By Paul Sills
The current state of the world and the problems we are facing, from both a health and economic perspective, are causing us all a great deal of stress. Some, however, are suffering more traumatic stress than others.
Many of those suffering from traumatic stress are our front-line workers in health care, mental health, and emergency services. But others may simply be overwhelmed by endless news stories of tragedy and suffering. As the Black Eyed Peas say in their chart-topping song “Where Is The Love?”:
“Wrong information always shown by the media
Negative images is the main criteria
Infecting the young minds faster than bacteria”
Courage, Compassion and Connection
Brene Brown ‘s research tells us that the three key components of leading a wholehearted life are courage, compassion and connection. Here, courage does not necessarily equate with bravery but draws on the original meaning of the Latin word cor – meaning heart. As Brown puts it, courage is: “To speak one’s mind by telling all one’s heart.”
In modern language – it means to be vulnerable, to wear your heart on your sleeve.
One of the key ways that we connect with others is through empathy. While sympathy drives disconnection, empathy drives connection. Empathy is not about feeling for someone (this is a common error); it is about feeling with someone.
Empathy and compassion are great traits or gifts for anyone trying to interact and get along with other people, whether in their personal or professional life (as though there is really a difference). Mediators are trained to “establish rapport” with the parties in dispute, but that may be better reframed as establishing a genuine connection. How do they do that? With empathy; by asking curious, caring, and open-ended questions; and by being mindful of what is happening in the room at that moment.
Too much of a good thing
So, can we get too much of a good thing? Are we at risk if we are too empathetic or too compassionate? Chinese philosophy would say yes: everything in moderation. Really? If they are part of Brown’s trinity of traits that lead to a more wholehearted life, then surely, we should seek more of them.
This is where compassion fatigue and empathy burnout come into play. They are related but not the same, and both can lead to burnout and what is often classified as secondary traumatic stress.
Compassion fatigue may be viewed as the negative cost of caring. It may arise when, for example, someone cares “too much” or must care relentlessly day and night (for example, caregiving for a terminally ill or cognitively impaired partner). As a result, compassion fatigue comes up often for our front-line heroes who are working directly with the victims of disaster, trauma, or illness. The most research into the condition has been done in the healthcare industry and, of course, that is the industry currently in the spotlight.
Those suffering from compassion fatigue will be emotionally and physically exhausted and can display a variety of symptoms, including reduced concentration, feeling numb, feeling helpless, irritability, withdrawal, and an inability to “face” going to work.
Our personality type may make us more susceptible to this trauma. Those of us who are overly conscientious, perfectionist and who believe in “self–giving” are more at risk. In addition, having poor social and familial support or high stress in your personal life also contribute.
Imagine being a nurse or doctor that goes to work every day, knowingly putting yourself in the path of COVID -19 while you care for others 14 hours a day in sub-standard PPE, and also leaving a partner at home who has just been made redundant and is depressed but who needs to look after your three young children. That is reality for thousands around the world at the moment.
It is small wonder that the famous street artist Banksy has just donated a painting to the University Hospital Southampton which depicts a nurse as the new superhero.
Tools for combatting fatigue and burnout
Can we help protect ourselves and others from compassion fatigue in a way that does not involve us simply stopping to care? As Bob the Builder would say, “Yes we can!”
Stress reduction and anxiety management practices are effective. Try breathing exercises (my current favourite is square breathing), physical exercise (of course!), and my personal favourite – develop a mindfulness practice (which perfectly complements breathing exercises and physical exercise). Develop a strong social network. Foster connections and be vulnerable – tell people that you need help and seek help from others: family, friends, colleagues, and pets.
Similar issues arise if you do not set boundaries around your empathy. Setting boundaries seems counterintuitive to being compassionate and empathetic, but it is not.
If I apply no conscious skills to my empathetic feelings, I run the risk of feeling without any limits or relief. If that occurs, I may become empathetically distressed at the same level of distress the other person is experiencing.
If I become burnt out and distressed from being empathetic, I run the risk of withdrawing into myself and then leaving the other person to suffer alone. I may lose the ability to be there for others: to be connected and compassionate when others need me. This is a real concern for two groups of people in particular: parents and caregivers.
Avoiding empathy burnout
Better instead to have empathy concern than empathy distress. That is, empathy but with a conscious plan. Similar to avoiding compassions fatigue, addressing the potential for empathy burnout requires the application of a conscious skill or skills that do not come naturally to us when we are faced with extended exposure to stress and trauma. We are not trained from an early age to deal with these issues. We must learn the skills over time.
The first “shift” you can make is to understand that empathy is not just about feelings, but it is also a skill. Skilfully managing your own emotions when you are being empathetic with others can help greatly. Mediators and psychologists, for example, know that the skill of empathy can be of great benefit to others but it is necessary to put some distance between themselves and others, and to be aware of their own self-care needs. If they do not implement these safety valves they will be unable to provide sustained empathetic support.
It is important to set clear boundaries around what others can expect from you. Remember that empathy is not feeling for someone but with someone. You need to keep a distance from other people’s emotions – know that you are with them but not in place of them. You are concerned not distressed.
Do your best not to take the other person’s issues personally. Of course, if you are dealing with a family member or close friend it will be personal, but you still need to exercise self-care and set boundaries (this is incredibly important when dealing with family and friends to avoid simply being an enabler). Being empathetic in your professional life requires a degree of discipline not to take everything personally or it will exhaust you and potentially lead to burnout.
Finally, and importantly – believe that the person you are empathising with can overcome their own problems. Be there with them, be connected and be empathetic but know, and let them know, that they can make it through. Have faith in others.
Paul Sills paul.sills@paulsills.co.nz is an Auckland barrister and mediator, specialising in commercial and civil litigation. He is an AMINZ Mediation Panel member.