“The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet.”
-Naomi Remen-
I remember after a long, hot day in Uganda, sweat seeping through my shirt, after spending hours in the hospital with another one of the women in my community who was diagnosed with HIV, I would collapse on my bed, face tear stained, so exhausted I couldn’t think about making dinner.
The reality was, those days were more typical than non typical.
Over time, the suffering of others can seep into your bones and drain you.
Missionaries and aid workers have countless trauma inputs every day from the threat of violence, to listening to traumatic stories, dealing the problems of others, to illness, domestic violence, child abuse, and even grieving the loss of someone in their community.
I didn’t have a name for what I was feeling then, but I do now. It’s called compassion fatigue. The sad reality is, most missionaries don’t know about compassion fatigue, the warning signs, or how to recover from it. Compassion fatigue refers to:
“Profound emotional and physical exhaustion that helping professionals, missionaries, and caregivers can develop over the course of their career as helpers. It is a gradual erosion of all the things that keep us connected to others in our role: our empathy, our hope, and of course our compassion, not only for others, but for ourselves.” (The Compassion Fatigue Workbook)
What I didn’t understand at the time, is that compassion fatigue is a normal consequence of the work that we do, and there is nothing shameful or abnormal in us succumbing to it.
Without proper prevention techniques and commitments to self care, compassion fatigue is almost inevitable.
Sometimes as Christians we think that taking care of ourselves is “UnGodly” and that martyrdom is the only way to please God. And yet, I’ve found that as we love ourselves and let God love us, we have so much more to give out.
After five years in Uganda, every morning I would wake up and still feel tired, but I thought if I just pushed through and worked harder, I could make a dent on the demands on me, I could push past the pain and keep helping.
What I didn’t realize was that I was making matters worse by trying to “push through.”
So what are the signs of compassion fatigue?
- Physical and emotional exhaustion
- Anger and irritability- difficulty controlling mood swings
- Exaggerated sense of responsibility- “I can’t stop, people need me.”
- Insomnia/difficulty falling asleep
- Shifting blame; taking out stress on others in personal relationships
- Susceptibility to illness
- Somatization: tension headaches, low back pain
- Increased use of alcohol, drugs, or food to self medicate stress
- Feeling like avoiding work or specific clients
- Reduced ability to feel sympathy or empathy “I know where this story is going”
- Resentment- “Why are all the demands on me?”
- Hypervigilance- feeling that you’re always “on” even when on break
- Difficulty separating personal and professional life
- Failure to nurture non-work related aspects of life
- Loss of hope
It’s important to regularly test yourself. You can take your own compassion fatigue self test here.
I had pretty much all the things on this list, and yet I had accepted them as part of my plot in life if I wanted to do missions and help people. I had no idea the harm I was doing to myself and others.
I ignored the warning signs like snapping at my husband, and feeling overly responsible for everything and everyone because I’d lost touch with what a normal healthy life could feel like.
I’ve been back in the States for nearly 3 years, and it’s only through dedicated self-care, therapy, and Jesus that I’ve been able to recover from it.
This is everything missionaries need to know to combat and recover from compassion fatigue:
Make a commitment to change
The most important thing you can do is realize that something is wrong and get help for yourself. Make a commitment that you will not let things continue as they are, but you will make yourself a priority for once. Try to treat yourself like you would treat others in need of help—would you be critical and bully that person, or would you have compassion on them? Realize that God wants you to be well just as much as He wants other people to be well. I started treating myself as someone who needed and deserved nurturing. What would it take for you to make some serious changes to your schedule and self care routine?
Listen to your body
Begin listening to the warning signs of your body and practice body scans. Sit in a quiet, peaceful room and focus on your breathing. Breathe deeply in and out. Relax your shoulders. How does your body feel? Is there a part you’ve been neglecting? When you ask your body if it truly wants to do a particular thing does is say yes or no? Ask your body what does it need to feel better?
Create work/life balance
Can you reduce your work load or go in later in the morning so you have time for self care, journaling, and time with God? Can you work 4 days a week and use the 5th day for planning and relaxation? Studies show that working 4 days a week instead of 5 does not lead to any major difference in work outcomes. Take 10 minutes at the end of your day to transition from work to home by breathing or stretching, taking a shower, or going for a walk. Clear your mind from “work mode” to “rest mode.” When you’re “off duty” can you turn your cell phone completely off instead of answering all calls? Can you close your computer and commit to not opening it? Can you designate someone else as an emergency responder? Can you take a half-day each week to sit down and plan restorative activities such as exercise, reading, or time with friends?
Rigorous self-care
You have to become your own best advocate.
Realize that you are precious to God, and having compassion for yourself is just as important as having it for others.
