What Missionaries Need to Know About Compassion Fatigue

January 28, 2016


missionary compassion fatigue

“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

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. 


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!


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.

**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.

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  • Sarita, this is wonderful!

    I so enjoy your posts! Thank you for spreading awareness to and for missionaries, as well as other caregivers.

    Grace & peace to you and yours,


    • You are so welcome Brianna. :) Do you have any other tips to add? :)

      • I think you pretty much summed it up, lady! If I ever think of anything, I’ll be sure to swing back by and let you know. 😉

  • Deborah

    Sarita, Thanks for this great article. I have also lived compassion fatigue and it took some drastic changes such as no more 7 day work weeks, coaching support, mini-vacations in-country and a shift in mind set to start to rebalance. Stepping out of country for a few weeks also helped and made me appreciate the work after I returned. Your focus on coaching will be a gift to those who need help from someone who has lived it. Blessings, Deborah

    • Thanks so much for sharing Deborah. It does take some tough choices. I’m glad you had the bravery and courage to make those choices. Thanks for the great tips and for your confidence in me. :) Blessings!

  • Lora

    Yoga is a practice of Hinduism. It envokes the spiritual enemies of Christ, and is bad for Christians and ministry.

    • Sarita Hartz

      Hi Lora, if that’s your view point than I definitely recommend you don’t practice yoga. However, I believe that yoga is a mind and body relaxation practice and when our mind is more settled and less stress we have more ease connecting with God. I believe that where we set our devotion has a lot to do whether or not something is right or wrong for us. I’ve been practicing yoga for years, and I believe that it makes me more receptive to God’s voice and I can hear Him better because of my calmness. Christianity Today actually published an article on this that you might find helpful: http://www.christianitytoday.com/ct/2005/mayweb-only/42.0b.html
      I am not repeating any Hinu mantras nor am I connecting with or opening myself up to any demonic presence. But it’s important that every person follow their own convictions. I wish you the best.

    • walkabout

      WholyFit Christian fitness has classes that are an alternative to yoga. Started by someone who was in the fitness industry, but left yoga because of conviction from the Holy Spirit. She started WholyFit and trains instructors to provide gentle body power classes with scripture memorization for a workout that is better than yoga in more ways than one.

      • Lora

        That is great to hear. All Christians need to be aware of pagan (Satanic) influences on Christian faith.

        • Lora I appreciate your view point. Sadly, many of our traditions, including Christmas have roots in paganism. I definitely think each person should follow the conviction of the Holy Spirit in these matters, but things that I would be more concerned about regarding demonic influence would be things like bitterness, unforgiveness, generational sin, etc. This is an article about compassion fatigue, not yoga. I think the thing to remember is that we are trying to practice mindfulness techniques that will root us in the present so that our para sympathetic response, our “fight or flight,” when we are constantly stressed out, can calm down. There are many others such as visualization, progressive relaxation breathing, meditation. I know many Christian healing ministries that employ these in a Christian way such as seeing Jesus in your mind and focusing on His words of love for you. The point is to find a mindfulness technique that works for you so that all the worry can slip away. Perhaps soaking to Christian worship music might be a better technique for you. But we are all different, so it’s good to leave room for what works for different people. Thanks :)

          • MaryAnne Biele

            These that you mention ” There are many others such as visualization, progressive relaxation
            breathing, meditation. I know many Christian healing ministries that
            employ these in a Christian way such as seeing Jesus in your mind and
            focusing on His words of love for you.” are all techniques used in and by New Age proponents and are thus very dangerous and should not be employed by Christians or G-D fearing people. Do not empty your mind and thus allow demonic spirits to deceive you. One should be active in their relationship with the L-RD, reading His Word and praying to the King of kings, the L-RD of lords, in the Name of His Only begotten Son!

          • brock

            lets not be ridiculous. jesus meditated. i bet if we could watch him heal someone in person today, the paranoid robotic christianity of our time would cringe in discomfort. lets not be so freaked out by anything that simply doesn’t fit our “mold.” jesus, john the baptist, the disciples, moses (on and on) were all bizarre! embrace the unusual – its beautiful! each of these heroes of the faith participated in things much more strange than yoga. its the heart that matters. if a jesus loving, spirit filled follower of christ wants to do yoga, or progressive relaxation, or whatever – who cares? the spirit will convict if necessary. how presumptuous to accuse that person of being deceived by demonic spirits…
            great article sarita… keep doing your thing.

