How To Prevent Compassion Fatigue
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Many people find themselves caring for others in their personal and professional lives. This may include those in helper professions, such as nurses, therapists, and pastors, and may extend to parents caregiving for a special-needs child and taking care of aging parents.
The increased caregiving duties of doctors, first responders, personal support workers, and those who work in homeless shelters has brought Compassion Fatigue to the forefront. Workplace managers may also experience the effects of extending sincere empathy to employees facing anxiety, challenges at home, and blurred lines between work-life balance.
Giving vast amounts of emotional energy engaging with others’ sharing their stories takes its toll, though, with the right support, you can gain the skills to gain resilience and thrive amid challenging times. Resources for Compassion Fatigue and burnout are needed now, more than ever before, as professionals feel the impact of vicarious trauma.
As a Burnout Prevention Strategist working alongside organizations and individuals to prevent burnout and support well-being, I’ve heard more people than ever complain of exhaustion related to leading others through difficult mental health, emotional, and physical challenges. Transforming organizational culture and helping people thrive is the foundation of this vital work.
“Transforming organizational culture and helping people thrive.”
What is Compassion Fatigue?
“The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet.” -Rachel Naomi Remen
Those who devote their lives to compassionately supporting others' suffering are at greater risk of facing compassion fatigue. They understand the significance of their job and give their everything to helping others. Often there is little energy or compassion left for themselves or their families. Perhaps you can relate.
If you are going to walk alongside people, it will affect you because it is very, very real. You are not invulnerable. There is a cost to what you do. Thinking burnout won’t happen to you does not serve you well. I once believed I would never become a statistic, but eventually went through burnout myself. Implementing practical strategies to care for yourself and your loved ones with grace will enable you to continue your valuable work.
This overextension in the workplace and resulting lack of energy and resources for loved ones creates another layer of suffering, frequently leading to shame and guilt. Responding to these feelings healthfully rather than by self-medicating with drugs, overeating, or binge-watching meaningless television is a necessary step in preventing exhaustion.
Definitions of Compassion Fatigue, Vicarious Trauma, and Burnout
Specific nerve cells in the brain, called mirror neurons, are associated with empathy.1 Research suggests when we witness others’ emotional pain, we actually experience it to an extent ourselves. This experience of empathizing with others’ pain creates an incident of vicarious trauma, which can lead to compassion fatigue.
To better understand compassion fatigue and how to prevent it, let’s begin with a few recognized definitions.
Compassion Fatigue
According to the respected research group, National Center for Biotechnology Information (NCBI)2, “Compassion fatigue (CF) is stress resulting from exposure to a traumatized individual.”3 Their research further shows compassion fatigue relates to secondary traumatic stress (STS), also known as vicarious trauma, and cumulative burnout.
Vicarious Trauma
The American Institute of Stress 4 defines vicarious traumatization 5 as the emotional strain associated with exposure to suffering people and notes that the exposure can be cumulative.6 In other words, the more one witnesses the distressing stories of others, the more it can affect the hearer.
Burnout
To understand burnout, find a curated list of the symptoms of burnout in this article.
What is the difference between compassion fatigue and burnout?
While burnout and Compassion Fatigue are not the same, they can co-exist.7 In its most basic form, compassion fatigue is linked to the exposure of another’s trauma, while burnout is associated with workplace stress that has not been successfully managed.8 Compassion Fatigue can lead to burnout.
“Resources for compassion fatigue and burnout are needed now, more than ever before as professionals feel the impact of vicarious trauma.”
Who is at risk of Compassion Fatigue?
Those in caring professions who experience potent empathy regularly are particularly at risk of burnout. Some of those positions include:
Healthcare professionals such as doctors, nurses, and personal support workers (PSWs).
Long-term care professionals and volunteers such as those working in hospice, palliative care, and nursing homes.
Helping professionals such as counsellors, therapists, coaches, crisis responders, and those caring for children and adults with special needs.
First responders, including police, fire rescuers, and paramedics.
Pastors and chaplains.
Those who work in the humanitarian sector.
What causes Compassion Fatigue?
Several factors conspire to create Compassion Fatigue. Beyond the exposure to heart-breaking stories and situations, it is the response to them that often defines whether one experiences the exhaustion of Compassion Fatigue or finds resilience. You will find practical solutions further in this article.
Not recognizing Compassion Fatigue
Therapist and Aging Well Consultant Shelley Read, MSW, RSW, says, “Developing an awareness of Compassion Fatigue in order that we recognize the symptoms is the first step.”9 Responding to crisis is challenging in and of itself. When it feels as though there is not enough time and not enough resources to respond to those challenges, it can become overwhelming.
