Compassion Fatigue: Legend or Danger Sign?

by Archpriest Steven Voytovich

This Spring I was invited to address a group of caregivers on the topic of Compassion Fatigue.  As a teaching chaplain and licensed community counselor, such opportunities to share are meaningful indeed, and yet my inner response to the topic was to wonder whether there might be another topic…

As a third generation of immigrants to this country, a strong cultural work ethic had been instilled early on within our family.  In addition, I spent significant time with extended family members who were dairy farmers.  Vacation was not a word that was spoken or lived.   The work ethic here was to apply oneself fully to the work at hand every day as this directly represented livelihood, and there was simply no one else who would otherwise take care of it.  Fast forwarding to counseling training, while I could certainly relate to the concept of “wellness” as a pastor and person of faith, the notion of compassion fatigue struck me as a form of cop-out given my background.  Nonetheless, I decided it was time to push through my own ambivalence to engage this topic in preparation for this presentation.

Compassion itself comes from the Latin, “Com pati:” to bear, suffer with, a sympathetic consciousness of others’ distress together with a desire to alleviate it.”  Compassion is known as a highly held virtue in virtually all the mainline religious traditions.  Defined from a pastoral counseling perspective in the Dictionary of Pastoral Counseling: “compassion appears to be rooted in the capacity to reconstruct the situation of another imaginatively and respond to it emotionally in ways shaped by cultural and other meanings and values.”  This response is further noted to be inclined toward informed, intelligent decision making, and the willingness to risk and give of oneself to alleviate suffering.  An important follow-up note is included in this definition:  “The ability to reconstruct another’s situation imaginatively entails the capacity to maintain sufficient cognitive distance to avoid mistaking one’s own reactions for the other’s while remaining close to one’s own vulnerability to suffering and participation in the common experience of being human.” (Dictionary of Pastoral Care and Counseling, Rodney Hunter Editor, Nashville, Abingdon Press, 1990, p. 206)  No wonder as pastors and caregivers we get tired while ministering to others’ needs!

Compassion Fatigue, an admittedly recent term that was first diagnosed in the 50’s among nurses, is a condition characterized by a gradual lessening of compassion over time.  Sufferers can exhibit symptoms including hopelessness, decreased experience of pleasure, constant stress and anxiety, and a pervasive negative attitude.  These symptoms may manifest professionally and or personally, decrease productivity and ability to focus, and grow new feelings of incompetency and doubt in one’s self.  Suddenly I became more fully engaged.  My hospital administrator had been cautioning me repeatedly about the high number of hours of work I logged weekly, and although I made full use of these hours, what I was able to accomplish was diminishing.  The smallest challenges were becoming tsunami waves, threatening to wipe out whatever energy and where-with-all I still had hold of.  A sense of vulnerability rode with me everywhere I traveled.  Bottom line was that I was throwing every ounce of energy into my work each day, and yet it kept piling up deeper.  To compensate, in reflection I saw myself taking work home, and resisting recreational activities in favor of trying to catch up.

Too burned out to care

An article in a family practice journal observed similar responses among physicians. They noted doctors trying to dictate orders while eating lunch, and in order to focus more intensively on patients, tended to eliminate friends, prayer, and meditation. And, they were increasingly prone to blaming others. No matter how much sleep they were able to get, they awoke exhausted. The same article includes a self assessment. To do nothing is to flirt with self destruction that will over time compromise our ability to reach out and care for anyone.

So in fact, compassion fatigue calls for what may be experienced as counterintuitive response.  Do less.  Take time to talk to others.  Exercise regularly.  Keep setting time aside for prayer, enjoyable activities, and relationships.  No, there is nothing terribly new here.  Being recharged through these self-care related activities, however, we are once again prepared to respond with compassion to those in need around us.  An article focusing on balancing personal and professional dimensions calls upon us to commit to life-long balancing that includes:  commitment to excellence, responsiveness to those we are called to care for, continuity of care, and self care before depletion sets in.  As Orthodox Christians we would add an active prayer life, work with one’s confessor, and regular participation in the Sacramental life of the Church.

“Regular participation in the sacramental life of the Church”

While perhaps needless to say, I found myself standing before this caregiving group as a convert, thankful to God for the message to me in this very invitation!  In being attuned to the level of compassion fatigue operating within me, I was likewise empowered to encourage those I was addressing to take time for what is important in the midst of our caregiving obligations.  If you are a parishioner reading this, be prepared to reach out for support from your pastor.  If you see signs of compassion fatigue in your pastor, reach out to him in support.  If you are a pastor or a caregiver struggling with dimensions of compassion fatigue, work with your confessor, trusted brother priests or peers, and if need be a counselor, to aid you in re-establishing the life-long balance that will best serve to distance you from this malady.  The good news is that taking such time can positively impact our ability to manifest compassion to others.  Even more importantly, as noted in Second Corinthians 1:3-7, God has prepared us for compassionately responding to others by first showing such compassion and comfort to us.  Thanks be to God.

By first showing compassion to us