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March 31, 2015

Watch out for compassion fatigue

The Canadian Charger

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Compassion fatigue is not the same as burnout, explained Dr. Tara Tucker. With compassion fatigue, unlike with burnout, the person can continue to work. Yet, the quality of work suffers.

Tucker is a palliative care physician and someone who also serves as a compassion fatigue educator.  She was lecturing at Ottawa Civic hospital campus to the Grand Rounds on March 20. 

Compassion fatigue is marked by emotional exhaustion, depersonalization, cynicism, and a loss of sense of accomplishment.  While Tucker addressed an audience of health care professionals, she pointed out that the condition is not restricted to them.  Police, teachers, clergy, and lawyers may also find themselves in its clutches.

What are signs and symptoms of compassion fatigue? 

A person may use alcohol or drugs more.  Anger and irritability can be more prevalent.  The caregiver may avoid clients, especially those who are more difficult.  Absenteeism may become a problem.  Decisions may be hard to make.  Forgetfulness may become a problem.  Client care may be compromised.

The helping person may engage in distancing from the client and experience negative self-image and depression.  Compassion fatigue affects a person beyond professional life.  It can have impact on personal intimacy. The person may become either insensitive or, on the other hand, hypersensitive.  There can be difficulty separating one’s personal and professional lives. 

Stress can lead to compassion fatigue. 

Tucker identified five areas of possible stress: relationships, environment, body, mind and spirit, money, and work.  In each of them, it is important to identify objectives.

Relationship difficulties involve people with whom the person interacts who drain energy.  Of course, personal relationships may impinge, but even relationships at work can be problematic.  There are the unreturned phone calls, e-mails, and letters, as well as unresolved conflicts at work.  Environmental factors include annoying clutter and a car needing attention.

The body, mind, and spirit category includes negative feelings about one’s physical appearance, not enough sleep or exercise, no time for books or movies, and lack of spiritual or religious practice. 

Conflicts at work or too much work are work issues.  Money worries are another possible stress factor.

So what can we do about compassion fatigue? 

Get enough sleep, rest, and exercise.  Have a proper diet.  Take a vacation.  Take part in activities that are replenishing.  If work is too pressing, move to part-time work.  In the aftermath of a difficult situation, have someone with whom you can engage in debriefing.

She recommends the exercise of mindfulness, a technique taken from Eastern religious traditions.  In mindfulness, the person is fully present in the current moment.  She gave the example of the athlete engaged in a competitive activity.  She also spoke of being in the shower and emptying oneself of all external considerations, focusing on the flow of the water on one’s body and its splashing on the tub. 

She says that eight to ten minutes of mindfulness practice a day is an excellent stress reducer.  And stress reduction has a hormonal impact.  Again from Eastern religion, yoga is also good at stress reduction.

If things bother you, you might try writing them down, even if you throw out what you have written.  Writing slows the mental process.  There are things you are grateful for.  Reflect on these first thing in the morning or last thing at night.  After a day’s work, reflect on great things you have done that day.

Tucker quoted psychologist Shauna Shapiro who said, “The heart must first pump blood into itself.”  It is not just the person as professional.  The professional must also be a human being who can be with others.  And it is okay not to be perfect.

A key question for us all: Am I happy? 

If not, I need to change something.  In dealing with imperfection, we need to identify one thing to change or accomplish.  Then the next thing, and so on.  “You don’t need to see the whole staircase,” she said.  “Just take the first step.”

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