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Compassion Fatigue

You might instinctively know that listening carefully, demonstrating interest, showing that you care, and offering reassurance are naturally part of what you must do when interacting with people daily, but what happens if you reach a point where you feel completely exhausted by having to do this all the time?

You can feel that you’ve reached a limit you weren’t even aware you had. What you may be experiencing is compassion fatigue.

In this article, we’ll provide an overview of what compassion fatigue is and learn who is most often affected by it and what types of demanding professions often increase the risk/susceptibility to develop it. Compassion fatigue differs from feeling burnt out, and learning the difference between these symptoms can help create better self-awareness. We’ll also share some coping strategies and discuss how to prevent compassion fatigue. This knowledge is vital to help people experiencing compassion fatigue find strength, develop more resilience, and engage in self-care. Fundamentally, it helps us all be more compassionate towards ourselves, as well as to others.

What is compassion fatigue?

Compassion fatigue is a form of stress that someone can develop when they have direct exposure to traumatic events (firefighters, police officers, paramedics, emergency hospital staff) or secondary exposure (child protection workers, helping victimized clients, or hearing clients talking about traumatic experiences) and are focused on helping others through extraordinarily stressful or traumatic situations. The effects of compassion fatigue can result in the person being left feeling exhausted and drained, both physically and emotionally. Often, there is little room for them to take the necessary steps that would allow them to recharge and recover.

Over time, people who assist others, who “are chronically in despair” and who experience “very difficult life circumstances,” are the ones at risk of becoming “profoundly affected and even possibly damaged by their work” to the point that they may gradually experience a decline in their ability to feel empathy and compassion. (1) When that happens, there is a tendency to view the stress from these helping interactions as a routine, psychological “cost of caring.” (2)

Carers may find that they begin to “make excuses” to mask what they are feeling to justify any negative behaviours they are starting to display. Often, they will use metaphors of strength, by saying things such as – “I’ve been doing this for a very long time now, so I know how to manage it” – or – “I stayed up all night helping [this person, so] that’s why I’m a bit cranky today.” (3) The reality is that these act as “invisible badges of honour” that justify how they feel and simultaneously hide the frightening truth that they are losing control. (4) The carer’s view of the world may start to change due to repeated exposure to other people’s traumas as they begin to vicariously feel like the experiences they have been trying to help people with are now happening to them. Charles Figley, who did extensive research in these areas referred to compassion fatigue as “a dark cloud that hangs over your head wherever you go and invades your thoughts.” (5)

Compassion fatigue is treatable, especially when those directly affected, and those who care about them, begin to recognize that the root cause is that they are afraid of how their brains and bodies are telling them that they are not okay. (6)

Understanding who is most at risk

Compassion fatigue is prevalent in high-stress professions, especially roles that focus on using empathy in their pursuit of helping or serving others. It frequently affects people in the following types of occupations and roles:

  • Healthcare workers (physicians, nurses)
  • First responders
  • Psychologists, counsellors, and social workers
  • Educators
  • Community service workers, foster carers
  • Customer service roles

What is the difference between compassion fatigue and burnout?

While compassion fatigue and burnout are similar, there are distinct differences in where the stress originates. People who suffer from compassion fatigue have their view of the world damaged or transformed because of the work they do.

Burnout can make people more vulnerable to compassion fatigue. Burnout is when someone experiences constant mental and physical exhaustion from being in a stressful situation where they feel overworked and unappreciated. Someone with burnout may become cynical, disillusioned, and demotivated because there’s a misalignment between their job demands, responsibilities and what they value.

Unlike compassion fatigue, burnout develops from providing care and support to people experiencing trauma, resulting in diminished empathy and feeling emotionally numb.

How does compassion fatigue affect someone’s life?

Compassion fatigue can have significant repercussions in someone’s life that reach far beyond their profession. They may begin to withdraw from friends and family because they feel emotionally detached from these meaningful relationships. Compounded by their emotional exhaustion and decreased empathy, they can strain connections, leading to misunderstandings that may make them uncharacteristically seek isolation. Ultimately, they may feel challenged to separate the different aspects of their lives, and their “work habits and patterns can become increasingly unpredictable.” (7) People with strong empathy seem more at risk because they are so attuned to the vulnerabilities and suffering of those they are trying to help.

What are some of the symptoms or warning signs of compassion fatigue?

