Compassion Fatigue, Exhaustion, Burn Out & Vicarious Trauma in Counselling Work

“Compassion Fatigue is a state experienced by those helping people or animals in distress; it is an extreme state of tension and preoccupation with the suffering of those being helped to the degree that it can create a secondary traumatic stress for the helper.” Dr. Charles Figley

Compassion Fatigue, exhaustion, burn out and vicarious trauma are conditions which actually affect more counsellors today than most of us are aware of. This is something that I quickly learnt during a particularly difficult time in my life which I really wanted to share to raise more awareness!

Last year I was involved in a car incident which changed my life. It created a tornado of confusion, pain and has led me on a journey that I am now still figuring out! I have no memory of the accident as I was knocked unconscious but the impact of the accident caused me to break two bones in my spine, to suffer a severe case of whiplash and to trap nerves and pull muscles throughout my body. Initially I decided to take 6 weeks away from client work and the pain was so severe that I had no choice but to stop. However my calling to get back to my client work and to continue to support clients through their journey was so strong that I chose to push through the pain and return to client work. I wasn’t very open with the people around me about the pain and the exhaustion I was experiencing at the time as I just wanted to overcome this and get back into my work, which I loved. I also felt quite vulnerable and did not want to talk about how I was experiencing life at the time. I can now see that I was judging myself and so felt that others would judge me too.

At the time, I was attending three weekly sessions of physiotherapy and I was struggling with chronic pain and deep exhaustion. I reduced the amount of clients that I was seeing and did not take on any more clients privately or within the agency in an effort to reduce my fatigue and pain levels.

I was exhausted and knackered but determined to keep doing my job.

What I didn’t realise at the time, was that I was slowly spiralling into a deeper fatigue that would effect me in a way that would change the way I work forever. What I didn’t realise at the time was that our bodies adapt to our pain levels and so although we feel like things may be improving, sometimes our bodies capacity to cope is strengthened but it uses so much more energy to be able to function at this new level. Our bodies fight or flight system is also triggered due to pain and the constant stress or pain that we experience is likened to Post Traumatic Stress Disorder. The body is constantly in fight or flight and is feeling vulnerable and therefore we are depleting out adrenal system and flooding our bodies with chemicals which are vital and useful in times of real danger, but not great as a daily coping ritual.

Adrenaline is produced by the adrenal glands after receiving a message from the brain that a stressful situation is happening and along with norepinephrine is responsible for the immediate reactions we feel when stressed. This increases our heart rate and provides us with a surge of energy to help us to react quickly so that we can make ourselves safe.

Cortisol is a steroid hormone which is released from the adrenal glands. When the Amygdala recognises a threat, it then sends a message to the hypothalamus, which releases CRH (the corticotropin-releasing hormone). CRH then sends a message to the pituitary gland to release ACTH (adrenocorticotropic hormone) and ACTH tells the adrenal glands to produce cortisol. When we are in constant fatigue and pain. Cortisol helps to maintain balance and blood pressure. It also helps to regulate our bodily functions regulating some body functions like immunity and digestion.

Norepinephrine is a hormone similar to adrenaline that is released from the adrenal glands and also from the brain and its main function is around arousal. It helps to move blood flow away from any areas that are not so important in the moment, like our organs, and toward more important areas at the time, like our muscles, so we can get away or fight. It has been said that depending on what has caused you stress or the amount of stress that you are experiencing, that it can take anything from 30 minutes to a few days to return to a normal state of relaxation. So when we are in pain, our bodies are continuously being triggered and we are constantly having to remain prepared for fight or flight. Just like if we were to touch hot fire or a burning pan. It is actually a fear signal and not a pain signal that is being sent from the body to the brain and back again.

Pain actually = FEAR

When you are under constant physical or emotional stress and your body is continuously releasing these chemicals then this can lead to chronic fatigue and adrenal fatigue. Your body tissue can store lactic acid and create chronic unexplained pains as well as leaving you feeling low in mood and unable to find any additional energy to support others in their time of need.

