Rethinking compassion fatigue

Abstract

Purpose The purpose of this paper is to argue for a revision of the concept of compassion fatigue in light of both its history and psychodynamics. Design/methodology/approach This paper calls into question conventional interpretations of compassion fatigue and the assumptions underlying them. As an alternative, a psychoanalytic interpretation is offered that sheds light on the phenomenon's unconscious and organizational dynamics. This interpretation also aligns with the concept's historical use in media and politics. Findings In contrast to the assumption that compassion fatigue arises from too much compassion, historical use of the term suggests just the opposite: compassion fatigue is the result of too little compassion. Healthcare literature on compassion fatigue has not only failed to account for this opposing view, but also the underlying psychodynamics at play. By attending to these neglected dimensions, healthcare scholars and practitioners can gain new insights into compassion fatigue and devise more sustainable interventions. Originality/value This paper reveals hidden dimensions to compassion fatigue that call into question conventional interpretations and offer novel perspectives on a core concern of healthcare work.

Physician Burnout and Compassion Fatigue: Individual and Institutional Response to an Emerging Crisis

“…Some physicians who suffer from compassion fatigue report feelings of failure to their profession, sleeplessness, anxiety, and a general lack of confidence [30]. Compassion fatigue may not be from the individual practitioner losing compassion but rather from Bunconscious motivations involved in compassion fatigue^ [31]. Gerard further discusses that many go into the helping professions to do Bover-good^as Freud wrote in Totem and Taboo.…”

“…Gerard further discusses that many go into the helping professions to do Bover-good^as Freud wrote in Totem and Taboo. BFor Freud, these displays of being over-good serve a defensive function, guarding against the anxiety provoked by a prior 'period of badness' that threatened the child's primary relationships^ [31]. Looking at compassion fatigue/burnout in this manner may help to explain why so many physicians suffer burnout.…”

“…In healthcare, the stakes are the highest of most professions and failure is not tolerated [10], even if the failure is not actually the failure of the provider but the system or even organizational requirements. There is also a high level of stress for some providers who fear that they will not be able to help patients or even the population where they practice [31]. In these situations, frustration and anxiety increase and the response of the provider may be burnout or compassion fatigue.…”

“…This may be one of the mechanisms that allow for those who study mindfulness to be able to more effectively navigate the current arena of burnout. If Gerard is correct in his assumption that some may suffer from compassion fatigue because of inner conflict over Bdoing goodâ nd lack and of positive feedback from patients, administration, and the public, then mindfulness may work by negating that effect [31].…”

Reparation Compulsion: Theorizing the pitfalls of guilt-driven labor

“…And yet, despite a flurry of attention and resources dedicated to this pressing organizational issue, little is still known about compassion fatigue’s etiology and relation to other psychological constructs (Sinclair, Raffin-Bouchal, Venturato, Mijovic-Kondejewski, & Smith-MacDonald., 2017). Moreover, virtually absent are any organizational-level hypotheses as to its perpetuation in healthcare settings (Gerard, 2017). One study that begins to break through this stalemate, however, is by Brenda Sabo (2011), who offers a more nuanced perspective on the topic.…”