Sometimes health professionals fail to improve the condition of the person they are treating, helping, or caring for. This produces in them a form of post-traumatic stress: compassion fatigue. It is a state that is the result of the constant energy erosion of caregivers for the therapeutic help they provide and the compassion they feel towards their patients.
This wear and tear makes visible the emotional state in which health professionals can find themselves by observing the physical, psychological, social and spiritual suffering manifested by those around them. In addition, with the passage of time they may even come to feel their pain and discomfort indirectly.
Empathy as a stress trigger
When a person has dialysis almost every day of the week, an emotional bond is inevitably created between the healthcare professional and the patient. They may not be able to maintain a personal relationship, but just seeing each other on a daily basis and exchanging observations and hope for improvement generates a friendly bond.
In these cases, knowing how to put yourself in other people’s shoes is key. Understanding their needs and their feelings promotes the bond created. Empathy can also play a bad role when it triggers the onset of certain types of stress. In fact, it is the trigger for the symptomatology of compassion fatigue.
Empathy increases the quality of treatment and intervention with patients. But, at the same time, it increases the vulnerability to erosion of the professional. With greater empathy, the risk of experiencing this effect is greater.
Brain Mechanisms of Empathy
“Compassionate fatigue” is a term uttered by Charles Figley in 1995, director of the Institute of Trauma at Tulane University (New Orleans). He observed that health professionals who work in mental health with traumatized people indirectly experience the effects of the trauma of the patients they assist with the passage of time.
Although the origin of this term is relatively recent, the brain mechanisms that explain it are imperishable and are linked to empathy and imitation behaviors. So, the amygdala, orbitofrontal cortex, and mirror neurons allow one person to feel what another person is feeling.
Moreover, if these sensations hide deep pain and immense suffering, this empathic capacity improves. And compassion fatigue becomes more evident.
Signs that characterize compassion fatigue
Compassion fatigue is the result of a cumulative process. As we have seen, it develops due to a state of emotional discomfort prolonged by continuous and intense contact with patients. But, what are the signs and symptoms that can indicate compassion fatigue?
- Cognitive : memory difficulties, lack of attention and concentration, recurring negative thoughts or flashbacks.
- Emotional: intense feelings of fear, sadness, anger, generalized hopelessness or loss of joy or happiness.
- Somatic : gastrointestinal discomfort, dizziness, headaches, hypertension, pain, muscle tension, chronic fatigue, difficulty in falling asleep …
At the professional level, certain signs can be identified such as for example low motivation, feelings of incomprehension, a perception of low professional capacity or distance within the team.
The relationship with post-traumatic stress
As we see, compassion fatigue shares characteristic symptoms of Post Traumatic Stress Disorder. But before we explain it, let’s see what PTSD is.
This disorder develops after a very stressful or traumatic event that poses threat or extreme physical pain to an individual. Thus, the body generates a response in the form of stress, the result of its effort to adapt to the environment. It can appear at any age, and develop after the fact.
For its part, has compassion fatigue appear suddenly and so acute . In addition, in this specific case, it has multiple triggers that generate a stressful effect on the health professional. The triggers are the constant exposure, the emotional compromise and the therapeutic relationship he maintains with his patients.
3 groups of shared symptoms
Compassion fatigue shares a series of symptoms within the psychopathological framework of PTSD:
- Re-experimentation : if the conflict is not resolved, the professional can relive or recall the traumatic experience in the form of rumination or flashbacks. In the case of health professionals, this is particularly delicate. The stress is not generated by an overload of work, but by the emotional compromise towards the patient who is being treated.
- Avoidance and mental boredom : the person makes efforts to avoid thoughts, emotions, places, tasks or situations that could remind him of the traumatic fact. On the other hand, she tends to eliminate important aspects of it and reduce her interest and involvement in activities that were previously rewarding to her. The person with compassion fatigue, in the same way he experiences PTSD, suffers from discomfort, irritability, confusion and irritability. With this, she takes a physical and emotional distance from her patients and the rest of the people, which can hurt her innermost circle.
- Hyperactivation or hyper-arousal : the arousal is the level of physiological activation. In the case of people suffering from this disorder, the state of tension and alertness are permanent. In fact, they find themselves thirsty, irritable, elated and show an extreme reactivity in the face of any event.
How to work on compassion fatigue
Knowing what compassion fatigue is makes us aware of the possible consequences of poor emotional management in dealing with patients by healthcare professionals. Some suggestions to improve the situation are:
- Make time on your own to see things in perspective and to disconnect.
- Identify the strengths and capacities available to cope with situations of pain and suffering of others.
- Get adequate sleep and get good nutrition.
- Perform relaxation exercises or physical activities on a regular basis.
- Share opinions with co-workers.
As we see, the side effects of a situation or circumstance with high emotional load and high suffering are tangible even among professionals who know how to deal with them. Taking care of ourselves is a priority that we cannot forget. In fact, it is the basis for providing quality treatment and attention to others.