I had compassion fatigue

Hannah Milton is a GP, mum, and runner.

Compassion fatigue is a state of reduced compassion or empathy because of repeated exposure to trauma or hearing the stories of trauma. It can lead to emotional and physical symptoms that make it hard to function effectively. All healthcare workers are at risk of this but I only came to learn about it through my experiences as an adoptive parent. Adopters and foster carers are used to dealing with the effects of trauma, as their children have experienced multiple levels of trauma in their short lives.

It took a year for me to realise that I had experienced compassion fatigue. I had returned from shared adoption leave six months after my two children came home and I felt anxious. Going to work felt like a break from the all-consuming nature of parenting traumatised children.

However one day I was rushing at the end of the work-day, as I wanted to get home to help my husband with bedtime. A time of day which at that stage was very challenging due to our children’s past traumas. In my impatience I was rude to a patient. They quite rightly made a complaint and I had to look hard at my behaviour. Writing the complaint response was difficult but now I realise that it was probably a turning point in my recovery from compassion fatigue.

I felt angry at my patients and at my children; that they were deliberately trying to annoy me!

Looking back, I can see that there were signs I wasn’t completely ok that I will hopefully detect if it occurs again. I lost weight and I slept badly. I believed I was innately bad (not just regretful of doing bad things but bad to my core). I felt angry at my patients and at my children; that they were deliberately trying to annoy me! It sounds ridiculous writing it down but I held these beliefs for a while, or I can see now that that was what I was feeling beneath the fog of ‘keeping going’, realising things weren’t quite going right and feeling shame.

My husband and I were dealing with two wonderful but traumatised and grieving children, who can behave in extreme ways. I was adapting to a new and intense life of parenthood and coming to work for what felt like a break from trauma. I have always loved working in general practice, but it is emotionally demanding and shouldn’t be viewed as a break!

I have found some amazing support within adoption fora, and first came across the term compassion fatigue there. There is a high rate of compassion fatigue within fostering and adoption and it is discussed regularly and with empathy. On these fora there is an understanding that people can respond unhelpfully to difficult behaviours but that shaming the parent doesn’t help to stop those unhelpful responses, whilst ‘being heard’ and empathised with can. I suspect there is a high rate of compassion fatigue within medicine and we need to start talking about it and supporting each other.

There are many things that helped me overcome compassion fatigue so that my family and professional life is currently thriving, although I am aware you can’t just “cure” compassion fatigue. We got funding from the Adoption Support Fund to see a trauma and attachment therapist, we talked a lot, we read book after book, I started practicing mindfulness, I stopped drinking red wine (this was hard), we read fora and watched online lectures about compassion fatigue and trauma in general.

It has hugely improved my understanding of my children’s seemingly irrational reactions based on their traumatic past.

I discovered ‘not over-reacting’! I prioritise my basic self-care needs so that I get enough sleep, healthy food and time for running every week. I am grateful to work with colleagues who see the value of meeting together daily and who understand that we all make mistakes.

My brief experience of compassion fatigue and working through it has hugely improved my understanding of my children’s seemingly irrational reactions based on their traumatic past.

Children who are adopted often have a deep sense of shame and responsibility for the horrible things that have been done to them. This can seem completely irrational to their parents who can only see their much loved and wanted innocent child. Experiencing, albeit briefly, the strong feelings of shame has helped me understand my children more deeply.

As with all life experience it has also helped me in my job as a GP too. It has deepened my ability to empathise with my patients. I believe I am calmer and more emotionally flexible than I was prior to having children.

Although there is still work to do!


Featured image by Gage Walker at Unsplash

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