Why addressing compassion fatigue amid the coronavirus crisis is crucial to navigating such extraordinary times
In one of his Patriot Act episodes last year, American comic Hasan Minhaj succinctly summarised compassion fatigue as having '50 tabs open in our mental browser and we’re about to crash.'
It's 8 am. You sleepily open your eyes and reach for your phone. You check if you have any missed calls, read your messages and emails. You then open Twitter and start scrolling. Slowly, your mind starts crowding with news from yesterday, and the weeks and months past: COVID-19, #BlackLivesMatter, cyclones, celebrity suicides, activists in jail, police brutality. A sense of defeat sets in; you wish to go back to sleep and put your phone away, but alas! There’s work to do, so you slogger on robotically.
As the day progresses, you keep mulling on the things you've read and watched. You tell yourself there’s really no hope left, and that everything is going to the dogs. You are past being surprised at the ignorance and apathy of people. You are done outraging on social media, and you ignore racist, casteist, classist, sexist, homophobic, transphobic comments on WhatsApp groups. You bumble through the day in a daze. Your work takes a hit and you miss a couple of deadlines. The laundry piles up, and the vegetables in the fridge go bad. Sleep eludes you and your bedtime gets delayed indefinitely.
At 2 am, you are still staring at your phone. Finally, you turn it off and the darkness envelopes you. You try to sleep, thinking and hoping that tomorrow will be a better day.
It's 8 am the next day, and your life is on loop. Everything you did yesterday, you repeat today...and tomorrow...and the day after...and the day after that...
Does this sound familiar? If it does, you’re not alone. There's a name for this phenomenon — 'compassion fatigue', or CF, is what experts have termed it. To put it simply, it means exhaustion from caring.
According to Dr Kaustabh Joag, Consulting Psychiatrist and Senior Research Fellow at the Centre for Mental Health Law and Policy, Indian Law Society, "Compassion fatigue is the cost of caring with compassion. It has a two-fold effect: burnout and secondary traumatic stress. The burnout impacts a person’s physical and mental abilities. It affects sleep and appetite, and causes fatigue. It reduces concentration, motivation, creativity, problem-solving skills and working memory. The secondary traumatic stress is more like PTSD where the person feels numbness, irritability, de-personalisation, detachment and difficulty in coping."
Take for instance Swati, a 24-year-old student in Delhi, who says that she has stopped watching the news as it has become too triggering. "I was actively involved in the CAA-NRC protests. I saw friends being picked up and thrown in jail. Then the coronavirus outbreak happened and everything went south. Every day there’s some terrible news or the other. Till March, I was managing, but now I can’t handle it. It’s just too overwhelming," she says.
In one of his Patriot Act episodes last year, American comic Hasan Minhaj succinctly summarised the feeling by saying "it’s like we have 50 tabs open in our mental browser and we’re about to crash." Emphasising on this fact, Dr Joag goes on to warn that compassion fatigue makes a person more vulnerable to depression, anxiety, substance abuse, and increases the risk of suicide. Therefore, it must not be disregarded as trivial.
But why is compassion fatigue on the rise? Ms Kamna Chhibber, Clinical Psychologist and Head, Department of Mental Health and Behavioural Sciences, Fortis Healthcare, says that we are more vulnerable to it at the moment due to a marked increase in stress caused by multiple factors, like the pandemic and civil uprisings. Dr Joag also adds that the scale of the pandemic combined with the lack of remedies and uncertainty about the future has created a sense of helplessness and hopelessness. "When you are constantly exposed to the news and are also up against social and systemic barriers, you are more likely to experience compassion fatigue," he explains.
Here, he also points out that frontline workers like healthcare professionals, hospital cleaning and admin staff, media personnel, fire-fighters, police, lawyers, activists and volunteers are most likely to develop symptoms of compassion fatigue. "They have to display high levels of compassion and empathy under very challenging circumstances. Sometimes the effect might linger and be overwhelming."
Anita, 38, corroborates this claim. On account of being a journalist who has to regularly talk to multiple people on her job, she often encounters heartbreaking and difficult stories. "I’ve lost count of the number of times people have broken down while recounting their stories. I try to comfort them as best as I can. I try to help them with whatever resources I have. But I also have to go back and write those stories. It’s not easy. Some days I’m all over the place. I write, I cry, I edit, I cry," she says.
The first step in the direction of managing compassion fatigue is creating awareness about the phenomenon and its symptoms. "Awareness brings preparedness and watchfulness towards the issue," says Dr Joag. "Be aware of your emotional experiences, and share your feelings with people you are close to. Consume information only up to the extent you can manage. If it starts to affect you emotionally and/or psychologically, avoid it. Spell out your boundaries with those around you. Let them know what you are okay with and what you are not. In short, be aware of what triggers you and keep your distance from such things," Ms Chhibber says.
The second step entails building a reliable support system comprising family, friends and colleagues. "Having a strong support system at the personal and professional level can go a long way in coping with compassion fatigue, especially for high-risk groups as they cannot avoid taxing situations," explains Dr Joag.
He also stresses on the fact that high-risk individuals should receive institutional training on resilience and capacity building. At an organisational level, strategy, planning and training to deal with the phenomenon is a must.
Thirdly, one must devote time to self-care. According to Dr Joag, taking regular breaks to refresh one’s mind is an imperative. "Spend some time by yourself. Exercise and meditate. Take part in recreational activities. Watch what you eat and try to sleep on time. If you can, do maintain an activity monitoring sheet or a thought diary," he says.
Ms Chhibber stresses on being kind to oneself. "Try and find meaning in the things you do to support others who depend on you. Do not be harsh on yourself if you are unable to provide for them the way you are expected to. It is important to consciously remind yourself that you are doing the best that you can under the circumstances." She also mentions the importance of gratitude. "Being grateful for the good that you have in your life can help take your mind off of things (in your life) that you consider bad or things that you want but don’t have at the moment."
A Vipassana meditation teacher from the Vipassana International Academy mentioned, on condition of anonymity, that performing Anapana meditation, or the first step to Vipassana, — an ancient technique of meditation rediscovered by Gautama Buddha around 2,500 years ago — can help in controlling compassion fatigue.
Anapana requires the meditator to concentrate on their natural breath without initiating any verbal or visual stimuli, or even counting. It helps one stay in the moment without reacting to any external prompt.
"It will make your mind calm, peaceful and happy," says the teacher. "Do it for 10-15 minutes every day. The peace and happiness you will feel will benefit you and everyone around you."
The Vipassana Research Institute website has detailed guidelines on doing Anapana meditation. One can also register for daily free live Anapana sessions conducted by SN Goenka, founder of the institute. The sessions are open to beginners and students who have completed one or more 10-day residential courses of Vipassana.
Another useful resource is the Doing What Matters in Times of Stress illustrated guide published by The World Health Organisation in April 2020. It 'aims to equip people with practical skills to help cope with stress’, and is accompanied by easy-to-follow audio exercises.
In conclusion, anyone can be vulnerable to compassion fatigue, and therefore, it must not be ignored. Having a strong support system is crucial in these extraordinary times. "But if you experience severe anxiety, depression or ideas of suicide, reach out to a mental health professional," cautions Dr Joag.
Illustration by Satwick Gade
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