Compassion Fatigue: What is it? How does it relate to stress & burnout?

Compassion Fatigue: What is it? How does it relate to stress & burnout?

06/25/18 Laura Gibbons

What is compassion fatigue? Do you, or might someone you know be suffering from it? How does it relate to stress and burnout?

The concept of compassion fatigue has emerged in recent years in professional literature. Compassion fatigue is a term coined by an RN, Carla Johnson, in 1992, to describe nurses who were worn down by daily hospital emergencies. Compassion fatigue is the emotional residue from exposure to working with people who are suffering, particularly those hurting from the consequences of traumatic events.

Professionals who work with these individuals must contend with not only the normal stress or dissatisfaction with work, but also with the emotional and personal feelings for those who are suffering.

Professionals especially vulnerable to compassion fatigue include, but are not limited to: emergency care workers, counselors, advocate volunteers, and human service workers such as EA professionals. An individual who feels as though he/she is losing his/her sense of self to the clients being served may be suffering from compassion fatigue.

Compassion Fatigue vs. Burnout
It is important to note that compassion fatigue is NOT the same thing as burnout. Burnout is closely associated with stress. It is cumulative and often predictable. However, compassion fatigue involves a state of tension and preoccupation with another individual or the cumulative trauma of clients (note the plural reference).

Compassion fatigue is similar to critical incident stress, in which the person is traumatized by something he/she has experienced or seen. However, an individual experiencing compassion fatigue is absorbing the trauma through the eyes and ears of someone else (namely, the caring professional’s clients). Compassion fatigue may be thought of as secondary post-traumatic stress.

Like other stress and burnout, there are human costs associated with compassion fatigue. Job performance goes down, while errors go up. Morale drops, and personal relationships are affected. Home lives may deteriorate, and the affected individual’s personality may worsen, eventually leading to a decline in the person’s overall health.

While starting out with the best of intentions, the professional experiencing compassion fatigue has developed a habit of caring too much for others, and not enough for themselves. The key, as in stress and burnout, lies in balance: in nutrition, between work and rest, vocation and recreation, and most of all, balance in perspective.

Stress vs. Burnout
Occupational stress is frequently associated with stressful working conditions, heart disease, depression, alcoholism, drug abuse, work-related and family violence, and divorce.

Most of us become stressed at times, but when stress becomes overwhelming it can lead to burnout. Burnout is a severe form of stress that results from an individual feeling “overtaxed” physically and mentally over an extended period of time.

Coping with Stress
Early warning signs of stress include loss of sense of humor, low tolerance for frustration, hypersensitivity, becoming isolated, and difficulty concentrating or staying focused on work-related tasks. Symptoms of stress include:
• Skin rashes and allergies;
• Depression;
• Use of alcohol and/or other drugs;
• Increased smoking;
• Increased blood pressure;
• Headaches;
• Poor appetite;
• Loss of sexual drive;
• Apathy;
• Irritability;
• Relationship problems;
• Anxiety and crying spells;
• Heart problems;
• Withdrawal;
• Increased sickness;
• Decreased amount of sleep; and
• Increased absenteeism and tardiness.

Other adverse reactions of stress include job dissatisfaction, alcohol dependency or other substance abuse, and mental illness.

Coping with Burnout
Burnout can be indicated by feelings of:
• Hopelessness;
• Helplessness;
• Guilt;
• Inadequacy or failure;
• Cynicism;
• Disillusionment;
• Suspicion; and
• Resignation and indifference.

Correlations of burnout include:
• Overextension, including too much overlap between work and family life;
• Conflicting demands;
• Lack of autonomy; and
• Administrative hassles.

It should also be noted that there is rarely any correlation between burnout and the amount of money earned. An individual earning a large salary might not feel that stressed, and an employee drawing a much lower wage could be experiencing a great deal of stress.

Why Employers Should Care

Regardless of individual differences, research has confirmed the overall harm that stress has on employers and employees. Stress is directly related to absenteeism, diminished productivity, increased employee turnover, and direct medical, legal, and insurance fees, accidents, and workers’ compensation claims.

An estimated 40% of employee turnover is due to stress. The Xerox Corp. estimates that typical employee turnover costs $2,000 to $3,000 per employee. All told the cost to U.S. employers is estimated to be $200 billion annually.
Are YOU Suffering from Compassion Fatigue or Burnout?

The following self-test may help determine if an individual is suffering from, in particular compassion fatigue, but also burnout. However, it is not intended as a substitute for medical advice or diagnosis. Consult a physician or mental health professional to discuss the results.

Are YOU Suffering from Compassion Fatigue or Burnout Quiz


Whatever specific form the stress takes (i.e. burnout, compassion fatigue, etc.) when stressful situations (at work) go unresolved, the body is kept in a constant state of activism, which increases the rate of wear and tear on biological systems. Ultimately, fatigue or damage results, and the ability of the body to repair and defend itself can become seriously compromised. As a result, the risk of injury or disease escalates.

The costs associated with stress, burnout, and compassion fatigue, as cited earlier, are substantial – not only on a personal level, but on a company’s bottom line. Businesses that ignore these issues do so at their own peril.

Sources: Gary Yeast, BA, MS, MS, LMFT, Fellow AAMFT; Ace-Network; National Institute for Occupational Safety and Health; and Florida State University Psychosocial Stress Research Program, part of the EA Report Brown Bagger May 2018 included in the Employee Assistance Report, Volume 21, No. 5 May 2018

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