Is This Compassion Fatigue?
I guess compassion fatigue will be experienced differently by everyone who works in the helping professions but I thought it might be helpful to describe my experience as a way of helping other clinicians pay attention to their well being.
My heart feels like a railway station at peak hour.
Long before I had heard of the term compassion fatigue when the only name I had heard to describe what happened to exhausted therapists was burn out, I experienced what I called burnt open.
When I am at the end of my helping tether my heart begins to feel like a railway station at peak hour through which too many people have passed. It is as though my skin has become porous, I feel pain and joy and love more deeply and I will cry easily at anything. It is an ecstatic compassionate experience but if I don’t take heed and rest shortly afterward I will become completely exhausted or fall ill. At these strange burnt open times I can also begin to feel like i am exhibiting behavioral traits of the clients I have been working with. For example on occasion when my exhaustion has come whilst working with clients vulnerable to suicide, I have begun to randomly experience the thought “I want to kill myself”. At these times I know that I must stop, rest and regenerate.
How might my fatigue impact clients?
Real or imagined I have a sense that without my emotional robustness to hold the safety and set the boundary of the therapeutic space my clients too can become more porous. They may feel their emotions more intensely and allow more deep or personal content to arise in the therapy session. Of course moving more deeply into trust and allowing meaningful content to emerge in session is good therapy, but it is essential that it arises in a safe way at the right time for the individual, with a therapist who has all their emotional and cognitive faculties about them.
At these times of fatigue I am very cautious.
I choose my group topics mindfully and I deliberately plan therapy groups which will engage participants intellectually rather than emotionally. In individual work I check more regularly on the safety and emotional status of my clients during the sessions. In both cases I pay more attention to thorough risk assessment and double check my decisions with my peers where ever possible.
I let my manager and supervisor and loved ones know where I am at so that they can support me and I plan a sick day and a holiday, I make a lot of art and try to increase exercise and meditation, get into nature and schedule in some gentle fun with friends.
But what causes it?
There are many contributing factors, the multiple of variable which can increase in the intensity of my client work, lack of supervision and consultation, beloved workmates resigning, interpersonal difficulties with other staff, time pressure and deadlines organisational instability, difficulties in ones personal life.
But it is never the clients i work with that cause my fatigue, quite the opposite in fact they are the source of inspiration, energy and constant learning.
What I notice brings me undone is feeling isolated or alone, not having a team, and the experience of being responsible for the therapeutic outcomes of too many people without the people power and support to deliver.
How to prevent compassion fatigue.
Make sure you know what it is to feel comfortable, content and relaxed within yourself before you begin practicing. Many training courses, particularly in clinical psychology are so demanding that clinicians begin their careers in a state of exhaustion and anxiety.
Get in touch with who you are and what really matters to you.
Bring awareness to what gives you joy and restores you to a sense of well-being.
Keep up regular exercise and mindfulness practice and find a creative outlet.
Seek out a really skilled, experienced, supportive supervisor and develop a peer support network for yourself.
Be gentle, there is too much pressure to work full time, don’t be afraid to decide for yourself how many days it is healthy for you to work as a therapist at any given time.
Please leave a comment about your experience of compassion fatigue.
My heart feels like a railway station at peak hour.
Long before I had heard of the term compassion fatigue when the only name I had heard to describe what happened to exhausted therapists was burn out, I experienced what I called burnt open.
When I am at the end of my helping tether my heart begins to feel like a railway station at peak hour through which too many people have passed. It is as though my skin has become porous, I feel pain and joy and love more deeply and I will cry easily at anything. It is an ecstatic compassionate experience but if I don’t take heed and rest shortly afterward I will become completely exhausted or fall ill. At these strange burnt open times I can also begin to feel like i am exhibiting behavioral traits of the clients I have been working with. For example on occasion when my exhaustion has come whilst working with clients vulnerable to suicide, I have begun to randomly experience the thought “I want to kill myself”. At these times I know that I must stop, rest and regenerate.
How might my fatigue impact clients?
Real or imagined I have a sense that without my emotional robustness to hold the safety and set the boundary of the therapeutic space my clients too can become more porous. They may feel their emotions more intensely and allow more deep or personal content to arise in the therapy session. Of course moving more deeply into trust and allowing meaningful content to emerge in session is good therapy, but it is essential that it arises in a safe way at the right time for the individual, with a therapist who has all their emotional and cognitive faculties about them.
At these times of fatigue I am very cautious.
I choose my group topics mindfully and I deliberately plan therapy groups which will engage participants intellectually rather than emotionally. In individual work I check more regularly on the safety and emotional status of my clients during the sessions. In both cases I pay more attention to thorough risk assessment and double check my decisions with my peers where ever possible.
I let my manager and supervisor and loved ones know where I am at so that they can support me and I plan a sick day and a holiday, I make a lot of art and try to increase exercise and meditation, get into nature and schedule in some gentle fun with friends.
But what causes it?
There are many contributing factors, the multiple of variable which can increase in the intensity of my client work, lack of supervision and consultation, beloved workmates resigning, interpersonal difficulties with other staff, time pressure and deadlines organisational instability, difficulties in ones personal life.
But it is never the clients i work with that cause my fatigue, quite the opposite in fact they are the source of inspiration, energy and constant learning.
What I notice brings me undone is feeling isolated or alone, not having a team, and the experience of being responsible for the therapeutic outcomes of too many people without the people power and support to deliver.
How to prevent compassion fatigue.
Make sure you know what it is to feel comfortable, content and relaxed within yourself before you begin practicing. Many training courses, particularly in clinical psychology are so demanding that clinicians begin their careers in a state of exhaustion and anxiety.
Get in touch with who you are and what really matters to you.
Bring awareness to what gives you joy and restores you to a sense of well-being.
Keep up regular exercise and mindfulness practice and find a creative outlet.
Seek out a really skilled, experienced, supportive supervisor and develop a peer support network for yourself.
Be gentle, there is too much pressure to work full time, don’t be afraid to decide for yourself how many days it is healthy for you to work as a therapist at any given time.
Please leave a comment about your experience of compassion fatigue.
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