I was 18 years old when I was first introduced to the concept of "systematic desensitization." The term, coined by South African psychologist Joseph Wolpe, describes a process in which people can learn to overcome their fears through gradual and systematic exposure (Dubord, 2011). If you have a debilitating fear of spiders, for example, the goal would be to slowly get comfortable thinking about and visualizing a spider until you can physically hold the creature in your hand (if this thought sends chills down your spine, know that you are not alone).

Systematic desensitization has been on my mind lately but in a more philosophical context. In psychology, it's a straightforward process: expose an individual to their discomfort to help them overcome their exaggerated thoughts and emotions. Yet, I've noticed this concept unfolding in our society in real time. Instead of fostering resilience by conquering a metaphorical fear of spiders, we are leaning toward indifference and apathy, a trend that should deeply concern us all, especially in our profession.

The current state of affairs is, to put it mildly, disheartening. Simultaneous genocides, famines, and wars are all vying for our time, attention, and empathy. Considering that up to 73% of genetic counselors are at moderate to high risk of compassion fatigue and that 1 in 4 are considering leaving their jobs because of this (Injeyan et al., 2011), it is unsurprising that we are safeguarding whatever leftover empathy we have. This empathic gatekeeping can take shape in many forms, most notably a desire to detach and disengage with current affairs. 

This apathy is a luxury we cannot afford as genetic counselors. 

It is crucial to remember that our field has problematic origins — the emergence of the genetic counseling profession has been postulated as a response to and a detachment from the oppressive eugenics movement (Zuckerman, 2021). The work of learning about the profound harm done to patients throughout history is deeply distressing but also vital to prevent regression and disrupt systems that continue to harm patients. As Samantha Betterman eloquently puts it in her recent Perspectives article: “to truly evolve and break free from our past, it is imperative that we openly acknowledge and address the uncomfortable aspects of our history and current state.” (Betterman, 2024). We must extend this call to action past the educational realm of the classroom and the individualistic landscape of the workplace if we are to truly impact change. As we strive towards developing a restorative, just, and ethical profession, we must also recognize that this work begins on the inside, within you and me. Empathy, therefore, is not a chapter in a textbook that can be taught in a three-hour class or workshop. Instead, it is an evolving process that requires systematic sensitization, a process that requires continuous learning, self-reflection, and learning from the discomfort.

As we consider where to expend our empathy, I invite you to pause and reflect on the following quote: “A threat to justice anywhere is a threat to justice everywhere” (Martin Luther King Jr., 1963). Consider how you have been engaging with and responding to the current and past injustices, whether in Ukraine, Congo, Sudan or Palestine. Do you feel the same level of empathy and support for all people experiencing oppression and violence? Are personal identities and internal biases preventing you from easily connecting and empathizing with some groups? Now, perhaps more than ever, we must recognize our own contradictions and knowledge gaps. Justice exists to uplift and empower human rights. Racial, reproductive, queer, and other forms of justice cannot exist independently of one another; rather, their coexistence is what drives meaningful existence and entices powerful change when one is threatened. 

Change is always challenging, and growth takes time. However, eventually, we will be able to sit with the discomfort of holding the spider and use it to nurture our empathic responses and advocate for those who need our voices to amplify theirs. That’s not too scary, right?

The author would like to extend a special thanks to Elizabeth Fieg for her editorial support and contributions to this paper. 

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References

Betterman, S. (2024). Shattering the Rose - Colored Glasses of Prospective Genetic Counseling Students. NSGC Perspectives; National Society of Genetic Counselors. https://perspectives.nsgc.org/Article/shattering-the-rose-colored-glasses-of-prospective-genetic-counseling-students 

Dubord, G. (2011). Part 12. Systematic desensitization. Canadian Family Physician, 57(11), 1299. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3215612 

Injeyan, M. C., Shuman, C., Shugar, A., Chitayat, D., Atenafu, E. G., & Kaiser, A. (2011). Personality Traits Associated with Genetic Counselor Compassion Fatigue: The Roles of Dispositional Optimism and Locus of Control. Journal of Genetic Counseling, 20(5), 526–540. https://doi.org/10.1007/s10897-011-9379-4 

Zuckerman, S. (2021). The emergence of the “genetic counseling” profession as a counteraction to past eugenic concepts and practices. Bioethics, 35(6). https://doi.org/10.1111/bioe.12861 

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