When the patient's suffering becomes the helping professional's suffering
Stephanie has always loved helping people. That's why she has gone into a helping profession.
She enjoys listening to her patients, caring for them, accompanying and supporting them.
Stephanie is a youth protection counselor. This is her dream job that she is passionate about.
Except today. Today, Stephanie is tired and exhausted.
She feels powerless regarding her patients. From her passion now comes anger and intolerance. For some time now, she has developed anxiety just thinking about her patients' obstacles. She has increasingly been isolating herself, has insomnia, and is more irritable and emotional than ever. As a result, she is losing interest for her work. She wonders how to help people.
Stephanie is tired. She suffers from compassion fatigue. Are you also tired?
What is compassion fatigue?
Working in helping professions is a rewarding career path that requires a great deal of empathy. However, caring for others is not without risk to oneself. Symptoms of compassion fatigue resemble those of burnout and post-traumatic stress disorder 1 . Burnout is caused by prolonged stress in one’s work environment and can be characterized by a sense of loss of control or low motivation at work. Post-traumatic stress may occur following a traumatic event and includes intense feelings of fear or helplessness, and nightmares or uncontrollable thoughts. Compassion fatigue is related to the relationship and exchanges between caregivers and care receivers 2 .
In sum, compassion fatigue is a feeling of physical and emotional exhaustion experienced by health care providers following traumatic events experienced by their patients either told to them or witnessed by them 3 . The people most at risk are those working on the front lines, that is, professionals who are constantly and regularly confronted with the psychological distress and suffering of their patients. Front-line workers mainly include police officers, firefighters, paramedics, social workers, nurses, doctors, lawyers, psychologists and sexologists 4 .
A large number of trauma victims use front-line services, which exposes workers in these settings to the stories and experiences of survivors and puts them at risk of experiencing trauma in turn. In this sense, neuroscience uses an effect called "mirror neuron" to explain compassion fatigue 5 . During encounters between caregivers and trauma victims, the caregiver's brain produces the same emotions as those of the victim. Trauma is rooted in the individual's inability to regain balance following disturbing events. Constant exposure to survivors’ emotional states puts workers at risk of experiencing trauma symptoms and compassion fatigue 6 .
Compassion fatigue can lead to the development of post-traumatic stress 7 . The caregiver may experience intrusive thoughts, such as dreams that recount the traumatic events experienced by the person being cared for, or flashbacks as if the events had happened directly to them. The caregiver may try to avoid the trauma memories, as they cause distress. Changes in the caregiver's mood (anxiety, irritability) and behaviour (isolation, neglect of personal care) may also be present. This creates difficulties in optimally performing one's job, which also puts the caregiver at risk of developing depression or even having to end their career.
Take better care of yourself to take better care of others
There are several strategies that can be put in place to prevent compassion fatigue. Ultimately, it is important to take care of oneself on an ongoing basis when one is exposed to the distress and suffering of patients. Here are some ways front-line workers can prevent compassion fatigue:
- Recognition of one’s difficulties:
- The starting point in getting better is recognizing the presence of a problem. By recognizing the existence of compassion fatigue and its effects, it becomes possible to identify the risk factors and therefore, better protect oneself from it.
- Introspection is a difficult task for some. However, it is an essential element of the health of care workers. Getting to know oneself is essential to understand and preserve one's mental health. Being able to interpret one's reactions in different situations allows us to be better prepared. Being aware of one’s emotions (e.g., depression, anger) and sensations (e.g., stress knot in the stomach, sweating) is a powerful guide to listening to oneself.
- By identify these feelings, becoming aware of one's traumas, one gives oneself the chance to adapt one's work according to one's needs, and thus, decreasing the risks of developing compassion fatigue.
- Physical care:
- It is important to take care of one’s body, to adopt healthy lifestyle habits, including a good diet, physical activity and sufficient and restful sleep. Healthy habits promote good mental health.
- Emotional and cognitive care:
- Giving oneself moments of comfort, enjoyable activities, simplicity and pleasure is essential to maintain a personal and professional balance! Humans need to take time out in nature, feel gratitude, take moments of deep reflection, be in relationships with others and laugh 8 .
- Professional care:
- Work is a major part of everyday life. It is therefore essential to maintain an optimal work climate, whether that means personalizing one's work environment, or creating interpersonal bonds with colleagues in order to foster a stronger sense of well-being. It is also essential to set professional boundaries and communicate them when necessary.
- It should be noted that employers also are also responsible for the mental health of their employees. Indeed, compassion fatigue is not only an individual difficulty; it can also be due to insufficient support from institutions.
In sum, helping professions are psychologically and emotionally demanding, and present a risk of experiencing trauma-related consequences, even without direct exposure. However, with preventive care and a work environment adapted to the needs of workers, the risks of compassion fatigue can be minimized.
Au besoin, voici quelques ressources qui peuvent vous être utiles :
- BounceBack | Reclaim your health Québec
- Groupe d'Entraide G.E.M.E. - Entraide, Service Social (In French)
- Quebec physicians’ health program
- The Vigile therapy home
*This article was written as part of a course taught by the TRACE director, Natacha Godbout (course title: Adultes victimes de violence durant l’enfance - Adult victims of childhood violence).
Lavoie Simard, R. (2022, May 19). Compassion fatigue. TRACE Blog. https://natachagodbout.com/en/blog/compassion-fatigue
- 1 Ondrejkov, N., & Halamová, J. (2022, January 16th). Prevalence of compassion fatigue among helping professions and relationship to compassion for others, self-compassion and self- criticism. Health and social care community. 1-15. DOI: DOI: 10.1111/hsc.13741
- 2Goetz, J. L., Keltner, D., & Simon-Thomas, E. (2010). Compassion: An evolutionary analysis and empirical review. Psychological Bulletin, 136(3), 351–374. DOI : 10.1037/a0018807
- 3Richardson, J. (2008). Guide sur le traumatisme vicariant : Solutions recommandées pour les personnes luttant contre la violence. Santé Canada. https://publications.gc.ca/collections/collection_2008/phac-aspc/H72-21…
- 4Thomas, P. Barruche, G., & Hazif-Thomas, C. (2012). La souffrance des soignants et la fatigue de compassion. La revue francophone de gériatrie et de gérontologie, 19 (187), 266-273.
- 5Jambon, C. (2016, April 12th). Tout comprendre sur les neurones miroirs en moins de 3 minutes. Apprendre à éduquer. https://apprendreaeduquer.fr/une-animation-pour-decouvrir-les-neurones-…
- 6Brillon, P. (2020). Entretenir ma vitalité d’aidant. Les éditions de l’Homme.
- 7Cocker, F., & Joss, N. (2016). Compassion fatigue among healthcare, emergency and community service workers: A systematic review. International Journal of Environmental Research and Public Health, 13(6), 618. DOI: 10.3390/ijerph13060618
- 8 Perreault, C. (2004). Fatigue des intervenants-es : Comment composer avec les effets de la violence. Association québécoise Plaidoyer-Victime, 4, 1-10. https://aqpv.ca/wp-content/uploads/2004_m3.pdf
Raïssa Lavoie Simard holds a certificate in criminology from the University of Laval. She is currently a student in the microprogram in sexual and interpersonal violence at UQAM. Also a police officer, she has a particular interest in the impact of sexuality on the development and interpersonal relationships of individuals, as well as on the issues faced by people who have experienced trauma.