Updated: Jun 16
Helping people is hard work.
Over the course of your career you will experience ups and downs, good days, bad days, and really really bad days. There will be times when you feel like you’ve got everything under control and times when you have no idea how to pull yourself out of the pit of compassion fatigue. There are an infinite number of factors that can shape your day, including work assignments, bosses, patients, co-workers, your own health, and your personal life.
But there is only one person who can make sure you always have what you need: you.
That does NOT mean you can do this alone. It simply means that sometimes other people cannot be there when we need them the most. If we only have one person on call to support us, we are likely to find a moment when the feeling of isolation hits hard. Before you get to that place, you can take steps to build your Compassion Fatigue Posse so that when you find yourself in the pit of compassion fatigue, you know someone will be there to pull you out of it.
What is a Compassion Fatigue Posse?
You probably have a few people with whom you share the stresses of your day.
It may be your spouse, your best friend, or your best work buddy. They will each have their own way of supporting you. I’m also willing to bet that sometimes you go to one person a little too often. You chose to go into the profession of healthcare, but if your confidant is someone who has a “regular” job (one where no one’s life is on the line), then they may not fully understand what you’re going through. They may become overwhelmed by the details of your day and stop listening before you’re done venting. You may feel like a burden to this relationship or like you’re taking more than you’re giving. What happened to the fun?
A solid posse is made up of the people you already turn to PLUS a few professionals.
A solid posse knows they are part of the team and who the other players are. Each team member has given their informed consent. They know the risks and benefits because YOU have informed them. They also know that the weight of your world does not rest solely on their shoulders.
A solid Compassion Fatigue Posse is made up of a three main categories of people: (1) friends and family, (2) mentors, and (3) professionals.
Let’s start with friends and family.
This category of people may be the only ones on your support team when you start out. It’s an okay place to start, but it will be important to also add the other categories into the mix. There are also ways you can help your friends and family be better prepared to help you. First, thank them for all the support they have already provided. Then tell them you are working on building a team of supporters and ask how they feel they can best provide support. This may already be obvious. Some people are huggers, some are fixers, some are epic listeners. Have a conversation about how this relationship works, write their name on your Safety Plan and always shape your plan to meet your own needs and circumstances.
In case you haven’t found the Safety Plan yet, scroll to the bottom of this page where it says "Freebie Alert." This worksheet helps your future self to know what to do when you are freaking out on the inside.
Sometimes your friends and family will be busy having their own lives, their own problems, and their own fun that doesn’t align with your meltdown.
In this case, it may be helpful to have a code word or a pain scale, so they know when you call them how serious the situation is. If you tell them you are at a 10 on the compassion fatigue pain scale, they will know this is very serious and that the fun thing they were doing is not the priority. However, if you just need to bitch about your boss and you are at a 3 out of 10, then you can ease their burden and yours by making a phone date for the next day. From someone else’s perspective, you may look stressed all the time and it can be hard to know just how serious it feels to you. Help them help you.
Next we have mentors.
These are the professionals and wise ones we encounter on our career path or our path through life. These are people who are not on our BFF call list, but who care about our success. They have seen the pitfalls on the path of healthcare or life and would love to share the wisdom they have gained the hard way. These people are not the ones who will simply listen and agree with you. They will challenge you to grow. They will ask you to take a look at your shortcomings and point you in a direction that will help you make your weaknesses into strengths. When you first start out, a mentor may be one of your professors or your great aunt who also worked in healthcare. As you move through your career, you will meet seasoned veterans who just seem to be more grounded than most people. Try to develop relationships with the ones who inspire you. Ask them questions, find out about the paths they have taken. These are the people who will be able to see through your vulnerable moments and point you to the strength that lies within. Also know that these wise ones are also human and must be given the grace to have human moments of weakness and their own vulnerabilities. Put them on a little pedestal, but not too high.
Then we have professionals.
