“Care for Caregivers”- How to Protect Against Compassion Fatigue and Burnout

Caregivers – mamas and helping professionals need to be cared for now more than ever.  

In January 2021 I shared with my social media community for Bell Let’s Talk Day how overwhelmed I felt. It was the height of the Pandemic and I was exhausted by my caseload as a therapist in a busy non-profit organization and exhausted feeling torn between being there for my clients and trying to be there for my children. I was worried for their safety and wellbeing and although they were older, having to close my door to them all day when they were so close triggered so much unhelpful mom guilt. We tried to go for walks daily but by the end of the day and workweek the weight of holding space for everyone’s fears and pain left me feeling like I had nothing left to give. This only triggered more guilt. Can you relate?

When the Body Says No

So many moms have been struggling with impossible expectations that only heightened during the Pandemic. Instead of feeling supported, female caregivers often hear the message directly or indirectly that they need to carry it all. This puts us in a survival state and is not sustainable. 

Physical pain forced me to stop and prioritize my wellbeing. Hearing about the rising rates of burnout and mental health struggles in mothers combined with my passion for prevention and education led to leaving my agency job in Sept 2021 to start my private practice dedicated to mothers and helping professionals. The following year I did training to became a Certified Compassion Fatigue Professional. 

Whether you’ve experienced developmental or reproductive trauma or not, many argue the Pandemic was a collective trauma. Just because it’s been declared over, doesn’t mean you aren’t still carrying the imprints of fear, stress, mom guilt or unprocessed losses in your nervous system. This is even more likely if you identify with a group that’s been discriminated against or experienced hate crimes. Or maybe you are struggling with guilt from moral injuries or the impacts of spending too much time in empathy. 

The Downside of Empathy

We go into this field because we care. But as Dr. Betsy Holmberg wrote in a recent article for Psychology Today while “empathy is a fundamental part of being human, helping us to bond and watch out for each other… when we spend too much time in empathy, we damage ourselves.”

Being a helper exposes you to trauma both directly and to secondary trauma stories and images that your brain can encode as its own experiences, impacting your nervous system and worldview. Working with dysregulated clients or colleagues or caring for highly anxious or dysregulated children can also trigger your threat response and keep you in a prolonged state of stress.

In this article, to help protect you from compassion fatigue and burnout, we will discuss personal vulnerabilities and things to look for in your colleagues and yourself as well as the importance of shifting unhelpful beliefs and adding new supportive resilience skills for sustained and effective caregiving at work and home.

 “Your compassion is incomplete if it doesn’t include yourself.”- Jack Kornfield 

Perinatal and postpartum clients are incredibly vulnerable. As Karen Kleiman of the Postpartum Stress Centre cautions, practitioners need to see beneath the mask new moms feel they have to adorn due to societal pressure to be perfect and fears about consequences if they are truthful about how much they are suffering. This requires us to be fully present and in a state of curiousity and advanced empathy, while remaining a separate sense of self. Compassion fatigue, which manifests in physiological and emotional symptoms including fear, agitation, exhaustion, apathy and avoidance has also been described as empathic distress as it actually diminishes our capacity for empathy over time.  This can have negative impacts on us and the mothers we aim to support.

Personal Vulnerabilities

One way to protect against compassion fatigue and burnout is to identify and start challenging unhelpful beliefs you may have internalized. Other personal vulnerabilities to be mindful of that may be attributed to a highly sensitive nature are: 

  1. Difficulty with self-awareness and self-regulation
  2. The tendency to lose oneself in another’s pain and suffering 
  3. Feeling overly responsible for another 
  4. Becoming overwhelmed or depleted by the amount of pain and suffering of your clients and the world 

Personal experiences can include: 

  1. Unresolved personal traumas or loss –current or past
  2. Currently being in an unsafe or unstable environment
  3. Perfectionism, People Pleasing (Fawning) or Over functioning

Can you relate to any of the above? Do you notice feeling drained or energized by your client or patient sessions? Are there personal struggles you’ve been minimizing in comparison to what your clients are going through? This is called comparative suffering and can prevent us from recognizing when we need help. 

“The cure for burnout is not self-care. It is all of us caring for each other. – Ameila Nagoski

As burnout happens gradually, we don’t always recognize it in ourselves. Here are ten questions from Homewood Health you can use to assess yourself and look out for in others:

  1. Have you become more cynical or critical of people?
  2. Do you reluctantly get out of bed every day?
  3. Have you become irritable or impatient with people?
  4. Do you lack the energy to be consistently productive?
  5. Do you find it hard to concentrate?
  6. Do you lack a sense of satisfaction when you complete a task?
  7. Do you feel disillusioned about your life?
  8. Are you using food, drugs, or alcohol to feel better or not feel anything?
  9. Have your sleep habits changed?
  10. Are you troubled by unexplained headaches, stomach or bowel problems, or other physical complaints?

Which ones can you relate to, if any? Have you shared this with anyone? What was their response? If you haven’t shared with anyone yet, what are you afraid will happen? Now, imagine continuing this way for another 6 months or a year. How would that be for yourself and the people you care about? 

If you’ve noticed it in someone else, can you share your concerns in a non-judgemental way? 

If you’ve left a toxic work environment, do you notice if you are repeating some of the unhealthy patterns like overbooking and not taking breaks or do you find yourself isolating? Therapy could be helpful to replace these patterns with healthy boundaries. 

Protect Against Compassion Fatigue and Burnout – “Small things often” 

In many cases it is not necessary to leave our workplaces or field but we need to develop resilience skills. 

Trauma and compassion fatigue expert, Dr. Eric Gentry shares the 5 primary resiliency skills caregivers need are: 1) being able to recognize when you are having a threat response and how to release stress from your body 2) intentionality 3) perceptual maturity or personal responsibility for what you can change 4) connection and support and 5) self-care and revitalization activities. 

“Small things often” was the motto of the Gottman’s Bringing Baby Home training I did over 15 years ago. While it was used in the context of maintaining a healthy and satisfying relationship, it’s just as relevant for protecting against compassion fatigue and burnout. 

Moment to moment self-awareness and incorporating micro self-care practices including self-compassion can support your nervous system and in turn how you show up for your clients/patients, children and yourself. 

Can you tell when you are being activated by others? Do you know how to shift from empathy to compassion? Simple sensory exercises can help you anchor into your ventral vagal safe and connected state at work and home.

If you are looking for a “soft place to land” with group support, accountability experiential exercises, a deeper look at sensitivity and self-regulation along with ways to protect your energy and time, reach out to join the waitlist for my virtual 4 week program with intuitive coach, Julie Cusmariu “Caring without Carrying it All” starting in November.   

Author bio: Nicole Schiener is a Nature lover and award-winning Registered Psychotherapist in Ontario Canada where she lives with her husband and two teen children. After twenty years in nonprofit, specializing in gender-based violence and anxiety management, Nicole started a private practice and facilitation business as part of her recovery from burnout and to honour her passion for prevention. As a Certified Gottman Educator- Bringing Baby Home and a Certified Compassion Fatigue Professional, she is dedicated to helping liberate women, especially sensitive mothers, and helping professionals from perfectionism and the pressure to do it all. She contributes to the Gottman Institute Blog and Psychotherapy Networker and provides trauma-informed workshops and online group programs. You can find a ton of free resources on her website https://peaceandpossibility.ca.
Keywords: compassion fatigue, burnout, caregivers, postpartum, baby blues, mothers, empathic distress, pandemic, vulnerability, self-care