There are several warning signs that someone may be experiencing compassion fatigue. (8)

How can someone learn to cope, recognize and reduce compassion fatigue?

Someone experiencing compassion fatigue needs to recognize the toll of believing they need to stay positive and happy even when a person they are helping’s situation is challenging or worsening. In reality, it’s contradictory and unnatural to do so but there are things to do that can help them learn how to cope.

  • Use self-compassion. Take the time to show yourself the same compassion you would others.
  • Focus on yourself, even for a short time between interactions, to reconnect and ground yourself in your awareness and recharge. That can look like giving yourself ten minutes to complete self-care practices such as:
    • Deep breathing
    • Meditation
    • Prayer
    • Journaling
  • Attend regular professional development and ongoing training, develop resiliency skills, and commit to change.
  • Recognize and feel your emotions so that you can begin to release your thoughts. Allow yourself to:
    • Look for and experience expressions of tension, irritability, anger
    • Tell someone how you are feeling
  • Prioritize giving yourself a real break. Gift yourself:
    • Better work/life balance
    • Vacation time
    • Time for positive expressions of self-care like:
      • Going for a massage
      • Treating yourself to some personal care
      • Watching movies or entertainment
      • Spending time with friends
    • And avoid potentially harmful and destructive forms such as
      • Over-consuming alcohol or drugs
  • Exercise has been proven to affect mental and physical health positively. When practiced regularly, it results in:
    • Reductions in stress, anxiety, and depression
    • Improvements in mood and self-esteem
    • The natural release of beneficial endorphins that help clear cortisol, one of the body’s stress hormones
  • Getting enough sleep allows your body to repair itself during the full range of a sleep cycle.
  • Maintaining good nutrition with food choices and portions that are healthy, natural, and deliver sustenance, plus essential vitamins, minerals, and nutrients.
  • Consider joining a support group for people who have similar roles and professional obligations that make them vulnerable to developing compassion fatigue.
  • Review and rebalance workload and look for ways to increase job satisfaction, self-awareness and limit trauma inputs.
  • Speak with a therapist to help you develop clear set boundaries that will help you both protect yourself and create more resilience.
  • Develop a prevention plan and regularly evaluate to notice and appreciate the changes.

How can you be supportive of someone who is experiencing compassion fatigue?

Acknowledging and understanding that this phenomenon is a by-product of the carer’s role, not simply someone having a bad day, is a great way to help reduce compassion fatigue.

If you know someone who may be experiencing symptoms of compassion fatigue, you can offer help. Educate yourself so that you can recognize and provide support through:

  • Develop appropriate boundary-setting
  • Active listening
  • Compassionate expressions of kindness and connection
  • Being empathetic to them

Organizations can also reduce or prevent compassion fatigue among their staff by offering adequate education, training, compensation, benefits and access to professional help.

References:

1. Tend Academy (n.d.) What is Compassion Fatigue? tendacademy.ca. Retrieved July 23, 2023 from https://www.tendacademy.ca/what-is-compassion-fati…

2. Charles Figley 1982, as cited in Tend Academy (n.d.) What is Compassion Fatigue? tendacademy.ca. Retrieved July 23, 2023 from https://www.tendacademy.ca/what-is-compassion-fati…

3. Cunningham, Amy (2016). Drowning in Empathy: The Cost of Vicarious Trauma. TEDxSanAntonio [YouTube]. Retrieved July 23, 2023 from https://youtu.be/ZsaorjIo1Yc

4. Ibid.

5. Charles Figley, as cited in Clay, Rebecca (2022 July 11). Are you experiencing compassion fatigue? American Psychological Association. Retrieved July 23, 2023 from https://www.apa.org/topics/covid-19/compassion-fat…

6. Cunningham, Amy (2016). Drowning in Empathy: The Cost of Vicarious Trauma. TEDxSanAntonio [YouTube]. Retrieved July 23, 2023 from https://youtu.be/ZsaorjIo1Yc

7. Stowen, Debbie. (2020 November). Moving from compassion fatigue to compassion resilience. Part 4: Signs and consequences of compassion fatigue. The Canadian Veterinary Journal. Retrieved July 23, 2023 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC75607….

8/ Kamkar, Katy. (2019 May 21). 20 warning signs of compassion fatigue. Canadian Occupational Safety: The Safety Magazine. Retrieved July 23, 2023 from https://www.thesafetymag.com/ca/news/opinion/20-wa…

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