Compassion Fatigue is a Killer - Ask Me Anything.

Linda Sage MA, BA Ed(Hons)
May 7, 2018

The stress, strain, pressure and speed of life today makes everyone struggle to fit everything into 24hrs, so one of the first areas you drop is your self-care.  Whether you are an entrepreneur or a brain surgeon you are giving part of yourself to others on an hourly basis.  If you do not refuel, you will soon be running on empty.

Compassion fatigue is not just stress, anxiety or depression, it is all of them plus a huge element of self-corrosion,  shutting yourself off from others, feeling overwhelmed and unworthy.  Self-care diminishes and in the long run exhaustion and burnout.

Compassion Fatigue awareness is essential

My background is psychology, having my own mega burnout in 2005, I did not get any support and things are not much better all these years on, so my passion is to get people to care for themselves as much as they care for others. AMA!

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What themes do you cover in your book Caring for the Caregiver?
May 13, 3:40AM EDT1

Hi, my background is psychology, so it deals with getting caregivers to re-evaluate the way they think, belive and feel about themselves and their values, because they will always put their needs after somebody else.   Raising their personal self-worth to care for themselves as much as they care for others.

There are stories of my experience and that of clients as well, it is very proactive and practical.   This link to Amazon you can read a section of it

Hope this helps.



May 13, 3:49AM EDT0
What motivated you to write your books? Was it your own experiences?
May 13, 3:12AM EDT0

Hi, it took me a long time to write my books, I had been encouraged by many people over many years (decades) to make it happen.  I did not see me as a writer, more of a speaker, trainer and mentor.

I had written many articles for newspapers and blogs, but sharing ideas and facts.  This is a link to a very recent article published that covers a lot of my reasons why 

I hit rock bottom in 2005 with Compassion Fatigue and got no support, and unfortunately, I have found that there is little or no progress in all this time.

So raising awareness, understanding and prevention has become my passion.



May 13, 3:44AM EDT0
What action could healthcare institutions take against compassion fatigue in order to improve the health of their own professionals? What would be a good starting point?
May 12, 11:16PM EDT0

Hi Bruno,

Great question,  first there needs to be an acknowledgment by management and staff that there is an issue, sweeping this under the carpet is no solution.

Do/have an assessment of how reality is within the working area, very often this is easier to outsource, because a 3rd party is not involved and sees more than an internal appointee.  Or talk to/ask your staff, start with the hands-on staff from the cleaning/serving staff upwards, doing this way, you can see more easily where the communication barriers start and teamwork breaks down.  (This is sometimes difficult for internal staff to hear and for them to talk about to an internal person.)

Post information about Compassion Fatigue as an organisation lead by example, make sure people can get break, are now bullied into working extra shifts, doing duties that are beyond their pay grade.

Have a reporting system for "near misses" and reward this, there is often an atmosphere of fear/shame in reporting, but this will save much bigger problems later on.

There is a lot that can be done by small adjustments, please email and tell me where you are and the size of your institution as this can aid implementation as well.

Your first point is, start a culture of talking openly to the staff, but really listen and act on what they say.  

Looking forward to hearing from you.



May 13, 3:36AM EDT0
Are there any programs or trainings that could be helpful to people suffering from compassion fatigue?
May 12, 7:36PM EDT0

Hi, thanks for your question, there are some, please can you let me know where you are and I can best advise you.  My email is  or an easy starting point is my book easily available on Amazon anywhere (this link will take you directly)

Hoping to hear from you, to discuss this further.


May 13, 3:18AM EDT0
What exactly is compassion fatigue? What are some common signs and symptoms?
May 7, 2:39PM EDT0

Compassion Fatigue is also known as Vicarious Traumatization, or Secondary Stress Trauma, it has been identified for over 35 years within the caregiving industry, but still ignored a lot.

There are many signs and symptoms a clearer detailed outline is on my website

It has many forms and is always aligned to caregiving in one form or another and the carer ends up running on empty giving of themselves to others and not taking the time to recharge themselves.



May 8, 1:49PM EDT0

Thanks for your great information, Linda! I work in education and often serve students with complex needs, and have seen some of these same symptoms you describe in our staff. Do you have tips for a supervisor? How can I help teachers and staff value and recognize the positive impact they are having, even when the student continues to have significant issues, and to treat themselves with compassion? 

May 7, 12:43PM EDT0

HI Ruth, thank you for your contact, I have been tied into education for many years and worked with many SEN, SpLD learners, as well as my daughter with numerous diagnosis.  

