By Beth M. Vaccaro, MA LPC

Have you ever heard the story about the frog in boiling water? As the story goes, if you put a frog into a pot of boiling water, the frog will jump right out. But if you put that same frog into a pot of cool water and slowly elevate the temperature, the frog will boil without knowing what is happening. This metaphor is often used to illustrate problems or situations that are harmful but often overlooked until it is too late. Both caregiver burnout and compassion fatigue are conditions that can slowly result in this “boil.”

These days, many frogs are boiling. The last 18 months of the pandemic have been difficult for everyone. A great deal has been articulated about the ill effects of isolation, threat of illness, and lack of structure for those with mental illness. Less information and conversation are available about the ill effects on the parents, spouses, and caregivers who bear varying levels of responsibility in their loved ones’ lives. The pandemic has certainly exacerbated the already challenging effects caregivers may experience, including exhaustion, feeling trapped, and feeling alone in their journey with a family member who lives with a mental health condition. The result of all this can be the slow to steady boil of compassion fatigue or caregiver burnout. 

So, what exactly are compassion fatigue and caregiver burnout? 

Compassion fatigue and caregiver burnout are related, but they are not the same. Compassion fatigue is a state of being where the caregiver feels overwhelmed by empathizing and feeling compassion for the person they care for. It comes on quite suddenly and causes overwhelm and emotional shutting down. In comparison, caregiver burnout occurs more slowly, is more pervasive, and a more severe state of being. A caregiver can experience burnout as they become overwhelmed mentally, physically, and emotionally over time. If compassion fatigue is the cliff, caregiver burnout is the cavern below. 

There can be significant overlap of symptoms between the two. Both can present with emotional symptoms of anger, irritability, bottled-up feelings, sadness, apathy, anxiety, exhaustion, difficulty making decisions or concentrating, and depression. Behaviorally, one might isolate, have difficulty sleeping, have somatic complaints, and potentially use or abuse substances. 

However, caregiver burnout, in particular, can look like a loss of interest in things that usually bring joy, neglect of one’s needs and health, loss of control over life, emotional exhaustion, and a reduced sense of meaning in life. It is more pervasive than compassion fatigue and is of serious concern for both the caregiver and the person in their charge. 

What can I do to prevent compassion fatigue and caregiver burnout? 

Step 1: Recognize. Perhaps you see yourself in one of the descriptions above? Perhaps you are even in a pot of water that feels like it is getting very hot. The great news is that recognition of a bad situation is indeed the first step. One must first have an awareness of the problem before addressing it. Fortunately, there are great self-assessments that might clue you in to your compassion fatigue or caregiver burnout, such as the one found at ProQOL.org.

Step 2: Balance. Now that you have identified you may have compassion fatigue or are approaching caregiver burnout, the next step is to bring balance. So many caregivers are consumed with the tasks, worry, and care of their loved one that their life becomes dreadfully imbalanced. Ask yourself, “Am I eating, sleeping, exercising?” And who are you confiding in? Who is in your support network? Also ask, “When  was the last time I spent a moment thinking about myself?” and “What are my interests and passions?” 

Patricia Smith, founder of the Compassion Fatigue Awareness Project, said that each day we empty ourselves caring for others, we must fill up again. Fill up, empty out. That is the healthy cycle. If we as caregivers empty out ourselves through caregiving, we must fill back up each day. What fills you up? 

Step 3: Connect. Finally, maintaining connections is important. Have you considered joining a support group? Have you confided in a friend or loved one who can truly hold some emotional time and space for you to have your needs met? Can you connect with nature or a pet to bring some ease to your mind and body? Have you considered talking with a professional about your current state? These are all great options to bring more and deeper connections to your world. 

So, recognize, balance, and connect. If there are only these three steps, why is overcoming compassion fatigue and caregiver burnout so hard? Well, many of us have grown up with the idea that there is nothing more valiant than putting others’ needs before our own. Valuing every other person more than we value ourselves is often a tenet of someone in the caregiver role. Our perceptions and values must shift if we are to avoid compassion fatigue and caregiver burnout. Perhaps the biggest part of this shift is to grant ourselves the permission to simply be human. And as humans, we need to tend to ourselves and not only to the other humans around us. 

After all, a bubbling pot results in a boiled frog if he does not realize the hot water he is in. 

Interested in learning more about compassion fatigue? Join us during our 2021 Leadership Summit and attend the session: Preventing Caregiver Burnout and Compassion Fatigue

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Beth Vaccaro is a person trying to figure it out, just like you. She is a St. Louis native, attended Webster University, and earned a Master’s Degree in Counseling. She did her post-graduate training at Care and Counseling and the St. Louis Psychoanalytic Institute. Currently, she is in private practice as a therapist in Clayton. She sees adults and adolescents with a wide variety of issues and practices from a psychodynamic perspective.