Compassion Fatigue: The Toll of Caring Too Much

Table of ContentsView AllTable of ContentsSignsStagesCausesBurnout vs. Compassion FatigueOvercoming Compassion Fatigue

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Table of Contents

Signs

Stages

Causes

Burnout vs. Compassion Fatigue

Overcoming Compassion Fatigue

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The ability to feel compassion andempathyfor others is essential forprosocial behaviorsand supportiveinterpersonal relationships.

“Authentic compassion, as opposed to being polite or nice, is a complex neuropsychological process that is related to frontal lobeexecutive functioning, the most recently developed and most complex of cognitive processes. To engage in compassion, you have to be cognitively present, understand one’s social surroundings, and be aware of one’s impact on others,” saysDr. Eric Zillmer, Professor of Neuropsychology at Drexel University.

For people who support those who are suffering, such as those who work in the helping professions, continual exposure to other people’s trauma can take a toll, making people feel that their well of compassion has been drained dry. Even when people want to empathize, they may find that they simply don’t have the emotional and physical resources to do so.

Compassion fatigue is more common in people who work in professions where they are tasked with supporting people who have experienced trauma.

People who work in healthcare settings are often more susceptible, including nurses, doctors, first responders, home health aides, therapists, social workers, and other helping professionals. It can also affect caregivers who are responsible for the day-to-day care of a loved one with a medical or mental health condition.

What Are the Signs of Compassion Fatigue?

“While it is common for individuals working in professions that involve healing others to experience compassion fatigue, it can happen to anyone, especially if you are that family member, friend, or coworker everyone turns to for guidance and support,” says Dr. Shakira Espada-Campos,MDLIVEAssociate Chief of Behavioral Health.

“Even behavioral health professionals who are trained to take on the trauma and suffering of others experience it,” she explains.

Compassion fatigue can affect people differently, but a few common signs can include:

People with compassion fatigue often find themselves feeling increasinglypessimistic. They may question their beliefs and question whether there is any good in the world. In the workplace, they may feel unappreciated, lose confidence and interest, and struggle to feel compassion toward people in their care.

Dr. Shakira Espada-Campos, MDLIVE Associate Chief of Behavioral HealthThe telltale sign is a feeling of numbness or finding yourself lacking empathy toward the suffering of others. You may find yourself feeling generally annoyed, irritable, judgmental, or sad. You may want to keep helping, but you feel like you have nothing left to offer.

Dr. Shakira Espada-Campos, MDLIVE Associate Chief of Behavioral Health

The telltale sign is a feeling of numbness or finding yourself lacking empathy toward the suffering of others. You may find yourself feeling generally annoyed, irritable, judgmental, or sad. You may want to keep helping, but you feel like you have nothing left to offer.

What Are the Stages of Compassion Fatigue?

Compassion fatigue tends to happen gradually over time. It is important to remember that this is a progressive and cumulative process and that compassion fatigue is the end stage.

Researcher Charles Figley has suggested a causal model that described different factors that predict the onset of compassion fatigue. It occurs in four primary stages:

When exposure to stress is prolonged, continuous, and intense, it makes it more likely that people will then experience compassion fatigue.

Causes of Compassion Fatigue

One of the key elements behind compassion fatigue is the constant demand for empathy. While empathy is essential in helping professions, it can become emotionally exhausting when the demand for empathy is persistent and excessive.

“Compassion is a meta-cognitive process—thinking about one’s own thinking. It is one of the highest forms of cognition in my opinion and, therefore, one only visits compassion. You can’t live there. It would be cognitively exhausting,” Dr. Zillmer explains.

When people engage in too much authentic compassion, fatigue sets in.

People who work in helping professions such as nursing and therapy rely on empathy to help them connect with others. This allows them to take the other person’s perspective, understand their pain, and respond to their needs in ways that can relieve suffering.

There are also factors that can increase a person’s risk of developing compassion fatigue in such situations. These can include:

Working in a setting that involves constant exposure to trauma, such as emergency services or social work, increases a person’s risk of experiencing compassion fatigue. Research has found that among helping professionals, the prevalence of compassion fatigue ranges from 7.3% to 40%.

While compassion fatigue and burnout share some similarities, there are important distinctions between the two.Burnoutrefers to a state of exhaustion that causes poor motivation and a lack of interest in work. Compassion fatigue, on the other hand, is a specific type of burnout that refers to the negative emotions and loss of empathy people experience after being exposed to other people’s trauma, pain, and suffering.

“Compassion fatigue occurs predominately in people who work in helping professions and pops up the most for those in direct patient care," says Kristen Tomlinson, Director of Grief Support Services forTaylor’s Gift Foundation, a national nonprofit organization that provides grief support for families of organ, eye, and tissue donors. “Having patients who rely on them can be a heavy weight to carry at times, especially when they don’t (or can’t) prioritize their own well-being, too.”

Unfortunately, such feelings can then spill over into an individual life outside of work and lead to other problems. People who experience compassion fatigue experience burnout that contributes to feelings of helplessness and hopelessness. They may become cynical about their work and feel that nothing that they do will have a positive impact on relieving other people’s pain.

“Burnout can happen to anyone in any profession and is usually confined to work duties only. People experiencing burnout can feel a sense of dread at work,procrastination, negative interactions with coworkers or clients, and other symptoms. However, these symptoms usually subside when not at work,” Tomlinson says.

Tends to build slowly over time

Creates work dissatisfaction

Linked to excessive pressure

Leads to loss of motivation, energy, and interest

May occur suddenly

Creates life dissatisfaction

Happens when people feel helpless or out of control

Leads to lack of empathy and PTSD symptoms

If you recognize the signs of compassion fatigue, it is important to take steps to address it before it begins to take a further toll on your emotional well-being.

