Compassion Fatigue

by: Trish Dingman 

Some times life gets so big.  It becomes so many things all at once; that it's hard to remember to take a deep breath.  I find on any given day my life can be beautiful and complete chaos; fulfilling and totally overwhelming; mindful and "I don't know where I left my keys or how I'm going to find time to feed myself- let alone the rest of the family". 

This is compassion fatigue. Compassion Fatigue effects 85% of caregivers.  (wikipedia) Compassion Fatigue can creep up on the most spiritual, well adjusted, intelligent individuals.  Compassion Fatigue can take hold, even in the midst of living a life you adore!  Most of the articles and studies I have read about Compassion Fatigue go something like this:

...found in nurses, doctors, mothers, teachers, healers.... Some physical signs and symptoms are exhaustion, insomnia, headaches, tendencies to get sick, somatization and hypochondria, weight gain, weight loss, gastro intestinal issues. ...Common emotional and psychological signs and symptoms are: emotional exhaustion, distancing, negative self image, depression, cynicism, dread of working with certain clients, resentment, feelings of professional helplessness, heightened anxiety/fear/worry, intensity to emotional material, hypersensitivity to emotional charged stimuli, loss of hope, failure to develop non work related aspects of self or life. ... Some behavioural signs and symptoms: increased use of alcohol or drugs, missing work, anger, irritability, avoidance of clients/ friends/ family/ situations, inability to make decisions, problems in personal relationships, compromised care for clients/ patients, family.(1) "...there are no known clinical treatment options for compassion trauma, but there are a number of recommended preventative measures..." (2) 

Signs and SYMPTOMS 

Borrowing from a great paper, by Françoise Mathieu, "Compassion Fatigue and Vicarious Trauma",  here is a breakdown of some of the Compassion Fatigue Symptoms that can start to wreak havoc on our lives- when we don't take time to personally refuel, nurture ourselves, seek out professional help- like therapy, breath work, yoga and other forms of inquiry for healing.  

  1. Increased use of alcohol and drugs: There is evidence that many of us are relying on alcohol, marijuana or over the counter sedatives to unwind after a hard day. And as I say in my workshops: Have you seen the size of wine glasses these days? Some of them are bigger than my fishbowl. So the “one glass after work” you are having is possibly 1/2 of a bottle of wine…The difficulty with increased reliance on drugs and alcohol is also that there may be a lot of shame associated with it, and it is not something that we necessarily feel we can disclose to anyone. Is the child protection worker going to tell his supervisor that he smokes a big fat joint every night when he gets home to unwind? Is the nurse going to tell her colleagues that she takes a few Percocets here and there from her mother’s medicine cabinet?                                               
  2. Avoidance of clients:  Examples of this can be: not returning a client’s phone call in a timely fashion, hiding in a broom closet when you see a challenging family walking down the hall, delaying booking a client who is in crisis even though you should see them right away. Again, these are not behaviours that most of us feel proud of, or that we are comfortable sharing with our colleagues and supervisors, but they do sometimes occur and then we feel guilty or ashamed which feeds into the cycle of compassion fatigue.

  3. Anger and Irritability:  Along with cynicism, anger and irritability are considered two of the key symptoms of compassion fatigue. This can come out as expressed or felt anger towards colleagues, family members, clients, chronic crisis clients. You may find yourself irritated with minor events at work: hearing laughter in the lunch room, announcements at staff meetings, the phone ringing. You may feel annoyed and even angry when hearing a client talk about how they did not complete the homework you had assigned to them. You may yell at your own children for not taking out the garbage. The list goes on and on and it does not add up to a series of behaviours that make you feel good about yourself as a helper, as a parent or as a spouse.  Try this: spend a full day tracking your anger and irritability. What do you observe? Any themes, recurrences? Any situations you regret in hindsight or where your irritability was perhaps out of proportion?

  4. Impaired ability to make decisions:  This is another symptom that can make a helper go underground. Helpers can start feeling professionally incompetent and start doubting their clinical skills and ability to help others. A more severe form of this can be finding yourself in the middle of an intervention of some kind, and feeling totally lost, unable to decide what should happen next.

  5. Distancing:  You find yourself avoiding friends and family, not spending time with colleagues at lunch or during breaks, becoming increasingly isolated. You find that you don’t have the patience or the energy/interest to spend time with others.

  6. Reduced ability to feel sympathy and empathy:  This is a very common symptom among experienced helpers. Some describe feeling numb or highly desensitised to what they perceive to be minor issues in their clients or their loved ones’ lives.

