Compassion Fatigue

Putting Yourself on Your Priority List: The Antidote to Compassion Fatigue

by Gerald J. Ellison, PhD, Psychologist, Mind Body Medicine

Cancer Treatment Centers of America/Southwestern Regional Medical Center, Tulsa, Oklahoma

In addition to managing her busy family, Susan is the primary caregiver for her aging mother who was diagnosed with cancer seven months ago. Her mother has had many "ups and downs" in the treatment process and depends heavily on Susan when she is most fatigued in the chemo cycles. Although Susan’s nature is to be energetic and optimistic about her life as a wife, mother of two teenagers, and adoring daughter to her mother, lately she's been experiencing fatigue, difficulty in concentrating on tasks, preoccupation with doubts of her abilities and fears of losing her mother even though her mother's treatment is going well.

Concerned that she may just "explode" in anger, she's withdrawn emotionally and sometimes physically from her husband, children, and close friends. Does this scenario sound familiar? Could it be that caring deeply for others hurts? If the answer to both questions is an emphatic yes, you or someone you know may be experiencing what is called compassion fatigue (CF).

Whether you're a family member providing care to a loved one or a professional or lay minister whose business it is to provide care to others, you can experience compassion fatigue. It is, if you will, the potential downside of caring deeply about the suffering of others.

The term CF, also known as secondary trauma, simply means that a caregiver is "taking on" the fears and anxieties, the traumas, of the other person. It's also true that this vicarious experience may be trigger related, with unresolved issues from the caregiver's own past. Taken together, caregivers experiencing CF must deal with the care needs of others while experiencing uncomfortable chronic stress symptoms themselves.

Consider Susan again for a moment. It's likely she took on the caregiving role for her mother as just one more thing she needed to do as a good daughter and believed she could manage the additional demands with better organization or multi-tasking skills. If so, it's a very short step to the belief that the current CF symptoms represent a personal moral failure or an ungrateful, selfish husband, children or other siblings. The challenge in CF is that resolution is possible only when caregivers give themselves and their own needs proper attention. In short, caregivers must put themselves on their own priority list.

One of the ways we can help caregivers avoid CF is to help them address the caregiving role realistically from the beginning. Caregivers, whether lay or professional, need effective stress management skills that they practice regularly. They need to make time, without fail, for reflection, contemplation, relaxation, and restoration. Taking this time for self is not selfish, it is vital to being an effective caregiver.

Journaling is an effective method of allowing the caregiver to explore feelings, reflect on the problems, express honest feelings, and process the difficulties of the role. Exercise is another great stress management tool with many health benefits.

There are some CF symptoms that signal a need for outside assistance. These include: preoccupation with blaming others, significant complaining or ventilating that is not accompanied by constructive problem-solving or taking up destructive habits like drinking or overeating. If these behaviors or other equally health destructive habits surface, professional counseling may be needed to get the caregiver back on track. Effective caregiving depends on caregivers taking good care of themselves too!