Compassion Fatigue

Dr. Gina Crean, LCSW, CFRC

A few months ago, I had the opportunity catch up with a former colleague who just happens to also be a retired First Responder. We got to a point in our conversation where they shared that one of the toughest points in their career was when they responded to a chaotic scene and they found themselves feeling apathetic, tired, and numb to those that were effected on scene. My colleague pointed out to me that they still very much enjoyed their job, so they were confused at why they felt the way they did when they were on this scene. My colleague told me that that they just remember feeling exhausted of seeing so many people being in pain. In that moment, we both gave each other a small smirk. My colleague looked at me straight and said “I know what you’re thinking. What a difference it would’ve made to know what I know now. I wish someone would’ve told me about compassion fatigue.” My colleague gave me permission to share that part of our conversation and it got me to thinking: it’s time to ramp up the conversation around compassion fatigue.

As we expand our knowledge around how the work that we do impacts us, there is growth in understanding that there is no longer an option to ignore it. It is encouraging that we are starting to have more training, conversation and intervention around these impacts and it is my hope that this will continue to increase. Recently, like my colleague, I have found that many of those that I work with have never heard of the term compassion fatigue. It made me curious about why this isn’t discussed more. For this brief article, I appreciate the opportunity to honor what my colleague shared with me in that they wish they knew what they know now about compassion fatigue. This article will provide an introduction to what compassion fatigue might look, sound like, and feel like and why we need to start having more acknowledgment that it is occurring.

Over time, we have demonstrated growth in responsiveness towards some of the other impacts that we may see in the work that we do. One of those is vicarious (secondary) trauma. Vicarious trauma occurs when witnessing or hearing about other’s traumatic experiences; specifically, those that we interact with while doing our jobs. In addition to vicarious trauma, there is also acknowledgment around experiencing burnout. Burnout is what we experience as a result of high caseloads, low staffing and being in work environments with a “too much to do and not enough time” mentality.

Now, it’s time to increase our understanding around compassion fatigue. The term compassion fatigue was coined in 1992 by a nurse by the name of Carla Johnson. This term was later expanded on by Dr. Charles Figley. They worked to bring awareness to this term in recognition of the impacts that we often see when individuals are in the professional business of caring for others. Compassion Fatigue is when we start to experience physical, emotional and/or psychological exhaustion as a result of interacting and caring for others that are in states of high stress, suffering and/or trauma. It can also be experienced if you are caring for an elderly parent, a spouse, and even parenting. Compassion Fatigue does not occur all at once but rather is accumulated over time.

Compassion Fatigue is often times referred to as “the cost of caring.” It is important to point out that if you are taking care of others in a professional or a personal capacity, compassion fatigue is actually quite common to experience. It does not signify that we do not care, or that we care less, but rather the chronic caring has created internal impacts to our own self.

There are 5 stages of compassion fatigue:

1. Zealot Phase

2. Irritability Stage

3. Withdrawal Stage

4. Zombie Stage

5. Renewal vs. Unwell Stage (or the Pathology Stage).

Sometimes, these stages are not experienced in linear fashion (or in order). While not an exhaustive list of symptoms, the below visual gives you a better idea of some things to be aware of in each stage

Here’s the good news: we can work to support ourselves to move through and forward from these symptoms. If you might be experiencing symptoms of compassion fatigue, here are some ways to address it:

Prioritize Self: Easier said than done, I know. However, it will be vital to identify what is important to you and what you need during this time. Intentional self care activities like hitting the gym, journaling, listening to music or practicing yoga can be helpful. However, it may also be something like prioritizing nutrition and sleep. It may also be something like getting back to a favorite hobby, or spending time in a particular place…or even placing your phone on silent once in a while and staying off social media. Reflect by asking yourself: If I could prioritize anything in this moment, what would it be? How do I get myself there? What are the barriers that are in my way to getting there?

Boundaries: “No” is a complete sentence. It is often difficult to use the boundary of “no.” Allow yourself to recognize where in your life you can reduce your involvement in activities or responsibilities that do not serve you best during this time. Get into practice of recognizing excessive demands and what is attainable for yourself.

Increase Self Awareness: Now that you are learning a bit more about compassion fatigue, allow yourself to check in with yourself daily about what you might be noticing and about how you are reacting to situations. Have you noticed any changes in your reactions? It will be important that these self check ins do not come with judgement, but rather, compassion for what you might be experiencing.

Reach out: If you notice that you may be experiencing some of the symptoms that come with compassion fatigue or have noticed other symptoms coming through, please feel welcomed to reach out to PSPG. We have a whole team here that is happy to talk things through with you and support you in being proactive in overall wellness.

Compassion Fatigue is a very real consideration in the work that we do. We have to start proactively paying closer attention to our own self when caring takes away from our ability for living. We have to do our best to keep our empathy and compassion for those that are in our communities, and you are an important part of that community as well.