Compassion Fatigue

How do you know when compassion fatigue is setting in for you? I think we talk about burn-out in our industry as something final – like when you’ve hit burn-out, you’re a charcoal husk of your former therapeutic self. But I think of compassion fatigue and that burnt-out feeling as something that comes in waves, and is there to ask us to re-adjust and look at taking care of ourselves differently.

Think for a moment about what we see in a day. We see so much distress. We see people's current relationship all tangled up with their family of origin traumas. We see relationships ending. Sometimes we see the moment a relationship ends, and we see at least one person in the full pain of losing their life as they know it. We sometimes have to be the only one in the room staying grounded while people melt around us, crying out for help we are trying to give them while they simultaneously bat it away. There is no way our bodies are meant to hold all that grief and strife, and it is essential for us to practice radical self-care and rest. 

But by the way, the kids need picked up and the daycare is closed tomorrow and the dog just crapped on the carpet and you forgot to get chicken at the store so now you just have rice and broccoli for dinner and everyone is going to hate it. Plus you forgot your mother-in-law's birthday and your partner wants to have sex with you but you can't stop thinking about how a client described walking in on their partner cheating on them.

Hmm, so what does balance even look like?

For me, I have to notice it is happening first. I have a few signals that I’m getting fatigued:

1)   I feel more negative and complaint-oriented in general. I feel more critical of my couples, less understanding.

2)   I feel less grounded in the room. I start to feel like I’m running around after my clients trying to put out the fires instead of staying grounded and clear in my seat.

3)   I lose sight of myself, and what is unique about me in the room. Each one of you has something special and unique about you that is important for your couples, beyond EFT and the techniques you are using. When we lose sight of that, or are working with clients who don’t seem to see that, it’s hard to feel positive about our work.

4)   I start hard-core longing for alcohol at 4pm. I barely drank in college, I don't remember alcohol ever feeling important to me in my 20s, I'm not a social drinker; but 35 and a couples therapist? Yeeaahh, I really want it. 

 

Working with couples is hard work. They are really looking to us to help them understand what to do and how to fix their marriages, and with the energy that we are going to be the ones that solve this. That is a lot of pressure! I have couples who have been disintegrating for 15 years who after two sessions say, “this isn’t working.” And I’m thinking, I’ve known you for 3 hours!! Give me some time! We also are experiencing two people’s distress, stuck places, and family of origin traumas. The work requires us to be much more active and alert than in an individual session.

It doesn’t feel good as a therapist to hit this place, and to feel crispy and less compassionate in general. But just like with our clients, I can also feel resistant to change. I want the bad feeling to change, and I want the tiredness to change, but I don’t always want to change other things in my life that I likely need to. So I’m here giving me and you a little push, because we know that if we don’t change something nothing else changes.

Depending on who you are, different things are going to be the solution for these feelings. I’m an introvert, so this is what works for me:

1)   I need to cut down on socializing. I don’t socialize a ton, but I keep up with friends and stay connected to them. I move a lot so most of my friends I take time to text or have phone calls with fairly consistently. I hate saying no to friends or not making an effort, but it drains me right now when I’m already interacting compassionately and relationally during the week.

2)   Take a night or day off here and there. It’s really hard to block off your schedule when clients need to get in, and it’s hard financially, but do it. DO IT. And then go away from your email and work phone. Maybe even put an out of office on.

3)   I heard this great talk from a therapist on depression last year (no recollection who, sorry citation gods!). He said the brain responds positively to two different states – Mastery and Pleasure. Mastery is making your bed and getting the groceries, and Pleasure is something for pure enjoyment or relaxation. For me, I’ve got the Mastery on lock. I’m a hyper-vigilant do-er, so I’m good at the getting things done. I’ll work out, I’ll get the groceries, I’ll do my notes, I’ll work on a blog post. The thing I’m bad at is giving myself permission for Pleasure, and total down time. My ideal recharge is about 3 hours of uninterrupted Netflix watching by myself, and finding time to laugh and take a walk with my husband. What's yours?

But check in with who you are. If you’re more likely to avoid the Mastery, forcing yourself to cross things off the list may actually help you feel less frantic and burned out.

Mostly I just want to normalize this and make it less scary. We are going to hit compassion fatigue and feeling burnt-out. We do something really difficult. We involve our whole selves in what we do. We also get yelled at sometimes by people we are doing our utmost to be empathic to. It is impossible to imagine we can do this without our bodies checking in with us and letting us know what we need more of or less of.