C. Figley, 1995
Burnout: Cumulative process marked by emotional exhaustion and withdrawal associated with increased workload and institutional stress, NOT trauma-related.
Primary Traumatic Stress: Primary stressors are those inherent in the extreme event, such as what was immediately experienced or witnessed, especially those things most contributing to a traumatic response.
Mother Teresa Understood Compassion Fatigue
She wrote in her plan to her superiors that it was MANDATORY for her nuns to take an entire year off from their duties every 4-5 years to allow them to heal from the effects of their care-giving work.
Is it Burnout or Compassion Fatigue?
The Stages of Burnout have been identified as:
Not only are care givers vulnerable, but members of the team/family are as well. Caregivers/team members should not intentionally expose themselves to trauma, unless required to perform a mission.
Commonalitities of Burnout and Compassion Fatigue:
- Emotional exhaustion
- Reduced sense of personal accomplishment or meaning in work
- Mental exhaustion
- Decreased interactions with others (isolation)
- Depersonalization (symptoms disconnected from real causes)
- Physical exhaustion
Clear difference: Compassion fatigue has a more rapid onset while burnout emerges over time. Compassion Fatigue has a faster recovery (less severe, if recognized and managed early).
“First, you should understand that it’s a process. It’s not a matter of one day, you’re living your life with a great deal of energy and enjoyment, and the next, you wake up exhausted and devoid of any energy – both physical and emotional. Compassion fatigue develops over time – taking weeks, sometimes years to surface. Basically, it’s a low level, chronic clouding of caring and concern for others in your life – whether you work in or outside the home. Over time, your ability to feel and care for others becomes eroded through overuse of your skills of compassion. You also might experience an emotional blunting – whereby you react to situations differently than one would normally expect.”
When Helping Hurts by F. Oshberg, MD
Find someone to talk to.
Understand that the pain you feel is normal.
Exercise and eat properly.
Get enough sleep.
Take some time off.
Develop interests outside of medicine.
Identify what’s important to you.
Look for a new job, buy a new car, get a divorce or have an affair.
Fall into the habit of complaining with your colleagues.
Hire a lawyer.
Work harder and longer.
Neglect your own needs and interests.
— Source: Landstuhl Regional Medical Center
The ABC’s of Prevention
What types of cases contribute to your stress level increasing your vulnerability to compassion fatigue?
- Ability to function is interfered with or altered.
- Situation or incident does not seem “typical or ordinary”, it feels traumatic.
- “Compassion stress” impinges upon or breaks through normal boundaries
- Regularly waking up tired in the morning and struggling to get to work?
- Feeling as if you are working harder but accomplishing less?
- Becoming frustrated/irritated easily?
- Losing compassion for some people while becoming over involved in others?
- Routinely feeling bored or disgusted?
- Experiencing illness, aches and pains?
- Practice excellent self-care
- Nurture yourself by putting activities in your schedule that are sources of pleasure, joy and diversion
- Allow yourself to take mini-escapes- these relieve the intensity of your work
- Transform the negative impact of your work (find meaning, challenge negativity, find gratitude)
Get medical treatment if needed to relieve symptoms that interfere with daily functioning- don’t use alcohol or drugs to self-medicate
Get professional help when needed to get back on track- we all need coaches and consultants at times
Build a positive support system that supports you, not fuels your stress
Pets accept whatever affection you are able to give them without asking for more—Pets are basically invulnerable to “provider burnout”–Blood pressure and heart rate decrease when interacting with animals