Compassion Fatigue
First, ask yourself some questions…
- Do you help others through traumatic or stressful situations on a regular basis?
- Have you experienced secondary trauma?
- Are you experiencing physical and emotional exhaustion?
- Do you feel like you are experiencing or taking on the trauma of others?
Compassion fatigue is an extreme mental state characterized by burnout and secondary trauma. It isn’t recognized as a full psychiatric disorder, but it can lead to similar symptoms and even diagnosable conditions. Physical and emotional exhaustion are prerequisites to this mental state. Unfortunately, the issue often stems from caring too much.
Compassion fatigue typically occurs when someone doesn’t have a healthy work-life balance. They overextend themselves because they feel they have a responsibility to others. The condition can minimize a person’s ability to empathize and feel compassion for others. This is the most tragic part since empathy and compassion typically lead to the issue.
A more serious form of the condition involves secondary trauma. This happens when a first responder starts to feel like they or their loved ones are experiencing the trauma of others. Those who live with the condition may also experience the anger of others or survivor’s guilt. These feelings can make it difficult for a person to comprehend the dangers they face.
The warning signs of compassion fatigue differ based on the severity of the condition. If a first responder has only gotten to the point of burnout, their symptoms are less severe than those experienced by victims of secondary trauma. Unfortunately, this doesn’t mean their mental state isn’t serious. This type of first responder fatigue can lead to many mental health issues.
Signs and Symptoms
Keep an eye out for the following signs of Compassion Fatigue:
- Depression
- Frustration
- Feelings of uselessness
- Cynicism
- Feeling disconnected from others
- Worries you’re failing at your job
- Constantly feeling exhausted or tired
- Feeling the need to drink alcohol or do drugs
These certainly sound like symptoms of PTSD, but experiencing a traumatic event is not necessary. Compassion fatigue can affect individuals even if their day-to-day operations don’t involve major disasters or trauma. This is what makes the condition so daunting for those dealing with it. With the right help, though, it’s possible to overcome these feelings.
Compassion fatigue symptoms often subside within two weeks. If they don’t — or symptoms become serious issues — it’s important to seek professional treatment. In many cases, though, you can take active steps for improvement.
Don’t wait until these worsen or turn into something more serious. Compassion fatigue can lead to major issues, so don’t hesitate to reach out for help.
Source: Help For Our Heroes
Self Help Goals
You can counteract compassion fatigue by eating healthy, getting regular exercise, having adequate rest and time off, setting emotional boundaries, practicing mindfulness, and communicating with social support. Other tips include:
- Take time to appreciate yourself, your hard work, and positive things (you can have visual reminders such as pictures)
- Set realistic expectations, focus on what you have control over, and realize you won’t have full control over most outcomes
- Schedule meaningful activities outside of work, such as a hobby with a loved one, incorporating meditation, yoga, or time in nature into your routine
- Keep a sense of humor
- Focus on balancing work and your personal life
- Set healthy emotional boundaries to maintain compassion and empathy without overly taking on someone else’s pain or tragedy
Another protective tool against compassion fatigue is compassion satisfaction. This refers to a sense of fulfillment individuals feel for their work when helping others through a traumatic experience. Focusing on positive things and knowing that what you do truly makes a difference can be a source of hope and resilience. Even when things do not go how you planned or hoped, appreciating each encounter, knowing you took action to the best of your ability, and extending your help to others can improve your compassion satisfaction
Source: First Responder Wellness
Moral Injury
First, ask yourself some questions…
- Did you witness an event in which you felt helpless in preventing its immoral outcome and have unresolved feelings of shame or guilt?
- Are you haunted by a decision in a difficult situation that did not reflect your moral beliefs?
- Due to your experience with traumatic events have you lost faith in faith in humanity or a just world?
Moral injury is a loss injury; a disruption in our trust that occurs within our moral values and beliefs. Any events, actions, or inactions transgressing our moral/ethical beliefs, expectations, and standards can set the stage for moral injury.
Some examples leading to moral injury include:
- Unintentional errors leading to injury or death
- Witnessing and/or failing to prevent harm or death
- Transgression of peers, leaders, or organizations that betrayed our moral/ethical beliefs or expectations
A large number of military personnel continue to experience deployment-related mental health problems, with moral injury playing a large proportion. Its repercussions can be very serious, and studies have shown that combat-related guilt is a contributing factor to suicides in the military. The moral injury also plays a significant role in the lives of police and first responders.
For many, the moral injury was never identified and only the diagnosis of Posttraumatic Stress Disorder (PTSD) was treated. Sometimes moral injury contributes more to the pain, suffering, and disability than the trauma exposure itself. Thus, recognizing signs of moral injury, opening up the dialogue, and receiving treatment can further help with prognosis and treatment outcome, level of functioning, and quality of life and well-being.
Signs and Symptoms
Examples of emotional, cognitive, and behavioral symptoms of moral injury include:
- Feeling anxious and afraid
- Feeling demoralized
- Feeling guilty
- Feeling ashamed
- Feeling “haunted” by decisions, actions, or inactions that have been made
- Anger in particular following betrayal
- Feelings of worthlessness, helplessness, and powerlessness
- Sense of loss of identity and role
- Questioning our sense of self and a loss of trust in oneself and others
- Persistent self-blame or blaming others
- Negative beliefs about self such as “I am weak”, “I am evil”; self-deprecation; self-condemnation
- Increased posttraumatic stress symptoms including distressing intrusive memories, nightmares, and avoidance
- Self-isolation, avoidance, and withdrawal from others
- Relationship problems
- Reduced empathy or wanting to interact with others
- Impairment in social, personal and occupational functioning
- Increase in substance use
- Suicidal ideation
If you feel you are suffering from moral injury and some of the symptoms above, please seek social support and professional help. You are far from being alone. Seeking quality social support is very important, and peer support is also helpful. Having a peer to talk to helps to alleviate feelings of loneliness or isolation, helps us regain connection and feel we are understood, can help us better cope with suffering and make it easier to reach for further help.
By Dr. Katy Kamkar, Clinical Psychologist at CAMH
Self Help Goals
Learning to speak openly about your experience is often the first step to the process of healing from moral injury. Reaching out to a trusted individual, who will not judge their experience, can provide an outside perspective and a more forgiving outlook. This could be a family member, a close friend, a support group of those with similar experiences, a spiritual leader, or a therapist.
Here are a few things you can practice on your own to help you grow and move forward with your life:
- Practice self-compassion. Be kind to yourself when trying to process traumatic events versus being self-critical. Treat yourself as you would treat a friend struggling with a difficult situation. Being mindful of our struggles, and responding to ourselves with compassion, kindness, and support in times of difficulty, things start to change.
- Seek positive outcomes. How can what you experienced help to seek change and moral, spiritual, and emotional development? Believing in a just world is also thought to be associated with better outcomes when dealing with moral injury.
- Forgiving oneself and others can be a critical step toward releasing the burden of moral injury. This does not mean making excuses but involves deciding to acknowledge responsibility for what happened.
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