The Caregiving Soul:

Compassion Fatigue: Recognizing the Symptoms

Hosted by Dannelle LeBlanc, May 22, 2023

Dannelle speaks with Patricia Smith, the Founder of the Compassion Fatigue Awareness Project and Healthy Caregiving, LLC. After being asked to lead a training on compassion fatigue by the Humane Society early in her career, she found she herself suffered from high levels of compassion fatigue, sending her on a path to educate herself and others on how to best manage symptoms while maintaining focus on care for others.


About Patricia Smith

Patricia Smith is the founder of the Compassion Fatigue Awareness Project©. As a certified Compassion Fatigue Specialist, she has been facilitating trainings worldwide for caregivers in all the helping professions for the past 20 years. She has authored five books and training materials on the subject. Additionally, Patricia is a Helen R. Whiteley Scholar, and has twice been awarded writing scholarships sponsored by the University of Washington, Seattle. In September 2016, Patricia presented a TEDx talk entitled “Navigating the Path to Wellness: Compassion Fatigue in Caregiving”.  


[00:00:00] [Music] 

[00:00:03] Patricia: Compassion fatigue does not play favorites. It can be the receptionist, the front desk, it can be the veterinary surgeon, it can be the ER doctor, it can be anybody. If you are in that environment, you’re at risk for high levels of compassion fatigue. 

Read More

[00:00:20] Dannelle: As a young person, Patricia Smith was naturally inclined to care for others. After a career in journalism, she made a shift to animal welfare work with the Humane Society. Early into the job, she was asked to lead a training on compassion fatigue. Without much background, she reached out to the primary researcher of compassion fatigue at the time, Dr. Charles Figley. After connecting with Dr. Figley, Patricia found she herself suffered from high levels of compassion fatigue sending her on a path to educate herself and others on how to best manage it while maintaining focus on care for others.  

[00:01:08] Welcome to The Caregiving Soul. I’m Dannelle LeBlanc. 

[00:01:15] [Music Ends] 

[00:01:15] Patricia: So, one thing led to the next, I started training for my volunteers, it was part of my job. And then the next thing you know, the ED said, ‘Gee, why don’t we offer it to the community? We can charge ’em $10 and throw in a lunch and maybe then they’ll start volunteering at the shelter”. Anyway, you can imagine what happened. It just grew and grew and American Humane came and asked me if I would train for them and in that time, I started the Compassion Fatigue Awareness Project, which was to simply educate caregivers about this.  

[00:01:44] And what really amazed me was I thought it was probably just healthcare and animal welfare, but it’s not. It’s across the board, it’s a family caregiver, it’s the firefighter, it’s the clergy. Anyone who’s helping other people. Compassionate, empathetic people are at risk for compassion fatigue. 

[00:02:03] Dannelle: And so how would you define compassion fatigue in a general sense? 

[00:02:10] [Music] 

[00:02:12] Patricia: Compassion fatigue is a secondary traumatic stress syndrome that can include emotional, physical, and spiritual depletion in those providing care to others. It’s associated with caregiving where people or animals are experiencing significant emotional or physical pain and suffering. Does that make sense? 

[00:02:33] [Music Ends] 

[00:02:34] Dannelle: Absolutely, it makes sense, and it’s so important to have a name for what it is that we’re feeling and how it impacts us physically, emotionally, and spiritually.  

[00:02:51] Patricia: Yes. 

[00:02:51] Dannelle: So, it is very, very real. One of the things that you mentioned on your website, when it comes to addressing it, that the first step is awareness, and so I’d love for you to speak a little bit about what it looks like. How does it manifest? What do we look for? How do we gain awareness? 

[00:03:17] Patricia: Well, the details are gonna be different for each person because we’re all unique, but there are a specific set of symptoms that will show up, and the first one is isolation. You start to isolate yourself from your loved ones, from your colleagues, from social situations, because you don’t want anyone else to come after you with anything. You have emotional outbursts. Now, what does this come from? This comes from years and years of pushing down all the emotion. “I can handle it. I don’t need help”. Caregivers are horrendous asking for help. That’s the number one thing. That is a strength to ask for help, not a weakness. 

[00:03:52] You feel sadness, you feel apathetic. And this happens a lot in caregiving professions. Persistent physical ailments, and that’s the headache. That’s a scratchy throat. That’s the back of the neck. That’s the gastrointestinal problems and the lower back. And what is that? That’s your body telling you, “Stop doing this. You’re hurting me”. But we don’t listen because caregivers keep going. “I can make it better. I can make it better”. And eventually you see what might happen.  

[00:04:17] So, you wanna catch it before that time. Denial – I often see this in working with ER folks, where it’s just constant and they’re always on high alert because they’re waiting for the buzzer to go and they say, “Oh, it doesn’t bother me. It doesn’t bother me”. Well, it does. 

[00:04:32] There’s all kinds of stress, cortisol, and things working through their body. Recurring flashbacks, nightmares. And I always tell people, if you’re to the point where you’re not sleeping because you’re keep thinking of those traumatic events that happened and they haven’t been able to calm down, you probably need some professional help to get you through it. It’s very difficult to get through it by yourself.  

