture promotes resilience in officers (Crank, 2015; Bayerl, 2014; Reisig, 2014) this may reduce the risk of officers experiencing compassion fatigue, and thus reducing identification with it.  However, other research cites length of service as inversely proportional to resilience levels in police officers (Balmer, 2014), which could be a future area of investigation.

The qualitative nature of this study allows a novel understanding of the dissonance between the police officer identity and cultural perceptions of compassion fatigue, implicating identification and warranting resistance with the term.  Findings challenge previous assumptions that professionals find the term compelling and identifies potential problems in the transference of the term across occupations. The results of this study also identify the issue of stigmatisation within the police, which seems absent in other ‘helping’ professions, and is not well researched or understood.  Limitations of the findings makes it impossible to conclude whether the findings are in relation to the police culture and identity or that, though more unlikely, police officers tend to possess very similar, resilient traits, which produce much the same outcome. Furthermore, it is difficult to deduce whether participants’ interview responses reflect socially desirable responses, with greater adherence to policing values (Van de Mortel, 2008), or whether the embodiment of the police identity is an accurate representation of their thoughts.

The main limitation of this study is that there was no actual assessment to determine if participants were considered to be suffering from compassion fatigue. Whilst the use of tools, such as the ProQOL (Stamm, 2002) may indicate the prevalence of compassion fatigue, they are not actual diagnostic measures, so quantitative results would not necessarily be accurate (Najjar, 2009; Stamm, 2002). However, a quantitative element to this study would allow for some comparison as to whether participants were in denial of their suffering, or whether this homogenous sample comprises a group at less risk.

As interviews were conducted whilst participants were on shift, issues of timing potentially prevented more in depth responses.  Similarly, particularly sensitive areas of discussion often highlighted hesitancy to provide fuller disclosure, which reflects police officers’ resistance to collaborate with academics (Anderson, 2015), issues of stigmatisation and cynicism (Bradford, 2014; Royal, 2014). As participants readily identified compassion fatigue within other police officers, further research should use quantitative measures to assess its prevalence.

Developing a greater understanding of compassion fatigue amongst police officers contributes to our knowledge of how these professionals perceive and relate to it, which is essential in developing support programmes to reflect this. This has implications for the wellbeing of police officers and the quality of their work environment.

This study considers stigmatisation surrounding compassion fatigue in police officers. The stereotype associated with the label represents weakness and incompetence in a culture valuing strength and dependability. The label seems to be managed through reluctance to disclose problems, which limits access to suitable support and does not challenge organisational attitudes.  However, it should not be assumed that the label will result in stigma and modified labelling theories (Link, 1982) suggest resistance to social devaluation is possible, although research generally agrees that the breakdown of stigma is necessary for officers to thrive (Bullock & Garland, 2017). The processes of stigmatisation are specific to the social relations in which they are embedded, meaning the solution must be found within these relations (Bullock & Garland, 2017). Therefore, it is vital that police forces work with officers to challenge stereotypes, engage in advocacy for change and are open-minded about compassion fatigue and other mental health issues.

Approaches to addressing the stigma rooted in the police organisation must address the fundamental cause. This would involve challenging the deeply held attitudes and beliefs that lead to stereotyping and discrimination, or changing the circumstances and environment so that their effect is reduced. Creating changes in the normative attitudes of officers is a well-intentioned aim, but given the long-established nature, is only achievable in the long term.

Police culture and processes of stigmatisation may be mutually reinforcing (Bullock & Garland, 2017), whereby stigma surrounding compassion fatigue may serve to strengthen the idea that police officers are resistant to traumatic exposure. However, constabularies should work to minimise the power of stigma, particularly by reflecting on how it has arisen and is reinforced, directly confronting discrimination. It is also imperative to increase awareness of compassion fatigue so that misconceptions leading to inappropriate reactions are removed.  The introduction of anti-stigmatisation programmes has the potential to be successful if effectively led and sustained over time, although they may be perceived cynically. Constabularies should also review policies and practices that may adversely affect officers with compassion fatigue in matters such as pay and prospects, and to reduce misunderstandings about the impact of psychological illness.

Sick leave taken by police offers on psychological grounds has increased by 35% in the last five years (BBC), of which compassion fatigue may be a factor. It can negatively impact on work performance and physical health (Halbesleben, 2008) and stigmatisation can lead to further decline as professionals are expected to conceal their distress (Gershon et al, 2007; Randall & Buys, 2013). As decreased work performance also has implications for service users, acknowledging and addressing compassion fatigue in police officers is essential. Constabularies must support officers to address self-stigma and could work towards encouraging, rather than abandoning officers when they are suffering. This could in turn, promote the use of organisational support and increase officer wellbeing. Finally, police officers would benefit from working with academics to understand the impact of stigmatising behaviours and attitudes and how anti-stigmatisation programmes could be valuable in the context of policing, which is currently understudied.

Further research should investigate whether the issue of stigmatisation, self-stigma and pervasive police culture is present across different constabularies. This would enable academics to discover whether all officers are subject to the effects of the organisational culture and associated stigma and if not, whether cultural differences affect police perceptions of compassion fatigue. Although research suggests that police culture is universal (Bayerl 2014; Bacon 2014; Crank 2015) there is no specific research to prove this. Research in this area would allow for a better understanding of whether police culture influences officers attitudes towards compassion fatigue. Similarly, future research should investigate whether the personality traits of individual police officers reinforce the idea of typologies, and if those attracted to the policing role possess similar traits. This would differentiate between the influence of personality traits and culture on experiences of compassion fatigue.

To conclude, this study represents an important addition to both the compassion fatigue and policing literature. The aim of the study was to explore how police officers perceive and relate to compassion fatigue. Findings indicate that they associate it with weakness, which directly conflicts with the police stereotypes and culture, of strength and resilience. In healthcare literature, compassion fatigue is presented as a compelling term, accurately representing professional experiences, contrasting with the way the label is regarded as problematic and stigmatising in the police force.

References