What is compassion fatigue? The signs, treatment and prevention

by Leanne Hall
Posted: November 26, 2017

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Empathy fatigue or compassion fatigue can hit any counsellor, caregiver or therapist - regardless of how many years they have been in the industry, says Clinical Psychologist and mental health expert, Leanne Hall. And when it does, it can throw you for a six. Why? 

Because it triggers certain fears and thoughts that represent those fraudulent schemas that we all secretly have, at least to some degree! This intellectual self-doubt can have even the most experienced and accomplished counsellor or caregiver feeling like an imposter; “what gives me the right to be here” “I feel like a fake”. 

These thoughts can be quite confronting and difficult to talk about. And while they can surface for many reasons, compassion fatigue is a big one. 

So what is compassion fatigue?

This young brunette girl is wondering what is compassion fatigue and if she has the signs

Empathy or compassion fatigue involves the gradual lessening of compassion over time. Basically, it’s like a form of post-traumatic stress disorder and can involve dissociation which as any counsellor will tell you - is the OPPOSITE of what you need to do when counselling someone. 

Hence, self-doubt can creep in, causing anxiety and even depression. Sometimes physical symptoms can also result such as nausea (especially at the thought of going to work), headaches, dizziness and sleep problems – all of which can lead to feelings of resentment, anger and anxiety.

It’s caused by the emotional and physical burden created by the trauma of helping others and listening (with empathy) to their traumatic and difficult circumstances. Think of it like vicarious trauma, or in psychoanalytic terms, “countertransference”, which means putting yourself in the shoes of someone who has experienced adversity. 

In a way, you feel what they feel. The only difference is as a counsellor or carer, you have the added expectation of being able to “help”. 

As you can imagine, some counsellors and caregivers are more at risk than others – for example, counsellors working with clients who have experienced trauma and/or grief, social workers who feel physically threatened by a person under their care or counsellors who have a client with severe mental health issues.

Having said that, all counsellors, caregivers and other community care workers are vulnerable to emotional stress and empathy fatigue simply because they are trained to utilise compassion and empathy. However much like a fuel tank, our supply of empathy isn’t endless, rather it requires constant “filling up” which we will discuss in more detail later.

Compassion fatigue vs. burnout: What’s the difference?

Blonde lady at home office. Does she have compassion fatigue vs.burnout symptoms?

Put simply, empathy fatigue is associated with the type of work you do. As such, changing jobs (to another counselling position) often won’t fix it. It also tends to have a fairly sudden onset and is not entirely predictable which can be quite unsettling. On the upside though, it is actually relatively easy to treat.

Burnout, on the other hand, is associated with where you work, as opposed to the work you do. This means that changing jobs is often a good start when it comes to addressing associated symptoms. It also tends to have a more predictable onset and gradual as opposed to the sudden onset of empathy fatigue.

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What are the signs of compassion fatigue?

Basically, the top 3 signs of compassion or empathy fatigue are:

  1. Emotional exhaustion, which persists after you leave the office.
  2. Alienation from job-related activities. This can feel like a form of dissociation where you feel “disconnected” and almost like you are not there, also commonly described as feeling “numb”.
  3. Reduced work performance. 

While many of us experience at least one of these symptoms from time to time, experiencing all three at once can certainly be a sign of empathy or compassion fatigue. 

How to treat compassion fatigue

If you feel as though empathy fatigue might apply to you, OR you would like to know what to do if it ever does, here is what to do:

1. Don’t fight it! 

Recognition is key – knowing the signs means you can hit “pause” and focus on what to do next.

2. Talk to someone about how you are feeling. 

This is where having a clinical supervisor is invaluable. Otherwise, there is no shame at all in seeing a counsellor – it’s good practice and all part of ensuring that you‘re able to provide an effective and professional service to your clients. 

3. Plan a holiday.

Sounds simple, but planning a break can provide a focus outside of work and create something positive to look forward to.

4. Focus on establishing a healthy sleep/wake cycle. 

Healthy sleep hygiene practices and good quality sleep are critical in reducing cortisol (the stress hormone) and increase the ability to cope.

5. Meditate. 

Creating space to be in-the-moment allows for a deeper understanding and awareness of ourselves. This is critical information, if we are trying to move through a difficult emotional process. 

What about compassion fatigue prevention?

Meditation on a beach is an effective form of compassion fatigue prevention

While learning how to treat compassion fatigue is important – it’s even more important to understand how to prevent it, especially given the fact that its onset can be quite sudden. Given that empathy is not in endless supply, it’s important to know how to make sure the cup is never empty. 

We can do this by learning how to be self-aware and practising self-compassion. Preventing empathy fatigue is all about ensuring a balanced lifestyle. By integrating these four elements into your life, you will undoubtedly reduce your risk of developing compassion fatigue. 

1. Having regular clinical supervision/therapy. 

Having a place where you can regularly discuss and process difficult emotions is important. 

2. Establishing a healthy work/life balance.

Having an identity outside of counselling and community support work is also important. 

3. Regular meditation. 

Research shows that regular meditation can increase compassion. It allows for counsellors to be able to be compassionate without taking on the client’s trauma/experience. 

4. Sleep and exercise. 

Both are important in helping to reduce cortisol and increase feel-good hormones such as serotonin, dopamine and endorphins.

The bottom line

It’s important to understand that compassion or empathy fatigue does not discriminate. While it’s something that is quite common, it’s also something that many counsellors, therapists and support workers do not like to discuss and/or accept. 

Why? Because it makes sufferers feel like a “fraud”, or question whether they are in the right profession. Sound familiar? Yes, it’s all about STIGMA. And while counsellors and carers work hard every-day to help their clients overcome this word, it’s about time that we applied our understanding of this potentially destructive term to our own profession. 

In other words, even counsellors and care workers are not immune to needing support and help. So never be afraid to ask for it!

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Leanne Hall

Leanne Hall

Leanne has been transforming lives for over 15 years as the mind and body expert for Channel 10 and as a practising clinical psychologist. Leanne Hall motivates her patients to achieve a healthy and well-balanced lifestyle using positive psychology and “mindfulness” techniques, holistic nutrition and exercise. Leanne's expertise covers everything from how the beauty myth impacts women's self-esteem, mental health and fitness.

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