Then I look again, and I see how each person is nested in the context from which he or she comes. I see the mothers and the fathers, the countries, the fabric of cultures and beliefs and experience. And, as importantly, I feel my own family behind me, I feel the support and interest of everyone who has brought me to this very moment, the one in which I get to meet these people, to do this meaningful work.

Most systems—family, organisations, communities, nations, religions—are deeply settled into years and years of patterning. We are born into these systems and answerable to their edicts. It follows that we later have great difficulty discovering our own internal sense of freedom, let alone feeling assured enough to embrace it.

Most systems—family, organisations, communities, nations, religions—are deeply settled into years and years of patterning

We stay loyal to the dynamics that immediately surround us. It’s a loyalty beneath the surface, subconscious and insidious. Our family loyalty may compel us in the opposite direction from what we want: Can we be happy when our father was not? Live fully when a sickly brother could not? Have love when our mother lost hers? Be successful when our country of origin is impoverished? Have children when others were given away? When such events occur when we are very young, or take place before our birth and are carried in the psyches of our parents, it is our ingrained sense that we must account for them.

On one level, our ‘instinct’ guides us to stay with the past, to not abandon those left behind. This is the message received. It’s not handed down in a deliberate way but it is felt as a compass hidden in a secret pocket. Deep into adulthood, this compass may provide instinctual information that we adhere to out of awareness. How can we tell? From the evidence. When something makes us happy, for example, we quickly sabotage the situation such that we cannot sustain it. Or, we find that we become involved with different individuals, but the same old dynamics always come up. Or, we have great ideas, all of which lose traction right at the threshold of success. Our own fruition seems too much to bear.

We stay loyal to the dynamics that immediately surround us. It’s a loyalty beneath the surface, subconscious and insidious

My curiosity with each person who comes to work is this: to what is his or her compass attuned? In what larger context does their way of navigating make sense? We know it doesn’t work well for moving forward, so where does it work? How does the person’s issue connect to the larger backdrop of the root system? And what direction is the subliminal compass still providing?

I use a Family Constellation to reveal a living map of the family’s history. In a workshop setting, we invite participants to represent family members or forces in the family in order to provide a ‘picture’ of what the client feels and what he or she is secretly connected to. Unlike a drama, the representatives are encouraged to explore the spacial relationships, to experience the tensions or freedoms of various positions, rather than to interpret or analyse information. In individual work, I will ask the client to imagine these components and to report what he or she sees. In either case, the image quickly shifts from something known to something new. Once this refreshed image takes a shape, and really engages the client, he or she will be able to explore the once-hidden dynamics safely and begin to envision new ways to express loyalty and love.

This was first published in the April 2015 issue of Complete Wellbeing.

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Speaking from experience, what we in helping professions or volunteer work don’t realize is that people aiding those who suffer need to take care of themselves as well. We are often so focused 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 traumatization’, ‘secondary traumatization’ 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 at Risk?

A survey showed that “86.9 per cent of emergency response personnel reported symptoms after exposure to highly distressing events with traumatized 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] traumatized, 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.

Warning Signals of Compassion Fatigue

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 realize that I had been in a grey space all year. [It] had sort of crept 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 socializing 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. [Also read: A dozen sure-shot ways to dissolve stress]

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 recognized 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 recognized 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 realized 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.

(Editor’s note: The following sections have been added by the Complete Wellbeing editorial team to expand on the original article.)

Compassion Fatigue vs Burnout: What’s the Difference?

The terms are often used interchangeably, but they describe different experiences, and the distinction matters when it comes to recovery.

Burnout develops gradually from prolonged workplace stress: an unmanageable workload, lack of autonomy, a working environment that feels thankless, or even boredom. It tends to build slowly and is generally linked to the job itself. A person experiencing burnout feels chronically exhausted, disengaged and cynical, but their distress is rooted in their own circumstances.

Compassion fatigue (also described as empathy exhaustion, helper burnout or caregiver fatigue) works differently. It stems not from one’s own situation, but from absorbing the pain of others. It can develop quickly, sometimes after a single deeply distressing encounter, and often catches the helper off guard. Where burnout tends to produce detachment and cynicism, compassion fatigue frequently produces something closer to the symptoms of trauma: intrusive thoughts, emotional numbness, hyper-vigilance and a pervasive sense of dread.

Another way to think about it: burnout is what happens when the work depletes you; compassion fatigue is what happens when someone else’s suffering gets inside you.

The two can and do co-exist, but identifying which is at play helps determine the most effective path forward.

How to Recover From Compassion Fatigue

Whether you call it empathy burnout or describe is as simply being emotionally drained from helping others, recovery from compassion fatigue begins with recognizing that what’s happening has a name, and that it is a recognized, natural response to sustained emotional exposure.

From there, recovery tends to work on a few levels:

Create deliberate distance. No, you don’t have to abandon the people in your care. But you can build structured breaks into a caregiving routine, time where the focus is entirely on one’s own needs. Even small, consistent pauses can begin to interrupt the cycle of absorption.

Debrief regularly. As the author notes in her own experience, isolation accelerates compassion fatigue. Talking to a trusted colleague, friend or therapist about what one is carrying, rather than internalizing it, is one of the most effective tools for relief. For professionals, formal supervision or peer support groups serve this purpose well.

Reconnect with the body. Because compassion fatigue often manifests physically (tension, fatigue, sleep difficulties or a general sense of numbness), physical activity, time in nature, and practices like breath work or meditation can help restore a sense of groundedness and presence.

Seek professional support when needed. If symptoms persist or worsen, particularly if intrusive thoughts, nightmares or emotional shutdown are present, speaking with a therapist trained in trauma or caregiver support is strongly advised. Compassion fatigue responds well to treatment; the key is catching it before it becomes chronic.

Recovery is rarely linear, and the timeline varies from person to person. But with the right support, most people find their way back to a place where caring for others feels meaningful again.

Related » My Partner Has Depression: How to Help Without Burning Out

In Closing

Call it compassion fatigue, caregiver exhaustion, helper burnout, caregiver fatigue, it is far more common than most people realize, and far more serious than it is usually treated. It affects professionals and family caregivers alike.

The capacity to feel deeply for others is a gift. But like any resource, it needs to be replenished. Paying attention to the warning signs, building genuine self-care into daily life, and reaching out for support when the weight becomes too much — these are the practices that keep compassion alive for the long term. As the author puts it: caring for yourself is caring for others.

A version of this article first appeared in the December 2014 issue of Complete Wellbeing.

Last updated on 21^st February 2026

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