Caring Professions and Compassion Fatigue

Coauthored by Tycee Belcastro, M.A., LMFT, and Katrina Katen, Psy.D.

The following article is based on a presentation delivered at Colorado Mesa University on 11/6/2023.

Prolonged exposure to other people’s trauma in a professional setting can result in secondary (or “vicarious”) trauma. This is compassion fatigue. Professionals in the caring fields are at high risk for experiencing the devastating mental and physical effects of this secondary trauma.

Compassion Fatigue vs. Burnout

Compassion fatigue is different than burnout. While both are related to stressful workloads and vocational environments, the key difference is that compassion fatigue results from being exposed to other people’s trauma. Warning signs can include a wide range of mental and physical symptoms such as: substance abuse, anger, depression, sleep disturbance, hypertension, immunity suppression, headaches, sadness, lack of drive, workaholism, social isolation, etc. Factors that increase the likelihood of developing compassion fatigue include: high stress levels, poor coping skills, lack of social support, insufficient self-care, a personal history of trauma, and poor interpersonal/emotional boundaries.

Mind, Body, Spirit, Heart

Just as the “whole person” can be affected by compassion fatigue, the solution and the preventive measures also must encompass the whole self. In other words, attention and intention must be given to the mind, body, spirit, and heart.

Mind

Our thought process serves as a “filter.” In other words, our conscious and unconscious thoughts, beliefs, and programming determine how we respond emotionally and behaviorally to an event. As such, becoming self-aware is essential. Cognitive Behavioral Therapy (CBT) is an excellent way to become aware of and challenge faulty thinking and beliefs that no longer serve us.

Body

We all know that eating well, hydrating, exercising, and sleeping are essential to healthy functioning. However, too often we believe that if someone is not engaging in these healthy habits, they must lack self-discipline. This is often not the case. For most people, poor health habits are a signal of an underlying emotional issue. So, while changing health habits can be helpful, the greatest change comes when we examine why we were engaging in the unhealthy habit in the first place.

Spirit

Spirit, in this context, refers to an individual’s faith and connection to their bigger meaning. In caring professions, staying connected to our own personal “why” is essential. What is your “why”? When did you know that you wanted to be a nurse, counselor, doctor, first responder, a caregiver? Never forget…your “why” really does matter!

Heart

The emotional experience of a caregiving professional is a key contributor to compassion fatigue. In the moment of responding to others’ needs or managing a crisis, there is not time (nor are our brains wired) to pause for emotional reflection. So, we pack away emotions and put them on the shelf to deal with later. The key is that we must deal with them later. There is a book title that says it all: “Feelings Buried Alive Never Die” (by Karol K. Truman). It is essential that we find a way to process through and understand our emotions.

Strategies and Resources

If you or someone you know is experiencing compassion fatigue, here is a list of things that can truly help:

The Mind

Reading
Education and classes
Meditation
Learning to center yourself during a crisis without engaging in denial and dissociation
Cognitive Behavioral Therapy (CBT)
Morning pages (mind dump)
Positive reinforcement
Core routine
Planning ahead
Money management
Studying Martial Arts
Workshops and trainings

The Body

Exercise
Enjoyable activity
Healthy diet
Elimination of toxins
Meditation
Healthy sleep
Healthy sexuality (massively stress relieving)
Healthy posture
Self-care habits and practices

The Spirit

Spiritual and/or religious practice
Connection to significant others
Community and cooperation
Participating in something greater than yourself
Meditation
Reading spiritual and inspirational work
Creating or appreciation of art and beauty
Time in nature
Prayer
Finding joy and play
Connection to meaning and hope
Yoga practice

The Heart

Consistent individual therapy practice
Group therapy
Support and debriefing groups and opportunities
Developing healthy and supportive friend relationships
Developing healthy and supportive relationships with colleague
Identifying your true values
Journal practice
Reading
Identification of and learning to deal with your personal issues
Offering support and nurturance to others – caring without taking on responsibility for others
Learning to identify and understand healthy limits of responsibility
Setting appropriate limits and boundaries
Creating emotional safety with self and other
Relationship skills

In addition, below are some resources that you may find beneficial:

The Ownership Yard, by Dr. Katrina Katen, Psy.D.
Man’s Search For Meaning, by Viktor Frankl
On Death and Dying, Elisabeth Kübler-Ross
Real Self-Care, by Pooja Lakshmin, MD
The Relaxation Response, by Herbert Benson MD
The Shocking Link Between Kindness & Illness!, YouTube presentation by Gabor Mate
The Body Keeps The Score, by Bessel van der Kolk
The Five Why’s Technique, Taiichi Ohno
Loyalty To Your Soul, Ron and Mary Hulnick

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