Compassion FatigueCompassion Fatigue, burn out, and self-care is a topic that, rightfully so, is stressed more and more. This is information not just helpful for social workers, counselors, or psychologists, but for anyone who works in a helping field.

After witnessing and hearing about traumas or seeing a client’s suffering, therapists and social workers can become vicariously traumatized through their clients and patients. This can come in the form of burn out and compassion fatigue. This response can best be explained using the three stages of Hans Selye’s “general adaptation syndrome.”

Alarm: First, the body experiences a stressor as an alarm. This is when the body’s fight or flight response begins, and the body prepares to physically fight or run away. For someone working in a hospital setting, this could include having three new admissions in one day, all of which have extensive trauma history. This may lead to initial thoughts and feelings of:

  • Victimization: “why do I always get all the admissions”, “Why do I always get the patients who have traumatic history”
  • Helplessness: “I’m never going to be able to help all these people, I will fail”
  • Being overwhelmed: “am I competent to handle all these patients?”

Adaptation: If a the stressor is long term, the body then begins to adapt to the stressor. Sometimes thoughts, such as those listed above, occur so quickly that the therapist may not be aware they need to adapt. It is not abnormal for these thoughts to impulsively occur, however to avoid compassion fatigue, adaptation would include using the same coping skills we teach to our patients. Reassuring ourselves that we are competent, only thinking about one patient at a time, reminding ourselves that although these stories are traumatic, that does not mean all people experience these horrible events.

Exhaustion: If one does not adapt, and continue to feel overwhelmed, incompetent, victimized, etc, this leads to compassion fatigue. This can also lead to countertransference, vicarious Trauma, and burn out. When one reaches this stage, the body goes into a state of exhaustion. This occurs when the body can no longer resist whatever stressor is taxing the body’s resources. This ultimately leads to an emotional and/or physical crash in the way of mental breakdowns, panic attacks, developing an illness, chronic high-blood pressure, or in worst case scenarios, heart attacks.

Mitigating Compassion Fatigue

The two main factors that mitigate effects of compassion fatigue, are feeling successful and enjoying your job. However, it is important to identify signs of compassion fatigue before reaching a state of exhaustion. Symptoms include:


       Emotional IndicatorsFeeling…

  • Anger
  • Sadness
  • Prolonged grief
  • Anxiety
  • Depression
       Physical Indicators

  • Headaches
  • Stomach Aches
  • Lethargy
  • Constipation

Personal Indicators

  • Self-Isolation
  • Cynicism
  • Mood Swings
  • Irritability with spouse/family

Workplace Indicators

  • Avoidance of Certain Clients
  • Missed Appointments
  • Tardiness
  • Lack of Motivation

Coping with Compassion Fatigue

Some things that help cope with compassion fatigue are:

  • Working to develop optimism and positive views towards clients, work, and everyday life
  • Exercise (releases excess stress hormones our body develops)
  • Good Nutrition
  • Limit fast food, caffeine
  • Increase fruits, vegetables, and water
  • Humor/Laughter
  • Consistent Supervision/Case Consultation
  • Balance of clients – trauma and non-trauma, if you are able, do not overload yourself with too many clients experiencing trauma, although this is essentially impossible in our current work environment, since everyone is in crisis.
  • Set realistic expectations of yourself, do not try to be superwoman (or superman!) and try to accomplish more than you feel you can. If you cannot do it all, then don’t expect yourself too.
  • Balance work with other activities (i.e. play!) Find time to go do something fun, that makes you smile and laugh, whether that’s playing with your silly dog, joking around with friends over lunch, etc.
  • Get enough sleep!!!

To prevent compassion fatigue, we essentially need to use the coping skills we teach to our patients – Practice what you preach!

Other helpful resources

Video Explaining the difference between vicarious trauma and burn out

Documentary: “Stress: The Portrait of a Killer”  (Note: I recommend EVERYONE watch this video at some point in time, you will be SHOCKED at how much worse stress can be for us than originally thought)

Psychology Today: Compassion Fatigue

Nicole Paulie is a Counselling Psychologist, and co-author of “How to be Happy and Healthy – The seven natural elements of mental health.” She provides therapy in the Dublin city area. Contact us to learn more or to book an appointment.

Compassion Fatigue
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