While anyone can experience burnout, compassion fatigue, and vicarious trauma, professional helpers who work in the health care and social services fields are more susceptible than the general population. Helping others as a career can be rewarding, but it can also come at an unspoken cost.
Defining Our Terms
Burnout is exactly what it sounds like. People get “burned out,” exhausted both mentally and physically, to the point where they cannot function. It is caused when a helper feels overwhelmed, powerless, and overworked. Symptoms include numbness, lack of motivation, depression, and anxiety.
Compassion fatigue (CF) manifests when a helper has had repeated exposure to traumatic situations and/or stories. For example, witnessing participants overdosing at a shelter, or hearing refugees describe the horrific circumstances they’ve fled.
The helping fields naturally attract highly empathetic people who are passionate about making a difference, but this becomes a double-edged sword when it comes to CF. “Caring too much” is possible, and it’s detrimental to the helper and client. The helper can quickly become fatigued, and they cannot pour from an empty cup. The client may feel like the helper is overly invested and become worried that retelling their story will adversely affect the helper. In the end, the client may not tell their story at all, which is unfair. Even worse, a helper experiencing CF may come across as if they don’t care or are making light of the client’s trauma.
Vicarious trauma (VT) is when a helper becomes traumatized themselves by hearing real life accounts of their clients’ trauma. This can produce an entire shift in worldview, even causing panic attacks or a change in the helper’s lifestyle.
A client with post-traumatic stress disorder (PTSD) might experience nightmares, intrusive thoughts, and the urge to avoid situations or activities that even remotely resemble their trauma. VT is when the helper experiences this as well, as if it had happened to them. Logically they know they have not had the same traumatic experience as the client, but the amygdala still creates the fight-flight-freeze response, which can feel as scary as it does for the client.
For example, a refugee at a homeless shelter may be triggered by an air show because it reminds them of bombing horrors they experienced prior to fleeing. When it comes to VT, a helper who has developed a close relationship with that client may be equally triggered by the air show. This is most likely to occur when the helper can vividly imagine the client’s situation or become emotionally affected to a high degree. They may both experience panic attacks, fainting, and will avoid the air show.
Helping others as a career can be rewarding, but it can also come at an unspoken cost.
Tools to Help Helpers
Unfortunately, burnout, CF, and VT are common among helpers who work with trauma survivors. But there are some tools that can help.
The Traumatic Stress Institute (TSI) utilizes an ABC approach to prevent this:
- Awareness of our needs, emotions, and limits
- Balance between our work, leisure time, and rest
- Connection to ourselves, to others, and to something greater
Step 1 | Awareness
The first step is to be proactive and catch the overwhelm before it gains momentum. In my professional experience, I have found this to be the tougher of the letters. The fact is being a professional helper is stressful, tiring, surprising, and the work never ends. Therefore, many people don’t stop to check in with themselves until the damage is done. This lack of self-awareness can be greatly improved by journaling and meditation.
There are rules to helpful journaling:
- Have a theme. Possible titles might be “Tiredness,” “Negativity,” or “Nothing Gets Better.”
- Be sure to keep it stream-of-consciousness. Don’t worry about spelling, grammar, or sentence structure. Let the words flow without trying to pause or dissect your writing until you are finished.
The first step is to be proactive and catch the overwhelm before it gains momentum.
Step two offers two types of meditations that can be beneficial. For each, try to keep a neutral spine and not move (except breathing) while practicing.
- Money Mind Meditation (MMM) will help you become aware of your thoughts. Simply set a timer and watch them. Think of your thoughts as clouds – the idea is to let them come to your mind and then to let them leave, not holding on to any thought in particular. For example, you may think about your personal relationships, work, or your grocery list. The challenge is to not dive into these topics. MMM is like you are doing a summary scan of topics that need to be addressed later.
- Emotional Release Meditation (ERM) will help increase your awareness of your emotions. Find a private space where you won’t be disturbed. You must be willing to feel painful emotions and to even cry if necessary.
- Sit or lay down and breathe into the base of your spine. This anchors the amygdala so it can allow heavy emotions to express themselves without worrying about safety in your survival brain.
- Inhale, hold, and exhale three times for seven seconds.
- Now, just like the journal, choose a theme you want to feel. Breathe into this theme as long as you can, especially where you feel pain in your body, which refers to a place you may be feeling triggered (e.g., the stomach).
- When you feel satisfied, exhale your emotions with hard breaths out, similar to an aggressive sigh or yawn. It may be helpful to imagine toxins or a colour leaving the body as visualization can help you release more emotion.
- Repeat this meditation three times.
Step 2 | Balance
Your life should include a balance of work, play, and rest. Without it, you’re easy prey for burnout, CF, and VT.
Make a schedule for your week where all three areas are considered. Helpers often feel guilty about “playing,” but from now on, develop the opposite mindset – feel guilty for not taking time to have fun. If you don’t plan time to do something enjoyable, you are more susceptible to burnout, CF, and VT, which is unhelpful to your clients. Be a role model of self-care.
Your life should include a balance of work, play, and rest. Without it, you’re easy prey for burnout.
Create a Custom Self-Care Plan.
Make a list of activities that bring you relief when you are stressed; then make another list of activities that give you joy in general. It’s important you are proactive and do this now because when you actually need it, you will be drained and not remember this crucial first aid kit for your mental health.
Step 3 | Connection
Talk to Someone
Research shows that the best thing a helper can do when in danger of second-hand emotions is to talk directly with someone else. This may be a friend, parent, peer, supervisor, team member, or therapist. Choose a person and setting where you feel safe, and don’t fear being judged for having a rough time. All helpers go through this one time or another, but most don’t speak up. Talking about your struggles with others may influence others to do the same.
Remember Your Successes
Make a list of the success stories in your career. Literally the only criteria is to write down situations or accomplishments that you are proud of yourself for. These can be small or big accomplishments, it doesn’t matter – all that matters is that you impressed yourself. Contribute to this list when you feel good about something and read it when you feel overwhelmed.
Good lucking implementing the practical and specific tools outlined in this blog, and remember, you really can’t pour from an empty cup.
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