Compassion Fatigue: How to Treat Yourself so that You Can Treat Your Patients

I’ve been talking a lot about trauma and trauma prevention in the past weeks, yet there is one group of individuals with a potential risk of traumatization who I haven’t yet discussed: you.

Anyone in the health or mental health community inherently knows about compassion fatigue, even if you don’t know the official definitions.

How many times have you gone home at night and then dreamt about a particularly tricky or heart-wrenching case?

If you have (and I know that I fall into this group), then you’re certainly not alone.

Social workers, counselors, nurses, psychologists, doctors. No one health or mental health field has fully escaped the effects of secondary traumatic stress disorder.

PubMed, the National Library of Medicine’s electronic publication database, is full of articles trying to document and then suggest treatment paths for practitioners who have endured compassion fatigue – or secondary traumatic stress disorder, as it’s officially called.

PTSD around the world

These studies aren’t limited to the US or even to the English language – studies have also been published locally in French, Chinese, and Romanian, just to name a few.

With so many studies out there, I want to highlight the findings of University of Georgia School of Social Work’s Brian Bride, PhD.

Through a series of studies, he has found the following results:

o Among juvenile justice education workers in the study, 39% met all three core criteria for post traumatic stress disorder (Journal of Correctional Health Care).

o Social workers are highly likely to experience secondary traumatization through their work with traumatized populations. Many social workers are likely to experience at least some symptoms of STS and a significant minority may meet the diagnostic criteria for PTSD (Social Work).

Practitioners suffer from secondary trauma and PTSD

This Social Work study found that: o 40 percent thought about their work with traumatized clients without intending to o 22 percent reported feeling detached from others o 26 percent felt emotionally numb o 28 percent had a sense of foreshortened future o 27 percent reported irritability o 28 percent reported concentration difficulties Recently, Cheryl Beck, DNSc, CNM, FAAN at the University of Connecticut’s School of Nursing conducted a systematic review of papers about secondary traumatic stress in nurses.

While Cheryl found that more studies with consistent and comparable measuring tools were needed, she also found that studies have reported the presence of secondary traumatic stress in forensic nurses, emergency department nurses, oncology nurses, pediatric nurses, and hospice nurses.

The high potential for compassion fatigue among our practitioners is one reason that I invited Mary Jo Barrett, MSW to participate in our New Treatments for Trauma teleseminar series.

Mary Jo is an expert in treating trauma, including the prevention of compassion fatigue among practitioners.

To hear more from her and other experts check out our other teleseminar series.

Please share your experiences with secondary trauma or compassion fatigue in a comment below.


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  1. ed sherran says:

    Awesome site! You’ve some quite interesting posts.. Nice background as well haha. Keep up the nice work, Ill make sure to come across to see really your page!

  2. Thanks for the good writeup. It in truth was
    a amusement account it. Glance complex to far introduced agreeable
    from you! By the way, how could we keep in touch?

  3. Mary Acer says:

    Finding out this is what I am dealing with as I was caring for three elderly parents. They have all passed in the last three years and I was just numb in having to do all the care with doctors their homes and now with finances and family. Also was leading the CARE Group for our church; many with chronic needs. I loved every aspect of my life even when being “spent” due to needs and I did not have time to do things for myself. Knew it would (will) come to an end in time. What helped was knowing it was a temporary condition of my head/heart…. Besides the lack of feeling, I was functioning okay…. Now I need to rest and reset my schedule and priorities and I anticipate a healthier return of emotion although I was never one to show strong ones either way…. It was so helpful to understand it because I knew it wasn’t burn out….

  4. Debora Abelar says:

    I have no feelings towards anyone, no love, no Carrington. But I just figured it was my work load. Then my sister had a heart attack and as I listened to her situation and the experience while she is still in the hospital, I answered her questions and finally hung up the phone, I realized I felt nothing. I was not sad, upset, worried. This bothered me, so searching for over a year and noticing people just irritated me. Family bothered me. I had no patience for anyone. But my animals I cherish. I searched for over a year and finally discovered Compassion fatigue. This explained everything. I do not have a normal family life. And work is my only normal survival. But even that has caused me issues. I put my all into my career. I worked what was needed. Learning what ever I had to, too succeed. I had to make my project succeed no matter what.

  5. nola says:

    I ran a animal rescue group for 20 years. I would like to hear from people with similar experience as I’m having a very hard time adjusting to life without feeling guilty that I am abandoning so many cats and dogs.

