Breathe

What is compassion fatigue?

Burned out from caring for others? Here’s why and what to do to feel better

Words: Leona Black
Illustration: Silvia Stecher

Do you work in a caring profession but sometimes think that you just can’t do it anymore? Are you in a caring role with a friend or family member, or maybe even a poorly pet? Do you feel exhausted from caring for others and find it difficult to put your needs first?

If any of these statements ring true, it’s likely that you have a deep sense of empathy or compassion for those you support. You might have also noticed, however, that there’s a cost to caring, whereby the daily strain you’re under can drain you of your natural capacity to demonstrate understanding and kindness. This is often referred to as compassion or empathy fatigue.

What is empathy?

Empathy serves as a bridge to connect humans together. This is a precious facet of our humanity, fostering bonds of support and understanding. In the realm of caring, however, this connection is sometimes a double-edged sword, blurring the lines between the pain of those in need of assistance and those giving it. Empathy can make it difficult to separate yourself from the lives of people you care about, causing you to shoulder their burdens and leading to the kind of profound exhaustion that sometimes affects the hearts and minds of caregivers.

What is compassion?

In contrast, compassion can be likened to a gentle flame that warms the heart, kindling a profound desire to enhance the wellbeing of others while maintaining a degree of emotional detachment. Compassion shifts the focus from feeling with the other to feeling for them. This approach is believed to provide a protective barrier, allowing for a degree of emotional distance from another’s pain. Each person’s recognition of their own limitations, as well as their strengths, is also vital for wellbeing. Consequently, compassion can empower caregivers to be wholly present for those they care for without being overwhelmed by their own emotional reactions to their pain.

What causes burnout?

Compassion also allows people to understand another’s perspective, extending kindness even when they may not entirely agree with their choices. Yet, much like empathy, the well of compassion can run dry. As then doctoral candidate Claire Sorenson et al wrote in a 2017 paper (published in the Journal of Nursing Scholarship), ‘compassion fatigue is the emotional cost of caring for traumatised individuals or bearing witness to others’ trauma’.

The impact of this kind of depletion is hard to quantify for those caring for loved ones at home, but studies in the professional realm may shed some light on the impact of the burden they bear.

Research carried out in 2020 by Allison Andrukonis and Alexandra Protopopova showed that increasing staff absenteeism and a rise in the numbers of employees leaving healthcare was a direct result of burnout, which the charity Mental Health UK describes as ‘a state of physical and emotional exhaustion’ that occurs as a result of long-term stress. This can lead sufferers to feel tired, overwhelmed and helpless. Understanding and supporting people with compassion and empathy fatigue has never seemed more important.

Why do people get compassion fatigue?

It’s crucial to note that compassion and empathy fatigue are a natural and understandable reaction to a challenging situation. Shutting down serves as a protective mechanism, attempting to shield you from unmanageable levels of distress. But reaching this stage (see our guide to the signs to look out for, opposite) risks inadvertently extinguishing the passion and desire that led you to want to care for others in the first place and may make you want to give it up or resent it if you must stay.

Understanding the risk factors can be helpful. There are common reasons why those in caring roles experience compassion or empathy fatigue.

Why is it hard to say no?

Pursuing perfection and feeling that every task must be executed flawlessly is one cause of compassion fatigue. This tendency might make you hard on yourself (see Breathe issue 31) and lead to doubts about others’ capabilities, which can make delegation difficult and result in you shouldering too heavy a load. Other things that mean you might take on too much include a desire to prove yourself capable, fear of conflict, a strong drive not to let others down and a reluctance or struggle to assert boundaries on time. All of these make it harder to say ‘no’ to requests, tasks and challenges. An absence of connection can intensify these overwhelming feelings. If you’re isolated in the workplace and unable to share your concerns with colleagues or you’re caring for someone at home and have no one to talk to, stress can strike a deeper blow to your wellbeing. These are all precursors to compassion or empathy fatigue, but there are ways to support yourself.

How to respect your own needs

Caregivers may also struggle with the fear of revealing vulnerability. Some perceive experiencing stress as a sign of weakness, a chink in their armour that they must conceal at all costs, and this can mean that self-care isn’t prioritised. This isn’t the clichéd image of a bubble bath accompanied by candles, either (though such moments are also encouraged). Rather, self-care, in its essence, encompasses activities that rekindle your inner sense of wellbeing and provide a safe haven from the relentless demands of your role. Without practising self-care, you will find it difficult to care for others as well.

You might be familiar with the aeroplane analogy, where you’re instructed to secure your own mask before assisting others. This is what self-care embodies. Just as ensuring your oxygen supply allows you to help others, practising self-care enables you to offer meaningful assistance, while safeguarding your own mental and emotional health. The journey of caring is one that begins by first respecting your own needs.

Signs of fatigue

How to tell if you’re on the edge of burnout

  • Intensified emotions. You may find yourself crying more, irritability might surface and irrationality may cloud your judgment.
  • Cognitive decline. Your ability to think clearly may diminish, accompanied by increased forgetfulness, as your mind reaches cognitive saturation.
  • Reliving traumas. Flashbacks and recurring images of distressing events may disrupt your thoughts. You might find yourself asking: ‘Could I have done more?’ or ‘Could I have done something differently?’
  • Feelings of despair. Statements like ‘What’s the point?’ or ‘I can’t go on like this’ might echo in your mind.
  • Judgmental attitude. You may become more critical of others and stop seeing the best in people, especially when you deal with traumatic situations caused by human actions.
  • Numbness and indifference. A sense of emotional detachment may envelop you, dulling your innate caring nature.

How to stay compassionate

There are ways to cope with compassion and empathy fatigue. Here are a few that can be incorporated into your daily routine

  • Prioritise self-care. Looking after yourself isn’t a luxury – it’s a necessity when caring for others. Identify the elements in your life that rejuvenate your personal energy. Rekindle your passions and explore new avenues of self-discovery.
  • Seek support. Don’t bear the weight alone. Look within your workplace for available resources and confidants. Initiate conversations, starting with less personal topics to gauge trust. Don’t hesitate to reach out to mental health professionals for support and advice.
  • Set boundaries. Learn the art of saying ‘no’. Having a plan in place might help you feel more prepared and confident. Think about the week ahead and note to yourself what you’ll need to say ‘yes’ or ‘no’ to. Compromise by offering something you can do instead, for example: ‘I can’t stay any longer tonight, but I can get here earlier tomorrow.’ This enables you to say ‘yes’ to spending time on other things, including looking after yourself.
  • Embrace breaks. These are moments of wakeful relaxation for mind and body, even a few minutes will help recharge you. Recognise their significance in replenishing your energy and providing mental clarity.
  • Find the positives. Compassion satisfaction refers to the positive aspect of being a caregiver and finding ways to experience it. For example, tactile and nurturing experiences shared between veterinary nurses and the animals in their care has been reported to create compassion satisfaction in veterinary practices. As a protective shield against compassion fatigue, amplify moments of compassion satisfaction in your role. Seek those tasks that bring joy and fulfilment, balancing the more demanding aspects of your role.

Leona has a doctorate in educational psychology and is a wellbeing coach with a particular focus on supporting schools, families and those in the caring professions. Find her at theblacklightcoach.com and blacklightlearning.co.uk

You can read more articles about mental health and compassion in the latest issue of Breathe magazine.