How does Compassion Fatigue affect workers in the animal care community, and how can its effects be minimised?
By Freya Locke
Being new to the Canine Behaviour industry, having only ever had pets and only recently beginning to work with animals, Compassion Fatigue Syndrome (CFS) is something I had never heard of or encountered before undertaking my ISCP Advanced Diploma Course. How a carer feels about caring for, or the situations of their charges had never crossed my mind – I had always assumed the carer was… well… just “ok” with everything.
I feel that a lot of the general public are also quite unaware of the effects that CFS may have on those in the caring sectors, both human care and animal care, the very people who dedicate their lives to taking care of those who they feel may be suffering in some way. My own ignorance of the subject surprised me and knowing now that peer pressure and fear of being judged can aggravate the condition, and that this can not only affect the mental and physical health of the care worker, but also as a result, then go onto affect the care and emotional state of the animal being cared for, I think more resources and consideration should be given to the subject of CFS.
It also strikes me, sadly, that perhaps if the general public were to take better care of their animals, children, infirm and each other then there would be less suffering in general, and then CFS in the animal and in the human care sector might be less prominent in the first place. We can but hope for a day when better attitudes towards our fellow beings become the normal state of affairs, and kindness, generosity, common sense and love rule the day.
I would like to say thank you to all the kind people, who trusted me with their stories and experiences of Compassion Fatigue Syndrome. You know who you are.
I would also like to say thank you, give appreciation and pay respect to all those warriors who are silently fighting through each day, trying their best in very difficult situations, to bring care and comfort to another being, coping with horrors and sadness untold, and making hard decisions on behalf of those who are voiceless. You are braver than you know, you are kinder than you think, and you are stronger than you ever realise. Do not ever doubt it.
Finally, I would like to say thank you to Lisa Tenzin – Dolma, Dale McClelland, Teresa Tyler, and the ISCP family, who have opened my eyes to a new and fascinating world, of both Canine Psychology and of the way that humans can be when they are at their best. You have encouraged and helped me along the way to this point, and beyond. ISCP really is the best school ever, and through you I have found my path in life.
- Aims and Objectives
7 -14. Literature Review
15 – 17. Methodology
18 – 23. Discussion
24 – 25. Conclusion
26 – 27. References & Appendix
Caring for another being can be one of life’s greatest pleasures. From the mother who has just held her newborn baby for the first time experiencing the surge of oxytocin rushing through her body to make her fall in love with the infant, to the excited child who has been bought their very first hamster and can’t believe how cute it is, to a doctor successfully treating their first patient, proudly writing the prescription, knowing that all will be well. Caring for and improving the life of another being fulfils needs within ourselves to see ourselves as “good”, to know that we have made a difference to the life of something else. It gives us a feeling of self – worth. (PSYCHALIVE, 2016, para.9)
But, as with all good things, it can turn bad. Caring too much can hurt. Caring too much can make a person ill. Caring too much can stop a person from caring. Caring too much can even kill. (Zimlich, 2014)
When a person who has cared, experiences trauma after trauma, be it in person or as secondary trauma (when a person is so affected by the traumatic experiences of another being, that they take on the symptoms of trauma themselves), it begins to take its toll on the carer and they can begin to exhibit symptoms of Compassion Fatigue Syndrome (CFS). (Compassion Fatigue Awareness Project, 2017)
CFS is seemingly largely unknown by the general public, although it is documented and written about in scholarly circles, and people in the animal and human caring communities may or may not have heard of it. They may know of the symptoms, have even have felt them, or known someone who has felt the effects, but have never known there was a name for how they were feeling. They may also not have known that help is available if they are only able to reach out for it. Sadly, not every person who ever had CFS found themselves recovering, some simply leave their profession and move on… and for some… there have been too many sad losses of wonderful kind, caring, empathic souls – who knows what greatness they would have achieved had their stories ended differently. Cases like those of Tiffany Margolin and Amanda Lumsden, both of Santa Barbara, within months of each other in 2017 and 2018. Both women were successful, with their own mobile Veterinary businesses, dispensing medicines, performing surgeries and giving general care at home to pets.
“Their deaths shocked colleagues and clients, who said neither had shown obvious signs of distress. But the losses are reflective of a quiet crisis within their profession. “It’s a problem in our field,” said Dr. Kristi Gibbs at the Adobe Pet Hospital on upper State Street. “Both women were probably the kindest people you’d ever meet, and the loss is especially devastating because we’re such a small community, but this is happening everywhere. That’s the kicker.”” (Hayden, 2018, para.2)
In this paper I shall explore the symptoms and effects of CFS on Animal care workers, and the ways of recovering from CFS or avoiding it altogether, by calling on existing literature, the internet and the experiences of friends and colleagues at various stations within the sector.
