When Too Much Is Too Much: On Burnout and Compassion Fatigue

Posted by Emily Piccirillo on

This piece is specially written in recognition of the 20th Anniversary of 9.11.

As we honor the heroes who responded to this national tragedy, we are reminded of the risks of burnout and compassion fatigue for all the wonderful people who commit themselves to making a positive difference in the world.

On Telling the Difference

Worn down, drained, strung out, on edge, wiped, threadbare, had it, done in…

Burnout and compassion fatigue are closely related because they’re both caused by sustained stress. Burnout is the broader category and compassion fatigue is a distinct subtype of it. It’s defined as “a chronic sense of depletion, emotional distress, or apathy resulting from constant demands of caring for or giving to others.”

Burnout is a weariness that can happen to anyone with a taxing lifestyle, but it is most often associated with helping professions and mission-driven work. This includes veterinary, aftercare, and bereavement counseling providers who support pet parents during the end-of-life experience of beloved companion animals.

The differentiating factor is that burnout tends to emerge gradually over time and compassion fatigue often has a swifter onset due to more concentrated contact with adversity.

Compassion fatigue results from absorbing the trauma and emotional difficulties of others, and this creates a secondary traumatic stress in the helper. Compassion fatigue is the residue from working with those suffering from hardship and its complications. Prolonged witnessing of clients’ intensely difficult experiences and frequent exposure to such narratives makes one susceptible to compassion fatigue. Despite its graphic nature, it’s not always easily identifiable.

An acute variation on this theme is moral injury. This occurs when a caregiver finds that even their best efforts are compromised, futile, or even harmful due to the circumstances in which they’re trying to function. It occurs in settings with poor leadership and inadequate staffing and resources, thereby burdening providers with unsafe risks, impossible choices, and tragic consequences. Stories of moral injury are rampant during the current pandemic and will likely result in attrition and a long-term healthcare crisis.

Strategies for Recognizing Compassion Fatigue

The first step in preventing compassion fatigue and building resilience is to know common signs. These features can alert you to a depleted internal state:

  • Persistent exhaustion (emotional, cognitive, physical, and/or spiritual)

  • Pervasive decline in efficacy and motivation (“going through the motions”)

  • Feeling perpetually overwhelmed / forgetfulness

  • Apathy / /numbing / reduced feelings of sympathy or empathy

  • Hypervigilance

  • Dread / guilt / negative self-talk

  • Minimizing or doubting whether one’s own distress is legitimate

  • Irritability / jitteriness / impatience / flashes of rage or aggression

  • Cynicism / disdain / denigration / mocking others

  • Alienation / depersonalization / dissociation

  • Hypersensitivity or indifference to emotional content (zombie-like)

  • Impaired decision-making / inflexibility / inability to listen

  • Problems in personal relationships

  • Tendency to socially distance and isolate

  • Inability to experience pleasure or diminished sense of fulfillment

  • Headaches / muscle tension

  • Insomnia / nightmares / lethargy

  • Swings in appetite

  • Loss of libido

  • Addictive behaviors

  • Malaise / helplessness / hopelessness / depression / suicidality

Strategies for Responding to Compassion Fatigue

It’s vital to avoid neglecting yourself, so here are protective practices compiled from various resources. A good regimen of self-care is unique to each individual, but tends to prioritize:

  • Eating a nutritious diet and drinking plenty of water

  • Engaging in regular exercise and/or yoga, especially outside in nature

  • Having a set schedule of restful sleep

  • Balancing work and leisure

  • Refueling with favorite fun, relaxing activities and hobbies

  • Take technology holidays

  • Finding an expressive or creative outlet (even doodling!)

  • Honoring emotional and physical touch needs

  • Cultivating and spending time with a supportive community

  • Developing a gratitude practice

  • Setting Limits — especially emotional boundaries!

Lifestyle Pointers

  • Becoming attuned to one’s own particular triggers, stress signals, and preferred responses is the best approach.

  • Be sure to find ways to cultivate healthy friendships outside of work. This diversifies pastimes and conversational content, protecting against drift to traumatizing topics.

  • Likewise, actively pursuing sources of laughter is profoundly healing.

  • When you find yourself struggling with stress, take short breaks when possible, stepping away to a quiet spot (even the bathroom), closing your eyes, and engaging in progressive relaxation, calming visualizations, brief guided meditation app, and/or deep breathing exercises. Putting a hand on your heart and sending yourself love can make a dramatic holistic difference.

  • And remember — it’s not all on you! Even with awesome personal habits, some workplace cultures are toxic and the only way to care for yourself is to leave. Resignation is not a sign of personal failure – you deserve to be happy and thrive! Let yourself fantasize about your next steps and tap your network as you create a path to realize your vision.

Workplace Pointers

In the meantime…the overarching challenge is to remain compassionate without becoming overly involved and taking on another’s pain. This helps to maintain a strong, helpful and meaningful connection while still honoring the fact that you are a separate person with your own needs and wishes.

If your workplace culture doesn’t currently have specific well-being strategies in place, consider suggesting their implementation. These can include:

  • Support groups, outside supervision, and integrated discussions about compassion fatigue

  • Regular breaks

  • Routine check-ins

  • Mental health days

  • Onsite counseling

  • Relaxation rooms, massage, yoga, guided meditation

Take Care

Please note: This is intended for informational purposes only and not to replace professional care. When it comes to any specific individual’s situation, if you continue to feel emotionally vulnerable, distraught, or overwhelmed, while friends and family may provide comforting support, it’s best to find a qualified therapist to help you sort out and process your experiences and implement an adaptive plan that will establish or restore a satisfying work-life balance.

Feel free to explore additional guidance here and, of course, I always welcome your insights and feedback here. You’ll also find helpful resources and self-assessment tools at compassionfatigue.org.

Warm regards! ~Emily

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