Compassion Fatigue Solutions

Last week I was at the drugstore with my 10 year old son. I was paying for my things when an elderly man approached the counter. He appeared to be in his late eighties and had deep red bags under his eyes. He looked, in a word, absolutely terrible. With a shaking hand, he took a photo out of his pocket and showed it to us and to the women behind the cash. "This is my wife" he said "She died two days ago, we were married for 58 years. She was the love of my life. Now I can't sleep and the doctor wants me to take these pills" We all fell silent for a minute and then I had a little chat with him. He told me his children all lived out of town, and that he was completely alone. When I left the store with my son in tow, I felt regret that I did not do more. My head was already buzzing with all the community resources I know about, how to link him with the right ones, how we should have taken him out for tea, etc. I was dying to case manage this man into getting support right on the spot but I also had to go home and cook dinner and take care of my family.

This is the constant challenge we face as helpers. Pain and suffering is all around us, it's not just at work. Where do you draw the line? Do you take every elderly widower out for tea? Do you tell every person with a funny-looking mole to go get checked out? Do you rescue every kitty you see? So what we do is we try our best to figure out boundaries. Sometimes we over-correct and we become like Fort Knox, not letting a single person inside our walls. Sometimes we go too far in the other direction and become ambulance-chasers, rescuing every stray dog and baking for every little old lady on our street.

In my workshops, I am always advocating that we need to gain a better understanding of our own warning signs along the continuum of compassion fatigue. Using traffic lights as an analogy, the green zone is where you are when you are at your very best (I sometimes joke that you are only in the green zone when you've been in the field for two weeks or when you have just returned from a 5 month yoga retreat in Tahiti). The yellow zone is where most of us live most of the time. We have warning signs emerging but we often ignore them. The red zone is the danger zone. The extreme end of the red zone finds us on stress leave, clinically depressed or totally withdrawn from others and wracked with anxiety.

We will all visit the less extreme end of the red zone several times in our career - it is a normal consequence of doing a good job.

What suffers first is our emotional and physical health, our family and friends, our colleagues and eventually our clients do pay the price as we become less compassionate, irritable and may make clinical errors.

But back to my story. The reason I am telling you this little anecdote is that I would not have always had this warm compassionate reaction to this man. In fact, my reaction is actually a sign for me that I am well out of the red zone of compassion fatigue (for the time being!). You see, there have been times where I have felt so depleted by all my work demands and difficult stories that I would have hardened myself to this old man's story and not talked to him at all. Not nice, eh? Have you ever noticed that in yourself or am I the only hard crusty person out there? Conversely, for some of you, being in the red zone would mean you would have jumped into rescuing this man and neglected your family's needs for the evening.

Research shows that compassion fatigue hits hardest among those of us who are the most caring. As helpers, we have a homing device for need and pain in others and we have this from childhood onwards (for many reasons: family of origin issues, birth order, heredity, etc.) So often for helping professionals the main challenge in their personal life is setting limits and not being a helper/rescuer to everyone around. But eventually, compassion fatigue makes us detach from others: often our colleagues, family and friends suffer far before our clients and patients. Although I am not proud of it, I know that I always seem to save the best for work and give the remaining crumbs to my loved ones. In my clinical work, I feel present, warm and loving towards my clients, even the most challenging soldier who has never wanted to come to counselling and hates being there. But when I am in the red zone I avoid my neighbours, ducking into my house as quickly as possible to avoid a chat, feeling slightly guilty and irritated at the same time. I avoid the phone: "why is my lovely dad calling me to say hi? grrr"

Each of us will have different warning signs. The key to developing an early intervention plan is getting better acquainted with your own. (If you want more resources on this, consider reading my Compassion Fatigue Workbook).

The fact that I feel ready to give again is a great sign of "green zonedom." Now the trick is keeping it in check and not overcorrecting and becoming depleted again. Keeping the balance, my friends, is a lifetime's work. I'm ok with that.