Monday, July 12, 2010

Moving out of the red zone of compassion fatigue: getting feeling back in my toes

Last week I was at the drugstore with my ten year old son. I was paying for my things when an elderly man approached the counter. He appeared to be in his late eighties and had deep red bags under his eyes. He looked, in a word, absolutely terrible. With a shaking hand, he took a photo out of his pocket and showed it to us and to the women behind the cash. "This is my wife," he said. "She died two days ago, we were married for 58 years. She was the love of my life. Now I can't sleep and the doctor wants me to take these pills." We all fell silent for a minute and then I had a little chat with him. He told me his children all lived out of town, and that he was completely alone. When I left the store with my son in tow, I felt regret that I did not do more. My head was already buzzing with all the community resources I know about, how to link him with the right ones, how we should have taken him out for tea, etc. I was dying to case manage this man into getting support right on the spot but I also had to go home and cook dinner and take care of my family.

This is the constant challenge we face as helpers and caregivers. Pain and suffering is all around us. Where do you draw the line? Do you take every elderly widower out for tea? Do you help every harried-looking mom you meet in the doctor’s waiting room? Do you rescue every kitty you see? So what we do is we try our best to figure out boundaries. Sometimes we over-correct and we become like Fort Knox, not letting a single person inside our walls. Sometimes we go too far in the other direction and become ambulance-chasers, rescuing every stray dog and baking for every little old lady on our street.

In my workshops, I am always saying that we need to gain a better understanding of our own warning signs along the continuum of compassion fatigue. Using traffic lights as an analogy, the green zone is where you are when you are at your very best (I sometimes joke that you are only in the green zone when you've been a helper or caregiver for about two weeks or when you have just returned from a 5 month yoga retreat in Tahiti). The yellow zone is where most of us live most of the time. We have warning signs emerging but we often ignore them. The red zone is the danger zone. The extreme end of the red zone finds us on stress leave, clinically depressed or totally withdrawn from others and wracked with anxiety. As caregivers and helpers, we will all visit the less extreme end of the red zone several times in the course of our lives- it is a normal consequence of doing a good job.

But, back to my story: the reason I am telling you this little anecdote is that I would not have always had this warm compassionate reaction to the elderly man. In fact, my reaction is actually a sign for me that I am well out of the red zone of compassion fatigue (for the time being!). You see, there have been times where I have felt so depleted by all my caregiving demands that I would have hardened myself to this old man's story and not talked to him at all. Not nice, eh? Have you ever noticed that in yourself or am I the only hard crusty person out there? Conversely, for some of you, being in the red zone would mean you would have jumped into rescuing this man and neglected your own needs or your family for the evening.

Research shows that compassion fatigue hits hardest among those of us who are the most caring. As helpers, we have a homing device for need and pain in others and we have this from childhood onwards (for many reasons: family of origin issues, birth order, heredity, etc.) So, often, for helping professionals and caregivers the main challenge is setting limits and not being a helper/rescuer to everyone around.

Unchecked, compassion fatigue makes us detach from others: often our colleagues, family and friends experience our anger and irritability far before the people we are caring for. Although I am not proud of it, I know that I always seem to save the best for work and give the remaining crumbs to my loved ones. In my clinical work, I feel present, warm and loving towards my clients, even the most challenging soldier who has never wanted to come to counselling and hates being there. But when I am in the red zone I avoid my neighbours, ducking into my house as quickly as possible to avoid a chat, feeling slightly guilty and irritated at the same time. I avoid the phone: "why is my lovely dad calling me to say hi? grrr"

Each of us will have different warning signs. The key to developing an early intervention plan is getting better acquainted with your own. (If you want more resources on this, consider reading my Compassion Fatigue Workbook).

The fact that I feel ready to give again is a great sign of "green zonedom." Now the trick is keeping it in check and not overcorrecting and becoming depleted again. Keeping the balance, my friends, is a lifetime's work. I'm ok with that.


  1. Great information. I struggle with being on the receiving end of tremendous acts of compassion. I feel a longing to send this karma forward (so to speak). On the rare occasions that I am not covered up with the day to day demands of caring for my severely disabled 6 yr old and in a "green zone" I jump in and try to "make-up" for all the kind acts that people have done for our family. This results in a speedy return to the "red zone." I have to find a better balance and I love this framework of compassion fatigue.

  2. Great post and so, so important! I have definitely been in the red zone for too long now, which is a HUGE swing in the other direction for me. I am historically a volunteer, a stray dog foster, the one who befriends the new person, etc. I am none of these things the past year and I dislike that. Thanks for giving me some good food for thought.

  3. I really like your post. Always been very informational.