We seldom take time out of our busy schedules as caregivers, friends, or helping professionals to consider the impact our caring for another person may have on our own physical and emotional health. There may be no better time to focus on our health than at the beginning of a new year. In my own work as a clinical psychologist, I often spend time in family based treatment (FBT) working on empowering caregivers in the treatment of their son or daughter. One of the messages often given to caregivers of a child or adolescent who is struggling with an eating disorder is a message of self-care (e.g., “We need you to be healthy, so that you can help nourish your child back to health”). But then again, how often do we as family, friends, and helping professionals take this advice ourselves?

The Miriam-Webster dictionary defines compassion as “sympathetic consciousness of others’ distress together with a desire to alleviate it”. Compassion fatigue is a term that has been around for some time, but has recently been gaining more attention within the general helping literature. It is defined as “a state of exhaustion – biologically, psychologically, and socially – as a result of prolonged exposure to compassion stress and all that it evokes” (Figley, 1998, p. 23). It can be both cumulative or occur in response to a specific challenge. Figley and his colleagues have proposed a model of compassion fatigue by which caregivers, friends, and helping professionals are all susceptible to developing symptoms from being empathically engaged with another individual. For example, the impact of hearing about and supporting another person who is struggling with an illness like an eating disorder may be transmitted through certain processes within what they call unconscious empathy (i.e., the empathy outside of our awareness and control), which may or may not have an impact on the health and well-being of the caregiver or helper. Although being highly empathic can be a positive quality, especially as a caregiver and helping professional, higher levels of empathy have been linked with being more susceptible to compassion fatigue symptoms (Figley, 2002). We also know that compassion fatigue does not discriminate; it has been identified as affecting caregivers, friends, and various helping professions, and has a number of warning signs and symptoms.

Recognizing the Warning Signs

The warning signs of compassion fatigue can be divided into physical signs (e.g., exhaustion, headaches, sleep problems), behavioral signs (e.g., irritability and social withdrawl, absenteeism, increased alcohol use), and psychological signs (e.g., negative cognitions, reduced ability to be empathic, hopelessness). Françoise Mathieu, M.Ed., a clinician and authority in the area of compassion fatigue, conceptualizes compassion fatigue as occurring on a continuum with emphasis placed on the importance of being able to recognize one’s own warning signs. She divides this continuum into three distinct zones:

(1) Green Zone – When you are at your very best and fully rested and energized. She sometimes jokes that for helping professions, you are only in this zone when you are in the first two weeks out of training, or as a caregiver, you have just returned from an extended vacation.

(2) Yellow Zone – This is where most of us live our day-to-day lives. It is in this zone that the warning signs for compassion fatigue emerge that we often ignore or are unaware of in the first place.

(3) Red Zone – This zone is where we find ourselves experiencing significant stress and anxiety that is negatively affecting not only our ability to help others, but other areas of our day-to-day functioning. As Mathieu notes, we will all visit the less extreme end of the red zone a number of times in our efforts as caregivers and friends, or during our helping careers. However, if we stay in this area for long periods of time or move deeper into the red zone, our ability to show compassion and help others effectively may become compromised.

Tips for Caregivers and Helping Professionals

Here are some helpful tips for taking care of yourself so that you may take care others in 2013. First, early recognition is key! We need to learn to recognize our own warning signs and be aware of which zone we are in before we can take any adaptive action. Second, striving to keep a good “caregiver life” or “work life” balance is important. This one is easier said than done and may be even more difficult for caregivers because the idea of taking time for yourself while a family member is struggling may feel selfish or may not fit with some of our core beliefs about helping others. However, remember the message from earlier, “You need to be healthy, so that you can help nourish your loved one back to health”. By taking time off and recharging your batteries, you will build up your own resiliency and be a much more effective source of support. Third, foster a climate of gratitude. As noted in her recent Psychology Today article entitled “The Benefits of Gratitude”, Susan Whitbourne, Ph.D. highlights the link between gratitude and increased energy, happiness, and optimism. When is the last time you showed gratitude toward someone in the circle of people supporting your loved one (e.g., spouse, extended family member, member of the treatment team) or had appreciation shown towards you? As Susan Whitbourne, Ph.D. (2010) puts it, gratitude is important because it is “what gets poured into the glass to make it half full”. Finally, celebrate small victories and closure. With the coming of the new year, we can look back fondly at 2012 and now turn our attention to 2013. Remember to take time to recognize small victories and to celebrate the closures that accompany the process of treatment and recovery.

In the famous words of Benjamin Franklin, “Things that hurt instruct”. I hope this discussion acts as a catalyst for caregivers, friends, and helpers to learn how recognize our individual warning signs of compassion fatigue. These warning signs are meant to instruct us to take some of the steps outlined above to move ourselves into a zone that will benefit the people with whom we are empathically engaged.

As we head into 2013, let’s remember that it is time to take care of ourselves so that we may take care of others.

For further reading…
Figley, C. (2002). Treating compassion fatigue. Routledge Psychosocial Stress Series

Mathieu, F. (2012). The compassion fatigue workbook: Creative tools for transforming compassion fatigue and vicarious trauma. Routledge Psychosocial Stress Series

Smith, P. (2008). Healthy caregiving: A guide to recognizing and managing compassion fatigue.

Whitbourne, S. (2010). The Benefits of Gratitude. Psychology Today, accessed online, 12-11-12: http://www.psychologytoday.com/blog/fulfillment-any-age/201005/giving-thanks-the-benefits-gratitude

By: Brad A. Mac Neil, PhD