Being Alert to the Signs of Compassion Fatigue

by Judith E. Courtney MPS, MA, LPC, NCC

Over time, certain professions have become synonymous with the tools of their trade: blacksmith/anvil, mason/trowel, painter/paintbrush. Even in the helping professions, there are easily recognizable tools unique to a specific field. For example, it’s hard to imagine a doctor without a stethoscope or a dentist without a drill.

But when it comes to the helping professions—medical, mental health, teaching, spiritual guidance, funeral services and many others—the key to success in these “high-touch” fields is the quality of the interaction between you and the people you serve.

Working Your Way Through
Simply put, as a caring helper, you are the tool of your trade. And how you care for yourself physically, emotionally, psychologically, and spiritually has a direct connection to the quality of the care you are able to offer. Taking care of yourself makes it possible for you to help take care of others. 

If the well-being of the person you are attending is the goal, ignoring your own self-care should raise some red flags. Here are some guidelines that can help you avoid the pitfalls.

Find a balance. 
As a caring helper, you know it’s anything but simple to maintain the optimal balance between caring for another and caring for yourself. Family, friends, hobbies—the stuff of life—all compete for your attention and time, so it’s easy to find self-care falling to the bottom of your to-do list. But the same personality traits and characteristics that make you good at what you do can also be the very things that do you in.

People drawn to the helping professions tend to be nurturing, compassionate, dedicated and responsible. But without good boundaries, these same traits can quickly evolve into “rescuing” behavior, taking on responsibilities that belong elsewhere.

Recognize the signs.  
Those who experience burnout find themselves tired, drained, without enthusiasm. They feel unappreciated, unrecognized, unimportant and they go about their jobs in a mechanical way. They often lose a sense of the importance or meaning of their work. And they may resent the system or institution they work within, feeling that it stifles any personal initiative.

There is no one cause for burnout; it results from an interplay of individual, interpersonal and organizational factors, such as: conflict and tension among staff, lack of trust between supervisors and co-workers, unrealistic demands on time and energy.

Certain personality traits can increase the risk of burnout. A strong need for approval for all that you do or an inordinate desire to be needed at all times can lead to burnout.

Compassion fatigue occurs when caring helpers become emotionally drained over time from strongly empathizing with the pain and trauma of their patients and families. The helper still cares and wants to help, but lacks the emotional energy to do so.

Set limits. 
One of the best ways to prevent burnout or compassion fatigue is to set limits and learn to say no. This can be difficult at first. But if saying no makes you feel uncomfortable, use it as an opportunity for self-exploration. The more you know yourself, and feel comfortable in your own skin, the more you can be present to your patient.

Caregivers who set realistic limits show respect for themselves, and thereby evoke respect from others. Saying yes when you know in your heart that you really should be saying no can lead to a destructive cycle of passive-aggressive behavior, fostering deep-seated resentment in you and alienating your peers.

“If we hope as counselors to promote growth and change in our clients, we must be willing to promote growth in our own lives.”
~Gerald Corey, Ph.D.

Realize that hospitality comes first. Throughout scripture, hospitality is a fundamental obligation for one and all. Those called to the helping profession have the opportunity to embody the scriptural value of hospitality every day, as they journey with those in their charge, by striving to create an open, compassionate presence.

Your ability to be both present and compassionate (literally, “to suffer with”) requires clarity, objectivity, and continual self-reflection. What you see, hear and experience when you’re with those in your care, and how you interpret and relay that information to others on your care team, demands sharp senses and honest insight on your part. Overextending yourself, poor diet, inadequate sleep or excessive alcohol consumption will have a negative impact on your attending skills.

One effective tool for self-reflection is to adapt part of the “spiritual exercises” of Ignatius of Loyola, called “The Prayer of Examen.” The exercise involves two steps: (1) an examination of consciousness to discover how God has been present throughout our day; (2) an examination of conscience to discover those areas in our lives that need further growth and healing.

Seek support and guidance.
Forbidden feelings, secret fears, past abuse or catastrophic injuries and illness: these are issues that overwhelm many of the people helping professionals serve. But when the caring helper feels overwhelmed by a client’s issues, this needs to be addressed, challenging though it may be. Untreated, this state of affairs will have a serious effect on a caregiver’s ability to treat the people served in a healthy way, and will also put great stress on the caring person’s personal relationships.

If you fear you are losing your objectivity due to the stress of coping with your patients’ issues, one of the best ways to address the situation is by seeking professional guidance. Make an appointment to sit down with your advisor, supervisor or therapist to share your concerns. Seeking guidance and supervision in the caring professions is strongly recommended by various professional ethical codes, for good reason.

Take heart.
Being open to self-evaluation and practicing self-care, you not only expand your self-awareness, but also develop your abilities as a helping professional.

Being both a private person and a caring helper, you live two intricately intertwined identities. It is important to be able to distinguish the two identities and to set clear boundaries.

Excerpt taken from Being Alert to the Signs of Compassion Fatigue CareNote.