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Caregivers need self-care to battle
compassion fatigue

Compassion literally means "to suffer with," and that is just what can happen to those
who practice great empathy -- they absorb the pain and trauma of others until they themselves become mentally, physically and spiritually exhausted. This condition is often called "compassion fatigue." Colleen Breen, the author of Making Changes: A Guidebook for Managing Life's Challenges, describes it as a kind of "soul sadness" because there is an inner, core reality that closes down when people become so overwhelmed by the needs and concerns of others that they forget to take care of themselves.

Medical and mental health care professionals, emergency care workers, clergy, counselors, and volunteers who work with very sick or troubled people are particularly susceptible to compassion fatigue. But anyone who is called upon to perform frequent acts of care, such as caring for a gravely ill or elderly loved one or doing volunteer work at a crisis center, is vulnerable.

Breen says that during her 27 years as a licensed social worker and psychotherapist in Minneapolis and St. Paul she has worked with thousands of caregivers who have so overextended themselves in the service of others that they suffer from "care-giving shutdown." They often become withdrawn and joyless, irritable, depressed, uninterested in intimacy and sex, and feel like they're "just going through the motions" of their lives with no sense of purpose or meaning. They might also employ what Breen calls "negative coping skills" by turning to smoking, drinking, drug use, or other addictive behaviors.

Breen speculates that there is a resurgence of interest in compassion fatigue in the wake of the terrorist attacks and tragedies of September 11, when millions of people all over the world experienced a sort of "secondary trauma" as they watched the images of wide-scale horror. When all the human suffering from such a catastrophic event is added to the mix of grief, worry and empathy that we've already got stored up inside ourselves, we become like over-inflated balloons, ready to burst from all we are trying to contain. We might have nightmares, develop stress-related illnesses, or exhibit the other symptoms of compassion fatigue.

Because compassion fatigue adversely affects body, mind and spirit, it makes sense to concentrate on those areas when attempting to treat or prevent this condition. People active in Twelve Step mutual-help groups such as Alcoholics Anonymous or Al-Anon are steps ahead of the game because they learn the importance of self-care and living a well-balanced life.

Breen also stresses the importance of nurturing body, mind and spirit. She says that caretakers should have some kind of physical regimen to deal with the stress that settles in their minds and bodies. It is equally important to take quiet time for reflection, prayer, or solitude and to engage creatively with things other than caregiving. Hobbies, engaging in the arts, and listening to music are wonderful ways to tend your soul, says Breen.

Many people in recovery from addiction have also discovered how critical it is to reach out to others when the weight of the world seems too much to bear alone. But asking for help is often difficult for those whose job or nature is to care for others. Caregivers suffering from compassion fatigue have expressed grief, shame and fear about the emptiness they feel. "They wonder," says Breen, "how they can tend to others if they feel like they've lost their compassion?"

Loved ones can often be catalysts for someone getting help. Breen suggests that you voice your concerns in a loving way in order to start a conversation with someone you think is exhibiting symptoms of compassion fatigue. Sometimes such an expression of concern is the first step toward addressing the problem.

Breen takes great hope in the fact that more and more mental health care organizations are paying attention to the issues surrounding compassion fatigue and discussing ways to prevent this occupational hazard.

"There is this myth that we have unlimited energy; but we are not Energizer Bunnies," says Breen. "We can't just keep going and going and going, giving and giving and giving. Self-care is a way to charge our inner batteries so we can continue caring for others."


The Hazelden Betty Ford Foundation is a force of healing and hope for individuals, families and communities affected by addiction to alcohol and other drugs. As the nation's leading nonprofit provider of comprehensive inpatient and outpatient addiction and mental health care for adults and youth, the Foundation has treatment centers and telehealth services nationwide as well as a network of collaborators throughout health care. Through charitable support and a commitment to innovation, the Foundation is able to continually enhance care, research, programs and services, and help more people. With a legacy that began in 1949 and includes the 1982 founding of the Betty Ford Center, the Foundation today is committed to diversity, equity and inclusion in its services and throughout the organization, which also encompasses a graduate school of addiction studies, a publishing division, an addiction research center, recovery advocacy and thought leadership, professional and medical education programs, school-based prevention resources and a specialized program for children who grow up in families with addiction.

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