The most obvious among these are the therapists of the world. These brave souls (maybe you are one of them) have voluntarily embarked on a path to support the mental health of the people in their communities. Day in and day out they listen to the problems of others. They have skills. They have boundaries. You are paying them to listen to you and that is their entire job. You can let go of the “am I being too needy?” guilt that can come with venting to friends, family, and mentors.
How to pick a therapist
First, there are several different types of therapists in the world. There are Psychologists, Psychiatrists (who can prescribe medication), Licensed Clinical Social Workers, Licensed Marriage and Family Therapists, Licensed Addiction Counselors, and more. The key here is to find someone who is licensed. You may have other non-licensed professionals on your team, but these people have to be accountable to their peers and that means they deserve some extra street cred. Personally, I think it’s a VERY good idea to have a licensed therapist on your team. You may hit a moment of crisis that can be dealt with much more quickly if you already have someone you trust on call to help you through it.
It can be hard to know who will be the best fit for you, but here are some ways you can narrow down your search. First, you can start by finding out who takes your insurance. If you don’t have insurance that covers mental health, reach out to your local health department or Medicaid office to see who is available at a reduced rate. You may even qualify for free mental health care. You can also narrow your search by googling therapists and reading through their approaches. You may want someone who takes a spiritual approach or someone who focuses on behavioral modification. Maybe you want someone who takes a more psychoanalytic approach. Then you can look for someone who specializes in the issues that are most relevant for you. Beyond your work in healthcare, you come to the work with your own personal issues. Maybe you are a survivor of violence, maybe you have always struggled with anxiety, depression, or an eating disorder. Find someone who focuses on what you need help with.
After you’ve done some narrowing, pick a few people and call them. Most therapists will give a free consultation. Just as you want to find the right therapist, they want to find the right clients. No one will be satisfied by applying the wrong solution to a problem. Find someone that you click with. I know this isn't very scientific, but you'll know when you feel it.
There are endless other types of professionals.
There are life coaches, personal trainers, massage therapists, clergy, spiritual practitioners, acupuncturists, martial arts senseis, nutritionists, yoga teachers and the list goes on. These people are all really good at helping you move through a challenge you are facing. Some modalities will be helpful for you, others will not. Pick what works for you and throw them into the mix of your Compassion Fatigue Posse.
To recap, there are three main types of people to recruit for your Compassion Fatigue Posse: (1) friends and family, (2) mentors, and (3) professionals. There are a bunch of other ways to build your team as well. Here are a few other ideas before we end this installment of “what to do when you are freaking out on the inside.”
There are also support groups.
The twelve-step community is one of the most prominent types of support group. These are community-facilitated groups that can help you deal with addictions. Alcoholics Anonymous is the most widely recognized, but there are many other types of groups. I recommend Al Anon to anyone who has had personal or professional relationships with anyone coping with addiction. If you are turned off by the “higher power” component, please give it a try before you rule it out. I consider myself to be spiritual but not religious. I have a non-mainstream conception of a higher power and may have even considered myself an atheist in the past. There is so much to be gained from these groups that it would be a shame to rule them out for this one reason. There are other types of support groups available as well. Check your community events calendars. Your local health center may have resources as well. These are not just for your patients. These are there for you to access as well. (I am assuming you’re human.)
There are lots of other people waiting to help you. Let’s just make a list:
There’s 911 if you are having a serious mental health crisis.
You may have an Employee Assistance Program (“EAP”) through your workplace.
Your supervisor may be helpful.
Your human resources professional actual has the word "resource" in their title.
There are professional organizations and unions waiting to provide you with relevant information and connections.
And there’s Cared to Death.
Scroll down to the comments and tell us who is in your Compassion Fatigue Posse.
Share with your friends. (You get more by sharing. Tell your inner pre-schooler.)
Leave comments. (This is your chance to connect with people who get you!)
Tell Jamie what compassion fatigue issues are nagging at you so she can write about them.
Listen to the Cared to Death Podcast on Mondays at 8 PM Mountain Time.