How to Understand Compassion Fatigue

Source: Françoise Mathieu, used with permission

Have you been feeling burned out at work lately? Does your job involve high degrees of stress and trauma? Often, we have compassion fatigue and vicarious trauma without even knowing it. Amid the COVID-19 pandemic, compassion fatigue and burnout can have serious effects on mental wellbeing.

Françoise Mathieu, M.Ed, CCC., RP, is the Executive Director of TEND, an organization that offers training and education for workplaces experiencing high stress, burnout, compassion fatigue, trauma, and secondary trauma. She is the author of The Compassion Fatigue Workbook, a founding member of the Secondary Traumatic Stress Consortium, and a sought-after speaker and educator in Canada, the U.S., and around the world.

JA: Why did you set out to write your book?

FM: After obtaining my master’s degree in counseling psychology, I began working in the field of community mental health at a busy clinic. My work involved offering crisis counseling and urgent mental health support to clients as well as liaising regularly with hospital emergency wards, police, and other community partners.

Although I loved the work, I started to notice some concerning trends such as workplace friction, cynicism, profiling, and, at times, minimization of client issues. I also started questioning the gaps in my training: Why had burnout and compassion fatigue never been discussed during my graduate training? What about trauma and social determinants of health? What about systemic inequities?

In addition to my professional concerns, I was feeling the strain of trying to juggle my workload and my personal life. Client stories were hitching a ride with me and I was finding it difficult to reintegrate into home life. Colleagues would tell me, “This is the job. If you can’t take the heat, get out of the kitchen.” But I started to question this. Do we really have to suck it up to successfully do this work?

When I started looking into what I was feeling, there was a lack of information. This problem didn’t seem to have a name — but once I started talking about it, everyone could relate. A colleague and I stumbled across the term compassion fatigue, we started teaching workshops on the subject, and then things grew from there. The Compassion Fatigue Workbook was written as a roadmap to, what was then, a misunderstood and little-known phenomenon.

JA: What is the primary takeaway you hope readers will learn from reading your book?

FM: Compassion fatigue is a perfectly normal response for professionals who work in high-stress, trauma-exposed settings. It is something that many of us will experience at various times if we stay in the field long enough. I don’t believe that compassion fatigue can be prevented; however, I do know that the effects can be mitigated, transformed, and treated.

The strategies to combat the effects of compassion fatigue are simple — but they are not always easy to implement. It requires courage and an open mind to change the way that we work and live. It also requires us to set limits on what we can do to help others.

JA: What are some lessons from your book that can help people live more resiliently?

FM: Resiliency can be cultivated through improved self-awareness and a reduction in chronic stress. Many helpers say that they can’t remember the last time they felt relaxed. The book encourages readers to take stock and to check in with how they are feeling and their current sources of stress.

Another tip is to be mindful of your level of trauma exposure. After working a 12-hour shift, do you come home and binge-watch Law & Order? Constant exposure to trauma wears us down and prevents us from restoring our barriers to protect ourselves.

The final component of cultivating resilience is making a commitment to daily, small changes. We need to build a resiliency bank so that we have something to fall back on when the going gets rough.

JA: What are some insights from your book that help readers support a friend or loved one?

FM: We know that social support is one of the key factors in mitigating the negative effects of compassion fatigue. If you suspect that someone close to you is experiencing compassion fatigue, be kind and supportive. It can be difficult to hear that something you have been trying to hide is obvious to others.

As well, keep in mind that there is still a lot of stigma around these issues. Although we know that compassion fatigue is a normal consequence of doing difficult work, helpers may still feel guilty for their feelings. They may perceive their symptoms as a weakness or as a fault in their character.

Improved self-care works best when we create an action plan and make a commitment. If your friend or loved one is open to the idea, propose a buddy system in which you hold one another accountable.

JA: What are you working on these days?

FM: I am preparing to work on a second edition of the book. It was first published in 2012 and since then, the field of compassion fatigue has grown exponentially — which is very exciting. I am also very fortunate to be part of a great community of specialists in the field through the Secondary Traumatic Stress Consortium. We meet regularly to explore new directions and research and so this keeps my work very interesting and dynamic.

JA: Anything else you would like to share?

FM: It can be challenging to work in mental health, particularly when we are faced with organizational barriers, unhealthy or unsafe work environments, or situations that provoke moral distress.

It can also be immensely rewarding work. As mental health workers, we have the privilege of witnessing our client’s courage in the face of adversity, developing a trusting relationship with them, and advocating on their behalf.

If you are feeling burnt out or depleted, your first step is to ensure that you are not socially isolated. Take care of yourself by creating communities of support, partaking in informal peer supervision, and developing a habit to frequently engage in non-psychology related activities or hobbies.

Lastly, if your frustration is largely a result of your working environment, it might be time to consider a change.