Compassion Fatigue in Therapists

Written By Carryn Lund

It’s Not the Compassion that’s Burning You Out

 
Compassion Fatigue in Therapists

Take Away

It’s not really compassion fatigue that is burning therapists out. Compassion is actually of benefit to therapists and is a renewable resource, emotionally speaking. Instead, it’s increased exposure to human suffering and vicarious trauma, combined with empathy fatigue, that is driving up rates of burnout among therapists, counselors, and other helping professionals. Fortunately, there are many practices that can help, and we can even learn to use compassion to benefit us during difficult times.

So, you’re feeling compassion fatigue. That’s normal. But is it really compassion fatigue?

Burnout for therapists and counselors (and other helping professionals such as teachers, healthcare workers,  clergy members, or social justice advocates) happens. It’s simply…true. Burnout, really, is an occupational hazard.

You know these feelings well, and we - as two therapists ourselves - do too.

Of course, as a helping professional, you find your work meaningful and gratifying much of the time. Yet, of course you also feel emotional exhaustion from time to time - especially during periods of heightened demand and stress. At times it’s just too much. 

When you witness so much suffering - and perhaps take it in as your own - it is inevitable that you will, at times, become depleted and feel numb. You may even feel like you care less. That’s a natural, and human, response.

But, is this feeling compassion fatigue? 

Maybe, but we don’t really think so.

More likely, it’s burnout, empathy fatigue, or vicarious trauma.

We know, actually, that compassion is of benefit to us and is, emotionally-speaking, a renewable resource. It is useful for therapists and other helping professionals to understand both their burnout and how to use compassion to actually support wellbeing.

Read on, and we’ll share how.

If it’s not compassion fatigue, is it burnout?

If you’re feeling drained or overwhelmed, know that it is normal (and, there are simple shifts you can take to help yourself). What you are feeling is likely a normal response to prolonged stress.

Burnout for therapists results when you witness too much suffering, carry too many responsibilities, and don’t receive enough support, training, or time off. It can be the result of a mismatch between too many demands on your care without systemic support to help you meet those demands. Or, it can be the result of too much stress in your personal life reducing your capacity to help.

Please know that no one - not even big-hearted and well-trained mental health professionals - can take in large doses of distress without feeling overwhelmed or pessimistic. These experiences indeed can result in burnout. 

It’s additionally harmful to hear messages that burnout results from a personal failure or mistake - that you’re not strong enough, that you need to just take better care of yourself, that you’re just not good enough at your job.

That’s simply not true.

Just as firefighters face smoke inhalation as an occupational hazard, therapists and counselors face burnout.

What are the signs and symptoms of burnout and how do we know it’s not compassion fatigue?

Signs of burnout for therapists and counselors, as with other helping professionals, include feeling:

  • Tired

  • Unmotivated

  • Detached or disconnected

  • Worried you’re not accomplishing enough 

  • Dread going to a job you once loved

(Two self-assessment tools can help you to take stock of your own risk: the ProQOL and the Maslach Burnout Inventory). 

So, maybe what you’re feeling is burnout - not compassion fatigue. Sometimes, people use the terms “burnout” and “compassion fatigue” to mean the same thing. Other times, they blame “compassion fatigue” as the root cause of “burnout.” 

We do believe that burnout is an inevitable occupational hazard for helping professionals - especially in hard times. However, we don’t believe that compassion fatigue in counselors or therapists is what is causing your burnout.

Why compassion fatigue is not the cause of therapist burnout.

Compassion doesn’t actually drain or fatigue you. 

In contrast, feeling compassion - a wish that a person’s suffering will lessen - fosters positive emotions and a sense of connection to others. Compassion activates areas of your brain associated with dopamine (related to a feeling of reward) and oxytocin (that enhances attachment and bonding). Rather than depleting you, your caring and your actions to diminish the suffering of your clients, likely inspires or rejuvenates you!  

So then, why do you feel so burned out?

We believe there are 2 culprits:

  1. As we described above, the imbalance between the resources you are receiving (for instance, support, vacation, time to do what replenishes you) and the energy you are putting out taking care of others. (And yes, this has to do with big, systemic issues that place undue burden on the individuals to solve problems.) 

