Compassion fatigue is also referred to as the “cost of caring”. Now this term can be confusing, and it can cause a lot of confusion for first responders and their families.
What I want to do is help you better understand compassion fatigue and how to manage it, so that you can keep doing the good work that you do without losing yourself in the process.
So right now, we are going to answer five questions:
1. What is compassion fatigue?
2. Who is most at risk of compassion fatigue?
3. How do I know if I have it?
4. Can’t I just tough it out? I mean, it’s an occupational hazard.
5. How to I prevent or manage compassion fatigue?
What is Compassion Fatigue?
Compassion Fatigue is more of a simple concept than it sounds. It is when our “compassion-ometer” has been drained to the point of depletion (fatigued).
Also referred to as “empathic distress”, it is when we find ourselves unable to be emotionally available for those we want to help. This is when the work that you do, protecting and caring for others, has caused an erosion on your emotional and physical ability to meet the expectations of first responder work. It is when we have given so much of ourselves to help others who are struggling that it has depleted us of our emotional reserves.
Think of a teapot at tea time. The teapot is filled with hot water, steeped with tasty herbs and leaves (mint is my personal favorite, but you can imagine any tea that you like). Now at tea time on Monday, there are two teacups on the table. The teapot easily fills up those cups, with plenty of tea left over. However, on Tuesday, NINE teacups are on the table, pleading to have the delicious tea. The teapot serves the first seven teacups, completely emptying itself.
Now with the teapot, we would naturally have to go heat up some more water, steep more leaves, and then finish serving the last two teacups.
However, our world of compassion does not work this way.
For example, let’s say there is an EMT riding in an ambulance for her twelve-hour shift. Her compassion-ometer is full at the start of her shift. However, after the fifth call, one where a child was rushed to the hospital because his car seat was not buckled properly in an accident, the EMT’s compassion-ometer has run empty.
Is she able to take the rest of the day off of work to “refill” her compassion-ometer? No way! She has to keep going and finish her shift.
But let me ask you, what happens during the next couple of calls where simple mistakes, such as texting while driving, caused a serious accident where another driver had bones sticking out of their legs? Do you think she will be patient and show compassion to help all of the people in the accident?
Heck no, techno! She will be short-tempered, bitter, and come across as “not caring”. She may even get a complaint filed against her for talking back to other responders on scene or yelling at the person who was texting and driving.
She has exhausted her compassion levels and has not been able to refuel or regenerate them.
This is compassion fatigue.
Who is most at risk of Compassion Fatigue?
Compassion fatigue most often occurs to those who have to open their hearts, open their minds, to others in order to provide people with empathy and support through a challenging times.
First responders, THIS IS YOU!
You are at a high risk of compassion fatigue, especially when the shiftwork causes disrupted sleep and poor nutrition and exercise.
This can also include hospital personnel, such as ER, trauma unit, and intensive care unit (ICU) staff. These folks have to show compassion and empathy to keep patients from becoming reactive and making situations worse.
These jobs are not easy, and require people to give a part of themselves to do the job right. But if they are not careful, they can run out of tea before they finish filling the cups by the end of their shift.
How do I know if I have Compassion Fatigue?
One of the most common mistakes we can make is getting three similar problems mixed up: compassion fatigue, burnout, and trauma.
We want to be clear when we are trying to figure out our own struggle, so make sure you have a general understanding of each of these issues before you label anything.
For compassion fatigue in particular, you want to look at what is being depleted.
Are you feeling physically eroded after intense situations occur? Emotionally, do you feel drained and unable to keep opening your heart to those in need?
Now while this may seem pretty similar to burnout, we want to also understand our attitude towards the problem. Our reaction to this depletion.
When it comes to compassion fatigue, your symptoms are similar to burnout, BUT, you still want to keep doing it, you just don’t know if you can. You actually want to be there to help others, to provide comfort and compassion during a crisis. You still love the work that you do, you just feel like you can’t meet the need.
Can't I just tough it out? I mean, It's an occupational hazard.
This may be tempting, and it may seem easier to do, but it will NOT be helpful.
The risk of compassion fatigue is high in first responders, absolutely! But it is NOT inevitable. And it should never be eternal.
If you try to just “tough it out”, you will actually cause more physical harm to your body, emotional harm to yourself, and put yourself at risk for vicarious trauma and other serious mental illnesses, such as Generalized Anxiety Disorder or Panic Attacks.
We all have multiple crossroads where we can decide to do something about our struggle, or just ignore it. When we hit compassion fatigue, this is an early crossroads where we can actually choose a path that will lead to prosperity and joy in the work that we do.
How do I prevent or manage Compassion Fatigue?
When I was in college at UCSB, I worked in the residence halls as a Resident Assistant. Our department had this motto: “Take care of yourself. Take care of each other. Thake care of this place.” And it was said in this order for a reason.
We cannot take care of others, or take care of our own place, if we aren’t taking care of ourselves.
Now, I am not saying that you should always put yourself first. Or that you should not help others if there is even a remote risk of compassion fatigue. Far from it.
When you cell phone is running low on battery, what do you do?
You plug it in!
You don’t run it until it is dead, and then run it some more. You plug it in and let it charge. You may not charge it fully all of the time, but you charge it so you can use it when you need it.
We need to do this with ourselves, as well. We need to take breaks and allow ourselves space to experience and/or process our emotions. Sometimes it may be that we need to cry. Other times, we may need a hug, or to go for a run, or hit the gym.
We do this by checking in with ourselves regularly to see what we need. Every couple of hours, just take 20 seconds, pause, and check in with your body, with your emotions. What I am feeling right now? Is it anger or hunger? Is it sadness or stress?
And then we need to ACTUALLY do what our bodies need. Maybe it’s to sneak into the bathroom so you can shed some tears without others seeing you. Maybe it’s a hug for at least 7 seconds with someone you care for. And if you can’t get a hug from another person, hug yourself or a pillow; this may seem weird, but there are actually oxytocin receptors on top of our heart, and by providing a slight pressure here, we can create the release of this self-soothing hormone.
When it comes to compassion fatigue, we need to look at it as information out bodies are trying to tell us about what we are doing. Think of these symptoms as warning signs that we are not taking care of ourselves to keep doing our jobs effectively.
Like the check engine light on your dashboard. We have to stop and get the car checked out before we cause real damage to the engine.
So take yourself in for a tune-up, plug yourself in, and get ready for tea time, because you CAN overcome compassion fatigue, you CAN rock it as a first responder, and you WILL make a difference.
Take care, friends!
Alisha is a Licensed Marriage and Family Therapist in California. She is also the Director and Co-Founder of Code 3 Counseling. Alisha specializes in working with first responder couples. You can contact her through our website.
If you find that this exercise or these conversations brought up some stuff you are struggling with, either individually or in your relationship, please do not hesitate to reach out to us for help. We are here to support you, and we understand that this can be a challenging issue to face.