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A spike in “compassion erosion”

For over thirty years my primary specialty has been the prevention of secondary stress (the pressures experienced in reaching out to others.) During these three decades, I have experienced periods during which the situation has become more difficult for those in the healing and helping professions. For the past several years up to the present, I believe this has become the case again—with an even greater, far ranging initial negative impact, not only for professionals, but also for those whom they serve.

In some cases, the impact I have noted is quite dramatic. When getting ready to speak to military chaplains in Germany, many of whom returned recently from Iraq and Afghanistan, a colonel walked up to me and said: “Before you give your presentation on resilience, I want to give you a caution.” “What is it?” I asked. “There are a lot of ghosts in this room,” he said. “What do you mean by that?” I responded. After a pause, he said, “There’s nothing left inside them.”

Such cases are often termed “acute secondary stress.” This occurs when helpers and healers encounter trauma in others in such a dramatic way that their own sense of well-being is psychologically contaminated. As a result, they too can begin demonstrating the symptoms and signs of post-traumatic stress. Their dreams can be disturbed, their sense of security disrupted, and their overall outlook on the world dimmed.

However, during these times, I have found that a possibly even more disturbing pattern is one termed “chronic secondary stress,” or what has long been called “burnout.” Although this sounds less dangerous, and is certainly not as dramatic as its acute counterpart, I find it to be more worrisome because it is so insidious. Marshall McCluhan, a Canadian philosopher of communications, once said, “If the temperature of the bath rises one degree every ten minutes, how will the bather know when to scream?” In today’s society, I don’t believe we know when to scream or, in the parlance of what I would term “compassion erosion,” know the signs of when it is essential to strengthen or own a self-care program so we can continue to have the broad shoulders to bear others’ burdens as well as our own.

This is not only an American problem, it’s a worldwide one. After presenting a lecture on maintaining a healthy perspective to an audience in Johannesburg, South Africa, a social worker said that she had had enough and was going to leave the profession. When I asked her why, she said that she worked with women who were single parents, had been sexually abused, and were living on the edge of poverty. When she would go to court with them because of the rape they had experienced, they would need to take a day off from work; something they could ill afford. Yet, often the judge would just look at them and say, “Oh, I haven’t had time to look at the material. Schedule another time to come back.” She was clearly despondent and felt she wasn’t making an impact, despite her efforts to help the women that she served.

Rosco, a post-traumatic stress disorder companion animal, stands behind his owner Sgt. 1st Class Jason Syriac, a military police officer with the North Carolina National Guard’s Headquarters and Headquarters Company, 130th Maneuver Enhancement Brigade, at his unit’s armory in Charlotte, N.C., during formation, Jan. 11. Syriac, a two-time Iraq war veteran, said he hopes that by other soldiers meeting Rosco, the experience will help other service members understand the benefits of a companion animal for those with PTSD.  U.S. Army National Guard Photo by Staff Sgt. Mary Junell, 130th via dvids Flcikr.Maneuver Enhanced Brigade Public Affairs/Released. via Military Times.
Rosco, a post-traumatic stress disorder companion animal, stands behind his owner Sgt. 1st Class Jason Syriac, a military police officer with the North Carolina National Guard’s Headquarters and Headquarters Company, 130th Maneuver Enhancement Brigade, at his unit’s armory in Charlotte, N.C., during formation, Jan. 11. Syriac, a two-time Iraq war veteran, said he hopes that by other soldiers meeting Rosco, the experience will help other service members understand the benefits of a companion animal for those with PTSD. U.S. Army National Guard Photo by Staff Sgt. Mary Junell, 130th via dvids Flcikr.Maneuver Enhanced Brigade Public Affairs/Released. via Military Times.

Even when the individual is initially optimistic and energetic, staying the course can still be problematic. A professional caregiver for the Veteran’s Administration enthusiastically greeted one of the returning Vets when he came in for his initial appointment. He responded by saying, “Boy, you are full of great energy.” To which she smiled and replied, “You have served our Country well. Now, come on in and let us know what we can do for you.” Yet, in the past months she has had to deal with the unpleasant reports that seem to tar the whole VA. Few reports include reference to those workers who are doing good work and truly respect the deserving clients they serve.

The problem goes beyond these events of course. Everyone, not simply helping and healing professionals, are being bombarded with negative and, in some cases, tragic events either directly or indirectly: news of the horrible outcomes of wars in the Middle East, physicians being sued not for malpractice but mispractice (even though no one can be perfect 100% of the time), financial stress due to the unavailability of good paying positions, educators being hounded rather than supported by parents when their children are corrected or not given the grade they expect, clergy being treated with disdain even though they have done nothing inappropriate themselves, nurses being unappreciated for their role as representing the heart of health care… The list is endless and causes both a drain on one’s personal quality of life and an increase in compassion erosion (a decrease in the ability to reach out to others in need on a continued, natural basis).

So what is to be done? Well, to start, several essential steps must be taken by all of us—not just those among us who are in the helping and healing professions. One of these actions is to reframe any efforts at helping others in our circle of friends, family, and those whom we serve so that we focus on faithfulness (which is in our control) instead of success (which never totally is). In the case of the South African social worker, I emphasized to her that she was the only one present to the poor abused women whom she served and this, in and of itself, was of crucial importance and was definitely a positive support.

In addition to appreciating the power of presence, spending time on self-care is also important because one of the greatest gifts we can share with others is a sense of our own peace and a healthy perspective – but we can’t share what we don’t have. In a restaurant, workers are mandated to wash their hands after they go to the lavatory so they don’t contaminate the food of those they serve. In the hospital, the workers must also wash their hands before as well as after they use the bathroom to decrease the occurrence of cross contamination. The same is necessary psychologically for those of us who serve others—even if it is simply our families or co-workers. We must take the necessary steps to be resilient so when encountering negativity, we are not psychologically infected by their problems. Of what good can we be when this happens?

Finally, recognizing the importance of alone time (time spent in silence and solitude or simply being reflective and mindful when in a group) is essential. When I was up on Capitol Hill speaking to some Members of Congress and their Chiefs of Staff on the topic of resilience, I took away an important quote by a former Senator. When asked what he felt was one of the greatest dangers facing the Congress today he replied, “Not enough time to think.” We need some quiet time to be mindful or we will not make it.

We are all in a tough spot now as compassion erosion seems to be spiking for the present. Many of us feel even more than ever before that life is not good and we have little to share with others. However, taking a page from the posttraumatic growth (PTG) literature is essential: namely, some persons who experience severe stress or trauma have the possibility to experience even greater personal insight and depth in their lives that would not have been possible had the terrible events not happened in the first place. So, chronic and acute stress need not be the last word. They may even set the stage for a life of greater, not less, compassion and an appreciation of what and who is truly important to us. However, for this to happen, we need to recognize the danger and do something about it now.

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