How therapists cope with compassion fatigue

By Tannis Price, therapist-in-training Have you ever found yourself feeling numb to other people’s problems, or to sad stories on the news? Have you ever screened a call from a friend because you just “didn’t have it in you” to hear them vent?  Everyone feels this way sometimes, but if you’re in a career on the frontlines of treating trauma, that numbness may be a result of “compassion fatigue,” or burnout. Several studies found that 27 to 37 percent of trauma therapists experienced emotional burnout persistently.   As a therapist in training, it’s one of the risks I’m most worried about. Compassion fatigue can lead to overuse of alcohol and drugs as a way to manage stress, difficulty in relationships, depression, work absences, drops in productivity, and a reduced ability to help clients or patients. Fortunately, there are ways to avoid these aspects of compassion fatigue. The trick, for many therapists and first responders, is having the self-awareness to notice their own mental health beginning to slide, and being willing to seek help.

Causes of Compassion Fatigue and Burnout

Compassion fatigue (CF) can happen when people are repeatedly exposed to the suffering of others. It takes a lot of energy to understand the point of view of someone in distress. Overdoing it can lead to indifference and a sense of hopelessness.  Similarly, burnout can happen to people in chronically stressful jobs, like trauma therapists, paramedics, or first responders. Constant stress can lead to exhaustion, lower productivity, and a lack of job satisfaction. 

Why does this matter?

When helpers experience compassion fatigue or burnout, productivity and concern for clients decrease. Some people overuse substances, experience interpersonal problems and suffer from physical or mental health challenges.  

How to prevent compassion fatigue

Know the Signs

There are tons of online resources to help you determine if you’re on the path to burnout or CF. Some signs are: recurring and persistent feelings of discouragement, hopelessness, irritability, exhaustion, or difficulty concentrating. 

Notice the Signs

Since one of the symptoms of compassion fatigue is emotional numbness, noticing its presence is challenging. Are you legitimately exhausted from one day of terrible events? Or was it an average day that feels overwhelming because of all the days that preceded it?  Checking in with your body as well as your emotions can provide clues. This means taking your awareness beyond, “This co-worker / client / situation is really pissing me off,” to, “I’m pissed off. My heart is beating faster. My shoulders are up by my ears. My scalp feels hot.”  Over time you’re going to have a clearer picture of the difference for you between frustration and rage, disappointment and grief. Does your body’s reaction surprise you? Or does it seem about right considering the situation?

Sitting with difficult emotions

This doesn’t need to involve hours. Regularly spending a few breaths noticing what your body is experiencing can be enough to stay connected. Meditation or sensation-focused yoga practices can increase your ability to focus and to notice more subtle messages from your body. Some people engage in a longer practice a few times a week. Others find that tuning in for one minute a few times in the day is enough to ground you during periods of stress.  With greater self-awareness, you can make a more informed decision about what next steps are necessary. 

Self-care

Self-care, ultimately, it comes down to whatever helps you cope with stress. Activities could be mostly solo: massage, exercise, bath, journaling, or spending time in nature. Or they could involve relationships with family, pets, partners, activism, or volunteering. The key is that the activity facilitates a sense of connection with yourself or others. As a therapist-in-training, I need to practice what I preach. For me, self-care looks like plugging into a great podcast and going for a walk with my dog. 

Create a Community

The worst part of compassion fatigue is feeling isolated. Rather than withdrawing, consider building a community around your helper life.  Therapists often work alone, so in my profession this might look like joining a peer consultation group. Having a community who share and understand your experience can reduce your burden.   It is also important to maintain a community that is separate from your work life! This might look like keeping a regular date night with your partner, joining a book club, and scheduling time to see supportive friends and family members. For me, creating community also requires setting boundaries. For example, I have a tendency to say “yes” to plans I’m invited to, even when I know my mental health will suffer from spreading myself so thin. 

Get a Therapist

If you’re working in a helping profession, you’re probably not used to asking for help yourself. It’s important to have a safe space to process work stressors. One that is free from judgement or fears related to loss of job status. Therapy is an opportunity to receive compassion instead of giving it for once. Other options are talking with a spiritual leader in your community, or asking a trusted friend for an hour of time dedicated to your own well-being. Tannis Price is a therapist-in-training at Adler University. 

Did you know?

Yoga Outreach teaches a self- and co-regulation class specifically for mental health and social workers, and first responders. Sign up as an individual, or schedule an exclusive workshop for your staff. No yoga experience necessary. https://www.yogaoutreach.com/training-for-facilities-2