[00:04:51] Dannelle: So, what I’m hearing is that compassion fatigue is something that occurs within us as individuals, but it’s also something that manifests in society, so I think we’ve gone through that with Covid. Just an apathy, if you will, towards all of the overwhelming suffering and pain that we’ve gone through. 

[00:05:22] I’d love to hear from you about, specifically about feeling apathetic, where it feels like what we’re doing as caregivers doesn’t make a difference, in a time when you recognized that in yourself and how you got past that? 

[00:05:43] Patricia: Well, the first thing like I said is awareness. Don’t go to denial, go to awareness. So, I kind of tie in stress, burnout, and compassion fatigue, because people often get them confused. And you can have all three, unfortunately. 

[00:05:55] With stress, it’s too much coming at you. It’s, it’s recognizing there’s real stress and perceived stress. Real stress is you look at your desk and you’ve got too many meetings, you’ve got too many responsibilities, and you can actually look at it and say, I need to get some help. 

[00:06:11] And perceived stress is when you feel, “I can’t handle it. I can’t do it”. You never look to help, you just say, “I can’t handle it”. So, you have the stress, then you have the burnout. Burnout’s too much. You realize it’s too much coming at me, and that’s when you become apathetic. And burnout, can, can occur in any profession.  

[00:06:28] Compassion fatigue is directly related to caregiving. So, the first thing you wanna say is, “Is that what I’m doing? Am I, am I caregiving in a situation? Am I caring for my elderly parents? Am I caring for a child? Am I a teacher? Am I over caring for my students? Am I a doctor over caring for my patients? You have to recognize where you’re putting it in your life, and then you have to learn to manage it. The will to manage it and to change. 

[00:06:53] Wellness is a process of growing and thriving and changing throughout our lives. It’s not just at any given circumstance. It’s ‘til we take our last breath. You know, we wanna continue to thrive, and that awareness tells us we’re not thriving, we’re stuck, our relationships are stuck, our job is stuck. We no longer have things that make us happy.  

[00:07:14] And then there are things you can do to heal, and that’s very personal. You have to look at what works for you. It can be whatever it is for you – being with someone you care about, cooking, baking. So, there’s a lot of work involved. It’s not a simple process of I’m gonna stop doing this, because it’s habitual.  

[00:07:33] Dannelle: Yes and opens the question up to the idea of wellness being a process that looks different for each of us. And so, you talk about this idea of the cycle of giving and replenishing. Can you talk a little bit more about that? 

[00:08:00] [Music] 

[00:08:00] Patricia: The healthy caregiver depletes in the work and then has to fill up. If you keep depleting, depleting, depleting, you fall into stress, burnout, compassion fatigue, and, and getting out sometimes takes professional help. You can’t do it yourself. You’re too embedded in it, what that thing is. 

[00:08:20] And what’s really hard, is that caregivers are what we call “other directed”. They take care of the needs of others before they take care of their own needs. So, the healing path is becoming self-directed after being other directed, probably a good portion of your life. And that is very, very hard to do. Because what happens is we get feelings of guilt, selfishness, self-centeredness, and, and no one ever tells us you need to fill yourself up. We have to have rituals to let go. And that can be anything. That, again, is authentic. It’s almost like a game.  

[00:08:56] [Music Ends] 

[00:08:58] And I, I like to tell the one story. I worked over in Santa Cruz for a while and I worked in elder care, and that’s very difficult because we lost, you know, there was no hope, uh, the people lived in the elder care facility and every day, every other day, one of them would die. And it was very painful.  

[00:09:13] And what I would do is I’d go down to the ocean at the end of the day. And since I’m a word person, I think of a word that would really kind of tie up what I was feeling, whether it was apathy or fear or pain or suffering. And I would write that word with a stick in the sand, and I would watch the waves come and take it away. And by the time that word was gone, I had let go of it. 

[00:09:37] So, people have all kinds of stories they’ve told me about what they do to let go so they can live their life in the evening and on weekends and fill themselves up. But you have to recognize all of it, and you have to be aware of it, and that’s the hard part. That’s the work. It takes time and it takes solitude, and that’s hard for caregivers cuz we’re people pleasers. 

[00:09:59] Dannelle: Yes, it is so hard and we’re not trained or taught how to do that, creating that time with self and creating these rituals to let go. Can you tell us, what, aside from awareness, being the biggest and most important step, are your top tips to the healing process? 

[00:10:30] Patricia: It takes a lot of bravery to make ourselves happy. Oftentimes we have, it’s what I call detached compassion, and it’s tied into mindfulness. But on the spot care practices will help you to identify it, to provide the skill to yourself, the coping skill, and move beyond it so you don’t carry it. And some of those skills are.  

