If you are a therapist, doctor, nurse, or if you are a care-giver for someone who is disabled, sick or in late stage of life you are at risk of something called compassion fatigue. In today’s blog article I want to teach you how to prevent and how to combat compassion fatigue and burnout.

 First, allow me to give you a little framework and a clear understanding of what exactly compassion fatigue is and then we will get into some practical tips and tools to help  you avoid and address this experience.

The idea of compassion fatigue came about in 1992 when the term was first used in a nursing journal. The term described nurses who were feeling depleted  by the work in hospital emergency rooms. Later that year Jeffrey Kottler wrote a book called Compassionate Therapy which addressed the essential presence of compassion when therapists are working with very challenging and resistant clients. While neither of these sources provided a thorough definition of compassion fatigue, both authors made note of how and why helping professionals often become unable to feel the compassion necessary for providing support to people who are suffering. 

There have been been ample research studies showing that effective therapy services occur when there is a therapeutic alliance between client and therapist in which the therapist has an ability to deeply empathize in order to understand and help clients (Figley & Nelson, 1989). If you are a helping professional or a care-taker, you will find that when compassion for the person you are helping is present, the suffering person benefits.

So, what exactly is compassion fatigue and how does it differ from burnout?

Compassion fatigue is another term for secondary traumatic stress. In simpler words, compassion fatigue is when you are witness to the suffering of others to the point you feel so overwhelmed you begin experience symptoms that make it difficult for you to function and nearly impossible to continue providing care for the people you are caring for.

Burnout is a similar experience, but with burnout you can take some time off, change job setting and typically feel relief. With compassion fatigue it’s more involved and there may be a need for professional support.

With compassion fatigue there are a long list of possible symptoms:

  • Difficult connecting with others, feelings of isolation
  • Sleep disruption.
  • Shortness of temper – angry outbursts for small or no reason
  • Feeling jumpy, easily startled
  • Intrusive thoughts about the trauma or suffering of those you have cared for
  • Repetitive dreams about those you are caring for and their suffering or trauma
  • Obsessive thoughts about the clients or people you are caring for outside of session
  • Preoccupation with a client or their family.
  • Feeling trapped in your job or duties
  • A sense of loss of hope
  • Excessive exhaustion and feeling “run-down”
  • Symptoms of depression
  • Trouble keeping work and personal life separate
  • Trouble feeling compassion for others
  • Find it difficult separating my personal life from my work life.
  • Feeling resentment and cynicism about your job, duties or career
  • Growing recurring somatic symptoms such as headaches or back pain
  • Feeling like there is not enough time to attend to self care
  • Typical self care habits don’t bring relief

4 Ways to prevent compassion fatigue

If you’re not having any symptoms but you are a care-giver or helping professional, be sure to observe these 4 steps to avoid compassion fatigue.

  1. Talk to a professional who understands the nature of your work. If you are a helping professional or care-giver you need your own helpers and care-givers. Ensure you have a therapist, coach, or mentor to meet with and talk to regularly.
  2. Surround yourself with peers who do similar work as you do and who understand the risks of compassion fatigue and with whom you can exchange support and discussion about self care on an ongoing basis.
  3. Create a self care plan and stick to it. List all the things you need to do for yourself, your body, your mind, your spirit on a daily basis, weekly basis, monthly basis, quarterly basis and yearly basis and get those things scheduled on  your calendar. Your regular ongoing self care should be honored – just as important as your client appointments.
  4. Take regular and frequent breaks from you work. Schedule lunch breaks. Take breaks for exercise or walks in nature. Take time off every week to do fun things separate from your work. Read light fiction. Go to a concert. Visit a comedy club. Have game night with your family or friends.

4 Keys to combat compassion fatigue and burnout once it occurs

  1. Go to therapy with a therapist who understands compassion fatigue and knows how to treat it. It is essential to receive treatment because compassion fatigue is very similar to PTSD. You may find relief with a therapist who uses EMDR or Internal Family Systems work.
  2. Take time off. If you are a care-giver, locate a substitute to stand in for you and perform your duties. If you are a nurse, doctor, massage therapist or other helping professionals side from a psychotherapist, allow another professional to step in and attend to your patients/clients. If you are a psychotherapist, you may need to refer out some of your clients in a clinically appropriate way or arrange for alternate treatment while ensuring the therapeutic relationship is not damaged. Some psychotherapists have to refer out all of their clients and conduct appropriate closing sessions in order to attend to their care. If you work in an agency setting, inform your supervisor you need to take time for self care. It is ethical to do so and you might site your ethics code.
  3. Immerse yourself in activities that feed your spirit. If you observe a particular religion, delve into spiritual reading, attend services, seek solace in your spiritual beliefs. If you are not religious, spend time in nature, read uplifting philosophy, surround yourself with people who are nurturing and positive.
  4. Deep self care is needed in order to heal and restore your mind, body and spirit. Nothing is more important than ensuring you’re seeing your health practitioners, getting deep rest, meditating, exercising, eating nutritious meals, finding reasons to laugh again and spending time away from your work for a while.

Experiencing burnout from your job or duties is something you can more easily alleviate with making a change, shifting direction, going on vacation. Compassion fatigue is a syndrome that runs much deeper and can sneak up on helping professionals and care-takers in a way that can be devastating if left unaddressed.

If you are a therapist providing play therapy or a supervisor of therapists who provide play therapy you might be interested in my 3 hour recorded workshop called Compassion Fatigue in Play Therapy: A Supervision Training

If I can be of support, I invite you to contact me for a free 20 minute phone consultation.