Key points:

• Compassion Fatigue is a normal consequence of working in a caring role

• To deal with it effectively you need to first be aware of it

• To prevent compassion fatigue from negatively impacting your mental health you must be proactive by building healthy habits that promote self-care; you cannot pour from an empty cup

• Your emotional health and safety must have equal importance to your physical health and safety

What is compassion fatigue?

Compassion is a natural motivation to take action. When you care for others and see them in distress, you want to alleviate it and get satisfaction from doing so. Unfortunately, if exposure to the suffering of others is long-term and you’re under-resourced and working in unrelenting distressing conditions, then compassion fatigue can develop. It is the physical and emotional reaction to the constant trauma and suffering you witness, and an occupational hazard. 

With decreasing empathy reserves, it becomes hard to feel or demonstrate compassion anymore and blaming or complaining may take its place. Other signs are exhaustion, irritability, cynicism, hopelessness, and guilt, along with difficulties in sleeping, eating, concentrating and thinking.

The 4 phases of compassion fatigue from Zealot to Zombie

Awareness of the changes that happen as compassion fatigue develops is key to preventing it from developing fully.

Zealot phase: In this phase, often when starting a new role, you do all the extra work and extra hours and go the extra mile without complaint, feeling that you really make a difference. You pacify yourself with reassuring reasons that you can deal with the stress because you’re a professional who has been doing this for years.

It might begin to feel like it’s hard to stay on top of things, so you work harder as you think this will help you feel better and make your stress go away. You may start to experience physical stress such as shallow breathing, sweating, palpitations, aches, and pains.

Irritability phase: At this point, there starts to be a change in how you respond to stress, and you become irritable, moody, or angry and may snap at colleagues. You may lose your sense of humour and be critical of others as well as yourself. 

If you feel undervalued and under-resourced you may blame others for not providing necessary resources. It becomes hard to focus when patients or colleagues are talking to you and you may begin to feel slightly tuned out.

Withdrawal phase: In this phase sleep is disrupted and you may have difficulty falling or staying asleep, so feel tired all the time. You may get minor illnesses such as colds and sore throats that won't clear up. You start to see patients or colleagues as irritating, and it becomes harder to feel empathy and see the good in them. You may justify this behaviour because you have been up all night or have worked a 70-hour week. You may want to withdraw from others and start using unhelpful means of coping.

Zombie phase: In this phase, you have nothing left to give, you feel depleted, disconnected, and numb. You operate on autopilot and find yourself going through the motions and making mistakes. There is potential for thoughts of self-harm and using negative coping techniques is common. Professional help is necessary at this stage.

4 ways to combat compassion fatigue

1. Make self-compassion a priority.

Those who are more compassionate towards themselves experience better psychological health, reduced anxiety, rumination, and perfectionism, lower levels of fear of failure and depression, less struggle with unwanted thoughts, and a greater willingness to accept negative emotions. 

The body keeps the score when it comes to stress. Self-compassion is your way of protecting yourself against the dangers of poor mental wellbeing and it is not self-indulgent or selfish. Listen to this self-compassion exercise.

2. Develop a self-care plan.

Practicing self-care is a critical method of protecting yourself against compassion fatigue. Using this self-care wheel for guidance will help you focus on a wide range of ways to look after yourself.  Eating well, sleeping, relaxing and recharging are vital sources of self-nourishment and necessary to good mental as well as physical wellbeing. Give some time to plan this into your week.

3. Taking care of your boundaries.

Protecting yourself may seem counterintuitive to being kind and caring, but being able to set and maintain personal boundaries actually allows you to care for individuals more fully because you can take a holistic view of their needs rather than getting so close it prevents you from being objective.  It allows you to fit ‘what you need’ into your daily life which keeps you well, such as self-care, wellbeing activities and to communicate these needs well at home and at work.

4. Find your support network.

Social support networks can help you recharge and feel understood by others, and provides an opportunity for replenishment. This is at a biological, physical and emotional level. Family, colleagues, and friends can also help you identify any signs of compassion fatigue that you haven’t yet recognised in yourself, so make sure you listen to any concerns they have.

Summary 

When the carer is suffering and struggling to care, compassion fatigue has likely set in. Individuals experiencing compassion fatigue have a hard time maintaining a healthy balance of concern and objectivity. It’s not easy to break out of the spiral, but support from others and compassion for yourself can help you both address and relieve these symptoms, and learn to love to care again.

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