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Stress, Compassion Fatigue, and Burnout

Personal resilience—the ability to recover from stress, or painful, difficult experiences—is essential to resolving trauma. Resilience is a life skill that can be learned. Under contract with the Department of Veterans Affairs, our institute provided a year-long training in resiliency skills to treatment teams in eighteen medical facilities in New York and New Jersey. What happens when people, particularly caregivers, lose their resiliency? Under stress without relief, they can develop compassion fatigue or spiral into burnout.

Compassion Fatigue

Stress, compassion fatigue, and burnout exist on a spectrum. We all experience stress and can learn self-care techniques to dissipate its effects. When stress buildup starts to take a toll, we move into a state of depletion called compassion fatigue. Let me illustrate the difference between experiencing stress versus existing in a state of compassion fatigue.

Even when experiencing stress and secondary or vicarious trauma, caregivers and others feel that they like their jobs. They like or love the people they serve and want to continue to be there for them. They are able to maintain a healthy balance between their needs and the needs of the people they care for. They get tired, but can usually recover with a day or two of rest. They use self-care techniques that work for them to recover and return to serving others.

Caregivers and others who have not kept up self-care methods to resolve their stress and vicarious trauma will start to feel lingering dissatisfaction with aspects of their jobs. They usually still like or love the people they serve, but they feel depleted in ways that might take a week or more to replenish and refresh. They find themselves consistently putting their client or loved one’s needs first. They are less satisfied in their work and are at risk, if they don’t turn things around, for burnout.


Compassion fatigue progresses to burnout when stressed and traumatized caregivers and others abandon self-care in essential ways. They no longer like their jobs and feel like they want to quit. They have a hard time caring for the people they’re helping and can become overwhelmed with their needs. They can become almost dysfunctional in meeting their own needs or the needs of those they care for. These caregivers and others are exhausted. It would take a significant amount of time for them to return to a healthy, rested state, capable of doing good work.

Addressing Compassion Fatigue and Burnout

Developing a repertoire of self-care techniques and practicing them regularly is essential for combatting compassion fatigue and burnout. Caregivers and others need to practice self-care that addresses all aspects of their health—physical, mental, social or emotional, and spiritual. There are many good resources available with suggestions for self-care activities. Ask others in your situation or profession, do some research on the web, or read our book, Trauma: Healing the Hidden Epidemic, for some helpful, practical guidance. With discipline and determination, you can remain resilient and effective in your calling.