I was working with severely mentally ill people in South Modesto at the time. I was enjoying the work I was doing, but I kept finding myself getting impatient with people in crisis for the ten-thousandth time that month. I was starting to not care about how my words could cause them to not feel supported or understood. I thought it was burnout at the time, but a few years later I learned about "compassion fatigue".
Compassion fatigue is also referred to as the “cost of caring”. Now this term can be confusing, and it can cause a lot of confusion for people who are first responders or in the helping professions, including pastoral staff and church leaders.
What I want to do is help you better understand compassion fatigue and how to manage it, so that you can keep doing the good work that you do without losing yourself in the process.
So right now, we are going to answer five questions:
1. What is compassion fatigue?
2. Who is most at risk of compassion fatigue?
3. How do I know if I have it?
4. Can’t I just tough it out? I mean, it’s an occupational hazard.
5. How to I prevent or manage compassion fatigue?
What is Compassion Fatigue?
Compassion Fatigue is more of a simple concept than it sounds. It is when our “compassion-ometer” has been drained to the point of depletion (fatigued).
Also referred to as “empathic distress”, it is when we find ourselves unable to be emotionally available for those we want to help. This is when the work that you do, caring for others, has drained you of your emotional and physical ability to meet the needs of others. It is when we have given so much of ourselves to help others who are struggling that it has depleted us of our emotional reserves.
Think of a teapot at tea time. The teapot is filled with hot water, steeped with tasty herbs and leaves (mint is my personal favorite, but you can imagine any tea you like). Now at tea time on Monday, there are two teacups on the table. The teapot easily fills up those cups, with plenty left over. However, on Tuesday, NINE teacups are on the table, pleading to have the delicious tea. The teapot serves the first seven teacups, completely emptying itself. And has none left over.
Now with the teapot, we would naturally have to go heat up some more water, steep more leaves, and then finish serving the last two teacups.
However, our world of compassion does not work this way.
For example, let’s say there is an EMT riding in an ambulance for her twelve-hour shift. Her compassion-ometer is full at the start of her shift. However, after the fifth call, one where a child was rushed to the hospital after he was not buckled properly in an accident, the EMT’s compassion-ometer has run empty.
Is she able to take the rest of the day off of work to “refill” her compassion-ometer? No way! She has to keep going and finish her shift.
But let me ask you, what happens during the next couple of calls where mistakes, such as texting while driving, caused a serious accident where another driver had bones sticking out of their legs? Do you think she will be patient and show compassion to help all of the people in the accident?
Heck no, techno! She will be short-tempered, bitter, and come across as “not caring”. She may even get a complaint filed against her for talking back to other responders on scene or yelling at the person who was texting and driving.
She has exhausted her compassion levels and has not been able to refill them.
This is compassion fatigue.
Who is most at risk of compassion fatigue?
Compassion fatigue most often occurs to those who have to open their hearts, open their minds, to other people in order to provide them with empathy and support through a challenging time.
Some of these people may be first responders, like EMTs, police officers, and firefighters. People who are going out into the community during emergency situations, and have to show compassion and empathy to help people in these circumstances.
This can also include hospital personnel, such as ER, trauma unit, and intensive care unit (ICU) staff. These folks have to show compassion and empathy to keep patients from becoming reactive and making situations worse.
They could also be mental health and community services professionals. People who work with CPS, going out to homes where children are in less-than-livable conditions, trying to help get them to a place of safety, need to have compassion for the children and not show judgement or disdain towards caregivers. Mental health professionals, listening to the gruesome stories of trauma that client’s experience, while needing to show compassion and holding space for those in pain.
And don't forget about pastoral staff and church leaders! These folks show compassion and empathy for people who are struggling, whether in relationships, emotional issues, or even doubting their faith. And for these people with servant hearts, they have a personal connection with most of the people they help; often helping those in their own church congregation. Talk about exhausting!
