“I just can’t feel bad for them anymore. I’m just tired of it.”
"I'm just done."
Maybe you've heard or even made similar statments recently. I've been hearing these kinds of comments from my collegues on the front lines a lot lately. At the core of their sentiments? We have clear preventative measures to effectively halt the progression of this pandemic, but a large proportion of our population refuses to get on board and the virus persists.
Whether you’re feeling angry, frustrated, exhausted or all the above, you’re not alone. Maybe you’re feeling guilty because these emotions run counter to how we’ve been trained. We’re expected to wear a coat of Teflon, not experience negative emotions about caring for patients.
That thinking is self-destructive and unrealistic. We’re humans and our training has not made us exempt from normal human reactions to extreme circumstances.
I’ve been a child and adolescent psychiatrist for 2 decades. Several years ago, I sat as a numb, compartmentalized version of myself listening to the story of sisters being sexually brutalized on video so their stepfather could sell the footage online. Psychological numbing and compartmentalization allowed me to get through the rest of my day caring for my other patients. Right on the heels of those emotional states were guilt about my self-perceived lack of connection to my patients.
I’m giving you permission right now to leave all your guilt and shame at the door. You’re allowed to be angry and frustrated. You’re allowed to be at the end of your rope. Your capacity to work for the greater good while at the same time caring for those who don’t hold the same commitment to our collective health and well-being has a limit.
If any of this rings true for you, then take some solace in the fact that this is a normal response to caring for others in incredibly difficult situations. And, you are not alone.
Sometimes called secondary trauma, compassion fatigue is a psychological and mental reaction to caring for traumatized or seriously ill individuals. Right now, health care workers are inundated with directly treating patients with COVID, treating patients for other medical conditions who also have COVID, or treating patients for other conditions under the constraints caused by COVID. On top of that, many continue minimizing or denying the impact of COVID or refusing preventative measures.
Compassion fatigue can present with:
· anger and irritability
· negative coping behaviors including alcohol and drug abuse
· reduced ability to feel sympathy and empathy
· diminished sense of enjoyment or satisfaction with work
· increased absenteeism
· impaired ability to make decisions and care for patients and/or clients
Compassion fatigue isn’t new. It presents in a variety of circumstances such as serious or chronic illness, acute injury, or situations of abuse or disaster.
Fortunately, there are ways that you can care for yourself if you’re experiencing symptoms of compassion fatigue. But first, any notions that your normal emotional reaction to difficult and traumatizing circumstances is wrong need to be dismissed. Emotions are normal signals telling you something important about your current circumstances. Don’t judge or ignore them. Attend to them.
As a child psychiatrist and physician coach I haven’t had to directly treat patients for COVID. However, my husband is an ER physician. Don’t think that I’m not frequently checking in with how he’s holding his own emotions and his mindset each time he leaves for a shift.
We still have jobs to do to the best of our ability and with integrity. Your most important job is in figuring out how you can do that while taking care of yourself.
If you’ve never thought too much about boundaries or are not great about maintaining them, now’s the time to start. Boundaries can be physical, temporal, emotional, or mental. They’re a key mechanism for protecting yourself from others’ needs, intrusions, demands. They clearly signal to others what you’re prepared to do or give in each situation. Boundaries also help you stay mentally and emotionally intact in demanding situations.
Remember, whatever difficult emotions you’re experiencing right now, you’re not alone. Lean into the supportive and caring relationships in your life. Seek greater connection with family, friends, and peers. Spend time with your people to decompress, relax, and have fun.
If it’s available to you, look for peer support from others with similar expereinces. Again, you’re not alone in this, so connect with others who are struggling with compassion fatigue and work through it together.
Professionals, such as a mental health professional or coach, are options if you’re struggling to manage your compassion fatigue on your own.
“Selfcare is not selfish!” I see this all over social media as more people are realizing that you aren’t any good to others if you’re not good to yourself. While boundaries and social support are types of selfcare, don’t forget sleep, exercise, well-balanced meals, and spiritual practices. Your resilience and endurance are optimized when you also prioritize your own wellness and stress management.
These are times of uncertainty, frustration, exhaustion, and the collective trauma is escalating. Show yourself love and care and give yourself what you need.