Special Report: Transforming Compassion Fatigue: Regain your Passion for Compassion!

Introduction

Transforming Compassion Fatigue: Regain your Passion for Compassion, is a special report written for the social workers who work at family service agencies, on the front line with clients who are experiencing financial, social and family hardship, the counselors working with mental health organizations providing care and guidance to thousands of people struggling with the emotional challenges of a rapidly changing society, the doctors and nurses in a rapidly changing and demanding healthcare profession and the many others who work in education, corrections, and other public and private organizations.

The essence of Transforming Compassion Fatigue: Regain your Passion for Compassion is about how to regain and maintain your positive energy as a healthcare provider. We will examine what compassion fatigue is and how you can become more aware of how it affects you before it drains your energy and robs you of your passion for your work.

What is Compassion Fatigue?

Compassion fatigue has been defined as: “The reduced capacity or interest in being empathic or ‘bearing the suffering of clients’ and is ‘the natural consequent behaviors and emotions arising from knowing about traumatizing events.’” [1]

Compassion fatigue is a state of physical and emotional exhaustion from repeated empathic engagement with people who are suffering. It is both tired from caring and even tired of caring. It is the “natural consequent emotions and behaviours” that often result from the work we do.

Compassion fatigue, also called vicarious traumatization or secondary traumatization is the emotional residue or strain of exposure from working with those suffering from the consequences of traumatic events. It differs from burn-out, but can co-exist. Compassion Fatigue can occur due to exposure on one case or can be due to a “cumulative” level of trauma.

Risk for Compassion Fatigue

Research indicates: “Healthcare professionals working with traumatized patients were at greater risk for CF, controlling for demographic factors, personal trauma history, social support and work environment factors…We suggest that the important variables in predicting CF include degree of exposure, personal history, social support, and work environmental factors.”[3]

Why would working with traumatized patients increase your risk for compassion fatigue?

Personal Trauma

It is believed that the secondary exposure to trauma from having an empathic, helping relationship with someone who is experiencing physical, medical, emotional or situational trauma can unconsciously trigger responses within your brain through a neural-psychological mechanism known as mirror neurons.[4] In essence, your brain and nervous system can literally mirror the physical and emotional responses of your client.

What the studies on mirror neurons also showed was, the more similar life experiences you have with your client, the more you are likely to mirror their responses.

What this means is, if I have personally suffered physical or emotional abuse I am much more likely to mirror my client who is suffering abuse in a more intensive way than someone who hasn’t had the same experiences.

In fact, personal trauma history is one of the most important factors in predicting a person’s vulnerability to compassion fatigue. It’s a two-edge sword. Personal history of trauma can make helpers much more empathic with their clients and effective as helpers, it can also render us more vulnerable to compassion fatigue.

Degree of Exposure

Other factors brought out by the research that have a bearing on how much helpers are vulnerable to compassion fatigue are degree of exposure, social support and work environment.

Degree of exposure refers to how many clients who are suffering from trauma you are working with in a day, a week, over the course of a career. It also refers to the intensity of the trauma one is exposed to.

Social Support

Social support refers to how much support you receive from your professional, personal and family network. It is now being recognized how crucial it is to have a professional support network because it can be difficult for family and friends to understand the nature of trauma that you are exposed to at work.

Working Environment

This brings us to the work environment which is one of the most critical and yet overlooked factors that can either contribute or mitigate and prevent compassion fatigue.

Research now shows that a safe, supportive working environment is crucial to mitigating and preventing compassion fatigue. As Rosenbloom, et.al [5] states:

“Prevention of potentially harmful effects from CF involves attention to both concrete issues, such as provision of supervision and adequate time off, as well as to less tangible sources of support, such as the organizations attitude toward the impact of trauma on helpers.”

Transforming Compassion Fatigue

Transforming compassion fatigue requires both awareness and action. Awareness begins with becoming conscious of those situations in which we are more likely to mirror the emotions of our clients so that we can take effective action to transform rather than internalize the stress.
Self-awareness is a core competency of emotional intelligence [6] and is defined as: “recognizing the feeling as it happens.” This means that we begin to follow some of the advice that we so readily give to our clients and start listening to our own feelings before, during and after we sit with our clients.

Prepare for Each Session

Preparing for each session with every client regardless of who they are or what their presenting problem might be is essential to being effective as well as maintaining our own emotional health. The simple fact is we don’t know what is going to happen in any given encounter with another person.

Preparing for each session means taking a moment to pause, relax and reflect before engaging. It means “having your head in the game” before you encounter your client. We are most vulnerable to mirroring and absorbing stress from our clients when our mind is somewhere else and we are not conscious, present and focused on what we are doing.

Being “Present”

Next, is to be conscious and present when you are with your client. This may seem like a “no-brainer” but you might be a little shocked by how often we actually “check-out” as we are “listening” to our clients.

This may be because we have already had a stressful day and have absorbed as much as we can take for one day and are not in a receptive frame of mind. Everyday stress can and does accumulate in our body and mind to the extent that it can affect how open and receptive we are to hearing other people’s problems.

Discharge and Re-charge

One of the strategies taught in the workshop is how to discharge the accumulation of daily stress. Day after day of “ordinary” stress in combination with secondary traumatic stress from our clients is a recipe for compassion fatigue and burnout. After each session take a couple of minutes to “discharge” the “energy residue” of the session and “re-charge” your energy through stretching, breathing, relaxing or some other conscious self-care activity (for more see articles on Techniques for Transforming Compassion Fatigue).

Conclusion

Compassion fatigue is a natural reaction to the work that we do. It is not pathological. It does not mean that we don’t care. It is the result of empathic engagement with people who are suffering. Over time, it can result in being “tired from caring, even tired of caring.”

We can learn to transform compassion fatigue by recognizing the signs and taking action by preparing for each session, being more present when we are with clients, discharging the energy residue and recharging our energy. By learning to care for ourselves we become more effective in caring for our clients.

Notes:

1. Compassion Fatigue Following the September 11 Terrorist Attacks: A Study of Secondary Trauma among New York City Social Workers: International Journal of Emergency Mental Health, Vol. 6, No. 2, 2004
2. Figley C.R., “Compassion Fatigue, Coping with Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized.
3. Ibid
4. The Mirror-Neuron System: Annual Review of Neuroscience (2004) 27: 169-192
5. Rosenbloom, et al: Helper’s response to trauma work: Understanding and intervening in an organization
6. Goleman, D. “Emotional Intelligence: Why it can matter more than IQ.” Bloomsbury (1995).
7. A term coined by Dr Peter Levine in Waking the Tiger, Healing Trauma for accumulated trauma energy that takes root in the nervous system.