Your job right now is to be kind to yourself. The basics of self care are sleep, rest, proper diet, exercise, and vacations, nourishing activities, a regular debriefing process.
Regular physical exercise is one of the best ways to manage compassion fatigue and work related stress.
Make sure you do at least one nourishing activity per day.
Ideas for nourishing activities for missionaries:
- 30 minute bath/shower
- Long evening walk
- Read a novel
- Digging in your garden
- Cook something fun and new to music
- Go for a run with headphones in
- Listen to a meditation cd
- Yoga
- Home workout DVD’s
- A bicycle ride
- Go out to a restaurant with a friend
- Have fun rituals like “Taco night”
- Have friends over for a BBQ
- Watch a movie or TV
- Get away for the weekend to a Safari lodge or capital city
- Journaling
- Write down what God is saying about His love for you
- Soak to worship music
- Keep a gratitude journal of things you’re thankful for
- Draw/paint/do art/write poetry
- Use essential oils
- Light a candle
- Sit outside on your porch and breathe deeply
- Give a long hug to a partner or friend
- Play with your dogs or children
Learn to say “No”
Boundaries are an essential part of self-care. I used to think of boundaries like a curse word. It just sounded like they would make me a no fun, mean person I didn’t want to be. But then I started implementing and realized that saying no to the wrong things frees you up to say yes to the right things. You will never be able to solve every problem or meet every need. You have to be in tune with yourself to know when you are reaching a depleted point and before committing to something ask yourself, “Is this what I really want to do?” “If I say yes to this, what will I have to give up?” Look at what’s on your plate and prioritize what is most important for you and say no to things that do not fall in line with those priorities. Boundaries are especially needed for introverts like me.
Saying no doesn’t mean you lack compassion, it means you are saving your energy to channel your compassion in the right direction.
Delegate
One of the biggest mistakes I see missionaries make is not relying enough upon their support staff. As a missionary or non-profit director, or aid worker, I believe one of your primary responsibilities should be to train and empower your indigenous leaders around you. They may not be able to do your tasks as quickly as you at first, but if you invest some time up front, this will lead to greater levels of freedom for you in the long run. You should also always be looking to see how you can work yourself out of your job. In the long run, how will these nationals lead. Spend your time mentoring and empowering them and it will pay off. Think about where you can shift some of your responsibilities to team members, volunteers, supporters, or board members. You don’t have to do everything!
Vacation
Yes, that’s right, I said vacation. I know that’s a word most missionaries seemed to have deleted out of their vocabulary. By that, I don’t mean a trip home where you spend two months on the road speaking at churches and raising money. That isn’t technically a vacation. I’m talking at least a week or longer, beach, mai tai, a bikini, waves, and no work! Most Americans do not use their vacation time and it’s literally killing us. Make it a priority to speak with your sending organization or Board that you need to raise money specifically for a vacation. Talk to your biggest supporters and let them know this is a need you have. Set aside the time on your calendar to do this. There are also plenty of missionary retreat places for those of you who don’t have the finances.
Ongoing counseling/support
This is one area that I wish I had realized the importance of when I first moved to Africa. I didn’t realize how the traumas would pile high up inside me and without release, they would begin to build pressure inside me. Many missionaries and aid workers suffer from PTSD because of the things they witness on a daily basis. War, hunger, poverty, disease, death, abuse, these things begin to erode at your hope and world view. You need a safe person to process with as you face these challenges of being a helper in a difficult situation. This should be non negotiable. I was afraid to tell people how I really felt, because I thought they would judge me.
I thought I failed God because I needed help and time to care of me. But through therapy I came to understand He was always the one trying to lead me into deeper levels of self love and care.
It’s important to find a therapist, coach, or person who has been a missionary and understands to talk with on a monthly basis and process life. This should be someone other than your friends who can provide a trained approach to your needs.
If you need help, reach out to someone. Don’t suffer in silence. Having someone who can listen and understand is a profound experience. Don’t miss out because you are afraid.
Ignoring compassion fatigue can lead to illness and greater levels of burnout which will mean you’ll be helping fewer people.
Lastly, compassion fatigue is something that can take time to recover from.
You might have to take a break from the field to truly get the support you need. Recovering from compassion fatigue for me meant making some tough choices I didn’t want to make, but am so glad now that I did. Whatever situation you are in, managing the symptoms early, can lead to better results.
Don’t confuse tough choices with no choices. You do have choices. Choose to communicate your needs. Choose to take care of yourself today. You’re worth it.
For more reading on healing compassion fatigue please read my other article.
**Download my new self-care plan for global workers to help you prevent compassion fatigue
**I now provide Skype coaching and pastoral counseling sessions to missionaries because it was something I so wished I had in my time serving overseas. Contact saritahartz@gmail.com today to schedule a Skype coaching session.
