Diagnosing & Treating Compassion Fatigue

by Jan Thomas

Unfortunately, compassion fatigue sufferers may be the last to acknowledge something is wrong or to take the necessary steps to correct it. This is particularly true for those who work in veterinary health care.

“Veterinarians believe they are supposed to help others and anything they do to help themselves is selfish,” says Elizabeth Strand, PhD, director of Veterinary Social Work at the University of Tennessee College of Veterinary Medicine. “It takes some convincing to get them to believe that it’s actually selfless to take time to care for themselves, but doing so means they can go back to work and be patient, be thoughtful and be able to provide good medical care. They can be mediators when there’s conflict instead of contributing to stress among the team.”

So how do you know if you have compassion fatigue — and what’s the treatment protocol if you do?

Charles Figley, PhD, professor of disaster mental health at Tulane University’s School of Social Work and Tracy Zaparanick, PhD, coauthor of Nonhuman-Animal Care Compassion Fatigue: Training as Treatment suggest looking for the following warning signs:

  1. Feedback from family, friends and coworkers that you’re preoccupied, sad, or overly serious,
  2. Feeling anxious or stressed out,
  3. Losing your sense of humor,
  4. Losing your ability to sleep well,
  5. Grumpiness/irritability because of too little sleep or because of situations that remind you of work,
  6. Overeating or under eating
  7. Becoming over-involved with patients or clients,
  8. Flashbacks,
  9. Overreacting,
  10. “Freaking out” at people who don’t take care of their animals,
  11. Avoiding social situations and/or not telling people where you work or what you do,
  12. Self-medicating with alcohol, drugs or food.

Remember, stress and exhaustion may mimic some compassion fatigue symptoms, so talk with someone you trust and use the resources listed in this article to help evaluate your situation.

If you do have compassion fatigue, Zaparanick and fellow researchers have good news. They’ve completed studies that suggest certain types of intervention may be effective.

“What we found was that people’s trait anxiety scores changed in a statistically significant way after a two-day intervention,” Zaparanick says. “We can’t say there was any kind of direct relationship because of the way the study design was set up. The methodology needs to be more rigorous and there needs to be a control group, but [the results] do provide us with more questions to ask.”

In the interim, Figley says there are steps that veterinary students, associates and technicians can take to either protect themselves from compassion fatigue or speed recovery if they already have it.

  1. Accept that you’ve been traumatized.
    “There is a systematic, organizational environment that breeds compassion fatigue,” Figley says. “Accept that you’ve been traumatized. If you can, take a two-week vacation and devote it to becoming un-traumatized.”
  2. Be a survivor, not a victim.
    “Someone who is a victim lives in the past. They say, ‘Don’t you know what’s happened to me?’ Survivors believe what they’re experiencing now is nothing compared to what they’ve already survived,” Figley says. “They don’t wonder when things will go back to being normal. They accept that this is the new normal.”
  3. Make peace with the past.
    Figley recommends answering these questions to put the past in its place:
    1. What happened to me? (Was there a bad outcome? Were there a series of bad outcomes? Were there too many euthanasias?)
    2. Why did it happen to me? (Was it fate? Did I study hard enough? Did I make a mistake?)
    3. Why did I respond the way I did?
    4. Why have I acted the way I’ve acted since then?
    5. What will I do if something like this happens again?
  4. Find allies.
    “Sometimes people can find their way through this by themselves, and sometimes they can’t,” Figley says. “If not, working with a friend, supportive coworker or family member is fine. This is memory management — you’re learning to live with those traumatic memories.”
  5. Prioritize self-care.
    “I anticipate people saying, ‘You’re just saying I need sleep; I need to exercise more,’” Figley says. “While I think those steps are important, they’re not enough. What really needs to happen is for people to be able to develop resiliency skills so they can manage their own anxiety. Each person has to figure her or his own way. What works for me may not work for you, and it may change over time. What you need at 20 may not be what you need at 40.

    “Self-care is a constant exercise in learning what you need,” he adds. ‘You have to expose yourself to aspects of your life that aren’t part of what you do, and those other activities must be enriching. It’s about filling up the gas tank. Do something for yourself so you can continue to give back.”

For additional information, consider these resources:

Self-assessment tests

  • Compassion fatigue self-test
    Use this free test from America’s Continuing Education network to judge the impact your job, your work environment and your response to stressful situations is having on your emotional health.
  • Professional Quality of Life Scale Test
    This free, online test is well-suited to those in the medical profession. Answer the questions online then tally your score and use the answer key to evaluate your potential for compassion satisfaction and your risk for both compassion fatigue and burnout.

Additional information

  • Compassion fatigue: when listening hurts
    This American Psychological Association article provides additional coping strategies.
  • What is compassion fatigue?
    Humane Society University
    The Human Society University offers Compassion Fatigue workshops for those who work in the animal care profession. You’ll find a link to upcoming classes here.
  • Self-Compassion
    Doctor, heal thyself is more than just a cliché. On this website, Kristin Neff, PhD, provides specific, actionable advice on how to be as compassionate to yourself as you are to others.
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