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Compassion Fatigue

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“The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet…” – Rachel Naomi Remen

Compassion Fatigue is a form of caregiver burnout (Figley, 2002). Our empathy and emotional investment in helping people who are suffering make us vulnerable. It’s not a matter of if stress will take a toll on us as helping professionals, but more a matter of when and to what extent we take effective action to limit stress intake, learn how to manage stress, and reach out to support systems. The signs of compassion fatigue are sadness, grief, avoidance or dread of working with others, reduced ability to feel empathy, somatic complaints, addiction, nightmares, increased psychological arousal, changes in beliefs, detachment, and decreased intimacy. It is important to be able to take care of yourself and know when you need to take a step back and engage in what will help you, even if it means saying “no” and setting boundaries.

Danielle Doby says, “It is unsustainable to give until you have nothing left. Before you hit empty, you’ll be giving something that isn’t real. Boundaries yield inner fuel. It is okay to ask for what you need, then believe you are worthy of receiving it.” Self-care is an essential survival skill. Self-care refers to activities and practices that we can engage in on a regular basis to reduce stress and maintain and enhance our short- and longer-term health and well-being. Self-care is necessary for our effectiveness and success in honoring our professional and personal commitments. Angela Davis says, “Anyone who is interested in making change in the world also needs to learn how to take care of themselves.” 

You might think of self-care in terms of Macro Self-Care and Micro Self-care. Macro Self-Care refers to the big, essential practices like vacations, exercise, social interactions, hobbies, supervision, adequate sleep, a healthy diet, and massages. These activities can be valuable, even essential self-care practices but they all require some larger combination of time, effort, and financial resources. On the other hand, Micro Self-Care Refers to practices that are simple enough to fit into your existing schedule, your current energy level, and your budget. Calm, awareness, rejuvenation, and balance can be summoned in the moments between and during normal activities. Micro-self-care is about coming home to yourself intentionally during any part of your everyday activities. (From Self-Care for Therapists by Ashley Davis Bush). Here are a few ideas for Micro Self-Care practices:

  • Chair Yoga
  • Stepping Away from the Screen
  • Body Scan
  • Belly Meditation for Boundaries
  • Embodied Check-Ins (practicing present-moment awareness of what’s felt in the body)
  • Daily Rituals
  • Digital Detox
  • Peaceful Transition: Work to Home/Home to Work
  • Restorative pauses and thoughtful transitions throughout your day between meetings
  • Water Bowl (write something on paper that you would like to release like “perfectionism” for example and tear the paper up or crumple it and release into the water)
  • Declutter Office Space
  • Essential Oils
  • Gratitude Journal
  • Sensory Anchors (i.e., objects from nature)
  • Mudras
  • Self-Compassion Meditation
  • Self-Massage
  • Heart-Focused Breathing
  • Affirmations (i.e., “I don’t have to fix everything for everyone. I know I can feel this person’s misery, but all I can offer is compassion.” “I release what is not mine to feel. This too shall pass. I can breathe and release. It’s not even mine.”)
  • A Mindful Lunch Break (get some sunlight, leave phone and multitasking behind)
  • A Mindful Minute (set timer for one minute and just notice breath/body sensations)
  • Creative activities (journaling, playing an instrument, art, crocheting/knitting/weaving)
  • Nasal breathing with a longer exhale which engages the parasympathetic nervous system (opposite of fight or flight) and slows the heart. Or, if you’re feeling a bit more low in energy, an equal length inhale and exhale.

Another insightful book on this subject is Laura van Dernoot Lipsky’s Trauma Stewardship. She says, “Before starting your workday, take a moment to literally stop in your tracks and ask yourself, ‘Why am I doing what I am doing?’ After you hear your answer, remind yourself, gently, that you are making a choice to do this work. Take a deep breath; breathe in both the responsibility and the freedom in this acknowledgment.”


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