Compassion fatigue...what is it?

Updated: Nov 12, 2019

I thought compassion fatigue was something that happened to people who were not tough enough to do the work of helping others.

Then the universe made sure I knew I was wrong. I had a big lesson to learn, and in 2010 I had my first panic attack.


It happened at work. I was the "Supervisor of the Legal Justice Team" at a large nonprofit that provides services to survivors of domestic violence and sexual assault. Part of my job was to read through the prior day's police reports. I had been working in the field of anti-violence advocacy for several years. I thought I had developed a thick skin. I had experienced sadness, anger, hopelessness, and frustration. I had also provided comfort, hope, and information. One time, I wrote a poem (this was before I was a songwriter).


But I had not yet had an epic meltdown. After reading one particular police report, all the secondary trauma I had bottled up over the years came back to bite me. A few months after my panic attack, the one that landed me in the same hospital as the survivor in the police report, I quit my job at the nonprofit. My compassion fatigue, coupled with an unacceptable work environment that did little to address the workplace hazards of emotional trauma, led me to take a leap into the unknown. I thought a change of jobs and locations would help me recover, but the work of helping people in trauma kept taking its toll. My next job was even harder and less supportive. After working in child protection, I knew I needed to detox from the emotional effects of witnessing trauma. Compassion fatigue had taken over.


But what is compassion fatigue?

It is surprisingly hard to find a straightforward definition. It is often described by its symptoms, which include (but are not limited to):

  • Feeling helpless and hopeless

  • Anxiety and depression

  • Hypervigilance

  • Inability to embrace complexity

  • Minimizing

  • Chronic exhaustion/physical ailments

  • Guilt, fear, anger, cyncism

  • Numbing and addictions

  • Blaming

  • Isolation

  • Insomnia

  • Physical and mental fatigue

Google's dictionary defines compassion fatigue as: "Indifference to charitable appeals on behalf of those who are suffering, experienced as a result of the frequency or number of such appeals."


Compassionfatigue.org says: "If you sense that you are suffering from compassion fatigue, chances are excellent that you are."


Psychology Today provides a list of symptoms.


One of my favorite resources, a book I share with colleagues who show signs of compassion fatigue, is Trauma Stewardship: An Everyday Guide to Caring for Self While Caring for Others. Authors Laura van Dernoot Lipsky and Connie Burk use the term "trauma exposure response" and define that as "the transformation that takes place within us as a result of exposure to the suffering of other living beings or the planet."


I think these definitions, where they exist, tell part of the story. I want to take a shot at defining compassion fatigue in a straightforward, non-clinical way.


My definition of compassion fatigue is:


Mental, physical, and spiritual breakdown which sneaks up on us while we are watching other people suffer and is compounded by inadequate workplace protections.


Let's look a little closer. Compassion fatigue is closely related to burnout but it has some components that make it more complicated and, therefore, more sneaky.


Stress

Stress, in general, starts with a whisper. Then it gets louder and louder until we finally pay attention and take care of ourselves. As healthcare professionals, we experience the same layers of stress that go with any job AND people's lives depend on us. We have chosen to get paid for helping people and our own survival depends on showing up for work.


Empathy

This is the really sneaky part of compassion fatigue. Not only is it difficult to watch other people suffer day in and day out, but we are actually taking on the stress of others. Even when we put up our best walls of compartmentalization, we are still surrounded by the pain and suffering of others. That pain and suffering has an energetic quality that will affect us over time.


Bureaucratic Limitations

There are times when the ethical path (the human path) breaks the rules of your organization. Workplaces have been designed around an Industrial Revolution-era model that works best for widgets. However, "productivity" becomes problematic when we are dealing with the health of human beings. Each person heals differently, dies differently, is born in their own time. As a healthcare professional, a human cog in the healthcare machine, we can feel the disconnect when we prioritize the system over the individual.


Grief

Through the stress, the empathy, and the bureaucratic limitations that go along with helping and healing others, we experience losses. We experience big losses like the lives of our patients or clients. This type of loss hits home personally when we have built a relationship with a patient over time. It also affects us through our empathetic response when we watch families lose their loved ones. We also experience countless "little" losses when we deliver bad news to patients, when we witness maltreatment or poverty, or when we don't make it home in time to have dinner with our families.


How has mental or physical stress snuck up on you?


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