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  • Blog Post
  • Pam Sikorski

Compassion Fatigue Symptoms and Strategies

If you’re feeling exhausted or numb, crying, or losing sleep because of the people who you care for, you are experiencing compassion fatigue symptoms.

 

Feeling empathy for those you care for may seem like a given, it may even be the reason you're doing what you do, but this empathy can often go too far, leading you to feel the symptoms of compassion fatigue as you suffer from another person’s trauma. 

 

Compassion fatigue, or vicarious/secondary trauma, is much more serious than general burnout: it’s a caregiver experiencing trauma after witnessing another’s physical, emotional, or spiritual pain. Concept pioneers McCann and Pearlman define it as “a process through which the caregiving individual’s own internal experience becomes transformed through engagement with the client’s trauma” (1990). 

 

According to the Compassion Fatigue Awareness Project, anywhere from 25–50% of healthcare workers experience symptoms of compassion fatigue. Everyone from long-term care workers to family caregivers to emergency room nurses to police officers may find themselves taking on others’ trauma. 

 

What are the symptoms?


A Canadian study in the Archives of Internal Medicine by Leeat Granek notes the following as common symptoms of compassion fatigue: 

  • Feelings of failure, guilt, self-doubt, sadness, and powerlessness 

  • Loss of sleep 

  • Reduced sense of efficacy on the job 

  • Difficulty concentrating

  • Feeling overwhelmed by obligations

  • Apathy and emotional numbness 

  • Secretive addictions or self-medicating in a variety of ways 

  • Isolation and withdrawal 

  • Exhaustion 

  • Intrusion symptoms in thoughts, dreams, or nightmares 

  • Bottled-up emotions 

  • Pessimism 

 

Those affected are sometimes the last to recognize what’s happening and may need family members, friends, or colleagues to help them make the realization.

 

As the symptoms of compassion fatigue closely resemble those of post-traumatic stress disorder, those affected often struggle to function in their day-to-day routines. And if multiple employees in an organization with these symptoms feed negatively off one another, a toxic culture can result. 

 

Who is most at risk?


Those new to the field of caregiving. 
Unlike burnout, compassion fatigue can happen quickly. New caregivers may be more likely to get overwhelmed by their responsibilities. 
 
Those with a history of personal trauma. 
Abuse, natural disasters, military experience, the unexpected death of a loved one, accidents, neglect—personal. 
 
Those who interact with many clients. 
The greater the number of clients, the greater the likelihood that one will be experiencing or have experienced traumas that a caregiver will be exposed to. 
 
Those working long hours. 
Many human services professionals work a great deal of overtime and regularly pull double shifts, and nothing can errode emotional resiliency like sleep deprivation. This also includes those who are caregivers in their personal lives, and do not have the opportunity to "clock out" and leave an emotionally fatiguing situation.
 
Those with a history of experiencing burnout. 
Job dissatisfaction built up over time becomes its own form of trauma and increases the likelihood of an individual developing compassion fatigue. 
 
Those who have trouble communicating. 
People to struggle to express their emotions may find it easier to bottle up the stress of being a caregiver, putting them at greater risk of trauma.

Those with inadequate personal support systems. 
When people don't have others to lean on and offer support—a significant other, family, friends, neighbors, trusted colleagues, church groups, clubs, even pets—trauma can result. 
 

What can I do about it?


Organizations should offer opportunities like those below to raise awareness and/or help those struggling with compassion fatigue. If your organization does not, advocate that they be added! 

  • Formal debriefing sessions 
  • Internal support groups  
  • Employee Assistance Programs 
  • Corporate wellness programs/committees
  • Flexible hours
  • Job sharing

 

The Ten Laws Governing Healthy Caregiving [PDF], along with other resources at the Compassion Fatigue Awareness Project, can serve as mantras to reframe situations from trauma to empowerment. 

 

Most importantly, though, you need to prioritize your own physical and mental health. Many in the helping professions excel at taking care of others and ignore thems own needs. Self-care isn't optional. It's a critical part of ensuring you have enough mental and physical energy to do your best at caring for others.

If you're not sure where to start when it comes to caring for yourself, learn the technique that nurse Laurie Barkin uses. Also make sure to: 

  • Get enough sleep 

  • Eat well 

  • Exercise regularly 

  • Do activities you enjoy regularly 

  • Build and maintain a good support system

  • Pursue a good work/personal life balance. 

 

When you do work that emotionally affects you, it's more important than ever to develop strong self-care habits. You're obviously overflowing with passion, given the work you’ve gotten into. Spare some of it for yourself.


If you want to learn more, listen to our podcast episode about surviving vicarious trauma.
 

Also listen to Patricia Smith share her story of compassion fatigue, and her path to recovery.

 

Additional resources


If you want to learn more about this topic and help raise awareness among your colleagues about it, check out the following resources.
 
  • Compassion Fatigue Awareness Project’s websites, compassionfatigue.org and healthycaregiving.com.
  • Compassion Fatigue: Coping With Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized by Charles R. Figley, Ph.D.
  • Compassion Satisfaction: 50 Steps to Healthy Caregiving by Patricia Smith
  • CPI. (2012). Instructor manual for the Nonviolent Crisis Intervention® training program. Milwaukee, WI: Author.
  • Figley, C. R. (Ed.). (1995). Compassion Fatigue: Coping With Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized. New York: Taylor and Francis Group.
  • Gift From Within’s Article Library on Compassion Fatigue
  • McCann, I. L., & Pearlman, L. A. (1990). Vicarious Traumatization: A framework for understanding the psychological effects of working with victims. Journal of Traumatic Stress, 3, 131–149.
  • Professional Quality of Life Scale (a measurement of the effects of helping others who experience suffering and trauma with sub-scales for compassion satisfaction, burnout, and compassion fatigue)
  • Smith, P. (2012a) Alleviating compassion fatigue before it drags down productivity [PDF]. Long Term Living.
  • Smith, P. (2012b) Nursing home employees often suffer from compassion fatigue [PDF].
  • To Weep for a Stranger: Compassion Fatigue in Caregiving by Patricia Smith

Originally published in the Journal of Safe Management of Disruptive and Assaultive Behavior, Fall 2013. © 2013 CPI. Certified Instructors, log in to read more JSM articles.
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