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Massage Today
June, 2011, Vol. 11, Issue 06

Caring too Much

By Ann Catlin, LMT, NCTMB, OTR

Years ago, while sitting in a restaurant with a colleague, I learned something about myself. We each worked as massage therapists in eldercare facilities and it was really nice to talk to someone who "got it." Our conversation took an unexpected turn.

We candidly admitted seemingly unhealthy responses to our work — and they were quite similar: distancing more than we thought we should and feeling irritated with other caregivers. There was one thing that stands out. We each were avoiding our work by putting off seeing clients and rushing through sessions. This caught our attention because we both love our work. So, why were we avoiding it? It just didn't make sense. We had a good laugh at ourselves, got some relief and I'm grateful for it even years later (thanks, Jeff).

I now realize that we might each have experienced compassion fatigue. As it turns out, we aren't alone. Anyone in a "helping profession" is vulnerable. Nurses, doctors, counselors, veterinarians, social workers, chaplains, emergency response workers and people caring for aging parents can also experience this. Massage therapists are on the list, too. I think those of us who specialize in working with frail elders and people living with terminal illness are especially vulnerable. Choosing to serve this special population means we are sensitive people to begin with — not a bad quality to have, but maybe it means we need to check in with ourselves from time to time to avoid the toll of compassion fatigue.

old lady - Copyright – Stock Photo / Register Mark Compassion fatigue is a relatively new term. Dr. Charles Figley, an expert on the subject, describes it as, "a state experienced by those helping people in distress; it is an extreme state of tension and preoccupation with the suffering of those being helped to the degree that it is traumatizing for the helper." He goes on to say that, "the capacity for compassion and empathy seems to be at the core of our ability to do the work and at the core of our ability to be wounded by the work."

Compassion fatigue results from the cumulative impact of taking care of people living with serious illness, trauma, abuse or severe conditions. It's different than job burnout, which is dissatisfaction with our employment situation, not necessarily the work itself.

Wanting Others To Be Happy

Compassion is our feelings and thoughts when we witness the suffering of another and the unconditional desire to alleviate that suffering. The Dalai Lama describes compassion as the "wish for another being to be free from suffering and wanting them to be happy." He also tells us that sometimes we confuse compassion with attachment, which is our own personal investment in the outcome of the situation. In other words, when we think we are feeling compassion, we actually are wrapped up in our own emotional needs rather than simply being open to the needs of the other person. Perhaps it's attachment that leads to compassion fatigue, not compassion itself. In my experience, when I truly feel compassion, I'm uplifted and it does my heart good. I feel love.

A perfect illustration of this happened just yesterday to a massage therapist named Jane in a workshop taking place in a long-term care facility. When Jane walked into the elder's room, she was stunned when she took in what she saw — an extremely thin, emaciated woman with severe bruising and discoloration on her arms and legs sitting in her wheelchair, alone. Jane described her first reaction as fear, which turned to sadness for this woman's condition and knowing that she really couldn't do anything to change it. But she conjured up the courage to stay present and focused her attention on this woman rather than the outer condition. The fear softened. She gently massaged the woman's shoulders and neck and she told Jane, "that feels good." Jane shared that following the session, instead of fear she felt good knowing she had made a difference by connecting with this woman. She was able to drop the attachment to the fear and sadness which allowed her to be present and both she and the elder were uplifted in the process.

Knowing the Signs

How can you recognize compassionate fatigue? Some of the symptoms might seem like "normal" stress responses and you might associate them with your work. After all, we live in a pretty stressful world these days. Some characteristics of compassion fatigue include:

  • Withdrawing from others.
  • Difficulty connecting with clients or detaching.
  • Feeling angry that other caregivers don't understand the nature of your service.
  • Life feels too serious.
  • Turning to compulsive or addictive behaviors such as overeating, overspending, alcohol, smoking, etc.
  • Physical symptoms: headaches, gastrointestinal symptoms, muscle tension.
  • Fatigue and apathy.
  • Difficulty concentrating.
  • Avoiding clients. Calling in sick or postponing appointments.
  • Thinking that this work isn't for you (when you know in your heart you really love it).

Recognizing our vulnerability to these symptoms is important. How can we avoid this reaction or ease them when they happen? The answer lies in holistic self-care. Advice about self care typically includes physical support like regular exercise, getting enough sleep and good nutrition. However, we shouldn't stop there. Nancy Jo Bush, an oncology nurse, says that holistic self-care also includes setting empathetic boundaries; self awareness and self forgiveness; being in tune with one's spirituality and finding hope. The experts agree that reaching out to others and developing a support system is critical. Who would you turn to if you needed the support of an understanding friend? I personally like the advice from a practitioner working in hospice who says, "lighten up and don't forget to laugh."

That reminds me of an old Joni Mitchell lyric, "laughing and crying, you know it's the same release." Thanks, Joni. We'll all try to remember that!

Click here for previous articles by Ann Catlin, LMT, NCTMB, OTR.


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