Speaker: Ms Smriti Joshi is the chief clinical psychologist at WYSA, an AI-enabled coach platform for emotional wellness and positivity. Smriti is also a TEDx speaker and has worked in mental health for nearly 20 years.

Q1: Could you please briefly talk about what compassion fatigue is?

The work of helping which psychologists and other mental health professionals usually do requires professionals to open their hearts and minds to their clients and patients. Unfortunately, this process of empathy makes us vulnerable to being profoundly affected and even possibly damaged by the work we do. The helping field has gradually begun to recognize that workers are affected by the work we do, and it’s also been explained as the cost of caring for others and emotional pain. Compassion fatigue refers to the profound emotional and physical erosion when helpers cannot refuel and regenerate. Another term closely related to it is burnout, but burnout does not necessarily mean that our view of the world has been damaged or that we’ve lost our ability to feel compassion for others. It describes the physical and emotional exhaustion that workers experience when low job satisfaction and feel powerless and overwhelmed at work. For example, when I see too many clients or unsatisfied with the work atmosphere or not being paid well or having more work at home and leading to physical exhaustion, it could all lead to burnout. But when it’s seeing too many people coming in with trauma, constantly being exposed to stories of abuse or people in helpless situations, we cannot do much to change the environment for them. We are more vulnerable to experiencing compassion fatigue.

Q2: What are the symptoms of someone experiencing compassion fatigue?

We often may confuse symptoms of burnout with symptoms of compassion fatigue. It’s important to identify when it is compassion fatigue, and when it is like burnout, burnout could be adding to one’s compassion fatigue that’s important to remember.

Some other symptoms:

• Difficulty in concentrating.
• Intrusive, imaginary or thoughts about what a client may have described in their abusive experience or a violent experience, or from a disaster relief side can be a symptom.
• Feeling very discouraged about the world hopelessness.
• A lot of exhaustion and irritability.
• Low frustration tolerance to videos that can trigger strong emotional responses.
• High attrition people could leave their professions and move on to something else.
• Negative outcomes where people cannot leave boundaries may be crossed with clients. They may be seeing the therapeutic alliance going in a negative direction.

These are some signs of vicarious trauma or compassion fatigue.

Q3: It is said that mental health professionals are more likely to experience compassion fatigue because of the nature of their work. How can this be prevented or managed?

We keep hearing in the flight; put on your oxygen masks before you help the one sitting next to you. I think that indicates that we need to manage to own ourselves. Suppose you’re feeling depleted or exhausted from constantly being present for another person. If we go back to the signs and symptoms, developing a warning scale that indicates not being able to function well as a professional, not providing as much empathy and compassion as needed so that you can be aware of those differences. Maybe it could also come via feedback from one supervisor that your performance isn’t well, or client complaints that you’re not doing as well, or you’re not present as well as you were with me earlier. These are all warning signs. So, developing a warning scale for oneself could be on a scale of 1 to 10. 10 being the worst you have ever felt about your work/ compassion/ energy and 1 being the best that you’ve ever felt and then breaking it down into steps: what does 8 or 5 look like for me? At what point do I feel completely exhausted? Then identify strategies. How do I go back from 10 to 9 to 8? For example, if I’m feeling exhausted, I will take a day or two days off, won’t see any clients and focus on myself. Maybe talk to my therapist. If I don’t have one, then seek professional help. Please speak to a particular professional about one’s concerns.

Another thing that one can do regularly is journaling daily, particularly on a day where you’ve seen an abusive client or more than one client with trauma in a particular week. A Journal or maybe a professional or a friend with whom you’re venting things out if you find you’re stuck with a particular case but discuss it with peers or take it up with the supervisor. So those are important aspects to remember that you need to develop and maintain a very strong social support system at home and work. If you’ve had a difficult day at work, you come back home, and you have the support system that would be there for you, helping you relax and kind of have your own space and not be too overwhelmed with things at home. Regular self-care is not just limited to exercising or sleep, or hydration. All this includes doing something daily which makes you feel good or come back to yourself and realize, okay, this is the person I am! I identify with this person and can go back to my clinic and see my clients tomorrow. It is a slow process. If there have been years of fatigue building up and no help, it can take some time to heal. Allow yourself the time to heal because that’s the only way we can be present in a non-judgmental, compassionate way for our clients and ourselves.

Listen to the Podcast here