Being aware  is the first step, noticing changes in staff members, being more isolated, taking their lunch/.breaks away from the staff room or colleagues.  Being more tired (than usual) not caring for their appearance, they make more mistakes than usual, get annoyed/frustrated and even argumentative with people around them.  Become more desensitized to others, small issues become big problems.  If you have designated people looking for signs, you see them a lot sooner, because this happens over time.

Giving time to talk freely, openly without fear of reprisals, share ideas for support and what people are interested, time is more valuable than money.  Giving rewards for highlighting issues and being proactive in finding solutions.

I do a lot of workshops for educators to balance their time, they are under great demands and always working to deadlines and budgets. Often a very effective way of helping staff is by bringing in a holistic therapist in a lunchtime/after school, for Reike/Indian Head Massage things that can take 30 mins and they do not have to get undressed for.  If they can unwind, sleep better, they are more motivated and productive.

Focus on the achievements of students (not trying to teach you to suck eggs) but maybe on thre social/emotional achievements, kids are used to being judged on academic outcomes, but when it comes to EQ they have little understanding.

I am sorry Ruth,  I have gone on a bit, but there are many areas of support for educationalist and their great work.  If you would like to discuss this any more please email me at 



May 8, 1:43PM EDT0
How do you manage to empower the others around you without losing a sense of power within yourself?
May 7, 7:17AM EDT0

Hi Paola, I am not sure exactly what you mean by this, because it has the opposite effect, when you see the arr haa moments, the progress and achievements of others it is really empowering, it is not draining at all.

However, I do keep up my own sessions with my mentor, as I have said in a previous post, investing in a mentor is the fastest way to grow and achieve your own goals.

If it is a different way you are looking at this question, let me know.



May 7, 8:47AM EDT0
Are there any unique challenges that doctors and nursing care workers face that contribute to their experience of CF?
May 7, 6:17AM EDT0

The unique factor of Compassion Fatigue is dealing with trauma on a regular basis. Stress, anxiety and depression have their roots in many causes and they are all part of Compassion Fatigue.



May 7, 6:49AM EDT0
What can healthcare professionals do to managing the impact of compassion fatigue in their lives?
May 6, 11:02PM EDT0

I am glad you asked about the healthcare professional, as it is not just an institutional responsibility, it is an individual as well.  Learning to say "no" is a lot of training I do, keeping your promises to yourself are as important as those you keep to others.

Many healthcare professionals compromise not only their own wellbeing, but that of their nearest and dearest and the relationships with them.

I have said previously about putting in your diary MeX,  Me time for doing XXXXXXX (whatever it is that you enjoy).  All healthcare professionals know about healthy eating choices, the importance of water, regular exercise and a good sleep regime, but we are usually the first to compromise it all.

Individuals do not need to make huge changes all at once, but small ones done on a regular basis will make a huge difference over time.

I personally find having a mentor is my best investment in me, somebody who keeps me on track and is there when I need to offload or get another perspective on things.  



May 7, 4:08AM EDT0
How does the current healthcare environment contribute to burnout in general and compassion fatigue in particular?
May 6, 8:35PM EDT0

In many places, the training of practical resilience is overlooked,  graduate nursing/caregiving staff cannot be taught the effects in a classroom.  No matter how many gruesome slides or pictures, individuals do not know or understand how they will react to dealing with trauma in a regular basis until they are hands on. 

There is a huge amount of bullying in the workplace, to cover extra hours, to do procedures/jobs people are not qualified for, plus there are generations now who are full time carers professionally and still have elderly parents and children at home.  So, never seem to get out of the caring role.

Before medical practitioners, in general, would get their tea breaks to chat (which normally meant offload) this has virtually disappeared, and in-situ supervision is very limited, usually only when a crisis situation has arisen.

There is little or no, prevention support, which would alleviate many of the bigger problems, before they became big.



May 7, 3:59AM EDT0
How does compassion fatigue develop?
May 6, 7:26PM EDT0

It develops over time, like a dripping tap, this is one of the main reasons people are not aware how bad they are feeling, until they start to feel better.

Caring less about your own appearance, making excuses socially (even to people you like) not to go/join in, get more emotional (crying/angry) at smaller incidents,  have more rows than usual, making more errors than usual, having issues sleeping and waking up feeling like you have not slept.

Symptoms are physical, emotional and psychological, add them together and you see a clear pattern emerge of Compassion Fatigue.



May 7, 3:50AM EDT0
Why do you say that compassion Fatigue is a Killer?
May 6, 1:47PM EDT0

The effects of Compassion Fatigue along with the anxiety and depression is isolation, a huge feeling of not being able to make a difference and overwhelmed.  This often leads to alcohol, self-medication (especially for those who professionally have access to prescriptions/medications).

If you Google highest professions suicide rates, 7 out of 10 are within the caregiving professions.



