Compassion Fatigue

Topic key points 

  • Compassion fatigue involves emotional and physical exhaustion that can affect people who have been present for other people’s traumas or stressors. It is characterized by a decreased ability to empathize, feelings of helplessness, and burnout due to the demands of supporting those who are suffering. 
  • It’s typically seen in those who work in jobs that involve supporting people who are suffering and require high amounts of compassion (i.e. healthcare, social services, caregiving).
  • ‘You can’t pour from an empty cup’ is an analogy that is fitting for this topic. If someone is experiencing compassion fatigue, it is likely they are trying to do just that. 
  • Compassion fatigue is widely recognized as a pathway to occupational burnout and is detrimental to physical and mental wellbeing. 
  • Symptoms of compassion fatigue can be cognitive, physical, emotional and behavioural 
  • Key interventions to recover from compassion fatigue include self-care activities, developing out-of-work interests, mindfulness, self-compassion and addressing relevant work-related factors.  

Introduction to topic 

Compassion fatigue is similar to but slightly different from vicarious trauma. Compassion fatigue refers to the feeling of ‘running on empty’ after continuously engaging in compassionate behaviours and actions. Vicarious trauma refers more to the impacts of second-hand exposure to trauma. Somebody can be experiencing vicarious trauma and compassion fatigue at the same time.  

Similarly, compassion fatigue and burnout are similar but not identical experiences. Burnout can happen in contexts that don’t involve compassionate behaviours. In addition, burnout tends to develop over time, whereas compassion fatigue can develop suddenly.  

Research suggests that compassion fatigue is connected to the therapeutic relationship between a caregiver and a patient such that the suffering of the patient triggers a response in the caregiver on multiple levels. This ‘residual stress’ can build up over time and lead to the experience of compassion fatigue (Adams et al., 2006). Those who are more empathetic are posited to be more vulnerable to developing compassion fatigue. 

Common symptoms of compassion fatigue include:   

  • Fatigue 
  • Exhaustion (emotional and physical)  
  • Feeling ‘desensitised’ to others suffering 
  • Apathy and sadness 
  • Helplessness 
  • Reduced feelings of empathy 
  • Dreading taking care of someone and feeling guilty about it   
  • Irritability or anger 
  • Headaches 
  • Difficulties making decisions 

The professional quality of life scale can be used to help assess for and identify compassion fatigue.  

Individual Interventions 

To help individuals with compassion fatigue it is helpful to: 

  • Validate and normalise their experiences and difficulties (this can help address guilt and self-criticism) 
  • Help people develop an awareness and understanding of how compassion fatigue shows up for them 
  • Encourage regular self-care 
  • Help them connect with out-of-work activities and social connections 
  • Consider looking at ways to reduce exposure to stress 
  • Setting healthy emotional boundaries 
  • Explore and address any unhelpful coping mechanisms and barriers to helpful coping mechanisms 

Work-related factors  

There may be work-related factors contributing to compassion fatigue that are important to address. This might be things like low support, job overload, workplace conflict or low job clarity. If you think that work-related factors may be contributing to a clients experience of compassion fatigue, then check out the resource page for the relevant factor to see if there are helpful tools/resources there.  

Process considerations  

  • Compassion fatigue can often come with experiences of guilt and self-criticism. Therefore, offering some validation and normalisation to a client can be helpful.  
  • Sometimes clients aren’t aware that they are experiencing compassion fatigue, and just giving a name to their experience can be very helpful.  

Included resources 

  • Professional quality of life scale
  • APA: Guide to compassion fatigue
  • Nurse and midwife support on compassion fatigue
  • Guide to understanding and overcoming compassion fatigue 

Copy for client 

Experiencing compassion fatigue is not uncommon for people who engage in frequent caregiving behaviours. Overtime, being compassionate towards others can drain our own cup. Included in this email are some resources that I hope will help you navigate through this experience.