Fatigue From Empathy: Wear And Tear Of Health Workers

Sometimes healthcare professionals fail to improve the person they are following, caring for or caring for. This generates a form of post-traumatic stress in them: empathy fatigue. A state that is the result of the constant energy expenditure generated by the therapeutic help they offer and the empathy they feel  towards their patients.

This attrition reflects the emotional state in which healthcare professionals may find themselves due to their exposure to the physical, psychological, social and spiritual suffering experienced by the people around them. Over time, they may even come to indirectly experience their aches and pains .

Empathy as a fuse for stress

When a person undergoes treatment almost every day, an emotional bond is inevitably created between the healthcare professional and the patient. Perhaps they do not manage to establish a personal relationship, but the simple fact of seeing each other daily and exchanging observations and hopes for improvement establishes a friendly and intimate relationship.

In these cases, knowing how to put yourself in someone else’s shoes is the right key. Understanding his needs and how he feels strengthens the bond created. However, empathy can also play a bad joke when it serves as a fuse for stress. In fact, it is the trigger of the symptom picture known as empathy fatigue.

Empathy increases the quality of care and medical intervention for patients but increases the vulnerability of the practitioner. The greater the empathy, the greater the risk of encountering this effect .

Fatigue from empathy: brain mechanisms

Empathy fatigue is a term coined in 1995 by Charles Figley, director of the Tulane University Institute of Traumatology (New Orleans). He noted that health care workers who worked with traumatized people over time indirectly experienced the effects of the trauma of the patients they cared for.

Although the origin of this term is relatively recent, the brain mechanisms that explain it characterize any era, are eternal and related to empathy and imitation behaviors. The amygdala, the orbitofrontal cortex and mirror neurons are in charge of this process that allows us to experience the same emotions as another person.

If these feelings conceal  deep pain and suffering, the empathic capacity is strengthened. And the empathy fatigue becomes more evident.

Fatigue from empathy: symptoms

Empathy fatigue is the result of a cumulative process.  As we have seen, it develops due to a state of emotional malaise prolonged by continuous and intense contact with patients. But what are the symptoms that can reveal empathy fatigue?

• Cognitive : memory problems, lack of attention and concentration, recurring negative thoughts or flashbacks.
• Emotional : Intense feelings of fear, sadness and anger, generalized despondency or loss of cheerfulness or happiness.
• Somatic : gastrointestinal disorders, nausea, headaches, hypertension, pain, muscle tension, chronic fatigue, difficulty in sleeping …

Even at work level, some signs can be identified, such as low motivation, feelings of misunderstanding, perception of poor professional ability or distancing from the team.

Fatigue from empathy and post-traumatic stress

As we see, empathy fatigue shares some characteristic symptoms of  PTSD.  But before explaining them, let’s see what PTSD is all about.

This disorder arises from a very stressful or traumatic event that presupposes an extreme physical threat or damage to the subject. The organism, therefore, generates a response in the form of stress, which is the result of its effort to adapt to the environment. It can happen at any age and appear after the facts.

Empathy fatigue appears suddenly and sharply  and there are many factors that cause a stressful effect on the health care worker. They are the constant exposure, the emotional involvement and the therapeutic relationship that he establishes with his patients.

3 shared symptom groups

Empathy fatigue shares a number of symptoms of its psychopathological picture with PTSD.

• Flashback : If the conflict is not resolved, the practitioner can relive or recall the traumatic experience in the form of  repetition or flashback.  In the case of healthcare professionals, it is a particularly delicate condition. Stress is not due to an excessive workload, but to an extreme emotional involvement with the patient who is caring for.

• Avoidance and psychic numbness:  The person makes efforts to avoid thoughts, emotions, people, places, tasks or situations that remind him of the traumatic event. On the other hand, it tends to abolish relevant aspects of the same and reduce its interest and involvement in activities that were previously rewarding. The person with empathy fatigue, like the one experiencing PTSD, experiences discomfort, irritability, confusion, and short temper. He physically and emotionally distances himself from his patients and the rest of the people ,  and this can have a negative impact on his closest circle.

• Hiperarousal (psychophysiological hyperactivation):  is the level of physiological activation. People with empathy fatigue have a permanent state of tension and alertness. In other words, they are altered, irritable, exalted and show extreme reactivity to any event.

How to manage empathy fatigue

Knowing about empathy fatigue makes us aware of the possible consequences of mismanagement of emotions by healthcare professionals when treating their patients. Some suggestions for dealing with this situation are:

• Spend time alone to see things from the right perspective and unplug.

• Identify your strengths and abilities to cope with the pain and suffering of others.
• Get enough sleep and good nutrition.
• Do specific exercises to relax  or various physical activity.
• Exchange views with colleagues.

As we see, the secondary effects of a highly emotional and painful situation or circumstance are tangible, even for professionals who know how to manage it. Taking care of ourselves is a priority we cannot  forget.  It is the basis for offering quality treatment and care to others.