Compassion Fatigue: When Caring Hurts Too Much – Part Two

Brain Injury Blog 

Compassion Fatigue: When Caring Hurts Too Much

Part Two—Preventing and Healing Compassion Fatigue

by Janet Cromer, RN, MA, LMHC

In Part One of this post, I gave you some information about compassion fatigue. In Part Two, I’ll share some strategies to prevent or treat compassion fatigue. 

Preventing compassion fatigue

Prevention is the best strategy. At the heart of compassion resilience you’ll find intention, connection, and the ability to shift from a stress response to a more relaxed response. These skills won’t take away the problems you face, but they may help you to be a stronger and healthier caregiver.  

Care for your spirit

  1. Intentionality is a key ingredient in preventing compassion fatigue. That means that you can clearly say why you have become a caregiver, what this means to you, and what you hope to contribute and receive. It’s like your mission statement, and helps you recognize choices and not just be driven by the constant demands.
  2. Connect with others. Connect through a support group, faith tradition, spiritual practice, or social circle. Connecting with others can help you find or make meaning and build strength.
  3. Replenish your spirit. At least a few times a week, do what gives you energy and pleasure. Play with children or pets. Get out in nature. Spend time on a hobby. Let someone take care of you for awhile. 

Care for your mind

  1. Believe that you have the right to care for your body, mind, and spirit every day. Believe that every act of caregiving helps your loved one to heal or recover in some way.
  2. Talk to someone you trust. Share your feelings, thoughts, and worries with a friend or professional. Pick someone who can help you deal with uncertainty, reality test, plan what to do next, or just keep you company.
  3. Recognize and express the range of feelings you may be having. Some feelings may be new, confusing, or frightening in intensity. Find healthy outlets for anger, fear, and grief. Talk, write in a journal, cry, exercise, punch a pillow, or take one constructive step to solve a problem.
  4. Take control in healthy ways. Loss of control is an intense emotion. Learn to partner with the treatment team, clarify the parts of care you will be responsible for, and make a plan for self-care.
  5. Think constructive thoughts. Uncertainty can be hard to bear, and can lead to racing thoughts and wild worries. Try to focus on this moment, this hour, this day. Test out your fears by asking questions. Recognize every good decision your make, and every step forward your loved one makes, no matter how small.
  6. Make time to worry. Anxiety and worry can run wild, often without a solution. Try setting aside a certain amount of time each day to worry. Perhaps 15-30 mins to put your worries into words. Sit quietly and write your thoughts and feelings in a journal to share with a trusted person. When the worrying time is up, stand up and stretch.
  7. Control anxiety. Practice thought stopping as one technique to lower anxiety. When you notice a ruminating thought, say “STOP” out loud, and switch your attention to a small physical task. Learning to relax your mind and body will also help.
  8. Learn to set boundaries. Try to learn to be present with the sick or traumatized person without absorbing his/her pain or emotions. I know this is much easier said than done, but a therapist or counselor can help you learn how.
  9. Take frequent breaks. Start by leaving your loved one’s room for a few minutes, then thirty minutes, then an hour. Build in distraction and pleasure breaks with conversation, magazines, a video, taking a walk, sipping tea, watching sports on TV, and laughing. To survive long-term caregiving, you need and deserve respite breaks, both short and long. The self-care habits you build in the first weeks and months will serve you well later. 

Care for your body

  1. Learn to calm the stress response in your body and mind. This is called self-regulation. The goal is to be able to switch from a stress response to a more relaxed and focused way of being. Good techniques include deep/relaxed breathing, mindfulness meditation, muscle relaxation, yoga, focusing attention on one object for five minutes, stretching, or prayer. If you practice for 15 minutes twice a day, or as often as possible, you’ll be better able to relax in stressful situations.
  2. Pay attention to your personal stress signals and stop the stress response from building up. Take frequent breaks throughout the day to scan for tense muscles, breathe, and relax.
  3. Tend to the basics: Sleep as much as possible. Eat nutritious food. Exercise by walking, climbing stairs, working out with a DVD. Avoid over-using alcohol or medications. 

When prevention is not enough

In Part One of this post you will find a list of warning signals. If you have any of these signals, please seek professional help. Compassion fatigue is not a failure or weakness on your part. Rather, it is a normal response to an extreme situation. It also means that the treatment plan for the sick person needs to be evaluated and changed. On the brighter side, compassion fatigue can also offer you the opportunity to learn new stress resilience skills and grow in ways that matter to you. With good treatment and enough assistance, you can regain your compassion resilience and health.

April 5, 2012

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