  7. Resentment:  Resenting demands that are being put on you by everyone. Resenting fun events that are being organised in your personal life. Resenting your best friend calling you on your birthday. Resenting taking an extra shift because your colleague is away on stress leave.

  8. Disruption of world view/heightened anxiety or irrational fears:  This is one of the key symptoms caused by vicarious traumatization or exhaustion fatigue. When you hear a traumatic story, or five hundred traumatic stories, each one of these stories has an impact on you and your view of the world. Over time, your ability to see the world as a safe place is severely impacted. You may begin seeing the world as an unsafe place. Examples of this are: A counsellor who works with children who have been sexually abused becomes unable to hire a male babysitter for fear that he will abuse her children. A physician forbids his children to ever chew gum after seeing a tragic event happen with a child and gum at his work. A prison psychologist develops a fear of home invasion after working with a serial rapist. An acquired brain injury therapist develops a phobia of driving on the highway after doing too many motor vehicle accident rehabs. (3)

So Let's get personal

I most definitely have suffered on and off from compassion fatigue. (and until January, not even knowing that Compassion Fatigue was "a thing")   I am a helper. I am a healer.  I am a perfectionist.  And now I'll get really personal and share something which is  VERY  hard for me to admit:  

A lot of my self worth comes from helping others and watching them succeed and heal because of my help.  A lot of my self worth comes from the recognition of being a great teacher, a patient healer and putting others before myself... I get my love hit, by helping someone else and hoping for love in return.  (this by the way is exhausting and usually unfulfilling)  Sometimes- especially when I am deep in overwhelm and exhaustion I refuel on other people's "Thank You"'s and praise.  


Truth is  I  KNOW  BETTER  and I have the tools and self knowledge to  DO  ME  BETTER  than these old patterns.  But the other truth is when I am in active compassion fatigue and overwhelm-  IT  IS  OFTEN  JUST  PLAIN  EASIER  TO  REVERT  BACK  TO  MY  OLD PATTERNS-   which in turn drives me further into exhaustion, people pleasing and over extending.  

so what's the fix?

Early this winter, I was feeling particularly exhausted.  I considered subbing my classes, to stay home and sleep and worry, daily.  I numbed out on Netflix when I had a few minutes to myself.  Put my partner, my students (and even the dog) before myself to the point of beginning to resent the time I was spending with (on) them.  So I went searching for a retreat or course for these feelings I was having and I came across the term  COMPASSION  FATIGUE.  This was it!  A name for the thing I suffered from!!!  And other people suffered from it to?  

I read a lot about it... but couldn't find a place to recover.  A retreat?  A rehab centre?  So.... I contacted my favourite psychotherapist and friend- Maddi Rundle and said-

We need to create tools for women to deal with compassion fatigue.  And not just to deal- but to evolve, inquire, heal and thrive.  And we need to do it in nature.  And we need to bring ritual back into women's lives.  And we need to laugh!!! And we need to understand we are NOT alone.  And we need to create it NOW!  Because I need to start using these tools... because I NEED TO THRIVE !   

And I believe Maddi just said- YES!  Let's do it.  

And so... here we go.... 


As we create.  I begin to practice these tools we are unravelling and working into programming format for the retreat.  I look big into my life.  I question my focuses and how they are serving me.  I question why and how and whom I am serving.  I check in with my resentment and anger.  I sit with it.  I run with it.  I do yoga with ALL  OF  MY  FEELINGS.  I spend time with other women now... talking... sharing... laughing.  I say NO! - when I don't have time or energy- no excuses- just a NO!  I make lists.  I prioritize my lists.  I make time to practice yoga.  To meditate.  To write.  I eat what nourishes me.  I exercise.  I sing.  I hike in nature.  I sing in nature.  I make time to treat myself to studying with the teachers who nourish, inspire and refuel me.  I unplug from social media, when I need to.  I cuddle the dog.  I laugh really hard.  I play in the forest.  I spend a day in silence when I can.  I consciously move towards REALLY taking care of myself.  I invite myself back in to myself.  Home.  I invite myself home.  I practice really filling myself up.  And then being able to serve from a place which is not just full, but overflowing. 

Heal. Evolve. Thrive.  is the beginning of my recovery from over extending, from giving to others first and me second.  It is the beginning of my recognition that the more I understand myself, the more I know who I am... the more deeply I fall in love with myself- and that is how  I  BECOME MY  OWN  FIRST  PRIORITY.  and knowing that this is not a selfish action BUT  A NECESSARY  ONE. 


1 and 3- Signs and Symptoms of Compassion Fatigue and Vicarious Trauma, Françoise Mathieu 2009

2- Huggard, P. (2003). Secondary Traumatic Stress: Doctors at risk. New Ethicals Journal