Freeman Medical Musings Blog


Compassion Fatigue

Posted by Dr. Kimberly Fielding, on October 06, 2015

In this blog post, the compassion continuum discussion continues using the pool metaphor. The pool refers to adults in children’s lives, i.e. adults are pools full of sources to share, or provide resources, to children. Hopefully, the water hoses coming into the swimming pool are keeping pace with the amount of water going out due to evaporation, splashing, and filters. High water levels are dependable under these conditions. Leaks in the pool will drain the water level, however. When water loss comes outside the healthy outlets, compassion fatigue is a likely result. While burnout is a work-overload issue, compassion fatigue is an emotion-overload issue. This place along the compassion continuum refers to all the usual routes of water loss and hoses being in operation, but holes are also in the pool. Like little punctures in the pool’s walls, these subtle leaks can be experienced as a constant stream of feelings such a feeling of being overwhelmed due to the emotional nature of the work.

Compassion fatigue occurs when coping skills are exhausted and/or dysfunctional. Coping skills involve mental effort to be aware, tolerate and effectively manage emotions involved with child-serving work. When internal capacity is compromised, the result for the helper is a wide variety of defensive emotional reactions. For example, if a person has difficulty with saying “no” to new requests for help, the workload is not the issue – the issue is emotional stress. A helper may experience feelings of hopelessness he or she applies more effort with little to no changes in circumstances due to situations beyond the helper’s control. 

Prolonged exposure to overwhelming situations can result in a helper adopting a defensive stance. In other words, he or she is in fight, flight or freeze mode in helping efforts. Fight mode can cause a person to be irritable and defensive about preserving the remaining resources available. An example may include a person who avoids situations or complains when receiving requests through the usual “hose out” venues. Yet, since the water is leaking through holes in the side of the pool, resentment may build against the typical giving activities. The helper resists swimming.

Flight mode can include feelings of disconnectedness and/or being “out-of-touch” with the usual helping activity. The helper is hesitant to approach activities out of fear of more water loss. He or she may feel that helping does not have a good cost-benefit ratio. The helper may ask him or herself, “Why bother?” The helper is reluctant to swim.

During freeze mode, a helper may be bogged down and thus not able to participate in the activities fully. An example may include a person who has difficulty actively listening, empathic highlights, case conceptualization or determining best-fit technologies or procedures. People who are experiencing compassion fatigue may also be identified by frequent absenteeism – or worse, presenteeism – in which they are physically present but emotionally absent. The helper is weary and paralyzed from swimming.

Regardless of the defensive posture above, the results are similar: the helper does not engage in the swim.

Signs of compassion fatigue:

  • Physical ailments such increased sickness and/or exhaustion 
  • Difficulty with concentration, morale, motivation
  • Reduced ability to feel sympathy and empathy
  • Angry, cynical, irritable or out-of-proportion reactions to events 
  • Increased use of alcohol and drugs
  • Loss of healthy client boundaries and motivation to help 
  • Decreased sense of enjoyment
  • Increased isolation
  • Disruption to world view, heightened anxiety or irrational fears
  • Intrusive imagery or dissociation
  • Hypersensitivity or Insensitivity to emotional material
  • Difficulty separating work life from personal life
  • Impaired ability to make decisions and care for clients
  • Contributing to a toxic interpersonal environment