Compassion Fatigue
Compassion fatigue: is a state of emotional, physical, and mental exhaustion, where one experiences; decreased self-esteem, chronically fatigue, helpless, loss of purpose, hopeless, has difficulty concentrating and can be cynical, about oneself, work, life, and the state of the world.
At the heart of providing effective care is the ability to join others in their painful journey and to lend strength to their process of recovery. One’s capacity for compassion sets the stage for compassion fatigue. A professionals’ constant surrendering to that deep empathy level can exhaust them and lead to compassion fatigue.
It is abundantly clear that therapists and counselors must make a conscious decision to protect themselves, if they are to survive working in the field, retain their effectiveness with clients, and live a fulfilling personal life.
Endless compassion combined with personal and professional stress can destroy optimism and diminish the belief in the human spirit's resiliency.
Signs and Symptoms of Compassion Fatigue
Each individual will have their own warning signs that indicate that they are moving into the danger zone of compassion fatigue. These may include some of the following:
o Exhaustion
o Reduced ability to feel empathy
o Diminished sense of enjoyment of career
o Difficulty separating work life from personal life
o Dread of working with certain clients/patients
o Impaired ability to make decisions and care for patients
o Heightened anxiety or irrational fears
o Intrusive imagery or dissociation
o Hypersensitivity or Insensitivity to emotional material
o Anger and irritability
o Increased use of alcohol and drugs
o Absenteeism – missing work, taking many sick days
o Problems with intimacy and in personal relationships
Creating a personal self-care plan:
· Accept that vulnerability to compassion fatigue is part of a counselor's life.
· Seek to understand the dynamics of compassion fatigue.
· Become aware of personal stress triggers.
· Become aware of personal indicators that compassion fatigue is corrupting your ability to function personally and professionally.
· Identify the self-care methods that will be most effective for you.
· Seek clinical supervision. If the employing agency does not provide it, purchase supervision from an outside source
· Use agency resources, such as EAP services
Questions that are helpful in creating a self-care plan:
· What attracted me to this field?
· What attracted me to this job?
· How do I handle change?
· How much change is going on in my life?
· How healthy is my lifestyle?
· When did I last take a vacation (not a conference)?
· What do I get out of over involvement in my career?
· What do I need to change?
· What am I willing to change on a daily, weekly, monthly, or yearly basis?
Self-Care Assessment Worksheet
This assessment tool provides an overview of effective strategies to maintain self-care. After completing the full assessment, choose one item from each area that you will actively work to improve.
Using the scale below, rate the following areas in terms of frequency:
5 = Frequently 4 = Occasionally 3 = Rarely 2 = Never 1 = It never occurred to me
Physical Self-Care
___ Eat regularly (e.g. breakfast, lunch and dinner)
___ Eat healthy
___ Exercise
___ Get regular medical care for prevention
___ Get medical care when needed
___ Take time off when needed
___ Get massages
___ Dance, swim, walk, run, play sports, sing, or do some other physical activity that is fun
___ Take time to be sexual—with yourself, with a partner
___ Get enough sleep
___ Wear clothes you like
___ Take vacations
___ Take day trips or mini-vacations
___ Make time away from telephones
___ Other:
Psychological Self-Care
___ Make time for self-reflection
___ Have your own personal psychotherapy
___ Write in a journal
___ Read literature that is unrelated to work
___ Do something at which you are not expert or in charge
___ Decrease stress in your life
___ Let others know different aspects of you
___ Notice your inner experience—listen to your thoughts, judgments, beliefs, attitudes, and feelings
___ Engage your intelligence in a new area, e.g. go to an art museum, history exhibit, sports event, auction, theater performance
___ Practice receiving from others
___ Be curious
___ Say “no” to extra responsibilities sometimes
___ Other:
Emotional Self-Care
___ Spend time with others whose company you enjoy
___ Stay in contact with important people in your life
___ Give yourself affirmations, praise yourself
___ Love yourself
___ Re-read favorite books, re-view favorite movies
___ Identify comforting activities, objects, people, relationships, places and seek them out
___ Allow yourself to cry
___ Find things that make you laugh
___ Express your outrage in social action, letters and donations, marches, protests
___ Play with children
___ Other:
Spiritual Self-Care
___ Make time for reflection
___ Spend time with nature
___ Find a spiritual connection or community
___ Be open to inspiration
___ Cherish your optimism and hope
___ Be aware of non-material aspects of life
___ Try at times not to be in charge or the expert
___ Be open to not knowing
___ Identify what is meaningful to you and notice its place in your life
___ Meditate
___ Pray
___ Sing
___ Spend time with children
___ Have experiences of awe
___ Contribute to causes in which you believe
___ Read inspirational literature (talks, music, etc.)
___ Other:
Workplace or Professional Self-Care
___ Take a break during the workday (e.g. lunch)
___ Take time to chat with co-workers
___ Make quiet time to complete tasks
___ Identify projects or tasks that are exciting and rewarding
___ Set limits with your clients and colleagues
___ Balance your caseload so that no one day or part of a day is “too much”
___ Arrange your work space so it is comfortable and comforting
___ Get regular supervision or consultation
___ Negotiate for your needs (benefits, pay raise)
___ Have a peer support group
___ Develop a non-trauma area of professional interest
___ Other:
Balance
___ Strive for balance within your work-life and workday
___ Strive for balance among work, family, relationships, play and rest
Scores:
Excellent Self-Care: 292-350 Good Self-Care: 234-291 Average Self-Care: 175-233
Below Average Self-Care: 174 and below
Source: Transforming the Pain: A Workbook on Vicarious Traumatization. Saakvitne, Pearlman & Staff of TSI/CAAP (Norton,1996)
Self-Compassion
Self-compassion refers to an emotionally positive self-attitude that may serve to protect the individual from negative self-evaluations, anxiety and depression (Neff,41 2003a). Although helping professionals are skilled at conveying an attitude of concern and compassion for their clients, this attitude of kindliness is often not directed inward. The development of self-compassion has been linked to improved psychological well-being, self-kindness and true self-esteem (Neff, 2003b). Self-compassion may prove to be a valuable component in reducing the experiences of both compassion fatigue and burnout in individuals who work with those who suffer.
Self-compassion (Neff, 2003a) is made up of three interrelated factors. These included:
Self-kindness (vs. self-judgment), Self-kindness refers to an attitude of self-acceptance characterized by kindness and understanding rather than negative judgment and self- criticism
Common humanity (vs. isolation) Common humanity refers to seeing one’s experience, both positive and negative, as being part of the unfolding human experience as opposed to suffering from feelings of isolation or separation.
Mindfulness (vs. over identification) Mindfulness refers to holding one’s negative thoughts and feelings in balance instead of over identifying with them and becoming lost in rumination or depression.
Emotional Resilience:
The ability to adapt to life’s stressful situations, unexpected challenges and crises that may feel initially overwhelming (Siebert, 2005). Resiliency has been defined as the ability to “spring back into shape” emotionally after struggling with setbacks and adversity (Howard, 2009).
The APA defined “resilience” as “an interactive product of beliefs, attitudes, approaches, behaviors and perhaps physiology that help people fare better during adversity and recover more quickly following it” (American Psychological Association, 2004).
Emotional Resiliency refers to one’s ability to (Seibert, 2005):
- Cope effectively with significant levels of disruptive change
- Overcome setbacks
- Triumph over adversity
- Experience feelings associated with grief and loss and eventually surpass them to rebuild one’s life
- Maintain physical and emotional energy during times of constant stress
- Adapt to new ways of living when former approaches are no longer feasible