Compassion Fatigue | CT1

On this podcast, Anita Brooks, author of Getting Through What You Can’t Get Over joins me to discuss an overlooked issue for twenty-first century coroners — Compassion Fatigue.

Compassion-Fatigue-coroner talkHelping others who have undergone a trauma from a natural disaster, accident, or sudden act of violence, can be highly satisfying work. But helping trauma victims can take a toll on even the most seasoned mental health professional. This is Compassion Fatigue. Ongoing exposure to the suffering of those you are helping can bring on a range of signs and symptoms — including anxiety, sleeplessness, irritability, and feelings of helplessness — that can interfere, sometimes significantly, with everyday life and work. In clinicians, including therapists, counselors, and social workers, this response is often referred to as “compassion fatigue” or “secondary post-traumatic stress.

Left untreated, compassion fatigue can lead to other issues that can be of concern, including burnout. If you are working with victims of trauma, it’s important to recognize that you and your co-workers are vulnerable to compassion fatigue. There are steps that you can take to recognize, limit, and treat the effects.

What is compassion fatigue?

“Compassion fatigue” is a fairly new term that describes certain emotions and behavior that people, often clinicians such as psychologists and therapists, sometimes experience as the result of hearing about and knowing about the traumatic experiences of others. It is part of the “secondary post-traumatic stress” family of responses that people may have when they help trauma victims. The symptoms, which are similar to the symptoms of post-traumatic stress, can interfere — sometimes profoundly — with a person’s personal and work life. Compassion fatigue has also been described as “vicarious traumatization.”

Who is at risk for compassion fatigue?

Clinicians who choose the “helping professions” are often extremely empathic people: they are able to step into another person’s shoes and understand what that person is feeling. This same quality that makes it possible to help others who are suffering may also heighten a therapist’s vulnerability to compassion fatigue. It is thought that some people are more vulnerable than others to compassion fatigue, particularly people who may have experienced unresolved trauma in their own lives. This is especially true if the clinician is experiencing the event at the same time as the people the clinician is trying to help.

So how do you know if you have Compassion Fatigue?

Signs and symptoms

The signs and symptoms of compassion fatigue are similar to the signs and symptoms of post-traumatic stress:

• Nervousness and anxiety. Feeling anxious and in danger. Feeling fearful about going out. Being hyper-vigilant about your safety and your family’s safety.

• Anger and irritability. Feeling “angry at the world,” or feeling anger toward people you love and trust. Arguing often with relatives, friends, or co-workers. Feeling angry toward specific people or groups of people. Feeling aggressive or having a hard time controlling feelings of aggression.

• Mood swings. Having trouble controlling your emotions. Experiencing moods that go up and down. Feeling fine and then suddenly crying or feeling very anxious.

• Flashbacks. First-responders to a scene of a crisis and others who are hearing the experiences of a trauma survivor may find themselves reliving portions of the crisis. This can mean experiencing nightmares containing images of the event, or having spontaneous flashbacks and vivid memories of the experience. Flashbacks are often accompanied by physical sensations such as sweating or a racing heartbeat.

• Difficulty concentrating. Difficulty concentrating or making even simple decisions. Forgetting parts of your ordinary daily routine, like brushing your teeth, paying your bills, or preparing meals.

• Lowered self-esteem. This can occur when you’re feeling as though you’re not doing enough to help, not doing everything “perfectly,” or feeling helpless to do anything to truly relieve another’s suffering.

• Feeling less trusting of others and the world. When you are continually immersed in a crisis, you may start to feel cynical and jaded by what you’ve been experiencing firsthand.

• Withdrawing from others. Becoming emotionally distant and detached. Not wanting to talk about the event. Isolating from friends and family.

• Changes in appetite, sleep, or other habits. Not feeling hungry or forgetting to eat. Eating too much or more than is healthy. Lack of interest in sex. Sleeping too much. Having trouble falling asleep or staying asleep. Having nightmares related to the events you’ve been hearing about in graphic detail.

• Physical changes. Physical symptoms like headaches, stomachaches, dizziness, heart palpitations, or shortness of breath. Feeling shaky, panicky, or very tired. Flu- or cold-like symptoms.

• Depression. Feelings of sadness and grief. Feeling a loss of energy, or a loss of interest or pleasure in ordinary activities. Changes in appetite or weight. Having memory difficulties, frequent crying episodes, feelings of hopelessness, or suicidal thoughts. (If you are having suicidal thoughts, it is important to seek professional help immediately.)

Coping and finding help

If you are experiencing symptoms of compassion fatigue, it is important to seek help. If compassion fatigue progresses without treatment, it can result in an inability to perform appropriately as a clinician. You may feel or appear callous, insensitive, or burned-out, which can seriously interfere with your work performance as well as your personal relationships.

People who have experienced unresolved trauma in their own lives — especially those who have not resolved the trauma — are at particular risk for compassion fatigue. It is important to be aware that our own life histories affect how we respond to hearing the trauma stories of others. Be aware that there is help for the helper.


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As Darren travels the country speaking, he keys into issues affecting those in the emergency care field, specifically coroners. Death is part of living, and those who live need compassionate concern when they lose someone to death.

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Thank you to Anita Brooks for joining the show today. You can find her book, Getting Through What You Can’t Get Over in all major bookstores starting in April, 2015. Connect with her on Facebook, Twitter, YouTube, LinkedIn, or on her website,

Tags: coroner, compassion fatigue, getting through what you can’t get over, darren dake, anita brooks, PTSD, trauma victims, symptoms of compassion fatigue, who is at risk for compassion fatigue, burnout, emergency care field

About the Author
Darren is a 30 year veteran of law enforcement and criminal investigations. He currently serves as an investigator for the Crawford County Missouri coroner’s office. He holds credentials as an instructor for the Missouri Sheriff’s Training Academy, has served as president of the Missouri Medical Examiners and Coroners Association, and is certified and credentialed in numerous fields of investigation. He holds the position of lead instructor and facilitator for the Coroner Talk™ community as he speaks and writes in the area of death investigation and scene management.

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