Compassion Fatigue: Resiliency and Self-Care
Every day we read about people all over the world who experience and endure traumatic life events such as natural and man-made disasters, violence, abuse, and other overwhelming adverse life situations. These occurrences are all too common. Research indicates that up to 60 percent of the U.S. population will experience a traumatic event during their lifetime and some experience multiple traumas first-hand. Traumatic exposure has been implicated as a risk factor for numerous health problems such as heart, lung, and liver disease. Trauma is linked to mental disorders including depression, substance abuse, and post-traumatic stress disorder (PTSD). The landmark Adverse Childhood Experiences study established how traumatic childhood events create toxic stress that is linked to life-long negative physical and emotional health problems including early death. Traumatic life events can inevitably have a profound and lasting effect on everyone who is directly and indirectly involved.
Researchers have recognized that professionals working with traumatized populations on the front lines on a regular basis takes its toll. There is a “cost of caring.” Emergency first responders, firefighters, law enforcement, physicians, psychologists, nurses, social workers to name a few, invest their time, expertise, and compassion as they extend care to suffering individuals facing life-threatening conditions or live in violent situations. This continuous contact with a traumatized population brings to light the issue of secondary traumatization.
Secondary traumatic stress (STS) refers to the presence of PTSD like symptoms caused by at least one indirectexposure to trauma. Secondary traumatization may develop from hearing about traumatic events or caring for someone who has experienced trauma. Symptoms of STS can emerge suddenly with little warning. The effects are cumulative and permanent, and evident in both the care provider’s professional and personal life.
Maintaining empathy and compassion are essential qualities of all helping professions involving high levels of personal need and emotional connection. Compassion fatigue (CF) refers to a depletion of physical, emotional, and spiritual energy, a consequence of empathic engagement in combination with constant, prolonged exposure to intense, traumatic events experienced by traumatized individuals. Compassion fatigue (CF) and secondary traumatic stress (STS) may be used interchangeably although compassion fatigue is a somewhat friendlier term.
Symptoms of STS and CF include: (1) Distressing emotions: sadness, depression, grief, despair, anxiety, anger, or guilt. (2) Intrusive imagery of traumatic material, nightmares, flooding, and flashbacks. (3) Numbing or avoidance of traumatic material. (4) Somatic complaints: sleep difficulty, headache, stomach distress, and heart palpitation. (5) Addictive or compulsive behaviors. (6) Physiological arousal: irritability, anger outburst, difficulty concentrating, hypervigilance, exaggerated startle response. (7) Impairment in daily social, professional, and personal functioning.
You may be thinking, “Aren’t there other professional “caregivers” who may exhibit symptoms of CF and STS?” The answer is a definite “Yes!” Year after year, caregivers in our communities administer physical, emotional, and spiritual care to individuals going through life’s most difficult challenges. They are educators who teach, mentor, guide, and support our children and young people. Home health nurses, physical therapists, hospice workers, clergy, as well as family members provide residential care for chronically ill, disabled, aging, and dying individuals. Religious leaders minister to the spiritual needs of the sick, dying, and grieving.
Helping professionals may have difficulty appreciating the connection between caring for themselves and their ability to care for others. First and foremost, self-care is a necessity not a luxury. Numerous studies linking traumatic life events to chronic diseases and psychological disorders provide compelling evidence for effective preventative self-care strategies. Research utilizing MRI technology provides hope for dealing with chronic stress, disease, and emotional health. For example, research has shown mindfulness meditation beneficial for reducing stress, managing anxiety, depression, and chronic pain, as well as lowering blood pressure, improving immune system, and managing chronic diseases.
Knowledge and awareness of indirect trauma exposure provides a sense of hope and empowerment to explore and utilize self-care strategies. Strategies include education and skills training, participation in self-care groups, professional consultation, scheduling downtime, and maintaining a healthy balance between personal and professional life helps promote renewed zeal and a reawakening of hope. Maintaining strong support networks, developing diverse interests, and seeking positive experiences outside of work are critical to self-care and resiliency. Remaining mentally and physically healthy requires a regime of regular exercise, balanced diet, sufficient rest, and time to laugh and play.
Self-care denotes a non-judgmental and compassionate attitude toward oneself. In these turbulent times we might all benefit from a little more compassionate self-care as we strive together to make the world a better place.