[00:10:54] Number one, more than anything, I cannot tell you how important this is, it’s breathing deeply. It’s nature’s way of calming us down, of helping our brains kind of get into a place where we can look at the situation and what we can do to help it, cuz that’s what we wanna do. We wanna help the situation. We don’t wanna escalate it. So, breathing deeply, you’re doing it all by yourself to calm yourself down so you can be the helper, you can be the one who changes the trauma. 

[00:11:24] Meditation, and I can honestly say 100% learning to meditate saved my life. Uh, it’s that simple. I highly, highly recommend meditation. The studies on it are amazing. It actually changes your brain. And it changed my brain. For about three years I’ve been doing very serious meditation, finding the time, and it helps.  

[00:11:44] Uh, laugh, humor, laugh, get it out. Humor is healing. We know that. Journaling, I’ve read more lately about studies on journaling and what is journaling is taking what’s inside and putting it out there. And that’s what you wanna do. You wanna get rid of it in a healthy way. And these are the coping skills that help us to heal. And, and I can say from 20 years of work with caregivers in all the helping professions, and family caregivers, they work, they sound simple, but they work and they also, it’s also based on my own experience with healing from compassion fatigue.  

[00:12:19] And I say that, but I can tell you we never heal from compassion fatigue. We learn to recognize it and we learn to manage it. Those neuro pathways that lead us to high levels of compassion fatigue are still stay very deep. Whereas if we learn to caregive from a place of detached compassion, being there for someone, being mindful of them, it’s their situation, not yours. It’s about that person. We wanna be mindful and we wanna be 100% present for that person.  

[00:12:47] Getting back to journaling, the work of Julia Cameron, “The Artist’s Way”. I don’t know if you’ve ever heard of “Morning Pages”, but studies have shown that this is probably one of the best things you can do before you get outta bed in the morning. If you can wait that long, three pieces of eight and a half by 11 right by your bed, and just do stream of consciousness writing. It takes what’s in there and it puts it out there. And the good thing about it is you can write whatever you want. 

[00:13:14] You can use whatever words you want, words you wouldn’t use in public. Uh, you can name names because someone is really bugging you and that’s a true thing. You can’t wash that away. That’s inside. You can actually put it on the paper. And then the secret is it’s your work. No one else can ever see it. You burn it, you tear it up, you shred it, it’s all yours. But what you’ve done is the process of letting go. 

[00:13:38] Take a brisk walk, if you can get away. I mean, the sky is blue, the birds are singing. I tell you, it’ll put you in a different place. Pray, if that’s what you do. Read a favorite quote or your mission statement. Put it somewhere where you can see it and whenever you’re, you’re feeling of why you’re doing what you’re doing, because it doesn’t make a difference. Get that mission statement out. Take a look at it. 

[00:13:59] That one is so, so very important. Listen to music. Research shows us that music changes our mind immediately, and then that practice of letting go ritual. Those are the kind of things, they sound simple, but they’re not easy to do. They’re not easy to do at all, but you have to find out the things that are authentic to you and do them every single day.  

[00:14:19] Dannelle: So, it’s creating and practicing these behaviors. It’s not something that’s just gonna come to us or happen. We have to be intentional about it.  

[00:14:30] Patricia: Right, because it’s a lot of work. I can’t tell you how much work it is, but it’s worth it. One day you’re walking along and you say, “What’s that feeling? I have a new feeling,” and you think, “I’m happy. I’m happy” –  

[00:14:45] Dannelle: Yes! 

[00:14:45] Patricia: – “satisfied. I’m thriving. I’m well.” And I get goosebumps just saying that because I’ve experienced it. I’ve had others tell me stories of experiencing this. It’s a wonderful thing. 

[00:14:57] Dannelle: 100% agree. Thank you so much for joining me today on The Caregiving Soul, Patricia. It’s been absolutely lovely speaking with you. 

[00:15:06] Patricia: Well, thank you.  

[00:15:07] [Music] 

[00:15:10] Dannelle: Thank you for joining our conversation with Patricia Smith. 

[00:15:15] One of the concepts that Patricia mentioned that stood out to me was how we can mirror the rhythms of nature as a way to connect to ourselves like sinking up our breath to the sounds of the waves in the ocean, or the wrestling of leaves in the wind. Make time for solitude in nature to identify and name what may have us stuck in compassion fatigue. These moments don’t have to be long, but a walk or just a step outside can help us be more present with the world around us.  

[00:15:56] Check out our show notes to connect with and follow Patricia on social media or learn more about her work in compassion fatigue. 

[00:16:07] Every episode of The Caregiving Soul has a page on where you can find the extended show notes, including tips and takeaways, transcripts, and relevant resource links.  

[00:16:20] For additional bonus content from this episode, and to connect with us, be sure to follow the Empowered Us social channels on Instagram @empoweredusnetwork and Twitter @empowereduspod. 

[00:16:36] The Caregiving Soul is an Empowered Us original, presented by Good Days, hosted by me, Dannelle LeBlanc. If you liked this episode, be sure to rate and subscribe to the show wherever you get your podcasts. 

[00:16:53] And remember, the right care includes care for you.  

[00:17:01] [Music] 

Read Less