  6. Oh, yes…something we all need to be aware of in this business of working with human emotion. When I worked in a county clinic, I reported at a staff meeting, on a lecture I went to called “Vicarious Trauma”. Everyone listened, and then we went to the next topic on the agenda. I requested follow up, in which we could have discussion of our own feelings, to no avail. When I was able to ease myself into private practice, I sought out colleagues who were able to share this phenomenon, and developed my website to help with this issue, as well as others…
    Thanks for this important topic!

  7. Rita Witt says:

    This is a very timely blog with all the natural disasters happening this spring which provided an opportunity for all those wonderful trauma workers to volunteer for more trauma work. We are ALL at risk for this. I am looking forward to the call. I also appreciate the comments and courage of the others who posted comments.

  8. Barbara Belton, MS, MS says:

    ‘Twas a wonderful healer in the body of an amazing md who diagnosed my ptss in 1995. I was working at the time in public funded behavioral health in a large city directing a politically-challenged recovery program for adults in the system. When I asked him, “Why now? after all these years of handling things so well?”, he replied, “Barb, I have folks coming in with ptss doing the work you all are doing who do not have your serious abuse hx.” I thinking, of course, that it was all the childhood stuff I had been working on via Al-Anon, therapy,books, et al for years…had even gone to work in beh. health “looking for answers to questions that bothered me so”. And he added, “The coping skills you have developed so well and that have made you able to function so highly are no longer serving you. You must be ready to take the next steps.”
    How lucky was I to be guided to this fine man/professional at just this moment in time…ahead of his time…who gave me just what I needed to renew my determination and perseverance?
    Was the journey easy? No Experienced all of the realitites spoken of above, including losing my job because of the stigma…as I never kept my dx a secret. I had grown up with one of those amazing healers who taught me early that a dx by an accomplished, educated, compassionate, intuitive person was a beginning not an end.

    And as my sweet husband and best friend says, “It’s Worth It!”

  9. Herb Cohen says:

    I do alot of trauma work including EMDR and found myself feeling “activated’ I felt like I can be emotional for no apparent reason and that I had alot of anger driving two creative projects I am currently devoting alot of energy to. At an EMDR workshop, I targeted this anger in a practice session and the vicarious trauma was revealed. I shut down the reprocessing of it in order to take advantage of the secondary gains(mydriving passion passion for the creative projects, but I am now awre of why I feel this high level of emotionality and I am taking responsiblity for keeping it away from yhe people I treat. Eventually I will need to processs it fully.

  10. kathleen says:

    I have experienced and definitely seen others reprimanded and ridiculed for compassion fatigue. I actually have see too much criticism of people who just have compassion, shed tears over a lost of a client, and feel sad for more than a nanosecond. I am a hospice nurse. I find that many nurses and social workers support and understand this, but we work with managers, administrative staff, and even doctors that accuse the sad person of having a character defect, or “milking it” or comments about using the situation to get attention. CAn you tell I was relieved to see your comment? THis happens everywhere?

  11. I’m wondering if any studies have been done on the negative judgments that happen in systems where compassion fatigue is a normal outcome of the work toward the worker. It has been my experience that one is viewed as having a character defect or is just not with it if they reveal any personal difficulties afer experiences with intense and difficult trauma work, whether it be in the emergency room, as a police officer, fire fighter, ambulance worker or counselor? Compassion fatigue has been something I’ve experienced working in the trenchs with trauma and loss in multiple settings for the last 30 years. I had to find my own island of safety and come to terms with my symptoms as a natural part of my work and learn self-care. However, I better not let anyone know about it for fear they would look at me as less competent, capable and knowledgable. I wonder if others have experienced this too? We do need to understand our own fears in dealing with the heroic, demanding and life changing work we do not as something wrong with us but as understanding this as part of the work we need to be mindful about and help each other grow through. as we do this we will only benefit ourselves and those we work with in a more deeply profound and healing way. We are truly all in this life together. thanks for the opportunity to share.

    • Edvan says:

      Your cat may have gotten sick. You can take him to the vet to check that out. I’m sure he is a liltte shocked from being in the house for 4 dats. He probably wasn’t treated real well and is most likely very scared. give him a few weeks to recover from the stress.Again the vet is a good option to be sure nothing is seriously wrong.

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