Not knowing how to take care of yourself
Effectiveness in the workplace is often based upon the work accomplished and rarely looks at vicarious trauma's long-term effects. Subtle messaging relayed in professional training and industry standards may suggest employees should know how to take care of themselves. The resultant shame often prevents employees from speaking to their managers about their exhaustion. The shame and guilt that typically accompany these complaints may lead to perfectionism and burnout.
Lack of boundaries
Standards overseeing caring professionals often communicate expectations that create a blurring of boundaries. More so, those who empathize profoundly and find meaning in their work may cross their own personal boundaries in order to provide care for another. Shelley Read, MSW, RSW, reports, “We often struggle with setting emotional boundaries and knowing when it is okay to say no.” Over time, these blurred boundaries set the stage for Compassion Fatigue and burnout.
What are the symptoms of Compassion Fatigue?
Compassion fatigue can take a physical, mental, spiritual, emotional, and professional toll.10 The American Academy of Family Physicians 11 provides the following list outlining the warning signs of compassion fatigue and notes that although symptoms vary, the following red flags may indicate that you have compassion fatigue.12
Abusing drugs, alcohol or food
Anger
Blaming
Chronic lateness
Depression
Diminished sense of personal accomplishment
Exhaustion (physical or emotional)
Frequent headaches
Gastrointestinal complaints
High self-expectations
Hopelessness
Hypertension
Inability to maintain balance of empathy and objectivity
Increased irritability
Less ability to feel joy
Low self-esteem
Sleep disturbances
Workaholism
Strategies to prevent compassion fatigue
1. Know your limits
Self-examination is at the heart of preventing compassion fatigue and creating a sustainable work-life balance. If you feel at risk of compassion fatigue, take time to ask yourself these questions regularly:
What external stressors am I experiencing? e.g., deadlines, responsibilities, or conflict.
What internal stressors am I experiencing? e.g., anxiety, self-blame, or a lack of self-compassion.
2. Create self-care rhythms
For 15 self-care strategies backed by science, click here.
Create and hold yourself accountable for manageable self-care routines. Think in terms of daily, weekly, monthly, and annual rhythms. Consider these questions:
How can I ensure I nourish myself with proper nutrition and support my physical well-being with exercise daily?
What activities fill my emotional tank? How can I choose to engage in these activities weekly?
What personal relationships make me feel alive? Who can support me professionally as a mentor, coach, or therapist? How can I schedule time for these relationships monthly?
When I think back on the past five years, what were the highlights of my year? How can I set goals to engage in these life-giving experiences on an annual basis?
3. Discover and implement healthy boundaries
In my coaching practice, I often hear people say they hit a wall. For years they put their head down and pushed forward through every kind of obstacle, including the internal and external stress signals meant to show them something was wrong. Unfortunately, people tend to seek help after they crash and typically feel like the crash came out of the blue. Once they start unpacking the steps it took to get to this place, they realize a crash was inevitable without intervention. What seems like a sudden crash took months or even years of cumulative stress and vicarious trauma to get there.
Ask yourself these questions:
Which of my boundaries have I let slide to support someone else?
Do I feel my workplace oversteps my personal or professional boundaries?
What boundary, if put into place, would reduce my stress by fifty percent?
4. Seek professional help
You cannot continually give of yourself without being adequately resourced.
Connect with a peer support group that shares encouragement and resources. You may start a professional support system with others in a similar role, even outside your direct profession.
Regularly receive counselling from a qualified therapist to unpack the vicarious trauma you have experienced and find tools to remain healthy.
Set up monthly appointments with a professional coach or burnout prevention strategist to help you create healthy rhythms, boundaries and find the support you need to thrive.
Refer to other professionals. Keep an up to date list of professionals and community supports you can regularly refer people to. You do not need to have an answer to everything or provide every support an individual requires. Having a group of trustworthy professionals you can refer to will take a sizeable load off your plate.
5. Feel your emotions
Witnessing others’ trauma can be very emotional. Professional training may have taught you how to remain calm and appear in control even when you can barely hold yourself together. Schedule space after appointments and interactions that brings you face to face with someone else’s trauma. Explore your emotions in a safe environment, your home, office, or car. Even better, take a walk, preferably in nature. Physical movement can help as you process your emotions, and research shows that nature can increase our sense of well-being.13
6. Take care of yourself holistically
It can be tempting to classify wellness to only your physical needs, which typically focus on self-care. It is essential to care for your physical and mental health, emotional well-being, relational supports, and spiritual well-being. Consider the following questions:
What activities make you feel calm and grounded?