These jobs are not easy, and require people to give a part of themselves to do the job right. But if they are not careful, they can run out of tea before they finish filling the cups by the end of their shift.
How do I know if I have compassion fatigue?
We want to be clear when we are trying to find out our own struggle, so make sure that you have a general understanding of each of these struggles before you label anything.
For compassion fatigue in particular, you want to look at what is being depleted.
Are you feeling physically eroded after intense situations occur? Emotionally, do you feel drained an unable to rejuvenate your ability to open your heart to those in need?
Now while this may seem pretty similar to burnout, we want to also understand our attitude towards the problem. Our reaction to this depletion.
When it comes to compassion fatigue, your symptoms are similar to burnout, BUT, you still love your job and want to keep doing it, you just don’t know if you can. You actually WANT to be there to help others, to provide comfort and compassion during a crisis. You still love the work that you do, you just feel like you can’t meet the need.
Can’t I just tough it out? I mean, it’s an occupational hazard.
This may be tempting, and it may seem easier to do, but it will NOT be helpful.
The risk of compassion fatigue is high in certain professions, absolutely. But it is NOT inevitable. And it should never be eternal.
If you try to just “tough it out”, you will actually cause more physical harm to your body, emotional harm to yourself and others, and put yourself at risk for vicarious trauma and other serious mental illnesses, such as Generalized Anxiety Disorder or Panic Attacks.
Back when I was working in South Modesto, I had not recognized the symptoms of compassion fatigue. My lack of response to those symptoms ended up turning into burnout; I became resentful of others at work and stopped caring about the work I was doing.
We all have crossroads where we can decide to do something about our struggle, or just ignore it. When we hit compassion fatigue, it is an early crossroads where we can actually choose a path that will lead to prosperity and joy in the work that we do.
How do I prevent or manage compassion fatigue?
When I was in college at UCSB, I worked in the residence halls as a Resident Assistant. Our department had this motto: “Take care of yourself. Take care of each other. Take care of this place.” And it was said in this order for a reason.
We cannot take care of others, or take care of our own place, if we aren’t taking care of ourselves.
Now, I am not saying that you should always put yourself first. Or that you should not help others if there is even a remote risk of compassion fatigue. Far from it.
When you cell phone is running low on battery, what do you do?
You plug it in!
You don’t run it until it is dead, and then run it some more. You plug it in and let it charge. You may not charge it fully all of the time, but you charge it so you can use it when you need it.
We need to do this with ourselves, as well. We need to take breaks and allow ourselves space to experience and/or process our emotions. Sometimes it may be that we need to cry. Other times, we may need a hug, or to go for a run, or hit the gym.
We do this by checking in with ourselves regularly to see what we need. Every couple of hours, just take 20 seconds, pause, and check in with your body, with your emotions. What I am feeling right now? Is it anger or hunger? Is it sadness or stress?
And then we need to ACTUALLY do what our bodies need. Maybe it’s to sneak into the bathroom so you can shed some tears without others seeing you. Maybe it’s a hug for at least 7 seconds with someone you care for. And if you can’t get a hug from another person, hug yourself or a pillow; this may seem weird, but there are actually oxytocin receptors on top of our heart, and by providing a slight pressure here, we can create the release of this self-soothing hormone.
And sometimes, this may require professional support, especially if you find yourself struggling often and heading down the road to more challenging effects from the job. Through professional support, you can have a space with an objective person to process what you are dealing with, and learn new tools to better respond in the future.
When it comes to compassion fatigue, we need to look at it as information our bodies are trying to tell us about what we are doing. Think of these symptoms as red flags that we are not taking care of ourselves in a way that will allow us to continue doing our jobs effectively.
Like the low battery message on your phone when it is at 20%, or at 10%. It is warning you that you need to do something or the consequence will be a dead phone battery.
So plug yourself in and get ready for tea time, because you CAN overcome compassion fatigue, you CAN rock it at helping others, and you WILL make a difference.
Take care, friends!