Freeman Medical Musings Blog


Compassion Continuum

Posted by Dr. Kimberly Fielding, on August 27, 2015

As parents, teachers, coaches, foster parents, child welfare workers, juvenile officers, nurses, youth leaders – we have feelings in relation to our work of helping children. Often, folks enter their professional helping roles with the intention of being the best support to children who need guidance as they develop towards adulthood. However, the challenges can distract from what we expected from the relationships. For example, the work environment in which we meet children can add a layer of complexity. We also bring our own history into the situation; children can be pleasant reminders of our childhood – or they could stir up distressing memories. Finally, children with trauma histories may present challenging situations.

Experts have investigated the costs and benefits of caring to address the needs of helpers realistically – whether they are helping in an informal or professional role. Studies have found important information regarding this topic. For example, helpers are at risk of not only physical exhaustion from frequent serving – emotional exhaustion is a realistic possibility as well. Prevention strategies are necessary to avoid physical and emotional fatigue. Yet, some circumstances lead to a need for intervention if the cost of caring is high. Therefore, this series of blog posts will involve the use of the swimming pool metaphor to depict the range of possible experiences for child-serving adults. I refer to it as the compassion continuum – from a full swimming pool to one that is drained bone-dry. 

The beginning point is to refer to a swimming pool as functioning at its best if it is full of water. Otherwise, one would get a wading pool! However, this metaphor refers to the pool full of sources, in which the adult then pours into children. Such sources for resourcing are related to psychosocial needs such a love, belonging, guidance, correction, handling frustration, encouragement, owning responsibility, problem solving, communication and enjoyment. The compassion continuum metaphor, therefore, relates to the water quality and levels within the pool of adults. The strength of the helper is the focus for this series of blog posts.

The continuum starts with a full pool of water (or resources). By nature, the pool is vulnerable to water loss. First, the sun will warm the surface of the water and evaporation will cause a gradual decrease in the water level. Also, the joy of splashing can bring just as much water outside of the pool as remains inside! Finally, the pool will likely have a water filter system where a syphon pulls water out on a regular basis. The swimming pool needs hoses refilling the pool with water in order to stay full and functioning at its best. Otherwise, instead of hoses, a helper can feel like they are just getting hosed! The various places along the continuum represent possible problems when a pool is not full of sources in order to be a resource – and the ways in which it can be replenished.

To prevent depletion and inevitable water loss, make sure plenty of flowing hoses are adding water to the pool. The pool has to have sources to offer them as resources to others! A water spigot is an image that comes to my mind. However, for those working with children and their spontaneous characteristics, it is wise for a child-serving individual to have a variety of hose options in case the moment calls and a spigot is not handy! When the water loss problem is not about splashing, evaporation or the siphon, it may be about not getting enough of the helpful sources to refill the pool. My future blog entries will discuss to those other possible hoses along the way.

Blog post #2 in the series will provide more in-depth understanding of the highest water level – compassion satisfaction. During compassion satisfaction, the water going out due to serving children is equal to the amount of water that the hoses are adding to the pool. There is constant water motion. However, without this movement, the water level may be full, but stale. This point on the continuum is often referred to as burn out. Since we are talking about water, some folks also refer to this stage as rust out.

Blog post #3 will focus exclusively on compassion fatigue. This place along the continuum refers to all the usual routes of water loss and hoses are in operation, but little holes are in the side of the pool. The leaks can be felt as feelings of being overwhelmed with the work.

Blog post #4 will include vicarious trauma and secondary traumatic stress. These are similar, but have some subtle distinctions for blog purposes. The similarities involve a helper closely identifying with the child’s traumatic experiences due to intense empathy or personal powerful sensory reactions.

Blog post #5 will close out the series with ideas for creating prevention strategies to act as a buffer zone to prevent any swimming pool water loss! However, for those who are experiencing a low water level, I’ll provide intervention ideas help you get back on track to ensure you’re receiving sources in order to be a resource!

Happy swimming!