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The Dangers of Compassion Fatigue

Posted on January 27, 2017

Empathetic intensity, or the transfer of emotions and pain from a client experiencing trauma to an empathetic helper, puts us at risk for compassion fatigue, vicarious trauma, and secondary trauma. These are REAL risks and have a tremendous impact on our psychological, medical, and social health. In this post, we will examine compassion fatigue, which happens when empathetic intensity overwhelms our ability to engage effectively in the healing process.

In the cup analogy, compassion fatigue is a gradual process that occurs over a period of days, months, or years. Over this time, the pain and hurt expressed by clients fill up our cup faster than we can reduce the overall amount of pain and stress in that cup. As our cup fills, we become less sharp, we start to feel tired and fatigued, and we have trouble being empathetic with clients. In the extreme, we can go into crisis, lose their positive view of the world and people, and become ineffective in our work.

There is something we do in our work that requires an incredible amount of robustness and resiliency. While I have never seen a scientific explanation of how we do it, it is critical to our ability to engage and be a meaningful part of our clients’ healing and change journeys. Somehow, we can connect with the intense suffering and pain of others, while keeping enough space in our cups strategically implement best practice interventions and care.

It’s as if we have a protective coating around our hearts. We sit with one client and hear their stories of abuse, violence, and hardship. Our ability to connect with this pain at a very deep level reassures the client that we understand their struggles and that they are worthy of our respect, compassion, and time.

After these interactions, we seem to generally be able to shake off this exposure to pain and trauma. Not only do we not allow this pain to overwhelm us, but we also find the robustness to go right into another meeting with a client, where we might hear new stories of pain and hardship. We again shake this off and confront the next struggle and trauma with the same level of compassion and empathy.

I have not yet found anything in my research to explain how we can expose ourselves to intense levels of suffering without it filling up our cups. Everything that I read shows that the contagious nature of emotions should overwhelm us and prevent us from meeting clients’ pain and suffering with hope and positive regard. There’s something very special and unusual about people who can maintain a positive worldview and a sense of hope for the future when they confront the traumas that impact people they care about so deeply.

While this ability is almost superhuman, many of us have at one time or the other experienced compassion fatigue. Maybe we feel like we don’t have enough time in the day to give the clients everything we want to give them. Other times, we might know what they need, but there may not be a resource in the community to help them reach their goals. Additionally, hearing struggle after trauma after hardship can just wear us down, especially if there are not enough positive client outcomes to offset the setbacks and difficulties.

The most common impact of compassion fatigue is that, as our cup fills up with the negative life experiences of our clients, our worldview can start to become cynical. When this happens, things like homelessness, our political reality, racism, poverty, and other social problems can seem especially overwhelming. It might look like these issues may never end, and that we have little power to make any meaningful change. No matter how hard we work, tomorrow there will be homelessness, tomorrow there will be poverty, tomorrow a child will be abused, tomorrow a person of color will experience racism, and tomorrow a family will go to bed hungry.

Compassion fatigue makes the negatives of our work outweigh the incredible accomplishments of our clients. It hides our impact from our own eyes, and can make us feel insignificant. The fact that compassion fatigue happens over time can also make it difficult for us to realize that the trauma we face in our work is gradually filling up our cup, and having more and more of a negative impact on our health and world view.

While I have come to conclude that most of us “should” be struggling with compassion fatigue, the reality I see on the ground is much different. Instead of hopelessness and resignation, I find passionate people all across the country who have dedicated their lives to their communities and those that are struggling. You are a freak of nature!

I want to open up the comments today for you to share any experiences you have had with compassion fatigue. Also, please share ways that you counteract all the negative stories and hardships you hear on a regular basis with the positive aspects of your work and life in general. Please take care of yourselves!

16 responses to “The Dangers of Compassion Fatigue”

  1. Joy favuzza says:

    I have been mediating twice daily with Dr. Joe Dispenza CHANGEgame app. I went to his weekend seminar and it has really helped me cope and keep me in a happier frame of mind. He also has utube videos and books. Keep well!

  2. Mollie Hiebert says:

    Oh, Matt, this is so perfect! I really needed this right now. Unfortunately, I am not a freak of nature. My cup overflows regularly (usually spilling out through my eyes). Since the election, I feel like my cup is at the bottom of the ocean. I think the only thing that keeps me going is that I don’t have much choice. I can’t just turn off the compassion. Being aware of when compassion fatigue is affecting my work or my life is of utmost importance. When I start to feel overwhelmed, I take extra time to make sure my words and actions are going to be helpful not hurtful. If I slip up, I make every effort to repair the damage.

    The other thing that helps is knowing I’m not the only cup in the sea. I agree with you that the women’s march was so inspiring and helpful to know there are that many people around the world who are going to stand up against atrocities and help those who need help.

    Thank you Matt for reminding us about compassion fatigue and to take care of ourselves as we try to take care of others.