Dr. Eric Zillmer, Professor of Neuropsychology at Drexel UniversityCompassion is supposed to be a positive action. If it feels like work, it is probably too much. It indicates that it is time for a break or to engage in more manageable acts of compassion.

Dr. Eric Zillmer, Professor of Neuropsychology at Drexel University

Compassion is supposed to be a positive action. If it feels like work, it is probably too much. It indicates that it is time for a break or to engage in more manageable acts of compassion.

Overcoming compassion fatigue can take time and requires people to focus on reducing their stress levels. Some strategies that can help people recover include:

Reduce Your Exposure to Stress

In the short term, relieving feelings of compassion fatigue may involve taking a break from the source of stress that is causing the problem. Taking time away from work is one approach that may help, but for many, it might involve temporarily reducing their workload, seeing fewer patients/clients, or working in a different area of patient care.

The ability to reduce exposure can vary depending on a person’s job, however. A therapist might be able to reduce their client load while a nurse might opt to switch to working in a different area for a time. An emergency room doctor or EMT, on the other hand, typically has less control over the patients and situations they will deal with in the workplace. In such cases, it is important to find other ways to cope with compassion stress.

Creating Emotional Boundaries

“The first step is to set boundaries. Recognize and accept what you can’t control and focus on what you can control,” Dr. Espada-Campos says.

For many people who are in helping professions or who are caregivers, saying “no” to someone in need can be a challenge. For example, a therapist might agree to arrange sessions during off-hours that interfere with their personal life. Creating specific rules for sessions, services, and hours can help.

Dr. Shakira Espada-Campos, MDLIVE Associate Chief of Behavioral HealthBe aware of your limits and take a step back to work on your own mental well-being when you’re feeling overwhelmed or experiencing negative emotions.

Be aware of your limits and take a step back to work on your own mental well-being when you’re feeling overwhelmed or experiencing negative emotions.

Practice Self-Care

If you feel yourself starting to experience symptoms of burnout or compassion fatigue, it is OK to step back and do what you need to do to support your own mental and physical needs. Espada-Campos recommends taking steps such as:

“Preventing or overcoming compassion fatigue comes down to self-care. Your physical, emotional, and psychological well-being must be in check before you can help others,” suggests Dr. Espada-Campos.

Compassion fatigue can be a risk for people who work in helping professions, particularly if they are exposed to high levels of secondary trauma. If you recognize the signs of compassion fatigue, it is important to take steps to care for yourself.

Self-help strategies can be effective, but it is also important to reach out for help if you need additional support. “Seek professional help if you are finding it difficult to pull yourself out of the situation, especially if you are showing signs of depression, anxiety, or overwhelming stress,” Espada-Campos suggests.

3 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Figley CR.Compassion fatigue: psychotherapists' chronic lack of self care.J Clin Psychol. 2002;58(11):1433-1441. doi:10.1002/jclp.10090Coetzee SK, Klopper HC.Compassion fatigue within nursing practice: A concept analysis: Concept analysis of compassion fatigue.Nursing & Health Sciences. 2010;12(2):235-243. doi:10.1111/j.1442-2018.2010.00526.xvan Mol MMC, Kompanje EJO, Benoit DD, Bakker J, Nijkamp MD.The prevalence of compassion fatigue and burnout among healthcare professionals in intensive care units: a systematic review. Seedat S, ed.PLoS ONE. 2015;10(8):e0136955. doi:10.1371/journal.pone.0136955

3 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Figley CR.Compassion fatigue: psychotherapists' chronic lack of self care.J Clin Psychol. 2002;58(11):1433-1441. doi:10.1002/jclp.10090Coetzee SK, Klopper HC.Compassion fatigue within nursing practice: A concept analysis: Concept analysis of compassion fatigue.Nursing & Health Sciences. 2010;12(2):235-243. doi:10.1111/j.1442-2018.2010.00526.xvan Mol MMC, Kompanje EJO, Benoit DD, Bakker J, Nijkamp MD.The prevalence of compassion fatigue and burnout among healthcare professionals in intensive care units: a systematic review. Seedat S, ed.PLoS ONE. 2015;10(8):e0136955. doi:10.1371/journal.pone.0136955

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Figley CR.Compassion fatigue: psychotherapists' chronic lack of self care.J Clin Psychol. 2002;58(11):1433-1441. doi:10.1002/jclp.10090Coetzee SK, Klopper HC.Compassion fatigue within nursing practice: A concept analysis: Concept analysis of compassion fatigue.Nursing & Health Sciences. 2010;12(2):235-243. doi:10.1111/j.1442-2018.2010.00526.xvan Mol MMC, Kompanje EJO, Benoit DD, Bakker J, Nijkamp MD.The prevalence of compassion fatigue and burnout among healthcare professionals in intensive care units: a systematic review. Seedat S, ed.PLoS ONE. 2015;10(8):e0136955. doi:10.1371/journal.pone.0136955

Figley CR.Compassion fatigue: psychotherapists' chronic lack of self care.J Clin Psychol. 2002;58(11):1433-1441. doi:10.1002/jclp.10090

Coetzee SK, Klopper HC.Compassion fatigue within nursing practice: A concept analysis: Concept analysis of compassion fatigue.Nursing & Health Sciences. 2010;12(2):235-243. doi:10.1111/j.1442-2018.2010.00526.x

van Mol MMC, Kompanje EJO, Benoit DD, Bakker J, Nijkamp MD.The prevalence of compassion fatigue and burnout among healthcare professionals in intensive care units: a systematic review. Seedat S, ed.PLoS ONE. 2015;10(8):e0136955. doi:10.1371/journal.pone.0136955

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