I started to notice that listening became very hard work. I noticed that I could easily dissociate from a session and found that although I loved my client work, that it was becoming hard work. I was feeling exhausted after only one client, when I was used to seeing five clients per day. I was working with clients who have experienced extreme trauma and what I started to notice was that listening to and holding clients trauma was creating additional pain, fatigue and anxiety within my own body. There was a direct trigger!

My body was craving sleep and time out. I had so many other things to worry about at the time which impacted on my decision making. If I stop what will happen to my business? What will happen to my clients? What will happen to my self-esteem? How will I cope financially? The questions were endless and I just did not know how to begin to decide how to move through this “stuckness”.

After exploring my feelings within supervision and speaking with agency managers and peers, I decided that my body was actually telling me that I had no choice! I had no choice but to stop and to heal! So I took the decision to close the doors on my full and thriving private practice as well as take time out from any work that I was doing within my agency. I stepped away from everything to rest and to heal!

I took time out and went back into counselling for work through my pain levels and the anxiety attacks that I was experiencing when in cars as a passenger or driving. I worked through how to listen to my body and what it needs. I spent hours every day focusing on wellness and creating I AM statements to boost health. I created time out to reconnect with yoga, to fill my inner well, to study EFT, to meditate, to sit in nature, to blob for no reason, to eat healthily, to sleep more, to watch films that make me cry and spent more time creating creatively for no reason. The impact of taking time out for me, was to experience a deeper connection with my work and what I love to do. So I decided to use my time wisely and I wrote a book, I developed courses, took additional training in online coaching and launched my new program to the world. I did this while experiencing healing and putting my health first!

What I learnt is that we can easily start to drift gently downward into a spiral of compassion fatigue, burnout, exhaustion and vicarious trauma. We often don’t realise what is happening until we have hit absolute inner drought and have lost the ability to give in any way shape or form.  Hitting that place of inner drought for me, was like hitting a brick wall and wanting to desperately reach people on the other side but not being able to even talk, reach up, wave or be seen in anyway. It is like being pulled to the ground and weighted so heavily that you feel like you can’t breathe and that the person you once were no longer exists!

What are the warning signs that you you may be gently floating down that spiral?

Signs and symptoms can include but are not limited to;

• Exhaustion
• Inability to listen or hear painful or traumatic material
• Headaches
• Low moods
• Irritability
• Sore muscles and body pains
• Skin rashes and disorders
• Dry mouth
• Nausea and stomach pains
• Painful periods
• Sore joints
• Sleep disturbance or wanting to sleep all the time
• Loss of intimacy or pleasure
• Emotional numbness
• Crying or weepiness
• Eye strain or blurriness
• Painful feet, legs or any part of your body that you associate with moving forward in life
• Loss of appetite
• Cravings
• Increased blood pressure
• Gallstones
• Stressed liver function
• Lower immunity from illness
• Colds and Flu (often only lasting a day)

The list is endless!

What I learned about myself as a person who “just gets on with it” is priceless! I learned that although I am a naturally caring and empathic person who genuinely wants to support others to achieve wellness in their lives, that…

…unless I have a well that is overflowing with self-nurture, self-compassion, self-care and self-soothing that I have nothing spare to share with others!

My daily routines are now set to enable me to create a well so full, that I can easily share with and support others on their journey back to wellness. Without my daily routines of self-care, the pain and fatigue that I experience could easily take precedent and create a deep inner drought!

One of the ways that I do this, is to meditate and incorporate daily creative healing & therapeutic visualisations into my routines! Taking time to meditate or to relax and visualise super health or vitality in the body can create a boost of happy chemicals which have the opposite effect within your body to operating at a constant low level of stress!

What your mind is focusing on your body is experiencing

So focusing on relaxation, wellness and healing helps to promote the body to rest, to fill with energy and to create a deepened space for peace. When you are in this state of being, you are creating abundance and health. Your ability to adapt in your work and your life is NINJA level and your creativity can flow much more easily!

I have spent many years developing a daily Mindfulness and meditation practice and I would love to show you how you can introduce these awesome creative practices into your work and self-care as a counsellor or therapist.