Compassion Fatigue: The Curse of the Caregiver

Caregiving is both a privilege and a potentially burdensome responsibility. Some are thrust into this role by unfortunate circumstances, others seek it out professionally, and still others seem to naturally assume it their relationships.

When someone is in a time of desperate need, and completely reliant on the care of another, a fully engaged caregiver can be crucial. For the caregiver, stepping into that role can be incredibly intimate and valuable. This time can be one in which he or she displays the most significant, deep, and clear embodiment of care of his or her lifetime. Some have said they did not realize the depths of their care, the extents to which they could go for someone, until they stepped into such a role. I’ve heard others say that their time as a caregiver was one of the most valuable gifts they ever received.

However, the role of the caregiver can also lose its luster. Days burdened with accumulated stress, urgent decisions, physical and emotional exhaustion (among many other stressors) can quickly drain one of the primary tool needed to fulfill this role: care.

Compassion Fatigue was a term coined in 1995 to describe the tendency of some critical care nurses to lose “their ability to nurture” (1). When I first heard the term I did not need a list of symptoms to understand its meaning–it is more than appropriately worded. However, for the sake of clarity, and those wishing to better understand it, I will attempt to further describe it.

Other words used in scholarly journals to describe the state of Compassion Fatigue include burnout and secondary or vicarious traumatization. Here are a few “regular” descriptive words: numb, disengaged, overwhelmed beyond a feeling, impatient, “pouring from an empty cup,” short-fused, and an exhaustion deeper than a need for sleep. Additionally, these important tasks may prove to be very difficult: concentration, social connection, personal hygiene and care (sleep, exercise, showering, relaxation, fun, eating, changing clothes, etc.) decision-making, listening, communication, memory, and the ability to care. This is definitely not an exhaustive (ha! Pun intended) description, but hopefully a picture of a person drained of his or her capacity to care, feel, and function due to chronic and sustained stress is emerging.

Unfortunately for both the caregiver and the recipient of care, those caught in the depths of Compassion Fatigue have difficulty extending care to the person receiving it. While the urgency of the need at hand can take the position of utmost importance on the list of priorities, I argue there is another item in need of re-positioning to a place of higher importance. Care of the caregiver is of utmost importance for the recovery of the person receiving care. Unfortunately, again, for the caregiver, the only person who can actually extend care to the caregiver is him or herself (I find that slightly ironic since so much is already expected of the caregiver, and now they’re asked to care even more!).

Now, don’t get me wrong, I am not saying the caregiver does not need anyone else, in fact reality is quite the opposite! The caregiver desperately needs others; however, the caregiver’s willingness to receive help, ask for it, or even identify what he or she needs are things no one else can do for him or her.

So, what’s a caregiver to do?! Although it may seem to require more effort than it’s worth, carving out time for self-care, hygiene, sleep, nourishment, and connection (or simply any one of the items on that list if it’s all that circumstances allow for) are what will make the difference between resiliency to sustained stress or a heart hardened and frozen over in an attempt to simply survive.

Dr. J. Eric Gentry developed a Compassion Fatigue Resiliency Program (1). A hospital attempting to respond to the rising number of nurses plagued by Compassion Fatigue employed his program. After five weeks of practicing self-care, directed by this program, the nursing staff saw significant improvement that was sustained for a 6 month period.

While taking time for self-care may seem like a luxury far beyond reach, one can draw from the principles of this study. In order to re-introduce compassion into one’s caregiving, taking intentional and regular time to care for one’s self, despite the urgency of the circumstances is what it boils down to. However, because of circumstances, sometimes this may need to be simply taking the time to brush one’s teeth, pausing to breathe before answering the phone, or hitting the snooze button.

Creating small moments of space helps reinforce the idea that you are important enough to make the list. Some examples could include: pausing to breathe, eating a bowl of ice cream, blowing bubbles, finger-painting, sleeping in 30 minutes, walking outside for a minute or two, calling a good friend, letting a call go to voicemail, accepting that meal someone offered to make for you, bowing out of a commitment, saying no to a new one. In this moment, what’s one thing you could do with the time, resources, and energy you have to show yourself a little care? Realize that today’s answer could be the exact opposite of yesterday or tomorrow’s. Today you may need silence, tomorrow it may be connecting with someone you trust.

Counseling may be something to consider. Because caregivers frequently care for the needs of others before their own, having someone listen to your thoughts and feelings, and take intentional time to care for you may be one of those ways to create space and care for yourself.

To wrap it up, I’ll leave you with my go-to quickie breathing exercise. It’s called four-square breathing. Picture a square. As you picture drawing the first side of the square, breathe in slowly as you count to four. Hold the breath for a count of four. Breathe out for a count of four (as you come down the opposite side of your pictured square). Then rest for four. Do this four times. It takes under a minute. Happy breathing and caregiving!

-Rebecca McBride, M.A., L.P.C.

Rebecca is a counselor at Lighthouse College unseling, Ltd., working out of the Waconia and Hutchinson locations.

1. Developing a Systemic Program for Compassion Fatigue–Potter, P., Deshields, T., & Rodriguez, S. 2013