Running Low on Empathy? How to Heal from Compassion Fatigue

The world is full of suffering. People committed to helping others—including those in helping professions such as mental health and medicine, activists, volunteers, and highly empathetic people—face nonstop exposure to a wide range of suffering. Compassion fatigue is a type of vicarious trauma that happens when a person is overwhelmed by the trauma and struggles of other people.

In its early stages, compassion fatigue may cause a person to be preoccupied by injustice and the desire to fix it. As compassion fatigue intensifies, however, it can lead to apathy and burnout. This can undermine a person’s relationships and connection to others. And for people in helping professions, compassion fatigue may prove professionally disastrous.

What Is Compassion Fatigue?

Compassion fatigue resembles burnout in that it may sap a person’s physical, emotional, and spiritual energy. Unlike burnout, however, it appears only in contexts where a person is providing extensive emotional support or emotional labor. In some cases, the symptoms of compassion fatigue resemble those of posttraumatic stress (PTSD).

Compassion fatigue resembles burnout in that it may sap a person’s physical, emotional, and spiritual energy.

Some other ways in which compassion fatigue differs from burnout include:

• Burnout happens when a person’s environment is stressful, whereas compassion fatigue happens when a person’s interactions with other people saps their emotional reserves.
• People with compassion fatigue may begin avoiding situations in which they must confront another person’s suffering but may not avoid other work.
• Compassion fatigue may cause a person to lose empathy for others.
• People with compassion fatigue may feel cynical, apathetic, or disconnected from others.
• Burnout typically gets better when a person takes time away from the source of the burnout. Compassion fatigue may persist.

Who Gets Compassion Fatigue?

Anyone who spends significant time helping others or thinking about others’ suffering may develop compassion fatigue. Some especially vulnerable populations include:

• Very empathetic people who tend to serve as the “therapist” in their family or among their friends.
• People in dysfunctional families who continually try to support other family members without seeking support for themselves.
• People in medical and mental health professions, especially providers who work with traumatized, abused, or dying people.
• People in fields that confront systematic injustice. Lawyers who work on challenging cases or issues of social justice, activists, people who work in child abuse prevention, and others who work to end systemic issues are at risk. The work does not have to be paid work. A volunteer rape crisis counselor, for example, could easily develop compassion fatigue.
• Professionals who routinely intervene in traumatic or life-threatening situations. First responders such as firefighters, police officers, and EMS professionals may report vicarious trauma or compassion fatigue.
• Caregivers to chronically ill people. An adult child caring for a parent with dementia or another terminal illness may feel fatigued and burned out.

Some research suggests that compassion fatigue is more prevalent when a person receives inadequate support for their work. A caregiver for a person with dementia may be more vulnerable to fatigue when other members of the family refuse to help or constantly criticize their caregiving.

Symptoms of Compassion Fatigue

The symptoms of compassion fatigue vary from person to person and may change with time. They include:

• Symptoms that resemble PTSD, such as flashbacks, avoidance, disturbing dreams, and nightmares.
• An inability to show compassion or empathy. A once-caring doctor may begin blaming their patients for their maladies, while a social worker may lose interest in helping struggling families.
• Anger and resentment.
• Becoming socially disconnected.
• Feeling poorly understood by others.
• Having increasingly few boundaries between work and home.
• A decrease in productivity and effectiveness.
• Feeling trapped.
• Depression.

Strategies for Preventing Compassion Fatigue

Compassion fatigue is a common struggle, and it is not always preventable. It often comes on suddenly, even after a person has managed stress well for years. Certain prevention strategies, however, may reduce the risk and help a person better manage symptoms of compassion fatigue:

• Schedule time for self-care, including eating healthy meals, exercise, and spending time on enjoyable hobbies.
• Set clear boundaries. No one needs to answer calls 24 hours a day or provide constant care to another person.
• Take time away from work or from caregiving labor whenever possible.
• Spend time with people who support and understand the work you are doing. A public interest lawyer, for instance, may find support and help from weekly meetups with attorneys in similar fields.
• Practice mindfulness. Compassion fatigue can cause a person to feel distracted and overwhelmed. Meditation and mindful living strategies may counteract these sensations.
• Avoid taking work home. Don’t read upsetting emails or listen to voicemails during down time. People involved in unpaid caregiving or activism should schedule time away from their pursuits.
• Seek help. No single person can solve the world’s problems. Family caregivers should look in to paid care options or ask other family members for help. Professional helpers should explore additional resources to help their clients while reducing their own exhaustion.
• Reward yourself for difficult tasks. For example, plan an outing with friends following a meeting with a difficult client.

Treatment of Compassion Fatigue

Compassion fatigue is a response to chronic stress, not a mental health diagnosis. This means that treating compassion fatigue requires a person to get some relief from their stress. That might mean:

• Reducing their workload or seeing fewer clients.
• Taking time away from work.
• Establishing clear work-life boundaries.
• Changing one’s approach to work.

In some professions, it may not be possible to reduce the stress. For example, an emergency room doctor who treats abuse survivors may have little control over their workload, while a skilled death penalty attorney might be the only person in their region who can handle such complex cases. People in these situations may require extensive ongoing support, medication to manage anxiety and depression, and regular breaks from work.

No matter the cause of compassion fatigue, a therapist can help a person:

• Assess their boundaries. In some cases, a person develops compassion fatigue because they feel an obligation to “save” everyone.
• Create a better work-life balance. Time away from work, meaningful hobbies, exercise, and self-care may all help with compassion fatigue and burnout.
• Relax. Develop relaxation strategies such as meditation and cultivating mindfulness in the moment.
• Identify other resources that may help. For example, a doctor may gain significant stress relief by hiring an office assistant or relying more on their nursing staff.
• Gain new skills. New strategies to deal with personal or workplace challenges may help a person avoid compassion fatigue. For example, by learning to listen without offering advice, a parent might offer greater support to a struggling child without feeling so exhausted after each conversation.

GoodTherapy can help you find a therapist who specializes in compassion fatigue. Begin your search here.

References:

1. Compassion fatigue. (n.d.). The American Institute of Stress. Retrieved from https://www.stress.org/military/for-practitionersleaders/compassion-fatigue
2. Compassion fatigue. (2017, August 23). American Bar Association. Retrieved from https://www.americanbar.org/groups/lawyer_assistance/resources/compassion_fatigue
3. Gallagher, R. (2013). Compassion fatigue. Canadian Family Physician, 59(3), 265-268. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3596203
4. Pfifferling, J., & Gilley, K. (2000). Overcoming compassion fatigue. Retrieved from https://www.aafp.org/fpm/2000/0400/p39.html

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