As a senior nurse in a paediatric oncology department, Manini works long hours, caring for children with cancer. The 33-year-old relishes her job when treatment works and her young patients go home well and healthy, but when the endings aren’t as happy, she carries the whole family’s anxiety, worries and fears around with her.
‘I sometimes feel as if I can’t take on any more bad news,’ says Manini, who’s single. ‘It’s as if I am full to the brim. I absorb all my patients’ worries.
‘I get involved because I care about the kids and their families. I know and share all their hopes and fears and I keep in touch with most of the parents whose children I’ve looked after.
‘But every now and then it all gets me down. What happens to some is heart-wrenching and then I feel as if life is really pointless and I wonder why we bother. When I get to that stage, I just want to curl up on the sofa and shut out the outside world.’
Unbeknown to her, Manini is a contender for compassion fatigue, which is a preoccupation with other people’s suffering – the fallout from caring too much for those we have responsibility for.
Dr Charles Figley, a professor at Tulane University in Louisiana in the US, is an expert in disaster mental health and he describes compassion fatigue as ‘an extreme state of tension and preoccupation with the suffering of those being helped to the degree that it can cause a secondary stress for the helper’.
And US writer Patricia Smith, who launched the Compassion Fatigue Awareness Project, says the condition comes about when people literally ‘care too much’, causing apathy, isolation and bottled-up emotions.
Manini is by no means alone. Compassion fatigue is rife among the caring professions, where surveys have revealed 86 per cent of health workers have spotted symptoms in their colleagues. It’s also common among charity workers who deliver aid after a disaster, such as a terrorist attack, a tsunami, a hurricane or flooding. Counsellors who unpick other people’s problems, teachers who try and help a troubled pupil and those who work in care homes for the elderly are also at risk.
Dubai-based life coach Kirsty McIntyre, who specialises in NLP (neuro-linguistic programming), explains: ‘The more regularly we’re exposed to suffering, the more likely we are to develop compassion fatigue. Healthcare workers, those teaching children with difficult home lives or people caring for relatives are more likely to develop it.
‘On a more personal level, you might find yourself developing compassion fatigue if you’re repeatedly exposed to other people’s problems and traumas – if people constantly call you to offload their problems or vent at you.’
Yet it’s an odd phenomenon, says UK self-development author Gill Hasson, who comments: ‘We’re programmed from being very young to love and care for people, so it’s natural to be upset when those around us are unhappy or suffering.
Gill, author of Kindness and Happiness (Capstone), adds: ‘Compassion can be a good thing and can motivate us to raise millions for charity or change people’s lives in a huge way.
‘But compassion fatigue can be overwhelming. That’s why counsellors have supervision where they can offload all the worries they absorb. Taking on someone else’s problems can be exhausting.’
So how do we know if we have compassion fatigue? According to UK-based clinical hypnotherapist Bev Cripps, who’s also a positive psychology coach and a resilience trainer, the symptoms can be harrowing, both physically and mentally.
Says Bev: ‘Compassion fatigue is empathy gone through the roof, when you’re exposed to people’s suffering, all day every day.
‘It can cause physical symptoms like exhaustion, fatigue, changes in appetite, digestive issues, headache and insomnia. Emotionally it will start to affect thoughts and even someone’s wellbeing outside of work. They might well suffer overwhelming mood swings, pessimistic thoughts and irritability, or they may have anxiety and depression as they view the world through a negative lens.
‘Psychologically, people with compassion fatigue might detach and withdraw from their normal activities, and they might turn to less-than-helpful strategies such as developing an addiction to shopping or eating or binge-watching Netflix.’
And Kirsty adds: ‘With more exposure, as compassion fatigue develops, we can start to find it difficult to connect in the way we did previously, and maybe become ‘hardened’ to other people’s problems. Drained and burned out, you might be less able to help people and you may feel a little bit guilty for your perceived lack of sympathy.’
So how can we still care for others, demonstrate compassion and help in times of real need, yet protect ourselves and swerve compassion fatigue?
‘Observe how you feel after interactions with certain people or even after you read newspapers, for example,’ says Kirsty. ‘If you experience heavy feelings for a prolonged period of time, then it might be a sign you need to protect yourself from compassion fatigue.
‘If you’re really invested in the situation or if you carry the other person’s emotions, you can express your kindness and sympathy to them, but be sure to visualise passing those problems back to the person before walking away.’
Develop a Self-care Regime
‘Self-awareness is key,’ stresses Bev Cripps. ‘It’s about knowing what the symptoms are and when you are exhibiting those symptoms. You may have worked through the pandemic or you might be a first responder, and you may well be exhausted.
‘Your self-care is vital. Staying hydrated is the easiest thing you can do for yourself, but you can also eat well, get enough sleep, stay active without running yourself into the ground and getting plenty of fresh air.’
‘Boundaries will protect you from becoming drained so make sure you have a few in place,’ recommends Kirsty. ‘For example, if someone calls you after a long day at work to vent, you could tell them kindly that you’re not able to support them every evening, but you could meet them for a coffee over the weekend when you’ll have more time and energy.
‘Encourage people to check with you that it’s a good time to share their problems – this will prevent them from diving straight into venting. Train them to check in first.’
Play to your Strengths
‘If someone in your life needs help, do what you’re best at,’ says Gill Hasson. ‘You might love driving or being on the move, so offer to give the other person a lift to the hospital or doctor’s appointments or to visit their friends. You might collect their prescriptions for them or walk their dog.
‘If you’re happiest when you’re still and chatting one-to-one, be a listening ear for them. The conflict comes when you do things you don’t enjoy. If you’re asked to do something that doesn’t play to your strengths, say you’re not the best person to do that and maybe suggest someone else, or proposed another job that would be better for you.’
‘Do a loving kindness meditation, which is all about being kind to yourself and it will calm your nervous system,’ suggests Bev. ‘Sit down somewhere quiet and close your eyes. Then repeat three simple phrases – may I be peaceful, may I be healthy, may I be happy.
‘Studies have shown the optimum period for this is 20 minutes, which may seem too much to ask of people who are exhausted or busy, but it’s something that can be practised anywhere quiet, maybe during a lunch break or even in the toilets.’
Analyse What’s Needed
‘It’s always good to measure how much support the other person really needs, especially if they’re a friend and you’re not responsible for their mental care,’ says Kirsty. ‘Are they going through a particularly tough time or have they been complaining about the same thing repeatedly for months without taking any action?
‘If it’s the latter, then you could let them know you’re concerned they haven’t made much progress with the situation and that it might be time to speak to a professional for more guidance than you can give.’
‘If you’re tempted to withdraw from your everyday life, admit you’re struggling and seek professional help’ advises Bev. ‘People who work in the caring professions don’t tend to want to burden other people or colleagues with their troubles, but it’s important to find a safe space where you can offload.
‘You might benefit from therapy, or journaling, or you might need some medication to help you avoid a total breakdown. Professional help will also help you organise some time out from work so you can focus on getting better.’
Be Cruel to be Kind
‘If someone you know is going over and over their problems with you, without taking any action, you may be keeping them stuck in victim mode,’ says Gill. ‘Stop seeing yourself as a rescuer. You can be supportive without immersing yourself in their problems.
‘If you’re always there to help or give suggestions, they’re never going to sort things out for themselves. Next time you’re in a conversation about the problem, use a counselling tip and ask: ‘What do you think you can do about that?’