How Caregivers Can Battle ‘Empathy Fatigue’ and Regain Their Compassion

By Erica Harrison for Seasons.

The guilt and confusion are overwhelming.

You desperately want to feel compassion and empathy—and you know you do care, deeply, for your loved one.

But sometimes, it feels like you’d need a backhoe to excavate that empathy and compassion from where it’s buried amidst the stress of caregiving.

You aren’t alone. This scenario is common with caregivers—so common that it’s earned a dedicated clinical term: “empathy fatigue.”

What is empathy fatigue?

Empathy fatigue is the hopelessness and numbness you feel in the wake of repeated exposure to the stress and trauma of caregiving. It’s the inability – or, at minimum, the struggle – to care or show concern.

Research shows that the deep psychological response unique to family caregiving makes caregivers more susceptible to empathy fatigue than traditional health care workers. After all, health care workers don’t have the same deep emotional ties to your loved one as you do.

Symptoms of empathy fatigue

Empathy fatigue is a neurological defense mechanism. Witnessing your loved one suffer activates the empathy area of your brain, the same part of the brain activated when you feel physical pain.

Over time, the stress of caregiving chronically activates this area of the brain. Because the empathy area of the brain is intrinsically connected to the brain’s pain center, these ongoing feelings of empathy begin to smother your innate ability to cope.

As a result, the empathy part of the brain becomes increasingly underactive in a protective effort to shield you from the damaging effects of chronic emotional stress. When this happens, empathy fatigue occurs.

You shut down.

Empathy fatigue can manifest in both emotional and physical ways, which then negatively affect both social functioning and work performance.

Emotional symptoms can include:

• Social isolation and inability to relate to others
• Feeling numb and exhibiting self-blame
• Lack of energy, feeling overwhelmed, powerless or hopeless
• Feeling angry, sad or depressed
• Obsessive thoughts about the suffering of others

Physical symptoms can include:

• Inability to concentrate, be productive or complete daily tasks
• Headaches, nausea or upset stomach, changes in appetite
• Difficulty sleeping, racing thoughts and constant exhaustion
• Self-medicating with drugs or alcohol
• Conflicts in your relationships and avoiding work or other activities

How compassion can protect you from empathy fatigue

Being a family caregiver doesn’t necessarily mean you’ll develop empathy fatigue. After all, humans are social creatures—we can’t just “turn off” our empathy.

So, what can we do when our empathy starts to become harmful? The answer is compassion.

• Empathy = ability to take the perspective of another person + feel the emotions of another person.
• Compassion = ability to take the perspective of another person + feel the emotions of another person + the desire to help.

But how can you instigate the “desire to help” once you have empathy fatigue and you don’t necessarily feel the desire to help?

Recent research shows that activating the “compassion” brain region in tandem with the “empathy” brain region helps to prevent and ease empathy fatigue.

Why compassion matters

Compassion is the neurological antidote to the slow drip of poison stemming from the neurological stress of witnessing the suffering of your loved one, day in and day out. Remember, your brain cannot decipher empathy from physical pain. Empathy hurts, literally.

The great news is that compassion is something you can develop at any point in life using a simple meditation called the loving-kindness meditation.

The loving-kindness meditation builds compassion

The loving-kindness meditation (sometimes referred to as metta meditation) is a guided meditation where you wish yourself and others to be happy, content and at ease.

Public health expert and preventive medicine physician Dr. Rashmi Bismark, MD, MPH, studies how complementary and alternative healing modalities promote health, primarily through improving risk factors and outcomes related to chronic diseases.

She explained that the guided imagery included in the loving-kindness meditation strengthens your capacity for self-love and self-compassion and heightens your compassion for others.

What to expect when you practice the loving-kindness meditation

The loving-kindness meditation is a guided meditation, making it particularly accessible to new and inexperienced medication practitioners alike; guided meditation allows the guide to do the heavy (mental) lifting of the meditation. You just sit and listen, releasing your imagination from the restraints of “adulting.”

To start, find a comfortable position, either sitting or lying down. After spending a few moments focusing on your breathing, your meditation guide will initiate the first phase of the meditation, which is for you to receive loving-kindness. (Remember, you need to build a protective compassion shield before you can safely feel empathy for others.)

During this initial phase, you will mentally repeat the following phrases:

May I be happy.

May I be well.

May I be safe.

May I be peaceful and at ease.

In the next stage of the meditation, you direct love and compassion to a friend or someone in your life who has deeply cared for you, slowly repeating phrases of loving-kindness toward them:

May you be happy.

May you be well.

May you be safe.

May you be peaceful and at ease.

The meditation continues to expand your circle of well-wishing, gradually extending these wishes to increasingly “unlikeable” others (from yourself to a friend to a complete stranger to someone difficult in your life and finally to all living beings).

Where to find a loving-kindness meditation

Loving-kindness meditations can likely be found in yoga in meditation studios in your local area. There is also a plethora of online resources offering excellent guided loving-kindness meditation practices.

Videos

• Loving Kindness Meditation by Emma Seppala, PhD, author of “The Happiness Track”
• Loving kindness with Sharon Salzberg
• Jon Kabatt-Zinn Heartscape Lovingkindness

Apps

• InsightTimer – Offers 130,000 free guided meditations, including an array of guided loving-kindness meditations to choose from
• Headspace – A leading meditation app that has a whole section dedicated to loving-kindness
• Metta App—Grow Love & Kindness – An app dedicated solely to loving-kindness.

Books and other resources

• Dr. Bismark offers information on Loving-Kindness Meditation for kids
• “Loving-Kindness: The Revolutionary Art of Happiness” by Sharon Salzberg
• “Training the Mind and Cultivating Loving-Kindness” by Chogyam Trungpa
• “Loving Kindness” (a picture book designed for ages 4-8) by Deborah Underwood
• “Loving-Kindness in Plain English: The Practice of Metta” by Bhante Henepola Gunaratana

Remember, empathy is an expendable neurological resource; you can’t safely pull from your well of empathy until you protect your neurobiology with a compassionate shield.