Compassion Fatigue: Know the signs and reduce the risk

Compassion fatigue can manifest in various ways, including physical, emotional, and behavioural symptoms. Some common signs include chronic exhaustion, emotional numbness, irritability, cynicism, difficulty sleeping, and decreased productivity. Let’s take a closer look:

1. Chronic exhaustion: Feeling constantly tired and lacking energy, even after getting adequate rest.
2. Emotional numbness: Experiencing a sense of detachment or feeling emotionally disconnected from patients, clients or loved ones. This includes emotional numbness in the workplace setting, but also extends to the other parts of a person’s life such as personal relationships.
3. Irritability: Becoming easily agitated, having a short fuse, or experiencing frequent mood swings. This may include becoming angry about things that did not previously irritate you, or having a chronic sense of irritability that does not seem to be related to anything in particular.
4. Cynicism: Development of a negative or cynical attitude towards people in your workplace and the work itself This might include patients, clients, colleagues, the health system in general, and even how you view your own role.
5. Difficulty sleeping: Experiencing changes in your sleep like insomnia, restless sleep, or frequent nightmares or dreams related to work experiences.
6. Decreased productivity: Finding it challenging to focus, feeling overwhelmed by tasks, or experiencing a decline in work performance. You may find that you start to take more days off work, or find reasons to start late or finish early, or you may distract yourself with less important tasks while at work in order to avoid working directly with patients of clients.
7. Physical symptoms: Experiencing physical ailments such as increased headaches, digestive or gut issues, or a weakened immune system due to prolonged stress.
8. Isolation: Withdrawal from social activities, avoiding social interactions, or feeling a sense of isolation or disconnection from others who you previously felt closer towards.
9. Loss of empathy: Finding it increasingly challenging to connect emotionally with clients or others more generally, or experiencing reduced feelings of empathy and compassion. In addition, you may notice instead feeling cynical or mistrustful towards people who present for your care.
10. Avoidance behaviours: An increase in avoidance of situations that require you to attend to the emotions of others, such as particular events, places, relationships, or particular work activities that are most emotionally demanding. Also be on the lookout for avoidance of your own self-care – you may find that you start to neglect looking after yourself in the ways you have done before, such as paying less attention to your diet and exercise, neglecting to brush your teeth or clean your clothes as regularly, and avoiding time to self-reflect on your emotions.
    Tips for safeguarding against compassion fatigue

If you are exposed to situations that involve providing care and compassion regularly to others, it is crucial to prioritise self-care and implement strategies to prevent or manage compassion fatigue. Here are some tips:

