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This week, we are very fortunate to have with us as a guest, Michele Grant. Michele is a very experienced trainer and coach, and she will be explaining more about vicarious trauma, burnout, and compassion fatigue, this builds on the overview I did in the podcast on February 17. Then Michele will go through three key things that you can think consider helping you to identify if you are experiencing compassion fatigue, and what you can do to become aware of it and to take positive action to manage it.

Michele specialises in supporting those who experience vicarious trauma, burnout, and compassion fatigue in different fields, not specifically for unpaid carers, although this is an area that she is currently collaborating with others on. Michele shares her huge knowledge in this field, as a coach, as a supervisor and trainer for 15 years and does a lot of training around mindfulness and resilience and wellbeing. This passion to support clients suffering from vicarious trauma, burnout, and compassion fatigue started following a long career in news, specifically with BBC News and working with journalists in the field, such as foreign correspondents who were increasingly coming back from their assignments, with signs of stress, vicarious stress and compassion fatigue, as they work covering stories that were deeply distressing, over and over again, and this was building up over many years. She then noticed that this was happening to people who were back in the UK, who were constantly looking through footage of distressing material, having to view the same footage over and over again, having to view testimony from victims.

From these experiences, she found that she could combine two very separate parts of my life, which was her news background and the work she was doing around resilience. That led her to take the skills and knowledge she had around wellbeing and resilience and apply them to the area of people’s traumatisation, burnout, compassion fatigue. Since then, she has worked with journalists with people, those working in the field of human rights law, with clients who are working in the community and those working with gangs, so many different walks of life. From all of this experience and knowledge from working with individuals dealing with situations that evoke high levels of emotions, she can relate these experiences to being an unpaid carer.


Michele started by describing the definitions of vicarious trauma, burnout, and compassion fatigue. The term vicarious stress is when you are exposed to the stress of others, by witnessing their distress you can absorb it and as a result, you can yourself then become potentially traumatised by it, so this vicarious stress can morph into vicarious trauma. The second term Michele used was ‘burnout’. This is a term that is often used, particularly at the moment, but in this context, if you think about burnout like when there is no fuel left in the tank of your car, there is nothing for it to run on. So, burnout is simply that the stress that you are under exceeds the resources that you have available to you. You have a set of resources, physical and emotional resources and when those resources are depleted, to the extent that the stress is greater than your ability to attend to the things that you need to attend to, that is when burnout occurs. Michele clarified that you can, of course, run low on gas and you can move in and out of that state in any given day and over time, but complete burnout is when there is nothing left, and it can’t be rekindled. So, thinking of it like a fire, if the embers are dying down, you can stoke it and get it going again. But when it is completely out, it’s out and you will have to build and start it over again.


The third one is compassion fatigue. Compassion fatigue is something that happens at the emotional level, where our empathy is exceeded by our sense of helplessness. Helplessness and empathy, these are the two things that if they are not in balance, or indeed, if the empathy that you feel in terms of the desire to care, is overwhelmed by a sense of burden, such as thinking, “I’m not good enough”, “I can’t fix this” “I feel helpless, I feel hopeless”, that is when you get into compassion fatigue. Of course, it can then turn into burnout, because compassion fatigue itself is a level of stress that is exceeding your resources. It is the emotional components of it that can particularly relate to unpaid carers, the potential for compassion fatigue is possibly greater than it is for other groups of people because unpaid carers have an even greater emotional investment in the first place. As well this emotional investment, there is also that unpaid carers set a really high standard for themselves that cannot be benchmarked against anything else.


