Compassion Fatigue in Health Professionals

Sometimes, health professionals are unable to make the person they’re treating feel better. This produces a form of post-traumatic stress in them: compassion fatigue. Compassion fatigue is a state that comes as a result of caring for and feeling for one’s patients. Witnessing the physical, psychological, social and spiritual suffering of their patients drains them. In fact, over time, they may even indirectly experience their pain.

Empathy as a trigger for stress

When a person goes to dialysis almost every day of the week, inevitably the health professional and the patient bond. The mere fact of seeing each other on a daily basis and exchanging observations and hopes for improvement creates a friendly kind of trust.

Granted, knowing how to put oneself in another’s shoes is important; health professionals should understand their patients needs and connect. However, empathy is a two-edged sword, and it can act as a trigger for certain types of stress. This is precisely the case with compassion fatigue.

Empathy increases the quality of treatment. But, at the same time, it increases the vulnerability of professionals to burn out. In short, the more empathy, the greater the risk of compassion fatigue.

Brain mechanisms of empathy

In 1995 Charles Figley coined the term compassion fatigue. He is director of the Traumatology Institute at Tulane University in New Orleans, and he observed that health professionals who worked in mental health with traumatized people indirectly experienced the effects of the trauma over time.

Although the origin of the term is relatively recent, the cerebral mechanisms that explain it have been around a long time. They’re related to empathy and imitation behaviors. In short, the amygdala, the orbitofrontal cortex and mirror neurons are responsible for when you feel what another person is feeling.

In addition, if there is deep pain and tremendous suffering in play, a person’s capacity for empathy grows. Then, compassion fatigue becomes more evident.

Symptoms of compassion fatigue

Compassion fatigue is the result of a cumulative process. As we’ve seen, it develops due to a state of emotional distress prolonged by continuous and intense contact with patients. But what are the signs and symptoms of it?

• Cognitive: memory difficulties, lack of attention and concentration, recurrent negative thoughts, flashbacks.
• Emotional: intense feelings of fear, sadness, anger, generalized despair, loss of joy or happiness.
• Physical: gastrointestinal discomfort, dizziness, headaches, hypertension, pain, muscle tension, chronic tiredness, difficulty falling asleep.

Lastly, signs that may manifest in the workplace include: low motivation, feelings of incomprehension, perception of poor professional training, and distancing from coworkers.

The relationship with post-traumatic stress disorder

You may have noticed that compassion fatigue looks similar to Post Traumatic Stress Disorder. Let’s see what PTSD consists of. A very stressful or traumatic event causes it, one that poses a threat of extreme physical harm to the subject. The body generates responds with stress as an effort to adapt to the environment. It may happen at any age and appear well after the event.

On the other hand, compassion fatigue appears abruptly and markedly. In addition, multiple triggers, not one, generate the stress. In other words, it’s from the healthcare professional’s constant exposure, emotional involvement and therapeutic relationship with their patients.

3 groups of shared symptoms

Compassion fatigue and PTSD share symptoms. They include:

• Re-experiencing the moment. If the conflict is not resolved, the professional may relive or remember the traumatic experience in the form of rumination or flashbacks. For health professionals, this symptom is especially tricky. Too much work doesn’t cause the stress; it’s their emotional involvement with their patient.
• Avoidance and psychic dullness. The person makes efforts to avoid thoughts, emotions, people, places, tasks and situations that remind them of the traumatic event. Additionally, they tend to get rid of things that relate to it and they stop participating in activities they used to enjoy. A person with compassion fatigue, in addition to experiencing PTSD, experiences discomfort, irritability, and confusion. They distance themselves physically and emotionally from their patients and other people, which can harm their social life.
• Hyperactivation or hyperarousal. Arousal is the level of physiological activation. In this case, their state of tension and alertness are continual; they react in extreme ways to almost everything.

How to work with compassion fatigue

Finally, now that you know what compassion fatigue is, you can see the importance of good emotional management in the treatment of patients by health professionals. Some suggestions to deal with the situation are:

• Take some time alone to get perspective and disconnect.
• Identify what strengths and resources you have available to you for situations involving other people’s pain and suffering.
• Sleep properly and eat well.
• Do relaxation exercises and physical activity.
• Share your thoughts and feelings with coworkers.

As you can see, the side effects of highly emotional and painful situations are very real, even in professionals who are trained to handle it. Caring for yourself is a priority you cannot forget. In fact, it is fundamental if you want to give the best treatment possible to your patients.