We feel better when someone shows compassion for our situation, perhaps by listening warmly and understanding our emotional and physical pain. So, isn’t it wonderful that there are people who commit their professional or personal lives to helping those who are in physical and psychological pain? However, this type of caring often contributes to symptoms in the helper that resemble the symptoms of the people they care for. This phenomenon is called ‘compassion fatigue’.

Speaking from experience, what we in helping professions or volunteer work don’t realise is that people aiding those who suffer need to take care of themselves as well. We are often so focussed on others that we forget to pay attention to ourselves or don’t know that we need to. Worse, it might seem selfish to us to try and meet our own needs, and even to enjoy life while others are suffering.

The self-care concept is often taken more seriously with other types of work, especially work that tends to tax the body—jobs that involve heavy lifting, repetitive movement, a high noise level or sun exposure. But, no matter what we believe, it’s crucial that we look after ourselves during the course of caring for others; otherwise we might end up with compassion fatigue and, in the end, lose the very ability we have to help others.

What is compassion fatigue?

Compassion fatigue develops when we witness or frequently listen to the traumatic stories of someone who is experiencing pain and fear and inadvertently take on some of that person’s symptoms. Other terms also used to express this are: ‘compassion stress’, ‘vicarious traumatisation’, ‘burnout’, ‘secondary traumatisation’ and ‘secondary traumatic stress’.

Amelia Lake [not her real name] a psychotherapist, describes the syndrome in this way: “[It feels like] I am the empathy lady from the old Star Trek episode, and I get maybe a 45 per cent hit of what my patients might be feeling 100 per cent.”

Who is in danger?

A survey showed that “86.9 per cent of emergency response personnel reported symptoms after exposure to highly distressing events with traumatised people.”

The term ‘compassion fatigue’ is usually reserved for professionals such as psychotherapists, physicians, emergency teams and others. But you don’t need to have a ‘degree’ to develop compassion fatigue. Family members or anyone who takes care of someone who is [or was] traumatised, is in emotional or physical pain, or suffers from a terminal illness can experience compassion fatigue.

According to one study, the caregiver is more at risk when the patient or the caregiver feels helpless and the patient is reluctant or resists getting well or taking direction.

The symptoms

Warning signals can be physical, psychological or spiritual. Therapist Nicola Rogers [not her real name] was surprised to find that she had carried her client’s symptoms for days, and she described experiencing “tightness in the exact same spot” as the client.

Amelia observed that her response to a patient was to feel as if she were walking around in an altered state. “I didn’t realise that I had been in a grey space all year. [It] had sort of creeped in,” and “it got to the point where I would feel physically [nauseated] before the appointment.”

Take time out for yourself when you notice that you feel:

  • Emotionally exhausted, lacking in energy, overwhelmed to the point of apathy, numbness or just an inability to listen
  • Irritated by or critical of the person, or preoccupied with thoughts about that person
  • Isolation, helplessness, depression, anxiety, hyper-vigilance, withdrawal or have ruminating thoughts or nightmares
  • An overwhelming sense of sadness and grief
  • Hopelessness  and suffer a loss of faith.

Compassion fatigue can affect you on a physical level as well. If you don’t look after yourself, you could end up with muscle tightness, weight gain, headaches, sleep difficulties and stomach issues.

What you should do

Taking care of others can be very stressful. However, the goal is not to forego caring for others altogether and become the cold person we often meet when we’ve stepped into some medical office or sat on the sofa in a psychotherapist’s office. The goal is to practise physical and psychological awareness and self-care in order to reduce or prevent the natural side effects of the helper’s syndrome.

Amelia advises, “If I stop sensing my body, I pause and just take a moment.” Giving ourselves permission to pause, check in with our body, take a deep breath, and make small movements helps our nervous system to stay calm.

You have to be aware of when something within you is shifting. Paying attention to your body’s signals, such as fatigue or psychological signals like anxiety or depression lets you know that you need to take care of yourself now.

Caring for yourself is caring for others

What would best nurture you? Is it taking time to be alone at home, getting in touch with nature, or socialising and talking to friends? What resources do you have in place? Having a support system, maintaining an appropriate workload with time off, balancing your life with relaxation are ways to reduce the stress of caring for others. Doing these might help to prevent compassion fatigue.

Yes, taking care of others can be taxing, but it can also be very fulfilling, offer a meaningful purpose in life, be transformative, provide deeper connections and contribute to our own personal growth and appreciation for life. Even though not everyone develops compassion fatigue, it’s normal, natural, and, to a certain degree, to be expected. So why not practice self-care from the outset?

My brush with compassion fatigue

While working as a trauma therapist in private practice, I recently had started feeling dazed—to the point of staring into space—and experiencing nightmares. I felt as if I wanted to withdraw from everyone: my friends and my clients. I recognised that this was not ‘me’. I love working with my clients, and although I need time to be alone, I usually want to visit my friends. I recognised my personal warning signals and examined why this was happening.
It struck me that I had been working with a very sweet, young female client who, due to chronic pain, had not been able to work. I felt helpless and worried about her future. One day, she told me she hadn’t eaten, so I gave her my energy bars and almonds but wondered what she would eat for dinner. I provided a few resources from where she could get food, but still, I was struck by the fear that she wouldn’t have enough food. I started thinking about her all day long.
I realised that I hadn’t been debriefing with my colleagues and friends as much as I usually do and, therefore, didn’t have the emotional support or resources that I needed. I had not been reconnecting with others enough, so my client’s world had become mine. I had taken on her fears. I started to worry about what would happen to me if I couldn’t work.
I determined to take positive action towards my own well-being: I planned a long hike in nature, consulted with other colleagues, reached out to my friends and family and lit a candle for my client’s wellbeing. Finally, my world began to look brighter again, and my concentration returned to where it needed to be.

This was first published in the December 2014 issue of Complete Wellbeing.

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