Feeling Empathy Burnout? Protect Yourself from Fatigue

Across the globe, healthcare providers have been on the frontlines of the COVID-19 crisis. They’ve worked around the clock and I can’t help but think about the amount of chronic stress, and even trauma, they must be going through. They’ve fought for patients’ lives, for adequate equipment, and against conspiracy theories. It’s no wonder that many are experiencing burnout.

What is compassion fatigue?

There’s a specific type of burnout that happens to healthcare workers that concerns me most: compassion fatigue. This can happen when you have experienced so much empathy for and absorbed so much of others’ anguish that you yourself begin to have trauma reactions. Those reactions can include things like emotional numbing, physical illness, and feelings of hopelessness.

Compassion fatigue was first described in emergency department nurses and oncology nurses. Compassion fatigue has also been documented in child protection workers and mental healthcare providers. Compassion fatigue might be on the rise for healthcare workers, but those outside the profession can be affected, too; people with high levels of empathy almost can’t help but feel others’ pain.

What can we do to protect ourselves from emotional burnout while still caring for others? The answer is not to become emotionally empty to others’ suffering, but to build good boundaries, take care of ourselves, and better understand our role.

Source: Shutterstock/Syda Productions

How to protect yourself from compassion fatigue

1. Know the signs. Fatigue—just being tired all the time—is one of the most common things people experiencing compassion fatigue report. That’s no surprise, seeing that they’re often using up a lot of energy pumping stress-related hormones and having the fight-or-flight system on high alert.

Some other signs of compassion fatigue include:

• Trouble sleeping (can’t quiet thoughts, feeling too wound up, easily woken).
• Irritability, impatience, blaming others.
• Dreading going to work (or finding yourself often late for work or calling in sick).
• Having a hard time finding meaning in your life or work.
• Having unexplained physical symptoms (such as exacerbated pain, acne flare-ups, GI problems).
• Feeling isolated or wanting to isolate from others.
• Feeling helpless, hopeless, or both.
• Struggling to make decisions.

If you’re experiencing a few of these, chances are good that you’re experiencing compassion fatigue.

The first thing to do is to recognize that compassion fatigue is not a weakness, nor does it reflect something about your levels of compassion. It’s natural for your body and mind to react this way. But now that you’re aware of what’s happening, it’s not too late to start guarding against it.

2. Hit the reset button and take care of your basic needs. Sometimes, when we’re overwhelmed or burned out, we neglect the basics—water, food, sunlight, oxygen. It can almost feel silly to say it, but a powerful reset button for your body and mind can simply be one weekend of:

• Carrying a water bottle everywhere and constantly sipping.
• Eating balanced meals and snacks at consistent times. (Routines are important.)
• Spending at least 30 minutes per day outside in the sun. (Bonus points if you get your body moving or spend time with friends.)

3. Beware of destructive coping methods. When we feel emotionally depleted, it can be tempting to reach for shortcuts. This might mean reaching for that third or fourth cupcake because it feels good in the moment, or compulsively online shopping because we find comfort in "retail therapy," or lashing out at the people we love because it feels like that’s the only way to express our anger. We'll try anything that gives us a chance to release some tension. The problem is that this release is fleeting; it’s just a distraction and doesn’t tap into what’s really weighing you down.

There’s no need to judge yourself for these impulses, but once you understand that they are quick fixes instead of long-term solutions, be honest with yourself. Take a deep breath and say out loud, “This is not the coping method that will really help me.”

4. Practice self-compassion. You’ve been giving compassion to your patients or your family or total strangers. But have you been giving any to yourself? Do you cut yourself some slack when you need a break? Do you speak kindly to yourself? Self-compassion is an important ingredient in loosening up compassion fatigue.

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Combating Compassion Fatigue

Start by simply sitting quietly with your eyes closed and asking yourself, “What do you feel? How do you feel?” Don’t feel like you need to immediately come to an answer. Take the time to walk your attention through your body and ask each body part what it feels. At some point, you’ll arrive at emotions that might have been hiding in your stomach or scrunching up your shoulders. When you get there, allow yourself to feel whatever emotions you find, whether pleasant or painful.

Say to yourself, out loud:

• It’s okay to feel like this.
• I’ve been carrying a lot, so it’s natural to feel heavy.
• I’ve been so strong, and I need some relief.

5. Practice radical acceptance. As an empathetic person, you might be holding onto ideas like:

• “I need to take care of people.”
• “I’m the only person who can take care of them.”
• “I can save them if I put my everything into it.”

This sense of responsibility we feel for righting wrongs and healing hurts is a double-edged sword. On one hand, it’s the fuel that drives us to be charitable and warm—to be a nurse, social worker, public defender, or just a very caring person in general. On the other hand, it can give us a disproportionate sense of responsibility, to the point where we think we can, and therefore should, make everything right. The reality is that there are many things we can't control no matter how much we care. When we find ourselves thinking statements like the ones above, we need to practice radical acceptance.

Radical acceptance means recognizing that you cannot ultimately control anyone or anything; you can only control your own actions. It challenges you to be okay with the knowledge that there will always be pain, injustice, ambiguity, and imperfection in the world. When you put down the weight of responsibility, you can feel grounded and be a force for good in a sustainable way.

6. Compartmentalize. We humans need contextual cues to help us switch gears between working, playing, relaxing, and all of our important modes of being. We can harness this to redirect from compassion fatigue to balanced living.

In practice, this means that if your job is causing you compassion fatigue, you keep work at work. When you come home, consciously tell yourself, “I’m leaving my patients at work” before walking into your home. Change out of your work clothes right away and immediately do something that takes up your attention, ideally something fun.

If your compassion fatigue is coming from work, some good elements you might include are:

• Maintaining a social life with people other than your coworkers.
• Consistently doing hobbies and activities that have nothing to do with work.
• If you work from home, making sure that you have a separate space for work and leisure.

7. Get support from friends (or a therapist). Social support is as close to a psychological elixir as it gets. This may be especially true when compassion fatigue makes us feel alone even when we're surrounded by people.

If you work in a helping profession, you may have access to support groups at work specifically designed to give you a safe space to vent. You’ll be surrounded by others who experience similar emotional rollercoasters, confusing changes in the way they think about people, or dips in their ability to find meaning in their work. Sometimes, just having these feelings validated can go a long way toward rejuvenating you. Better yet, join a mindfulness class or an art therapy group.

If you don’t have support groups, share your feelings with a trusted friend or coworker, someone who will not be judgmental. A therapist, too, can help you to process what you’re going through. We all deserve to have an empathic ear when we’ve been lending ours, and to be carried when we've been carrying others.

Medical Disclaimer: All content here is for informational purposes only. This content does not replace the professional judgment of your own mental health provider. Please consult a licensed mental health professional for all individual questions and issues.

A version of this post also appears on Quick and Dirty Tips.