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12.3.2 Recognizing Compassion Fatigue
Figley ( 1995 , 2002 ) developed a framework for characterizing compassion fatigue
symptoms. His model is useful for helping you recognize your own tendencies to
experience compassion fatigue. In this section, we describe eight categories of
symptoms and illustrate them with examples from genetic counselors who partici-
pated in research on compassion fatigue.
- General Symptoms: avoidance, hypervigilance, hyperarousal, and flashbacks
- Example:
"A patient was diagnosed with a neurologic condition of relatively quick onset and the
partner was struggling with both the diagnosis and the effects of the condition on everyday
responsibilities and the couple’s relationship. The partner contacted me repeatedly to dis-
cuss her frustrations and wasn’t comfortable talking with professionals to whom I referred
her. I found myself not answering my phone in case she was calling so that she would get
my voicemail. It was exhausting, though I really wanted to be sure that she was safe and that
she spoke with a professional" (Udipi 2007 , pp. 129–130).- Physical Symptoms: exhaustion, sluggishness, and lack of enthusiasm
- Example:
"I work in both cardiology and neurology clinics and work with support groups for both. I
find that in doing so I am starting to feel what I consider compassion fatigue in that every
one of the patients who come to the group wants to speak with me separately before or after
because I am so involved in their ongoing care, their families, etc. and when you constantly
have your empathy on, it gets exhausting!" (Udipi 2007 , pp. 143–144).- Emotional Symptoms: irritability, angry outbursts, and crying and sadness
- Example:
"I find myself having heightened irritability, and a quick temper - with occasional angry
outbursts - and I am immediately frustrated and angry with myself - because I do not want
to be like this. I also do wake up in the night and start thinking about cases/patients/situa-
tions that I am dealing with and what I could possibly do additionally, or should have done
to the point that I can’t sleep. This happens probably once a week at least" (Udipi 2007 ,
p. 134).- Cognitive Symptoms: quitting the profession, or moving to nonclinical work
- Example:
"We were seeing a patient in follow-up (another counselor had seen her for the initial
appointment) for twin to twin transfusion syndrome. Ultrasound revealed that both twins
were deceased, and I was the person who told the family. I relive this moment even now, 7
years later. From that point on, I was intensely sensitive to high stress situations of my
patients and my role in them. This was a main reason I stopped seeing patients" (Udipi
2007 , p. 132; Udipi et al. 2008 , p. 467).- Behavioral Symptoms: avoidance
- Examples:
"One of my patients recently died. He was 23 months old. A couple days later, a family
member [of mine] died. I decided to not attend the funeral because I didn’t want to think
about death anymore" (Udipi 2007 , p. 132).12 Genetic Counseling Dynamics: Transference, Countertransference