“I feel like therapists are expected to have an unlimited amount of compassion, and I’m not sure if that is really a reality.” These words came from a colleague in the field as we chatted during coffee. We both let the words hang in the air for a bit because we sensed the guilt, but truth that came with them. Being in the helping field means that most therapists (hopefully all) truly care for other humans. Our days are consumed with holding our client’s pains, sorrows, disappointments, and frustrations. So much so, that we sometimes ignore our own human needs in that moment like hunger, thirst, needing to go to the rest room, the need to daydream, or even fatigue. A full day of compassion can be difficult for many therapists, and many successful therapists practice 30 clinical hours a week for decades. Compassion fatigue becomes very real.
Compassion fatigue is often described as a loss of caring about clients, often to a degree of feeling irritated by their problems (Brown, 2017). A person-centered approach is often noted as the foundation for any therapeutic relationship. A person-centered approach includes having unconditional positive regard, empathy, and congruence for a client. Compassion fatigue and person-centered therapy simply cannot go together. In fact, most experts would agree that the therapeutic relationship is the most important indicator for the likelihood of success in treatment. The question becomes how can therapists continue to practice to earn a living while also making themselves susceptible to compassion fatigue?
One of the first ways to reduce compassion fatigue is varying your efforts. Think about what you can really withstand as a counselor? Are you able to do 8 60-minute session back to back? Most likely, no. Are you able to return home after a full day of sessions and return emails? Most likely not long term. This means that in order to truly be a good therapist, you need to get rid of the notion that you have to be a perfect therapist. You cannot do everything for your client. You likely need to put up a boundary of when you return emails. You might have to scale sessions from 60 minutes to 50 minutes. Most seasoned therapists naturally have “boundaried generosity” (Brown, 2017). This means that the therapist realizes in order to be effective they need to have boundaries that include how much they are willing to give emotionally. Consider the saying, “can someone really pour from an empty cup?” The same goes with therapists; helping professionals are no longer able to pour when they have nothing left for themselves. Boundaried generosity is not just a boundary of time, but also a boundary of compassion. The therapist allows themselves the emotional boundary of not taking the emotional load of their clients home with them. The therapist intentionally create a boundary between work and home. They also might give a B+ effort in the counseling room instead of an A+ effort. The client is cared for enough, and the therapist is able to maintain appropriate levels of empathy throughout the days, weeks, and years. Again, it is time that us therapists put away the notion that we need to be perfect for our clients. Instead, it is time to settle for good enough in order to truly be effective in the field.
Compassion fatigue and burnout are similar but different. While all humans are susceptible to burnout, only helping professionals experience compassion fatigue. Further, individuals in the helping profession who experience burnout are even more susceptible to compassion fatigue. Subsequently, by understanding the signs of burnout, a therapist can begin to create necessary changes to prevent compassion fatigue. Burnout is defined as a state of chronic stress which can lead to physical and emotional exhaustion. One of the best ways to prevent or treat burnout is daily self-care. Self-care can be as simple as time away from work, time spent with friends, or intentional daily exercise. Burnout is our mind and body telling us to take a break, and it is crucial to listen to this message.
Being in the helping profession takes a toll on everyone. Burnout and compassion fatigue are real. In fact, the statement of “I feel like therapists are expected to have an unlimited amount of compassion, and I’m not sure if that is really a reality” is absolutely true! Therapists are humans and humans have a limited amount of compassion. There are steps to take to prevent this. Listen to your needs, practice being good enough, set boundaries, including boundaried generosity, and practice daily self-care. It might be necessary to cancel a day’s worth of clients when burnout symptoms appear in order to truly be available for the client the following week. And never forget that in order to truly be a good therapist, you need to get rid of the notion that you have to be a perfect therapist.
Brown, S. (2017). Burnout... the high cost of caring? Burnout is an ever-present risk in the caring
professions. Sally Brown talks to counsellors about their experiences, and how to avoid
it. Therapy Today, 28(9), 8-11.
Running on Empty: Compassion Fatigue in Nurses and Non-Professional Caregivers.
(2017). ISNA Bulletin, 44(1), 10-14.
Written by Amy Rollo, M.A., LSSP, LPC-S
Amy Rollo is a Licensed Professional Counselor Supervisor and owner of Heights Family Counseling. Amy has been practicing counseling and diagnostic evaluations for fifteen years. She has doctoral level training in the areas of child and adolescent counseling, evaluations, marriage and family therapy, and adult counseling. Amy Rollo provides counseling and evaluation services in the Houston Heights and surrounding areas. Amy’s goal in counseling is to journey with her clients in order to foster positive changes and growth in their lives. Read more about Amy's counseling style by visiting www.heightsfamilycounseling.com and read more about her services.