I first learned about compassion fatigue on a police department ride-along. I was researching a book about crime scene investigation, and one of the investigators was collecting blood samples in the rain after a shooting. Even soaked and working in the dark, she said the job was easier than her previous one. Prior to becoming a crime scene investigator, she had worked as a police dispatcher, fielding calls for help that came into the department.
That job, the woman said, was unrelenting. Some of the calls were soul-sickening: suicides; a person who rolled over and smothered their sleeping child. To work as a dispatcher, you had to maintain a heightened state of alertness hour after hour. The woman kept feeling like she should have done more to help the people who called. Predictably, she fell apart.
We talk a lot about burnout in this country, about how long hours and lack of agency at work can lead to psychological paralysis. Far less is said about compassion fatigue, in part because its effects can be painful to admit to. For some people, it manifests as a numbness to the suffering of others, an inability to care any longer. (You can find one standard scale here.) For the police dispatcher, it resulted in judging those who it was her job to help. She began to wonder why people didn’t make better choices or fix their own problems. “I know [it] sounds really awful,” she says. “Over the course of a couple of years, I had less empathy for people in general.”
If there was ever a time to talk about this unpleasant quirk of human psychology, about how helping someone can morph into resenting them, it is now. Not only because hundreds of thousands of health care workers and first-line responders are currently living through their own version of the dispatcher’s most difficult hours, but because, to a lesser degree, the rest of us are susceptible as well.
The perfect conditions for compassion fatigue
Even those who have never set foot in a Covid ward are feeling constant pressure to alleviate the endless suffering around us. We are hypervigilant not just for the virus, but for systematic injustice, for destitution. We are shouldering a burden of protecting each other that should be shouldered by companies, institutions, and the state. And it is crushing us.
“I think there are two reasons why the general public needs to be concerned with [compassion fatigue],” says Aron Steward, chief of psychology at UVM Health Network’s Champlain Valley Physicians Hospital. Steward not only treats compassion fatigue, but she has also experienced it herself. “The first is that in order to keep our public servants well enough to keep working… the public has to be willing to put systems in place to protect them.”
“The second is that — because the pandemic is a stressor that hits everybody, now everybody knows what compassion fatigue feels like. It’s no longer a thing that public servants get from work. It’s a thing that everybody feels now just from living.”
What compassion fatigue looks — and feels — like
Once I learned about compassion fatigue, I started to see it everywhere. Could compassion fatigue explain the moment a friend snapped at her elderly mother for giving out her social security number to a phone scammer? Was it driving the woman I saw at a Wegman’s grocery store yelling at a scared, confused stocker for not wearing a mask for a second? Was this what was going on with the people who refused to cooperate with public health advice?
“Everywhere we look, we find it. It is a natural and normal phenomenon,” says Charles Figley, the Tulane psychologist who popularized compassion fatigue as a concept after developing it himself. Some psychologists, such as Figley, describe compassion fatigue as a PTSD-like inability to function that can absolutely destroy people, a sort of communicable stress that you can catch by going too deep on another’s misfortune.
Others describe it as interpersonal burnout, like the feelings the police dispatcher had. In the ’90s, it became a pop-psych buzzphrase used to explain a creeping inability to care about images of violence that appeared in the media. Susan Sontag wrote about it, about how the relentless presentation of “shock-pictures” such as bombed-out buildings and dismembered children could be affecting us in maladaptive ways. The unifying characteristic appears to be a sense of having given more of yourself than it is possible to give, and thereafter, giving up.
Since the onset of the pandemic, what seem like clear examples of compassion fatigue have popped up everywhere: Doctors overwhelmed to the point of crying in the shower, teachers exhausted by the challenges of holding classes over Zoom, parents fed up with the simultaneous demands of home-schooling, parenting, and working. People abandoning family members who have been sucked in by conspiracy theories and won’t listen to reason. Epidemiologists growing disillusioned with the public they exist to help.
Who is most susceptible
Of course, not everyone is equally vulnerable. The intensity of your life’s demands makes a big difference. Being a New York City EMT in April 2020 was clearly a trying situation. But in less extreme situations, personality and temperament may determine who develops compassion fatigue. “Some people you can tell fairly quickly, they’re going to have a hard time,” says Figley. “Those are the folks that cry easily, the folks that can imagine [the suffering of others] crystal clear.”
Those who consider helping others to be a core part of their identity have an especially tough time, as do those without a lot of experience practicing emotional separation. Police officers, doctors, nurses, psychologists, and other people whose lines of work require the constant outflow of service often learn skills to prevent compassion fatigue during their training. “When I was a baby psychologist, I had a lot of old-head psychologists tell me things,” Steward says. “[They would say] ‘The way I handled that situation is to not feel anything about it. That’s what you should do. Don’t feel anything about that situation. Put it away. There’s nothing you could have done.’”
People in nonservice careers usually don’t have access to this kind of advice, Steward says. And so those of us who work as, say, supermarket cashiers, or writers, or bartenders, who have less experience with hardcore caring for others, aren’t as used to maintaining a core self away from these demands. And yet we all need reminders to step back, to breathe, to take moments to hydrate, to do yoga or paint or walk the dog. It feels perverse to recoil from those who need our help, and so we don’t. It never occurs to most people to put themselves first. But there’s a reason why you strap on your own oxygen mask before assisting others.
A counterintuitive solution
Even if you’re feeling numbed out with compassion fatigue, though, you can recover. The key is to take time to focus on yourself. Yes, it sounds counterintuitive. But consider that Mother Teresa famously required the sisters under her authority to take a year off every four to five years to recover from the stress of caring, and she was, quite literally, a saint.
Steward recovered from her compassion fatigue with yoga and mindfulness. The dispatcher moved into a new job, focused on meditation, and came back to herself after about a year. She now believes her capacity for empathy is even greater than it was before her experience with compassion fatigue because she’s had the space and time to think about larger systemic issues that affected the people who called her, things like inequalities, adverse childhood experiences, and the criminal justice system. Unfortunately, most of us can’t take a year away from our responsibilities. So we’ll have to settle for deep breathing, hydration, and self-care. At the very least, it can be comforting to remember you’re not alone. If you’ve overworked yourself into a state of compassion fatigue, it’s because you care for others; now all you have to do is let them care for you.