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Compassion Fatigue
Compassion fatigue is a recent concept that refers to the emotional and physical exhaustion that can affect helping professionals and caregivers over time. It has been associated with a gradual desensitization to patient stories, a decrease in quality care for patients and clients (sometimes described as “poor bedside manners”), an increase in clinical errors, higher rates of depression and anxiety disorders among helpers, and rising rates of stress leave and degradation in workplace climate. Helping professionals have also found that their empathy and ability to connect with their loved ones and friends is impacted by compassion fatigue. In turn, this can lead to increased rates of stress in the household, divorce, and social isolation. The most insidious aspect of compassion fatigue is that it attacks the very core of what brings helpers into this work: their empathy and compassion for others.
The term helping professional is a broad term used to describe anyone who works in a professional helping capacity with other individuals: nurses, doctors, allied health professionals, mental health counselors, teachers, police officers, victim service workers, personal support workers, lawyers, animal care workers, paramedics, firefighters, and aid workers, to name a few.
Caregivers
Caregivers can also develop compassion fatigue: having to care for a spouse with Alzheimer's disease at home for many years, caring for a child with pervasive developmental delay or complex health care needs—these can take their toll on caregivers' emotional and physical health and lead to a reduction in their compassion and ability to care for their charges. Helping professionals are often initially attracted to this field for personal reasons: Some research indicates that around 60% of individuals who choose to become helping professionals have their own history of trauma or loss (or witnessed someone close to them struggle with mental health, addiction or a traumatic event). This means that many helpers have an increased vulnerability to developing a mental illness and can find themselves triggered by the traumatic stories of their clients, particularly if they have not sought treatment for their own emotional injuries.
In addition to prior life history, which creates vulnerability, research shows that some helping professionals are at an increased risk of developing compassion fatigue: those who work full-time in direct client service, such as child protection; those who work with inadequate resources (insufficient referral sources, poor pay, dysfunctional organizations); helpers who are exposed to a great deal of traumatic material; and those with inadequate training.
History of the Term
Compassion fatigue was not a well-known concept until the late 1990s. The term “burnout” had been popular since it was first coined in the 1970s, and it was often used as a catch-all term to refer to work-related exhaustion, frustration with work, low levels of engagement, dissatisfaction with inadequate pay, excessive workload and poor supervision for employees in any field of work. In the 1990s, however, researchers started finding clear evidence that helping professionals were experiencing something more complex than regular burnout: Social workers, nurses, crisis workers and other helpers were exhibiting signs of marked emotional and physical exhaustion with a deep shift in their ability to connect with feelings of compassion for others (clients, colleagues, and loved ones). Many confessed that they were becoming desensitized to their patients' stories. In addition, research found that exposure to traumatic material was negatively impacting helping professionals: Helpers were experiencing intrusive images, nightmares, and difficulty getting rid of traumatic stories recounted by their clients. They were also noticing that the stories they heard were profoundly changing their view of the world; some helpers who were parents described feeling a loss of a sense of safety for their children, being unable to hire babysitters for fear of molestation, for example. Some cancer workers noticed an increased hypervigilance about any physical symptom that may indicate warning signs of cancer (a headache becoming a sure sign of a brain tumor). In addition to this shift in worldview, some helpers were experiencing symptoms similar to posttraumatic stress disorder, without having experienced primary trauma themselves.
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