  2. Not your compassion, but your empathy.

So, then, what is empathy fatigue?

What is Empathy Fatigue

Empathy involves feeling other people’s emotions as if they are your own. Your mirror neurons allow you to sense into what it would be like to feel what another person is feeling. This empathy is essential for therapists and helping professionals. It is one of your best assets and most important therapeutic skills. It allows you to resonate with your client’s experience, helps them to feel understood by you, and can help guide your intervention choices.

Yet, feeling deep empathy (what we call “empathic resonance”), can take a toll on your body and spirit. You are not meant to simply feel another’s suffering all day. Empathy, unchecked or without other practices, may actually increase your risk for burnout. 

Mark Stebnicki, PhD, a professor emeritus at East Carolina University, and a licensed clinical mental health counselor, coined the term “empathy fatigue.” Writing in Counseling Today, he proclaims “that one cannot ‘avoid’ empathy fatigue working in our profession for it would be unnatural to ignore, suppress and avoid the natural feelings and emotions that arise as a result of our professional role.”


Research shows that empathy for the pain of someone we care about can activate the pain or alarm centers of our own brains. It is understandable in a time of prolonged and collective crisis to have trouble differentiating your client’s distress and your own. It is this chronic exposure to distressing emotion that depletes dopamine and can lead to the symptoms of burnout. No wonder you feel a sense of diminished reward, pleasure, and motivation.

Burnout is not your fault

The most important message we want to send about burnout is this:

Burnout is not your fault.

It bears repeating: burnout results when the demands on us outpace our resources, or from feeling fatigued from too much empathy. 

Please know you are not alone, and it is not your fault. In challenging times, you (or your loved ones), may be confronting illness, grief, job loss, or discrimination. You also may be juggling intense and varied family responsibilities. It is not surprising that there have been reports of higher rates of burnout for mental health professionals. 

We get it: some days it is hard to muster the energy to go to work or to “care” the way you usually do. When one more client shares their anxiety about all the challenges in our world right now—including some stuff you are scared or sad about too—it is natural you might feel your heart racing, sinking, or even closing off. You may feel like you are reaching your limits on caring.

How to help burnout and empathy fatigue

You may ask: ”If burnout is inevitable, and empathy is both a key tool in the therapy trade and contributes to burnout, what can I do to feel less depleted by my work in hard times?” 

We have some suggestions for you that don’t generally require more time and energy on your part - and, which actually use compassion to support your wellbeing.

We teach a fresh perspective of what we refer to as “moment to moment self-care.” You already are working as hard as you can. We don’t want self-care to become one more burden placed on you. We also know you are trying to put boundaries around work in place to protect you. Yet, evidence supports that small shifts in how you work and replenish yourself can make a meaningful difference. There is a cumulative positive effect to little moments of care throughout the day.


1. Shift, intentionally, from empathy to compassion

Both empathy and compassion are meaningful therapeutic tools. Yet, using compassion in moments of witnessing suffering, is protective for you. Empathy alone is draining. Compassion is protective and helpful.

Research shows that compassion training decreases fear of suffering and enhances the capacity for positive affect when witnessing distress. Similarly, practicing compassion meditation yourself can make you happier and boost your immune system.

As needed when you’re with a client, take a breath in for you and an exhale out for them. Remind yourself, “I am safe in this moment witnessing someone else’s distress. This is not happening to me right now. I wish for their suffering to ease.” 

For more guidance on this practice, check out our free downloads on Empathy with Equanimity and  Presence is Self-Care. 



2. Increase self-compassion 

Gabor Maté, a physician and trauma survivor argues persuasively that it is too little self-compassion, rather than compassion fatigue, that leads helping professionals to experience burnout. If you sense you might be low on compassion, give yourself some. Self-compassion practice answers the question, “What do I need?”

When you notice those signs of burnout within you, you need care and a wish for your suffering to ease. Do not judge or criticize yourself. 

Instead, try shifting to a kinder, more curious stance.