How are you growing as a person, both personally and professionally?
What is the simplest way for you to spend meaningful time with friends and family?
What spiritual practices can create a foundation for your overall health?
7. Grant yourself permission
People who empathize genuinely with others tend to feel guilt or shame when considering tending to their own needs. There will always be more people to help, one more thing you can do to support another, and a new crisis around the corner. To remain healthy and continue to provide for others over the long haul, you must proactively take care of yourself.
Gift yourself the
Permission to rest.
Permission to shut off your phone notifications after work.
Permission to be where you are, even if you are struggling.
Permission to seek coaching or counselling to get the support you need.
Permission to engage in self-care.
Permission to stop thinking about work.
Permission to have fun with your friends and family.
Permission to have a life.
8. Commit to productivity and time-management
Your time is valuable. Though you could spend copious time with various people or work toward perfection with your latest project, there are only so many hours in the day. Consider the following hacks to help you become more effective and create more breathing space:
Use an uncomplicated online scheduler to keep your tasks straight. Try Remember The Milk.
Keep communications short. Aim to limit emails to 3-5 sentences and avoid replying to all unless necessary. Keep text communications to a maximum of 2 texts. If more back and forth is required, pick up the phone to cut to the chase.
Automate everything you can. AppSumo can help you find the solutions you need at a low cost.
Determine your most significant priorities using our Priority Action Matrix.
9. Engage your Workplace Wellness Program
Effective employee well-being programs offer supports for your physical, mental, emotional, and professional health. All too often, when budget crunches occur, one of the first cuts organizations make is to employee well-being programs and supports. Instead, focussing on supporting staff at all levels can save time and money by reducing sick days, increasing productivity, and decreasing resignations. Organizations that train managers to recognize signs of compassion fatigue and burnout, know how to respond with empathy, and provide necessary resources. Healthy, happy employees create healthy organizations that thrive.
“Healthy, happy employees create healthy organizations that thrive.”
10. Remember
Keep in mind why you provide compassion and empathy in your workplace and personal life.
Remember that you are only one person.
Remember to take care of yourself.
Remember your passion.
Remember to ask for the help you need.
Remember, the world needs you.
“Remember, the world needs you.”
Bring our burnout & compassion fatigue training to your workplace.
About the Author
Bonita Eby is a Burnout Prevention & Organizational Culture Consultant, Executive Coach, and owner of Breakthrough Personal & Professional Development Inc., specializing in burnout prevention and wellness for organizations and individuals. Bonita is on a mission to end burnout. Get your free Burnout Assessment today.
References
1. Neff, K., Dr. (2015, February 22). Why Caregivers Need Self-Compassion by Kristin Neff. Retrieved January 27, 2021
2. Wolotira E. A. (2023). Trauma, Compassion Fatigue, and Burnout in Nurses: The Nurse Leader's Response. Nurse leader, 21(2), 202–206. https://doi.org/10.1016/j.mnl.2022.04.009
3. Cocker, F., & Joss, N. (2016, June 22). Compassion Fatigue among Healthcare, Emergency and Community Service Workers: A Systematic Review. Retrieved January 27, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4924075/
5. Compassion Fatigue. (2017, January 04). Retrieved January 27, 2021, from https://www.stress.org/military/for-practitionersleaders/compassion-fatigue
6. P. Skapinakis, G., M. van't Leven, G., P. Skapinakis, G., SB. Harvey, S., M. Maes, F., K. Kato, P.,T. Pawlikowska, T. (1970, January 01). Determinants of fatigue and stress. Retrieved January 27, 2021, from https://bmcresnotes.biomedcentral.com/articles/10.1186/1756-0500-4-238
7. Compassion Fatigue. (2017, January 04). Retrieved January 27, 2021, from https://www.stress.org/military/for-practitionersleaders/compassion-fatigue
8. Burn-out an "occupational phenomenon": International Classification of Diseases. (2019, May 28). Retrieved January 27, 2021, from https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases
9. https://www.sreadtherapy.com/
10. Compassion Fatigue. (n.d.). Retrieved January 27, 2021, from https://www.goodtherapy.org/blog/psychpedia/compassion-fatigue
11. https://www.aafp.org/home.html
12. Pfifferling, J., PhD, & Gilley, K., MS. (2000, April 01). Overcoming Compassion Fatigue. Retrieved January 27, 2021, from https://www.aafp.org/fpm/2000/0400/p39.html
13. A. Mihyang et al., “Why We Need More Nature at Work: Effects of Natural Elements and Sunlight on Employee Mental Health and Work Attitudes,” PLoS One 11, no 5 (May 2016): e0155614. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4877070/