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Stages of Helping Fatigue: Guilt and Shame

Posted on March 17, 2017

Over the years, I have seen numerous studies showing that those in the helping professions rank at the top of professions at risk for burnout. For years, I just accepted this, without thinking too much about the causes behind this reality. As self-care training has become more of a part of my work, I have searched for answers to why those in public health, social services, education, and other helping professions are at some of the highest risks for burnout, and what the negative consequences of that may be.

The conclusion I have come to, after many years of research, is that those in our professions transition from the first stage of helping fatigue, exhaustion, to stage two, guilt and shame, more quickly than most any other profession. Most of us would agree that our clients need us at our best every single minute of every single day. Even when we are at our best, there never seems to be enough time, resources, or energy to give our clients everything they need. This reality is a key contributor to why we become exhausted, but also why we transition quickly out of exhaustion and into shame and guilt.

If we believe that our clients need us at our best, but because of our exhaustion we cannot deliver the quality we know they need, this can quickly trigger a sense of shame and guilt. In many occupations, being exhausted might not have terrible consequences, as things may just happen more slowly, and the decreasing quality does not always impact people’s health, housing, future success, the ability to get food, and the other kinds of critical tasks that we do for clients. Consciously and unconsciously, we know the vital role we play, and the detrimental costs to our clients if we fail to fulfill this role to the best of our ability.

Whereas people in some professions might exist in exhaustion for several months without progressing to the next stage, those in the helping professions can often progress rapidly to stage two. Exhaustion is a sense of tiredness from not being able to keep up with the work, and guilt and shame are feelings of being overwhelmed by the intensity of the problems we are trying to solve, and the limited impact we often feel we have on these problems. We start to believe that we can never do enough to counterbalance the pain and suffering our clients are experiencing. This reality can create feelings of helplessness and hopelessness in the face of this pain, and the larger societal issues causing them.

In this stage, we often have an increased awareness and internal unrest about the privilege we have in our lives. It becomes harder to go home and enjoy our family, friends, and life when we know so many people we care about are homeless, hungry, experiencing violence, and are alone. In our professions, we are hyper aware of the divide between the “haves” and “have-nots,” and the social and economic injustice behind this divide. As we work with, support, and try to help those impacted by this injustice, it can become difficult for us to leave work and then enjoy the privilege we have established in our lives.

The sense of shame and guilt resulting from this awareness can start to deteriorate our ability to get pleasure out of our work, or even our lives outside of work. If we do not feel like we are significantly impacting the injustice facing our clients, it starts to feel like we are part of a system designed to simply manage these issues instead of solving them. Why do we get a home when others are homeless? Why do we get to go out for a nice dinner when others go hungry? Why do we get to go home to loving families when others experience only fear of violence? These can be hard questions, even when we are not experiencing helping fatigue, but become especially troubling when we are already struggling with guilt and shame.

One of the results of guilt and shame can often be a sense of hypervigilance, which usually only increases our experience of exhaustion and makes helping fatigue even worse. We will start to work longer hours, work weekends, and not take vacations to offset a further experience of shame and guilt. Just because are working longer hours does not mean the quality or impact of our work increases. In fact, the opposite is true. The more extended hours are often unproductive, and the resulting exhaustion decreases the energy we use to engage clients and be productive in our work.

We also have trouble disconnecting. We will start checking work emails at home in the evening, and even on vacation. Unconsciously, this can be an intent to do more when we believe we can never do enough, but it never gives our brain a chance to refresh, disconnect, and relax. The very things we are trying to do to work harder and longer to alleviate the guilt and shame just make the problem worse.

It is not uncommon for those experiencing trauma to develop a sense of shame and guilt around the experience. It is not a surprise that in professions with high levels of stress and a risk for secondary trauma and vicarious trauma, shame and guilt are so prevalent. In many ways, this is a natural response to the societal injustices we deal with every day. While shame and guilt might be a natural response to this work, it diminishes our ability to be effective with our clients.

My challenge this week is for you to take a minute to be introspective. Take a few moments just to sit quietly and see if you can recognize any shame or guilt you are experiencing around your work. If you can recognize it in your situation, what impact is this having on your professional or personal life? If we can identify areas of shame and guilt, it allows us to work through those experiences and address them so that we avoid the negative consequences it can have on our effectiveness at work and in our overall well-being.