First, observe how you are feeling burnout. Is it a physical sensation in your body? Does it arise with particular images or memories? What are the specific emotions here now? 

Next, allow yourself to recognize that you are not alone. So many therapists, healers, and other humans are feeling this same sense of burnout right now. 

Finally, offer yourself some kindness or a gesture of tenderness while these feelings are here. What words of reassurance do you need to hear right now? It may be even a simple: This is so hard. It’s okay to feel this way. May my suffering ease.”  To support you in this practice, we offer a free meditation on Lovingkindness for Therapists.



3. Offer compassionate care to your body

Self-compassion also can take the form of attending to the basic needs of your body before, during, and after your workday. We know you might not have time for big workouts. Yet, each time you offer yourself rest, nutrition, hydration, and simple movement you affirm that your needs matter too. These small gestures sometimes can shift the balance between what you give to others and what you give to yourself. 

If you have time to listen on a walk or drive to Brené Brown’s podcast episode with identical twin sisters, Emily and Amelia Nagoski, about their book, Burnout, you will learn that taking a few minutes to release tension from your body also makes a difference. They emphasize the need not only to address stressors, but to complete the stress cycle in your body to combat burnout. Examples of such strategies include: jumping jacks, a quick dance party with yourself, a good cry, or a deep belly laugh.



4. Treat your thoughts with compassion, too.

What might it look like to use compassion to soften the thought patterns that contribute to your burnout as a therapist or other helping professionals? A focus on shifting your thoughts towards easing suffering might involve things like: savoring meaningful moments in your work, kindly noting (rather than reacting to) self-critical thoughts or rumination, or believing in your ability to make it through a hard time. One of our favorite practices for compassionate thinking is from Laura van Dernoot Lipsky, of the Trauma Stewardship Institute, who advocates creating a mission statement that is under your control and allows you to feel you are doing enough (an example: May I treat each person with respect and dignity). 



5. Consider fierce compassion 

In addition to the kind and gentle compassion you might offer your mind and body to combat burnout, consider fierce compassion as well. This might entail taking a stance of strength and courage to say a firm (or difficult) no and prioritize your own needs. Or it could involve advocacy to challenge stigmatizing practices or oppressive policies in your workplace.



6. Compassionately replenish your spirit.

When you take breaks, during or after work, notice what fuels your energy and hope. Maybe spending time in nature or with loved ones helps you to feel restored. Observe how your exposure to media adds to, or counterbalances, your stress exposure and experience of burnout as a therapist or helping professional. 



7. Get support from a compassionate community of healers

None of us are meant to do this work alone. We encourage you, when possible, to seek connection and community. We offer meditations, by therapists for therapists (some only a few minutes long) designed to support you before, between, or after sessions. We also have a weekly letter of wisdom and lovingkindness written for therapists, Dear Healer, that lands in the inboxes of therapists worldwide every Monday. In addition, seeking additional training or professional inspiration can help to refill your cup and buffer burnout.

Compassion Won't Fatigue You

Final thoughts on why compassion won’t fatigue you

Although we recognize your burnout as inevitable, we are quite clear that your compassion is not what is depleting you. Your compassion is serving both you and the people you serve. Your empathy, and high demands for your skills without adequate time off, may be the culprits. Fortunately, your compassion is a renewable resource, and one that you can share with yourself to combat burnout.

As we close, please know how deeply we honor the work that you do. We appreciate the sacrifices you have made to care effectively for others during your career. We are here to help protect you from undue sacrifice. Our mission is to support you in enhancing your resilience and fulfillment as you spread healing ripples in our world. As always, we wish you good healing.

Get all these tips in a handy download — grab it here:

We have other resources on burnout, too:

Meditations for Therapists, by Therapists

Free Download - Empathy with Equanimity

Self-Paced Course - Transforming Vicarious Trauma

Additional Resources on Compassion

Mindful Self-Compassion (MSC) work by Kirstin Neff and Christopher Germer

Meditations for empowerment or nurturing - we like both Liza Colpa and Jack Kornfield

Learn more about the power of compassion instead of empathy with this video by by Matthieu Ricard


Carryn Lund
Next

Blessing for a Therapist