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Understanding and Preventing Compassion Fatigue |
| Posted by Donna on May 08 2009 at 6:14 PM |
Understanding and Preventing Compassion Fatigue
By Dr. Angelea Panos PhD
Most of us became counsellors because we wanted to assist others in need. Yet our capacity for compassion, along with the intensity of our work can, at times, leave us vulnerable to "compassion fatigue,” This is a term that was coined to describe the set of symptoms experienced by caregivers who become so overwhelmed by the exposure to the feelings and experiences of their clients that they themselves experience feelings of fear, pain, and suffering including intrusive thoughts, nightmares, loss of energy, and hypervigilance. It can be cumulative (from the effects helping many clients) or occur in response to a particularly challenging or traumatic individual case. This extreme state of anxiety and preoccupation with the suffering of those being helped becomes traumatising for the helper. For this reason it is sometimes called “vicarious traumatisation” or “secondary traumatisation” (Figley, 1995).
Who is at risk?
While our training, professionalism and good boundaries within our helping roles are protective, really anyone with the capacity for true compassion, empathy, concern and caring is vulnerable to compassion fatigue. In other words, the greatest strength that you have to bring to your occupation - your capacity to develop a compassionate connection with your clients - is also your greatest vulnerability. Therefore, it is not a characteristic that you would choose to give up, rather it is more logical to educate yourself so you understand compassion fatigue and know what you can do if you begin experiencing symptoms. Realise that the more prolonged exposure to traumatic events you experience (ie working long hours), the more personal life demands you have, and the more isolated you become from others collectively increase your vulnerability for compassion fatigue.
Warning signs and symptoms.
The symptoms of compassion fatigue are similar to those of Posttraumatic Stress Disorder, only instead of the symptoms being based upon a trauma that you directly experienced, they are due to the trauma that your client(s) have experienced. Additionally, there is a cynical, discouraged or hopeless attitude about your work or your career that begins to set in. Paradoxically, you may find it difficult to leave your work at the end of the day. You may have thoughts that preoccupy you about a particular case. Being aware of what these symptoms mean and how they are affecting you is important. You can evaluate yourself with an excellent self-assessment tool that can be found at: http://www.isu.edu/~bhstamm/tests.htm. While this checklist is more comprehensive a few of the predominant symptoms of compassion fatigue are listed below:
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Feeling estranged from others (having difficulty sharing or describing feelings with others).
- Difficulty falling or staying asleep.
- Outbursts of anger or irritability with little provocation.
- Startling easily.
- While working with a victim thinking about violence or retribution against the person or persons who victimised.
- Flashbacks connected to clients and their families.
- Needing more close friends - feeling there is no one to talk with about highly stressful experiences.
- Working too hard for your own good.
- Frightened of things traumatised people and their family have said or done.
- Experience troubling dreams similar to a client and their family.
- Experience intrusive thoughts of sessions with especially difficult clients and their families.
- Suddenly and involuntarily recalling a frightening experience while working with a client or their family.
- Preoccupied with a client or their family.
- Losing sleep over a client and their family's traumatic experiences.
- Feeling trapped by working as a helper.
- Feeling a sense of hopelessness associated with working with clients and their families.
- Feeling weak, tired, rundown as a result of working as a helper.
- Feeling depressed as a result of working as a helper.
- Being unsuccessful at separating work from personal life.
- Feeling little compassion toward most co-workers.
- Thoughts of not succeeding at achieving life goals.
- Feelings of working more for the money than for personal fulfillment.
- Finding it difficult separating personal life from work life.
- A sense of worthlessness/disillusionment/resentment associated with work.
Prevention, resiliency and treatment.
Early recognition and awareness is crucial in being able to be resilient to compassion fatigue. Compassion fatigue is treatable! Keeping your life in balance or getting it back in balance, by taking some time off work, or enhancing your self-care are critical techniques. Keeping your body and your health in good shape is essential. You are not going to be resilient if you are not well rested. You may need medical attention if the symptoms of compassion fatigue, such as sleep disturbance, start interfering with your ability to function. If you are eating poorly and not exercising you are more vulnerable physically and emotionally to the effects of distress. Therefore, keeping a healthy balance in your life is a requirement to prevent and treat compassion fatigue. Caregivers that have a structured schedule that allow them time to organise and do good self-care are more resilient (Panos, 2007).
Another essential factor to prevent and treat compassion fatigue is to have some good relationships with either colleagues, a supervisor, or a therapist that you can safely and confidentially discuss the distresses you are experiencing. Isolation is a symptom of compassion fatigue and is ultimately dangerous. To be resilient you need to have good support and connections with others.
Many counsellors report that creative therapies such as writing in a journal, or expressing their feelings through music or art are helpful. Diversions and recreation that allow you to take mini-escapes from the intensity of your work is absolutely essential - not optional as some may think. Research on resiliency in paediatric healthcare workers show that those that have the ability to “turn their thoughts about work off” are more resilient throughout their career. Sometimes this involves developing a little ritual at the end of the day to transition into your life outside of work, while leaving your cares and stresses in the workplace (Panos, 2007).
What to do if you have symptoms of Compassion Fatigue:
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Have a recognition and awareness of the symptoms of compassion fatigue in yourself.
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Restore a healthy balance in your life, including good sleep, good nutrition and exercise.
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Get medical treatment for those symptoms that are interfering with your daily functioning.
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Utilise your positive supportive connections with others to process your feelings.
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Implement regular mini-escapes in your life, like recreation, creative therapies or other healthy diversions from the intensity of your work.
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Don't self-medicate with drugs or alcohol!
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Don't use other self-defeating addictions!
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Get professional help for yourself if needed to get back on track.
Conclusion.
Unrecognised and untreated, compassion fatigue causes people to leave their profession, fall into the throws of addictions or in extreme cases become self-destructive or even suicidal. It is important that we all understand this phenomenon for our own wellbeing, but also for our colleagues. If you notice a colleague in distress, reach out to them. Point them to this article and let them know that you are available to talk if they need to.
If you feel you or someone you know is suffering from compassion fatigue, education and training is available. Call Donna Bond for more information on 01989 730777 or 07973 827821.