Has compassion fatigue touched your life? It’s more common than you think…
Most people who choose a career in one of the helping professions—like nursing, medicine, psychology, psychiatry, or social work—are hardwired for helping others. Professional helpers never thinks they will tire of doing good, which makes it all the more difficult for them to cope when compassion fatigue sets in. Compassion fatigue, also known as secondary traumatic stress, or vicarious traumatization, arises from being constantly exposed to the acute or chronic suffering of others and not being able to alleviate it.
One of my coaching clients, who had worked for 20 years as a critical care nurse, described her own personal experience with compassion fatigue this way: “One day, I simply ran out of that caring feeling. Like a car that ran out of gas. There was nothing left inside of me to give. My heart was empty and my core was numb.” Fortunately, my client recognized what was happening and got the help she needed.
Unfortunately, not everyone who is at risk for, or suffering from, compassion fatigue realizes what they have or what to do about it. Anyone involved in full-time caregiving, whether by employment, by choice, or by circumstance, is at risk, but it does not stop there. Compassion fatigue is also experienced by families of institutionalized individuals, law enforcement officers, firefighters, emergency first-responders, foreign aid workers, lawyers, non-profit leaders, and anyone who watches the news regularly. The total number of potential victims represents a huge percentage of the population.
Many Complex Symptoms
Betsy S. Murphy, a registered nurse in private practice in Illinois, listed of some of the key symptoms of compassion fatigue in an article she authored for Beginnings, a publication of the American Nurses Association, in August, 2014. The list is long, and demonstrates clearly that compassion fatigue affects the body, mind and spirit. A partial list of the symptoms of compassion fatigue includes: anxiety, irritability, self-doubt, loss of a sense of purpose, withdrawal, isolation, lack of joy, hopelessness, impersonal interactions, avoidance of interactions, lack of empathy, apathy, poor concentration, intrusive thoughts, headaches, insomnia, gastrointestinal problems, hypertension, fatigue, and depleted immune system.
Different From Burnout
Murphy distinguishes compassion fatigue from the related concept of “burnout,” even though the two words are sometimes used interchangeably. While both compassion fatigue and burnout result from repetitive emotional involvement with other people and prolonged exposure to traumatic stress, the two conditions have important differences most notably that compassion fatigue has an acute, or sudden, onset whereas burnout has a slower, more insidious, trajectory. Murphy notes that an unsupportive work environment is likely to lead to burnout and describes compassion fatigue as a repeated inability to alleviate suffering, implying that it could happen in any environment. That being said, compassion fatigue and burnout do often go hand-in-hand, for example, a work environment that prevents a person from doing everything possible to alleviate the suffering of others, could contribute to an overall feeling of helplessness. Murphy suggests that if a person still loves his or her work, he or she has compassion fatigue, but if the love of work is lost, the person is suffering from burnout.
The consequences of leaving compassion fatigue untreated are unacceptable for the wellbeing of individuals and society at large. If left untreated, compassion fatigue leads to empathy depletion and, ultimately, apathy. When compassion is defined as an active response to empathy, a lack of empathy creates a lack of compassion, which in turn leads to an even broader absence of emotional expression. When the ability to put oneself in another’s shoes is lost, and emotions are not experienced or expressed, the very essence of humanity is diminished.
When an individual’s lack of empathy and apathy are multiplied within a group, whether that group is the workplace or the global community, the result is a culture of uncaring individuals without the skills or abilities to teach kindness to the next generation. Fortunately, studies show that early recognition and treatment of compassion fatigue makes maximum recovery possible.
Preventable and Treatable
While compassion fatigue is both preventable and treatable, the condition must first be recognized. Not only may caregivers fail to recognize their symptoms, but, as Murphy observes, caregivers who suffer from compassion fatigue may actually justify experiencing the symptoms as part of the act of, or “cost” of, caring.
An additional concern is that the hardwired personality traits of professional helpers may prevent a significant number of caregivers from taking action in seeking treatment for compassion fatigue. Patricia Smith, founder of the Compassion Fatigue Awareness Project (CFAP), cites J. Eric Gentry, PhD, a trauma expert, as noting that caregivers are often inspired to pursue careers in the helping professions because they were taught from an early age to satisfy the needs of others before their own. Thus, caregivers are often others-focused by nature and nurture, and may already be suffering from compassion fatigue before their caregiving careers begin.
The American Institute of Stress (AIS) offers the ABC’s of Prevention for managing compassion fatigue: Awareness, balance, and connections. Awareness involves being aware that the condition exists and learning how to recognize it. Balance involves implementing tools and methods, especially self-care practices, for achieving balance in daily life. Connections involves creating access to resources, including other people and pets, who can help a person in the event that compassion fatigue strikes.
Self-Care for Organizations and Individuals
Most effective treatments for compassion fatigue center around self-care education and integrating self-care into existing organizational structures. Among her many notable accomplishments, Mother Teresa was a proponent of providing self-care as part of organizational infrastructures.
Mother Teresa advocated strongly for avoidance of compassion fatigue prevention by suggesting a mandatory year off for each of her nuns every four or five years to allow them to heal from the effects of their caregiving work. While sabbaticals may not be practical in all workplace environments, employee assistance programs and in-service training programs help deliver the many practical tools that are available for individuals and employers to help prevent and treat compassion fatigue.
Effectiveness of Mind-Body Tools
Murphy notes that while compassion fatigue needs to be studied further, the research literature to date indicates that among the methods available for self-care, programs that incorporate mind-body tools can be especially effective. Mind-body tools include such practices as mindfulness meditation, yoga, massage, and Healing Touch. The mind-body practices are ideal tools for managing compassion fatigue because they are capable of simultaneously addressing the physical, emotional, and spiritual needs of a person, effectively balancing the array of physical, emotional and spiritual symptoms created by the condition.
One of the sources cited by Murphy explains compassion fatigue in terms of energy expenditure, stating that when the relational heart energy that is expended surpasses the ability to recover, psychological and physical symptoms begin to develop. This relationship between compassion fatigue and energy suggests that among the mind-body interventions, the energy medicine, or biofield therapies, such as Healing Touch, may be especially useful for both self-care and addressing the emotional-spiritual needs of clients.
During my own journey to become a certified Healing Touch practitioner, I learned that hands-on energy medicine therapies are grounded in the principle of nonattachment. I practiced the skill of letting healing energy flow through me, as a conduit, without using up my own energy reserves. And I learned to encourage my client’s innate self-healing ability, that the act of healing heals the healer, and that consistent self-care is required. I now view the skill of letting energy flow through me instead of giving away my own reserves, as a basic life skill that can be applied to every type of caregiving encounter and every aspect of daily existence. Energy management is a skill that can be learned and, I believe, should be taught and encouraged more widely.
Kindness as a Mind-Body Tool: Plugging in the Light of Kindness
If one can master the lesson of not using up one’s own energy in acts of kindness, then by plugging into the infinite source means more kindness to give. Instead of thinking of kindness as a currency to spend, which implies that kindness is available in a finite quantity, I like to think what the world would be like if we could conceptualize kindness in differently—maybe as a form of energy, like electricity or light, which we could plug into and direct where it needs to go. Practicing kindness, then, would be like plugging in a lamp and shining it on an object we need to see more clearly.
The antidote for the consequences of bestowing too much kindness on others appears to be—bestowing more kindness upon yourself. In other words, if you ever catch yourself running out of “that caring feeling,” like my client did, try consciously taking consistent action to be kinder to yourself . We can all combat compassion fatigue, no matter what business we’re in, by committing to being kind to ourselves first, without fail.