Is Compassion Fatigue a Myth ...?

I discovered that compassion fatigue is a real thing.

Chris Marlow

Hi Everyone!

Happy Autumn! And welcome back from a hot, dry and smokey summer. I hope you've kept safe and well and have managed to make some time for respite and refreshment.

During the summer heat, a colleague sent me an article suggesting that Compassion Fatigue (CF) is a myth because compassion research (not compassion fatigue research) shows no negative effects of using compassion in relationships. This critique, like others I've seen over the years, seems to indicate a misunderstanding of the basic concept of CF. It assumes that CF arises from the use of compassion rather than from trauma exposure.

CF is, at its core, a trauma issue, not one of compassion or fatigue, as the name might suggest.  In CF, exposure to others' trauma and suffering leads to symptoms of posttraumatic stress in the helper , culminating in a diminished capacity for, or interest in, being empathic with others' suffering and in emotional withdrawal from the very people we are trying to help.

We don't know, conclusively, what mechanism accounts for the transmission of traumatic stress from helpee to helper. Some researchers/theorists relate the transmission to emotional contagion through empathic engagement, some to overuse of compassion, some to underuse of compassion, some to the accumulated undischarged fight-or-flight energy from the helper's posttraumatic stress reactions to helpee's stories, some to workplace issues, some to the helper's unconscious need to atone for perceived childhood "badness" through "caring too much" for others, and others, to childhood attachment issues.

In my own experience of CF, the core experience was one of compassion becoming fatigued through acccumulated trauma exposure, not through overuse of compassion. Even now, I remember having a vivid daydream in which I was walking along a semi-circle of closed doors inside my head, pausing briefly to open each one in search of the caring person I used to be. I knew, intellectually, that I had once been that caring person but could find no evidence of her in my current felt sense. My caring, and even my desire to care, had disappeared - and, in fact, it took some years for it to return fully.

I believe that we in the field hold some responsibility for the ongoing lack of clarity regarding CF.  We often do not refer in enough detail to the rapid evolution of CF nomenclature when we teach about CF. We chose a "user-friendly" but ultimately confusing term in naming the experience "compassion fatigue" rather than "secondary traumatic stress".  And we don't yet agree on a standardized definition for CF. (Much of our theoretical fuzziness can be resolved through a careful reading of reading Chris Marchand's excellent article, Compassion Fatigue: History of a Concept.)

So, do I think CF is a myth? No, it is a real, painful and debilitating experience that requires the addressing personal trauma, workplace trauma and their accompanying burnout and accumulated grief in order to heal fully.  It is a response to trauma exposure rather than an over- or underuse of compassion.

The best news is that we now have skills and strategies that will help to ease the effects of our secondary traumatic stress and boost our resilience.

If you're interested in learning more, please do consider joining us at the next Caring On Empty Workshop at the Granville Island Hotel in Vancouver on Friday, October 27th. (email me at caregiverwellness@shaw.ca for registration brochures.)