Last month I was asked to work with a group of healthcare professionals on ‘Compassion Fatigue’ - how to recognise it, even when it is creeping up, and how to develop strategies and practices to avoid it.

Compassion or, better still, Caregiver or Empathy Fatigue is rampant in our world. People who care and look after others – whether in their family, with marginalised people in society, animals, or in their capacity as healthcare professionals – go buckled under what feels like a never-ending tide of suffering.

For someone who is caring, selfless and generous, it can come as a nasty surprise when you find yourself relieved at the cancelation of a client; irritated, cynical or even increasingly indifferent to people’s stories of woe. It can be confusing too, as a caregiver’s sense of identity is often bound up with her warmth and interest in the plight of her fellow men and women. Who are you, if you’re not the kind person you thought you were?

Other symptoms of ‘compassion fatigue’ can stir up health anxieties, particularly when we don’t recognise the link with the caregiving role we take on in our lives. Think of difficulties with concentration, fatigue, abdominal pains, headaches or insomnia. The list goes on and until it hits us, it remains something theoretical that only happens to others. The drive that comes from our energy, motivation and focus on doing good, makes us feel invincible. Our attention is locked on all that needs doing, day in – day out; at the expense of caring for oneself.

The Health Service offers an interesting case study. Many patients experience the service as lacking in care and compassion. It can sadly leave us feeling distinctly uncared for.

This however, is in stark contrast to the individual reality of healthcare professionals themselves. Large numbers of them feel defeated by the weight of their task, utterly exhausted by the amount of people they see, the suffering they encounter and frustration at everything that gets in the way of doing the best job they can.

Compassion Fatigue, or secondary traumatic stress disorder, comes about when caregivers become over-exposed to the suffering of others. The body shuts down and disconnects the caregiver from further exposure. “That”, she says, “is that!”

What We Can Do

Caring makes us human. Feeling the pain of others as our own connects us, but what can we do to take better care of ourselves, so that we can wholeheartedly be and remain there for others?

I heard Brené Brown quote a priest who said: ‘if you don’t want to burn out, stop acting like you’re on fire’. How - you may well ask – are we supposed to keep warming others, without burning out in the process ourselves?

Good ideas abound, but make a distinction between (1) the practices that help rebalance and pace your life, and (2) those that help you deal with your response to what comes up in the heat of the moment, when you are heart-to-heart with the pain of others.

Feed Your Soul

Rebalancing your life requires you to reintroduce activities that allow you to disconnect and unplug from everything that links to your (main) caregiving role. Nature is a great healer. It reminds us of the relativity of things, shows us that everything is always changing and passing (even without our interference), and demonstrates that there are things we can control and others we simply can’t. It also energises and inspires us – it literally in-spires, gives us breath.

Spend time with people who feed and lift you. Good connections transform our state of mind.

Bring Compassion to the Moment

How is it that caring can cause so much pain?

Recent research by the well-known Buddhist monk Matthieu Ricard and scientist Linda Singer has shown that when we empathise or ‘feel with’ another person their feelings become ours. The brain of an empathetic listener literally lights up the same pain pathways as that of the sufferer. The brain activity of the caregiver mirrors that of the patient. We also call this resonance.

So, even if you help the patient or client and their burden is alleviated, you will see another pained person and then another, and so on for years. No wonder that your brain can eventually close down.

This state of burn-out or running on empty is better described as empathy fatigue. Not compassion fatigue. Compassion it turns out, actually alleviates the pain and when really experienced, lights up a very different pathway in the brain of the caregiver; one that actually energises her.

Here’s How To Do It

Develop an awareness of your own physical, embodied discomfort that arises when you listen to the stressful situation of another. Do this regularly. The discomfort that wasn’t there before you spoke to the patient.
Acknowledge what you are feeling. Locate it and name it. Just this act can help us calm down and become more present to the other person again.
Breath kindness into your own ache, allowing it to be there and giving it some space. Meanwhile, keep focussed on the other person, without responding to any personal urge you may have to offer solutions or explanations. Just breathe into your own twitches and listen to the other.
Breathing in kindness (or warmth, love or light – whatever works for you) for yourself and then breathing out the same for the other. In for me and out for you.

At the recent workshop with the team of healthcare professionals, participants were delighted with the comfort this exercise brought, and how it enabled them to stay more present with their patients.

I hope it can help you too.

About Renée

Renée van der Vloodt ( M.A. , FHGI ) is a psychotherapist and coach – and has had a private practice for over 20 years, which is now based in Woodchurch (near Ashford), Kent. She also works with people around the world via online sessions.

Renée works with children and adults as a coach and therapist to help them overcome life's challenges and emotional difficulties including stress, burnout, anxiety, depression, post-traumatic stress disorder (PTSD), anger or addictive behaviour.

Renée is a regular contributor to Breathe Magazine and the author of the CD Calm the Chaos of the Creative Mind.