1. Recognise the Signs: Know the signs to look out for (see above), and be alert to changes in these areas.
2. Prioritise Joy and Relaxation: Make self-care a non-negotiable part of your routine. Engage in activities that bring you joy, relaxation, and rejuvenation – these will be different for every person. What activities are your go-to places for fun, play, relaxation and recharge? This may include exercise, hobbies, spending time in nature, practising mindfulness or meditation, cooking, gardening, painting, going to a concert, reading, or connecting with loved ones in a particular way.
3. Set boundaries: Start to pay attention to your wellbeing and notice what your personal limits are – when do you start to feel drained and withdrawn? Once you know these limits, start to communicate them to people clearly. Let your colleagues, supervisors, or clients know about the limits you have set for yourself. This could involve communicating your availability, scheduling breaks, or establishing protocols for when you need time off. Open and honest communication sets the expectations and helps others understand and respect your boundaries.
4. Schedule regular breaks: Regular breaks are not a luxury but a necessity to recharge and protect your emotional well-being. Incorporate short breaks throughout your day to engage in activities that help you relax and rejuvenate. Whether it’s taking a walk, getting a coffee, practising mindfulness exercises, or simply disconnecting from work-related responsibilities, these breaks allow you to decompress and replenish your energy levels.
5. Practice saying “no”: It can be challenging to say “no” when faced with requests or demands, especially if you have a strong desire to help others. However, learning to say “no” is a powerful way to set boundaries and prevent overextending yourself. Be selective about the commitments you take on. Remember that by saying “no” to some things, you are creating space to say “yes” to the things that truly align with your abilities and interests.
6. Limit exposure to distressing content: If your work involves regularly encountering distressing or traumatic situations, it’s crucial to set boundaries around your exposure to such content. Establish guidelines for how much time you spend reading or watching distressing news or social media, limit exposure to graphic imagery, and consider implementing self-care practices after encountering challenging cases. By managing your exposure, you can reduce the risk of becoming emotionally overwhelmed.
7. Practice Emotional Limits: While empathy is a crucial aspect of caregiving, it’s essential to establish emotional limits and boundaries to prevent emotional overload. Learn to differentiate between empathising with someone versus taking on the pain and suffering of others. This means offering support and care without internalising every hardship. Practice active listening and empathy while also maintaining a healthy emotional distance to protect your own mental well-being.This can be a challenging skill to master, but there are many helpful techniques for learning to walk this middle road. Again, psychologists can be particularly helpful in teaching you ways to do this that work best for your particular circumstances and strengths.
8. Develop Coping Strategies and Habits: Discover and implement coping strategies that work for you when faced with challenging and distressing situations. These strategies may include deep breathing exercises, journaling, engaging in creative outlets, practicing mindfulness, or seeking professional supervision or consultation. Experiment with different techniques until you find what resonates with you personally. Having an end-of-day habit or ritual for when you are leaving work can also be helpful, as it helps you to psychologically place a boundary between your work and the rest of your life. For example, you may take 2 minutes at the end of each work day to imagine opening up a hypothetical suitcase, placing the day’s feelings and challenges inside, and lovingly closing and leaving the suitcase there at work until you return the next day. Take a few deep breaths as you do this, and imagine stepping back out into the world as the ‘you’ outside of your work persona, with your workday challenges safely stored away to address next time you are there.
9. Build a Support System: Having a strong support system is invaluable for mitigating compassion fatigue. Surround yourself with understanding and emotionally-mature people who can provide emotional support and focus on your needs without making it all about them. This could be colleagues, support groups, mentors, friends, or family members who can lend a listening ear, share experiences, offer guidance, and also just sit with you through the hard times. These might also be people who can do activities with you outside of a work context, too. Participating in support groups or seeking counselling or psychology support can also be beneficial in processing emotions and gaining new perspectives.
10. Resilience practices: Resilience is the ability to bounce back from adversity, and it plays a crucial role in combating compassion fatigue. Cultivate resilience by focusing on personal growth, maintaining a purposeful mindset that takes into account you as a whole person (not just the version of you that helps other people),, and nurturing a sense of purpose in your work – try to remember the deeper values and meaning that you find in your day to day tasks. Specific activities that promote resilience are doing things where you continue to learn and grow, practicing gratitude by reflectoing on the aspects of your day that you are thankful for (alongside the challenges), and reflecting on what makes you proud about your actions such as the positive impacts you’ve made (no matter how big or small) and the ways you have supported yourself or challenged yourself.
11. Regularly Evaluate and Adjust: Regularly assess your well-being and monitor the signs of compassion fatigue. Place a time in your diary each month to check-in with yourself and your mental health. Take time to reflect on your experiences, feelings, and the effectiveness of your coping strategies. If necessary, make adjustments to your self-care routines, boundaries, or support systems. Remember that boundaries are not set in stone. It’s essential to regularly assess whether they are still serving your well-being effectively. As circumstances change and your needs evolve, be open to adjusting and refining. Flexibility allows you to adapt to new challenges and maintain a healthy balance between caregiving and self-care. Stay open to seeking professional help when needed, and think about setting up a mentor or professional guidance relationship with a senior colleague who you admire for the ways in which they manage their own work-life balance.
12. Peer support: Perhaps you have other colleagues who would be interested in setting up a regular peer support group, either virtually or in-person, so that you can get together and share stories, struggles, and successes as a group. Because one thing is for certain – you will not be alone in your struggles, and other people around you are bound to experience similar challenges.
13. Practice self-compassion: It is perfectly acceptable and necessary to prioritise your well-being. Be kind to yourself – notice any guilt or self-judgement associated with setting boundaries and try to allow yourself to make the decision to look after yourself anyway. Treat yourself like you would a dear friend – what would you say and how gently and kindly would you relate to a friend going through a hard time? Apply this same compassion to yourself. Remember that by taking care of yourself, you are ultimately better equipped to provide meaningful support to others.