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Strategies for Recognizing and Avoiding Compassion Fatigue

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Years ago, I found myself working for Family and Children Services in rural North Georgia. I investigated reported claims of child abuse. It was a never-ending, highly emotionally charged job, but I was good at it. My compassion to help vulnerable families was strong. However, where I failed was in taking care of myself. And it caught up with me – I burned out. My health, my family, my spirit, and my mind all suffered. I remember coming home one afternoon so downcast that when I heard my kids laughing and having a good time in the other room, I became extremely jealous of them.

 

Only my wife might be able to describe what horrible shape I was in. I had given so much of myself to others, I failed to care for myself and my family.

 

I now work as a Hospice Chaplain. When I completed my Clinical Pastoral Education, with a self-reflection, I was finally introduced to the concept of Compassion Fatigue. What is Compassion Fatigue?

I like the following two definitions the best:

  • “A state of exhaustion and dysfunction, biologically, physiologically, emotionally, (or spiritually) as a result of prolonged exposure to compassion stress” – Dr. Charles Figley
  • “Described as the ‘cost of caring’ for others in emotional and physical pain. It is characterized by deep physical and emotional exhaustion and a pronounced change in the helper’s ability to feel empathy for their patients, their loved ones and their co-workers. It is marked by increased cynicism at work, a loss of enjoyment of our career, and eventually can transform into depression, secondary stress and stress-related illnesses. The most insidious aspect of compassion fatigue is that it attacks the very core of what brought us into this work: our empathy and compassion for others.” – Francoise Mathieu M.Ed., CCC.

I find myself doing supportive work around Compassion Fatigue with myself, my patients’ families, my team and other medical staff on a weekly basis. It is some of the most important work I do. After I explain the importance of recognizing Compassion Fatigue, I will share my personal top ten coping strategies for my own self-care.

Compassion Fatigue is serious, and all of us in caregiving positions need to be mindful of its effects on our lives. The following are all possible symptoms of Compassion Fatigue:

 

  • Exhaustion
  • Reduced ability to feel sympathy and empathy
  • Anger and irritability
  • Increased use of alcohol and drugs
  • Dread of working with certain clients/patients
  • Diminished sense of enjoyment of your career
  • Disruptions to your worldview
  • Heightened anxiety or irrational fears
  • Difficulty separating work life from personal life
  • Absenteeism (missing work, taking many sick days)
  • Impaired ability to make decisions and care for clients/patients
  • Problems with intimacy and in personal relationships

When you find yourself experiencing manifestations of these, take them as warning signs. And if you find that you are experiencing more than two or three of these symptoms, it’s time to consider taking steps toward better self-care.

We cannot afford to not take care of ourselves, and here is why…

  • Our Ethical Obligation: We owe it to ourselves to take care of ourselves.  There is only one you and one me. What we do to nourish and strengthen ourselves is our responsibility and no one else’s. How can we provide compassionate care for someone else and not ourselves?
  • A Worthy Investment: We owe it to our team of co-workers, and to our families to take better care of ourselves. If we suffer, eventually they will. I am blessed to serve on a really strong team of nurses, social workers, CNAs, Nurse Practitioners, volunteers, and other staff members. They deserve my best work too. My family deserves my best as well.  My kids deserve to grow up in a home where they see their father live a whole, healthy life with good, strong coping skills. And it will better prepare them for their future.
  • Patient and Community Satisfaction: We owe it to our patients and communities that we serve. As with our families, if we suffer, eventually they will too.

I like this statement from Francoise Mathieu M.Ed. in his article Transforming Compassion Fatigue into Compassion Satisfaction:

 

“It has been shown that, when we are suffering from compassion fatigue, we work more rather than less. What suffers is our health, our relationships with others, and our personal lives and eventually our clients.”

 

And referring back to Mathieu’s definition earlier regarding “the cost of caring” – we spend a lot of ourselves caring for others, and we cannot underestimate that cost. We need to be mindful of it, and pay attention to it. Compassion Fatigue is real, and the very things that drive our care can also destroy our ability to care. So what do we do about it?

There are many great self-assessment tools out there, but the best assessment tool you have is yourself. Pay attention to yourself.  Finish this statement: “I know I am headed for trouble when …”. If you take the time to truly evaluate yourself, you are going to be the best observer of your own warning signs. Come up with a plan for when you experience those warning-signs. How do you cope? There are many options, but here are my own personal Top Ten Coping Strategies:

 

  1. Practice personal spiritual disciplines. In my own faith practice there are certain routines that I do daily to nourish my relationship with God. It is important to find spiritual support in ways that complement your belief system.
  2. Set healthy boundaries between work and personal life. There are rare times when it is okay to stretch the boundaries (but not often), but principally my time is my time, my family time is family time, and my work time is work time.
  3. Ask for help. It’s okay to have someone to talk to or call upon. If you find yourself in a situation where you are unable to ask for help, something is wrong.
  4. Be intentional and be assertive when necessary. Meet the problem before it becomes a problem. Be intentional about taking care of your own needs.
  5. Do things in moderation. 
  6. Practice good nutrition. Drink water, not soda. When I was working in Georgia, moderation and good nutrition were not in my vocabulary. Interestingly, when I got out of that life situation and found myself in a better place physically, emotionally and spiritually, I was able to be more intentional about my own self-care and I lost 90 pounds. And I have kept 80 pounds off for the past three years now.
  7. Be humble and teachable. When your own stress causes irritations and stress in others, be aware and willing to apologize. Sometimes we even need to learn how to apologize to ourselves.
  8. Seek moments of solitude, take personal retreats. Do something fun or peaceful for yourself every once in a while to help stay balanced.
  9. Foster good communication in every area of your life. 
  10. It’s okay to say “no” sometimes.

 

These are just some of the things that I do for self-care – perhaps you might add more to the list. It is not meant to be an exhaustive list, but it’s a good place to start. I will conclude with this powerful statement:

 

“The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet.” (Remen, 1996)

 

Compassion Fatigue is real, and something we all need to be mindful of. Take care of yourself, because you deserve it.


Guest Blog Contributor:

Jeromy Guthrie is a Hospice Chaplain, part of the team acquired from Elmhurst Memorial Hospice. He has been a bi-vocational minister for the past 12 years. His background is in Social Work, and alongside his ministry vocation he has been employed in the fields of Drug/Alcohol Counseling, Family and Children Services, and Adult Probation. He has served in Community Chaplain Services for the past 5 years, including his Hospice work over the past two years. He completed his undergraduate degree in Social Work at University of North Alabama, and his Masters of Theology at Golden Gate Baptist Theological Seminary in Denver, Colorado. He is also a certified Compassion Fatigue Educator through the Figley Institute, and an endorsed Disaster Relief Chaplain. He spends his free time with his family, riding his bike, reading, and connecting with people of different cultures.