I asked Michele is she could describe two or three ways that people might notice compassion fatigue in themselves, particularly as it might be something that is creeping upon them, and they might not notice on a day-to-day basis


Michele shared that the kinds of things that you want to be looking for are a sense of overwhelm and exhaustion, which seems way beyond your normal level of exhaustion.  A lot of people who are caring are likely to be tired a lot of the time, but it is noticing when you are getting to a level of exhaustion that is really right at the edge of your ability to cope. Another thing to look out for is ‘avoidance’, again this can be something that you notice though if you are a bit tired or feeling exhausted. However, it is when you notice thoughts such as, “am I actually avoiding something, or I am I avoiding the person that I’m caring for?”. Michele was not referring to the type of avoidance when you are not actually taking care of your loved one, but more as a kind of negative feeling, perhaps that you want to get away from the whole and that you don’t feel that you have a choice anymore. It can be a subtle feeling, but there is a distinction between feeling that you must remove yourself from a situation and just noticing a kind of ‘automated avoidant behaviour’, perhaps just not noticing the things around you so much. If it is the former, then you need to be present and make a decision to put yourself first, perhaps take a short break and go do something for youself, to ensure that you are attending to your own needs, as well as your loved ones.


Michele shared about experiencing impatience and irritability herself when a family member was suffering from dementia and these can also play a role in compassion fatigue. However, she also said that everyone has the right to be a bit irritated or impatient from time to time, it is just part of our nature as human beings and this is really important to remember. Michele felt that it was vital to stress this, that you are allowed to have the full range of human emotion, just because you are a carer or, you are doing human rights work, or, you are reporting from a famine,  does not mean that you are not allowed, as a human being, to have the full range of human emotion, to be sad, to be happy, to be irritated, to get angry, you are allowed all of it. Another key area Michele shared was if you start to notice cynicism or hopelessness. This might begin with ‘dialling down the caring’ (the emotion of caring, rather than the act) as this is a self-protective mechanism. She gave an example that if you are telling yourself “I don’t really care”, then it won’t hurt you so much, because you won’t be worried about that balance between empathy and helplessness, and you won’t be so upset because you don’t really care anyway. So, if you notice that you are dialling down the caring, or notice you are using gallows humour, which does have a small place, but if that is becoming a default cynicism, then that is something to watch out for.


Next, I asked Michele to share with us some thoughts about what you can do if you notice that you are dialling back your emotions?


Michele shared that drawing on her experience, three words to frame this, awareness, normalising and centring. In addition to self-care, which is an important element of minimising compassion fatigue, it was useful to consider these three words on a conceptual level and why they work. So, the first thing is to develop awareness: awareness of what is going on for you; what your emotions are and what your energy patterns are. Michele reflected that this last one was really important.  It isn’t simply understanding what your energy levels are like, such as knowing that at three o’clock in the afternoon your energy is low or first thing in the morning it is high. It is about planning your routines around the awareness of them. So, if you know that you are an early bird and your energy level is high in the mornings, then arranging to take on activities, such as important meetings or completing those tasks which require more patience in the morning. Then likewise, if you are energy levels are low in the afternoon, then planning fewer complex jobs, ones that don’t require high levels of concentration or patience.

 
The second one Michele discussed, was normalising. She stresses that this relates to what she mentioned earlier, about it being normal for you to experience the full range of human emotions. There is something about people who are in caring professions, sometimes they think they have to be superhuman or robots and that they don’t need to have the full range of human emotion. But Michele’s messages is `’Oh, yes, you do`’. Therefore, you need to normalise mild irritation, before that mild irritation, if you’re suppressing it, and you’re suppressing it, sooner or later, it is actually going to turn into anger or even into a kind of violent emotion. So, normalising the lower level, difficult emotions that you are having is really helpful. 


The third and last word is centring. Michele shared that what she means by centring is that, from time to time, and regularly, from time to time, it is important to put yourself at the centre of your world and at the centre of your experience. It is natural, for you to feel that the person that you are caring for is the centre of your world. But actually, that’s not true, you are the centre of your world and by centring yourself and allowing yourself to be at that core, you will become more resilient and therefore, that strength will radiate out from you. If you don’t regularly centre yourself, then you would be bouncing off the person you are caring for, like you are a pinball, in a pinball machine.  Using that analogy of a pinball losing its energy and getting slower and slower means that your ability to bounce decreases the more tired you become, the more frustrated you are, and that whole range of emotions that carers feel, will feel like a tsunami and be harder to deal with.