May 7, 3:44AM EDT0
Do you think that compassion fatigue is becoming more prevalent or getting worse?
May 6, 1:19PM EDT0

Hi Allison, Compassion Fatigue has been identified for over 35 years, but I do not think it has ever been given its due attention.  In Australia and New Zealand it is acknowledged as an official syndrome, but the rest of the world has to catch up.

There is no doubt that demand and stress in life in general has increased, but this is now a global issue, every country I have worked in has the same issues.  I particularly looked at medical and educational career paths, as they are my backgrounds, but since starting this awareness campaign many other professions have contacted me to say they also identify with it, such as prison officers, and religious leaders.

From a small niche that I had experience in, it has expanded considerably.

What do you think?



May 6, 1:34PM EDT0
Where can people learn more about compassion fatigue? Do you offer some kind of consultations on the subject?
May 6, 12:59PM EDT0

Hi Phillip, unfortunately, Compassion Fatigue is not given enough priority, as it is often misdiagnosed as stress, depression or anxiety.  My website does have a lot of information.

Yes, I do offer consultations, training and personal mentoring.  Let me know where you are and we can discuss the possibilities.



May 6, 1:26PM EDT0
What are a few concrete, everyday ways for shelter staff and management to incorporate and support self-care in their workplace?
May 6, 12:17PM EDT0

Reinforce the positive points of reporting, reward open discussions.  A lot of staff are scared to talk to management because of reprisals, sanctions or financial loss.  Management should be supporting all "near misses," all "small niggles;"  because if you can catch them at this point, you can eliminate a lot of in-house bad feeling, hostile teams and absenteeism.

Hope this is a pointer for you.



May 6, 1:22PM EDT0
How did you recover from your burnout in 2005 and what did you learn about yourself through the process?
May 6, 11:30AM EDT0

I recovered slowly, because although I had my profession burnout, my private life was still receiving major blows until 2009.  I hid myself away and started working on myself.

I had gained a huge amount of weight, I was living in denial and my daughter took a photo of me in our new house in Spain, not only did she take the picture without me knowing about it, she posted it on Facebook.  She was thrilled with me being by the pool, I was fuming.  I stayed angry with her for 10 days, before the penny dropped I was angry with me. I had turned into a whale and not seen it!

It has been a long climb back and I am still learning and challenging myself to new adventures, now they are exciting not scary.  I listen to people, I open up and share my experiences more and realize the importance of enjoyment, laughter and friendship.

Hope this gives you some insights to my ongoing journey.  Oh, writing the book certainly helped as well.



May 6, 1:16PM EDT0
Is there anything a person can do on a day-to-day basis to combat burnout?
May 6, 11:07AM EDT0

Yes, there are lots of things.  Start by monitoring your self-talk, stop berating yourself and start praising.  If you spoke to a friend like you speak to yourself, do you think you would be friends for long?

Write in your diary/journal etc MeX - that means time for Me doing X, write it in like an appointment, then keep to it like an appointment.

Small steps make a big difference.



May 6, 1:07PM EDT0
What sparked your interest in psychology and how is it helping you to better understand and deal with burnout?
May 6, 10:12AM EDT0

My background is psychology I have a degree and Masters in Criminal Psychology

I have worked in many areas from prisons to corporate, but I have seen the effects of Compassion Fatigue in many countries and it is all too often misdiagnosed, so raising awareness, understanding and prevention have become my passion.

Caregivers are leaving fields of specialism in droves, and the demand for them is increasing, so we need to make some changes.

I have been through a huge burnout, had no support, was  caring for elderly parents, a child with SpLD, moved countries, dealt with divorce, and spouse death.   

I understand personally and professional Compassion Fatigue with all its traits  and am here to help others.



May 6, 1:03PM EDT0
How do you approach compassion fatigue and burnout in your clients?
May 6, 1:58AM EDT0

The first step is always looking at a balance wheel, because most caregivers, do not see how unbalanced their lives are and how far down the balance they put themselves.



May 6, 12:55PM EDT0
If someone is feeling depressed or having suicidal thoughts, what should one do?
May 5, 8:45PM EDT0

Marija thank you for your message, most important talk to somebody, if you do not have anyone close to you, find a helpline,  and one reason why to get up in the morning, that takes you through.  

Marija I am assuming you are not in the UK, so please see what support your country has.

I have been in that place, and I have lost a partner to suicide.  Both are not easy to deal with, but time does make you grateful to just keep taking that one step forward.

Hope you will see some light at the end of the tunnel, one step at a time.  Open up and talk, it will be painful and you will cry a lot, but it releases the internal pressure.   Thinking of you.  Linda 

May 6, 12:54PM EDT0
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