    • Matt Bennett says:

      Thanks Mollie, it was so fun marching with you and your mom! Make sure you keep the impact you are having in the front of your mind as you help make the world better every day. Also, I have added the coping skill of calling my Republican Senator every day. So far I have left messages on health care and torture, I think today might be on education, tomorrow why a president who one the election is going to spend million investigating that election. If anyone else wants to leave Corey Gardner a message here is the number (202) 224-5941

      • Mollie Hiebert says:

        Great idea Matt! I left him one message and was so frustrated that I didn’t get even half way through all I wanted to say before the voicemail cut me off. I’m going to put his number in my phone right now and call him every day with a different issue each time. Maybe by the end of the year I’ll get through them all! 🙂
        One of my favorite signs from the march was “Men of quality don’t fear equality.” You are definitely a man of quality Matt! I’m so glad you were at the march with us, if nothing else than to keep my mom from getting lost in the crowd. Ha!
        🙂

  3. Matt Parkhouse, RN says:

    “worldview can start to become cynical”. This is occurring among us caregivers, in part for the reasons you cite but also because there is a change in how the organisations function. I’ve noticed, over the years, that at conferences and community meetings, that the status of those serving their needing populations has changed. It used to be “lots of volunteers and a few paid staff”; now, it is “lots of paid workers and a few volunteers”. As one who organised his life to keep income and service to others in separate boxes, I believe that how one looks at the service he or she provides in a very different way when “homeless dollars are paying your mortgage, feeding your family and sending your kids to college”. I don’t know if this is a bad thing or not. It seems to be inevitable – Eric Hoffer really nailed it with his observation: “All movements start out as causes, become businesses and eventually, evolve into rackets”. You can put every non-profit you can think of, somewhere on that continuum. I know a number of former volunteers who left their field of endeviour, when it became too business like. Believe me, the recipients of your service notice it too.

    • Matt Bennett says:

      Thanks Matt for this powerful comment. It is so easy for compassion fatigue to take over entire systems and organizations. Being around a while now, I have seen national programs go through ups and downs. My heart breaks because I think everyone (or at least the vast majority) go into work as employees or volunteers with great passion and intention. Compassion fatigue can replace this with cynism and callousness which can prevent the work from being done in an effective way.

    • Mollie Hiebert says:

      As a nurse, can you imagine hospitals being run by a few paid workers and lots of volunteers? It’s the same for most organizations that serve people. We need the right training and education to be able to best serve. That training and education is not cheap or quick so not many people are going to go through that just to volunteer unless they are independently wealthy. I have worked in many non-profits and I have never seen one that evolved into a racket. I’m not saying it hasn’t happened, I’m just saying it is rare. Yes, you must have good business sense to keep a good system going but that doesn’t make it less valuable to the people it serves.

  4. Trudy says:

    This is just what I needed today! I’ve really been struggling with all the political horrors that have been pushing my buttons. Yes, meditation is helping and I’m really trying to carry that reverent expectation of Good mindset with me into the workplace to help sustain me while I’m “in the trenches” working with those who will be most harmed by recent political enactments. It’s not easy but talking about it with others and being reminded about self care is so important and helpful! thanks!

    • Matt Bennett says:

      Thanks Trudy, you are not alone in your struggles my friend. If you get a chance watch this video https://www.youtube.com/watch?v=qEPZhGJxP0o. I cry every time I watch it. We made a ton of progress the progress the last eight years. Watching the time lapses from the Marches in contrast to the YUUUGE crowds at the inauguration shows that millions are ready to march for justice and human right. It might have been easy for many to sit on their butts and let government do the work…Saturday showed me that I’m far from alone in my fear and frustration. We are the movement my friend!

  5. Philip J. Malebranche says:

    As you know, my worldview is shaped by Christianity, the Faith to which I came as a teenager. Contrary to the propaganda and resulting popular belief, the history of Christians is not about being weak, naive, clueless and malleable. Christ taught us to be “wise as serpents.” The apostle Paul invited his listeners and readers to join him in suffering–knowing that there would be persecution; in fact, Paul was the most notorious among the aggressors of Christians before his conversion. Belief should be clear-eyed; practice can be rugged. Those who teach that the Faith is for wealth-accumulation and plastic smiles may be deceived, or deceivers. Many of the Letters, or Epistles, were prison letters. The enemies of Christians, for instance, will seek to take advantage of the commandments to do good. On the street, some panhandlers will approach me for help, but I resist my own tendency to help, knowing that that is my tendency and some want to use it against me; to ensure that my pockets remain empty. The pattern is such that I believe in the tactic to impoverish aggressively. We are observing it in national politics. Biblical teaching warns against deception, false prophets and so forth. My personal study of history and current events in light of this worldview give me insight, I would say, in the ruses of political extremism. Compassion fatigue may be counter-balanced by the imperatives of the Faith (“Seek peace and pursue it.” “Do Justice.” “Love your neighbor as yourself.”), while continual observation of the activity of the enemies of Good assists in parrying the dangers.

  6. Ellen McNish says:

    I’m an ICU RN in a major medical center. I couldn’t make up the stories of real people I encounter. My “break away” is to the ocean. In between times, I need alone time, from the noise, the constant need of me, the intellectual and physical demands. There are an army of us. Taking care of the sickest of the sick. They are my tribe. I love them.

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