Michele finished with some sage advice. As they always say when you get on an aeroplane and the crew do the safety demonstration, always fit your own oxygen mask BEFORE trying to fit others and pretty much sums it up! Compassion fatigue is something that can and does affect unpaid and working carers. However, if you feel that this is something that you are experiencing, then Michele great insight and advice will help you to start taking the steps you need to rebalance your emotions. If this is something that you think you would like to explore further, then check out the previous podcast about compassion fatigue and I put some resources I shared on there in the resources section below as well.  I have also shared details about Michele’s practice and most importantly, if you feel that this might be negatively impacting your mental health, then please reach out to a professional coach or your GP. Don’t suffer in silence because there is help out there, you just need to acknowledge that perhaps you need a little bit of support and that is OK.


We really hope you enjoyed the interview with Michele. I took so much away from it and it has really turned the light on for me as to some of the intense feelings that I had been locking away and beginning to understand why I was doing that. As I unlock those feelings moving forward, I have got three key things that I can work on to help me. So, again we are very grateful to Michele for her time and for sharing all that experience with us.


So, I hope you can join us next time, where we will be exploring the emotions that go with being a long-distance carer. So, you are still caring for a loved one, but you perhaps may not be in the same town or village or even country as them.  Being a long-distance carer is another way the role can be different and can bring with it a whole set of different emotions. So, thank you again for reading this post, we really hope you can join us next time and remember what a special thing it is that you do.

About Michele

Michele’s website

Michele Grant is a Professional Certified Coach and Coach Supervisor specialising in personal resilience.  Alongside her coaching she is a leading practitioner of training in the field of Vicarious Stress, Trauma and Compassion Fatigue.   She regularly runs her course Looking After Yourself as a Witness to Distress and has been a contributor to The Aspen Institute’s work on Vicarious Trauma. 

Michele also works with the Open Book Project at Goldsmiths University which offers a flexible route into higher education for people with challenging circumstances, including unpaid carers. 

As a coach supervisor she is currently working with Project 5 which is supporting frontline NHS workers during the pandemic. 

Michele gained her Mindfulness-based Cognitive Therapy teacher certification from Oxford University Dept of Psychiatry and runs mindfulness-based course in resilience. She is also trained to teach Acceptance and Commitment Therapy (ACT), holds a Practitioner Certificate in Trauma Risk in Management and is a certified Mental Health First Aider.

Resources

Compassion Fatigue – When caregivers go beyond burnout

Compassion Fatigue

Mental Health America

UK NHS Mental Health Helplines

Health Direct – Australian Mental Health Helplines

Caregiver Stress

Caregiver Stress Syndrome

Seven Ways to Build Emotional Resilience – Chris Johnstone  (affiliate link)

7-11 Breathing Technique (audio)

7-11 Breathing Technique (written)

Chris Johnstone – Exercise 1 (worksheet)

Chris Johnstone – Exercise 2 (worksheet)

Self-compassion – Positive Psychology Today blog and Kristin Neff’s exercises

Kristin Neff – Definition of self-compassion

Kristin Neff – YouTube video explaining self-compassion

Kristin Neff’s Self-Compassion Exercises – Written

Kristin Neff’s 3 Self-Compassion Exercises – Audio

Loving Kindness Meditation (short audio)

Loving Kindness Meditation (written)

Understanding the Stress Response

Mind – Symptoms of Anxiety

The Short and Long-Term Effects of Anxiety on the Body

Compassion Fatigue Exercise

References

Description of meaning of Compassion Fatigue

Figley, C. R. (1995). Compassion fatigue: Toward a new understanding of the costs of caring. In B. H. Stamm (Ed.), Secondary traumatic stress: Self-care issues for clinicians, researchers, and educators (p. 3–28). The Sidran Press.

Joinson, C. (1992). Coping with compassion fatigue. Nursing.  22, 116-120

Music Composed by Michael Coltham – Black Lab Music

Black Lab Music