          • Thanks so much for your defense of my article Brock. :)

          • Madelyn

            Hallo Sarita, all I can add to this posting is that you please go and listen to people who came OUT of yoga. NO FORM of yoga is acceptable. I know that the Holy Spirit needs to speak to you about this and bring the conviction to your heart but the Lord also speaks through His body. Remember that deception is NOT something we SEE because Deception is what it is, it is DECEPTION. Why do Christians want to do yoga? why even use the terminology “yoga”… why not just do it like the Bible says we should do it.. spending time with the Lord in meditation ON HIS WORD… spending intimate time with Him? Why bring in yoga which is demon worship?. Please if you haven’t read the book “Death of a Guru” by Rabi R Maharaj please get a copy for yourself and read it. He is a man who was very strongly involved in Yoga and was a Hindu. What he said about yoga is that he was very shocked to see how much yoga has infiltrated the church… I know this article is not about yoga, but I just like Mary Anne Biele, cannot agree with it and unfortunately you mention yoga often in your articles

          • MaryAnne Biele

            Brock, Jesus Christ, the Only Begotten Son of G-D certainly did pray to His Father in Heaven and was learned in the Law or Torah. And by meditation, the Bible gives examples of what that means. Such as,
            Joshua 1:8
            “This Book of the Law shall not depart from your mouth, but you
            shall meditate on it day and night, so that you may be careful to do
            according to all that is written in it. For then you will make your way
            prosperous, and then you will have good success.”
            Psalm 1:2
            “But his delight is in the law of the Lord, and on his law he meditates day and night.”
            Psalm 19:14
            “Let the words of my mouth and the meditation of my heart be acceptable in your sight, O Lord, my rock and my redeemer.”
            Psalm 119:15
            “I will meditate on your precepts and fix my eyes on your ways.”
            Philippians 4:8
            “Finally, brothers, whatever is true, whatever is honorable,
            whatever is just, whatever is pure, whatever is lovely, whatever is
            commendable, if there is any excellence, if there is anything worthy of praise, think about these things.”
            Psalm 119:97
            “Oh how I love your law! It is my meditation all the day.”

          • Devon van Tyn

            Thank you Mary Anne for sharing what the Word of God has to say on these matters. Yes, the Word is the Sword of the Spirit and is what we need to study and know in order to be able to discern in these situations. Satan is very good at disguising evil as another “great and good thing that is “helpful” to Christians”.

          • MaryAnne Biele

            Also, each time Jesus was tempted by the devil after Jesus fasted for 40 days, Jesus’ response to him was to speak the Word of G-D to the devil directly, which is the Sword of the Holy Spirit which is our only offensive weapon in our arsenal to defeat the enemy. G-D’s Word is Living and Active to tear down strongholds of the enemy, and since we struggle not against flesh and blood but against powers and evil forces in the heavenly realms, we need the ever ready weapon of the Word of G-D. So when Jesus was meditating of G-D’s Word all those days, He was ready to defeat the enemy Satan.

      • Thanks! That’s a great alternative for people who are sensitive to this kind of stuff.

    • JBK007

      The article is great, but this comment and self-righteous thinking is what is behind most of the problems missionaries introduce in the world. Yoga is excellent for flexibility, muscle tone and inner peace, none of which contradict the teachings of Jesus who purportedly traveled and studied in India, which informed his own teaching.

  • Bill Swan

    Thanks for writing this with such clarity. I lead a team of people who are leading and caring for missionaries, and I think many of them struggle with compassion fatigue. I’m currently working with a team to help figure out how to create a culture where we care deeply, for ourselves and others. This helps.

    • Bill, that’s so wonderful that you are on the forefront of missionary care. These are issues that really need to be addressed with missions sending organizations. I provide monthly Skype support, counseling, and coaching to missionaries on the field because I know it’s something that I needed, and that they need. It’s so sad when we don’t realize the dangers and we send people out without preparing them for what they might face. I’m so glad you are working on this! Do you guys have an organization?

  • I find this statement to be so important for us to buy into

    “Saying no doesn’t mean you lack compassion, it means you are saving your energy to channel your compassion in the right direction.”

    If I think saying “no” is always shirking my responsibility or somehow ignoring God’s will then I will eventually run myself down to nothing. I have to trust that when I say “no” God will take care of things, including me.

    • Sarita Hartz

      That’s such a great insight Caleb! It’s a hard one to learn–surrender, but so important. Thanks for sharing your insights! :)

  • Grace Hartmann

    This is a great post!! And so true. We met briefly years ago in Gulu & I have followed your story since. I am currently getting my master’s in counseling with a long-term goal in mind of counseling missionaries while they are on the field. (Both via the internet & visiting them.) It is so very needed yet so very overlooked. Glad to see more attention focusing on it!

    • That’s wonderful Grace! It’s so needed! I’m glad to hear there are others working on this. We should share insights with each other :)

  • Stephanie Matthews

    Hello. My name is Stephanie and Im a missionary. Im planning a missionary trip to India. Plz check out my campaign. Every little bit helps and is greatly appreciated. God bless you all. gofund.me/49nu8sak

  • raycom4rt

    Compassion fatigue? That’s funny! How about just plain exhausted! All I do is pray and the Lord provides respite. That will be the day, I call myself compassionate! You’re here, you do! I’m also brave, clean and reverent! BWAHAHAHA!