Working in the healing professions involves engaging with suffering. There is an art to showing compassion without cheapening it into pity or being sucked into the pain we witness. Those of us in the healing professions face a tricky balancing act – trying to uphold high professional standards and expectations while dealing with bureaucracy and managing our personal lives. But regardless of how passionate we are about our jobs, we are all only human and we have our limits. Reaching those limits does not mean we have forsaken our calling; rather, it can be an invitation for personal growth and for changing our relationship with our calling.
Three psychological signs that a person has reached their limit are: burnout, compassion fatigue and vicarious trauma. The three are often lumped together but it is important to understand their differences in order to come up with meaningful solutions. It is equally important to honor whatever words people use to describe their experiences, even if they don’t neatly fit any of these labels.
Vicarious trauma is one way in which our thoughts might respond to witnessing trauma. An example of this is being bogged down by existential questions such as, “What is the meaning of life if there is suffering? Why do good people have bad things happen to them?” While there is no problem with posing existential questions, there is a difference between being able to use your curiosity about them to grow versus having difficulty in staying focused and hopeful because of them.
Compassion fatigue, also known by its more stigmatized name of secondary trauma, is another possible response to witnessing trauma. The difference is that this response goes deeper than just the realm of thoughts. It is felt physically and almost mimics the symptoms of post-traumatic stress disorder (PTSD).
Unlike the previous two psychological responses, burnout is a response to chronically unmanaged work-related stress and is not specifically related to trauma. It can occur in all jobs. Some of its signs may overlap with compassion fatigue but it tends to appear gradually over time rather than suddenly.
Not everyone who deals with stress or helps heal people will have these responses. But the risks, which could harm both the worker’s mental health and the people they serve, are real, so we need to be proactive as individuals and organizations. Stigma is a barrier to proactivity. Societal expectations of what it means to be a “professional” or an “expert” do not allow room for vulnerability. We are expected to “market” ourselves. It is often claimed that if we are truly passionate about our jobs then we will never get bored of them. Employees may fear losing their jobs if they admit to having feelings of ambivalence or doubt, especially if they work in a competitive office culture and if they don’t have a trusting relationship with their employers.
Here are examples of what we can do to prevent burnout, compassion fatigue or vicarious trauma. But they won’t be effective without supportive employers and networks who won’t make us feel ashamed of our feelings.
- Create a self-care routine, even if it involves only five minutes a day.
- Establish a ritual of self-reflection through keeping a journal, taking part in creative arts, voice recording your reflections or meditating. Whatever method you choose, what is important is that you are neither avoiding difficult emotions nor are you dwelling on them; instead, you are using them as an opportunity to learn more about yourself and how you can grow.
- Seek psychotherapy to work through your feelings out loud.
- Find peers who would be open to meet on a regular basis to reflect on difficult feelings related to work. Talk to your employers about the importance of establishing team meetings in which these conversations can be normalized.
- Establish firm boundaries such as allocating certain times of the day during which you will not check work-related emails or messages.
- Limit the time you spend talking about work during social gatherings.
If you come to the conclusion that have, in fact, reached your limit, you might reassess your the caseload and the roles your job entails or take a holiday to focus on self-care or consider taking a different direction in your career. And if you choose the last option, consider the skills you have learned which you can take with you as you embark on a new career path.
Reema Baniabbasi is an Emirati US-trained counseling psychologist at The Psychiatry & Therapy Centre in Dubai Healthcare City. She is also a monthly columnist at Sail E-Magazine and an emerging poet with English works published in Proverse Hongkong, Art Ascent, and Snapdragon.