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Compassion Fatigue

One of the greatest strengths that you have to bring to your occupation- your capacity to develop a compassionate connection with your clients-is also your greatest vulnerability.

Most of us became vets and nurses out of a love of animals and a desire to help them.

But the love of humans was not listed as a prerequisite for our career choice. Sometimes we love them, sometimes we’re stressed by them, and sometimes we shut ourselves off from their emotions as an act of self-preservation.

Nevertheless, the more we ‘love’ the people who are tethered to our patients, the more job satisfaction we are likely to have. This is particularly true when fixing fractures, obstructions of any system, and heart disease.

If we can celebrate with the owners of our patients, then it’s all good right?

The downside to having a close emotional bond with our clients is that, without good self-awareness and self-regulation, we can feel their emotions a bit too intensely. We can ‘become’ their emotions of fear when investigations are being discussed, and grief and sadness when things aren’t going well.

This, in turn, saps our strength and leaves nothing in the tank for actually doing what the client wants us to do: diagnose and treat.

Our capacity for compassion, on top of the insanely busy days, other emotional strains, even without a global pandemic added to the mix, can lead to emotional exhaustion and compassion fatigue.

 Unfairly perhaps, one of the greatest strengths that you have to bring to your occupation- your capacity to develop a compassionate connection with your clients-is also your greatest vulnerability.

So, shutting off from others is the solution? No. This only serves to increase our vulnerability. This is because being a rock and an island is only ever a temporary ‘fix’. Humans need positive relationships to thrive.

There is an abundance of literature showing that people who are socially integrated, and who experience more supportive and rewarding relationships with others have better mental health, higher levels of subjective well-being, and lower rates of morbidity and mortality compared to others. (1)

Even more interestingly, a meta-analysis (2) shows that being socially integrated into a network of meaningful relationships predicts mortality more strongly than many lifestyle behaviors (e.g., smoking, physical activity) i.e. the better the relationships, the lower the mortality rate in middle age.

What are the symptoms of compassion fatigue?

Compassion fatigue and PTSD have many symptoms in common:

Depersonalisation (isolation from others, feeling like a zombie or an onlooker onto your own life)

Difficulty falling asleep or staying asleep.

Feeling like you’re never refreshed when you wake up.


Hopeless attitude towards your job.

Feeling like you have to just ‘get through’ each day.

Difficulty in leaving work at the end of the day.

Thinking about cases when not at work.

Dreaming about cases.

Awfulising about cases (an irrational and dramatic thought pattern, characterized by the tendency to overestimate the potential bad outcomes of a case). Predicting the most catastrophic outcome.

How do I prevent or recover from compassion fatigue?

  1. Awareness of the symptoms and early recognition are crucial.

Using mindfulness to enhance self-awareness will alert us to the difference between having good empathy with a client and having ‘too much’ empathy with them.

  • Self-regulation. Knowing when the drain on your emotional resources is more than what is being replenished as it’s happening in the consulting room or on the phone.

And being able to stop yourself from traveling down that emotional spiral with your distressed client to stay strong.

  • Taking time off doesn’t necessarily bring relief for many of us, either because we’re thinking about work and checking our emails while we’re off, or because we return to the workplace having done little to no self-care whilst away.

A holiday can still be a holiday even if we’re getting the ‘chore’ of self-compassion done.

Self-care and self-compassion ideally shouldn’t be at the bottom of our ‘to-do list’, only to be ignored when we’ve finished work because we’re exhausted.

Making time for short mindful meditations every day provides a structure for psychological self-care. Make that 10 minutes or half-hour non-negotiable with your self-neglecting self.

“My mission in life is not merely to survive, but to thrive; and to do so with some passion, some compassion, some humour, and some style. Surviving is important. Thriving is elegant.”

– Maya Angelou

  • We all know that good nutrition, good sleep and exercise are helpful. I don’t know any vet or nurse who’s nailed this.

    Maybe this could be adjusted for each of us to make it realistic and achievable. E.g., slightly less than a bottle of wine, no screens just before bedtime, and walking some of the ways to work. Whatever plan you make, stick to it. Because if it’s your plan it’s a great deal more valid than a plan your therapist has made for you.

  • Invest in your positive relationships and nurture them with more than just text messages and Facebook posts. Spend time with these people who feed your soul and who genuinely care about you. Put your phone on silent somewhere else when you’re with them if you can.
  • Spend less time with the negative influences in your life.

Unrecognized and untreated compassion fatigue causes vets and nurses to leave the profession, hit the bottle, or, in all too many cases become self-destructive or suicidal.

Recognizing the symptoms in ourselves and our colleagues benefits everyone: those with emotional exhaustion, those trying to avoid it, and the clients we see.

“Taking care of myself doesn’t mean ‘me first’ it means ‘me too’”

– L. R. Knost.


  1.  Cohen & Syme, 1985Collins, Dunkel Schetter, Lobel, & Scrimshaw, 1993Kawachi & Berkman, 2001Lakey & Cronin, 2008Miller, Lachman, Chen, Gruenewald, Karlamangla, & Seeman, 2011Sarason, Sarason, & Gurung, 1997Seeman, 2000Uchino, 2009Uchino, Cacioppo, & Kiecolt-Glaser, 1996Vaux, 1988)
  2. Holt-Lunstad & Smith, 2012