Aims and Objectives
The aims of this thesis are:
- To explore and study the area of CFS in the canine care community, using various sources including literature, the internet, a questionnaire, interviews and informal chats, to see how it affects the workers in the various animal care related professions
- I aim to explore and describe how to recognise the symptoms of CFS in the self, and in others, again using various sources
- To seek out and discuss methods to either help the CFS sufferer be relieved of their symptoms, or to help the workers avoid CFS altogether, using the experiences of other people who have had problems with CFS or have managed to avoid it altogether.
- To make the sufferer realise that they are by no means on their own with this problem, and that things can, and will improve if they will let them. Other people have suffered, and recovered, and it is possible for them to do the same.
By doing this, I aim to not only help ease the problem of CFS by suggesting ways to help minimize and avoid the problem, to make people who might be at risk aware of its existence and make it more widely known about, but in turn also benefit the animals who are being cared for, as they need and deserve for their handlers to be ‘on top of their game’ and in an optimal frame of mind, in order to be able to provide the best care and most effective treatment to these animals.
Post-Traumatic Stress Disorder (PTSD) is a widely talked about condition, that affects people and animals who have been through a traumatic experience. According to NHS Choices (no date), the symptoms of PTSD are often:
- repetitive and distressing images or sensations
- physical sensations – such as pain, sweating, nausea or trembling
- avoidance and emotional numbing
- angry outbursts
- sleeping problems (insomnia)
- difficulty concentrating
- other mental health problems – such as depression, anxiety or phobias
- self-harming or destructive behaviour – such as drug misuse or alcohol misuse
- other physical symptoms – such as headaches, dizziness, chest pains and stomach aches
Children might experience:
- Stomach aches
- being unusually anxious about being separated from a parent or other adult
- re-enacting the traumatic event(s) through their play
(Figley & Roop, 2006, p.23)
Related to, and very much like PTSD, Compassion Fatigue Syndrome (CFS), which is also known as a “Secondary Traumatic Stress Disorder” or a “Vicarious Stress Disorder” (Compassion Fatigue Awareness Project, 2017), seems to be prevalent in any occupation or vocation that involves caring for others, from human health care workers to vets, from care home workers to those who volunteer at rescue shelters. Although I shall be concentrating mainly on canine care workers for the purpose of this essay, anyone who’s time is spent on improving or maintaining the wellbeing of another being is at risk of succumbing to CFS.
The person suffering CFS empathically takes on the emotional pain of the other being – who has been through a trauma, (regardless of if the other being suffered PTSD), and begins to exhibit symptoms, as if they had witnessed the trauma of the other being first hand. This creates an emotional stress within the CFS suffering carer who becomes so immersed and overwhelmed by their caring for distressed and traumatised beings, in this case dogs, that it can cause the carer pain, suffering and further mental health problems – such as the symptoms of PTSD. (Compassion Fatigue Awareness Project, 2017)
The Compassion Fatigue Awareness Project website was the brainchild of Patricia Smith, a Compassion Fatigue Specialist with over 20 years’ experience, and has written many books on the matter. It is an easy to understand website, with links to talks, information and books, alongside self-tests and other tools to help raise awareness and to relieve the severity of suffering with CFS. It is mainly aimed at human-human care, in fact animal care is barely mentioned or referred to, but many of the resources are still relevant in the context of this essay.
“Caring too much can hurt. When caregivers focus on others without practicing self-care, destructive behaviors can surface. Apathy, isolation, bottled up emotions and substance abuse head a long list of symptoms associated with the secondary traumatic stress disorder now labeled: Compassion Fatigue” (sic). (Compassion Fatigue Awareness Project, 2017, para.2)
Suicide rates and depression among vets are much higher than that of the average rates – with 1 in 6 having considered suicide, and 1 in 10 having had experience ‘severe psychological distress’ since graduation according to a survey by the National Association of State Public Health Veterinarians, Auburn University, and the CDC of over 10,000 practising veterinarians (Larkin, 2015), – as a result of seeing terrible things day in, day out.
CFS is also a major problem for rescue shelter workers and behaviourists who have to deal with traumatised, sick and sad dogs day in, day out – and these people need to be in a good frame of mind in order to be able to help these poor canines, many of whom will have already experienced traumatic and stressful situations, and can pick up on ‘bad vibes’ coming from their new handlers, when what they really need is careful, gentle, and positive care in order to create a secure base for their own peace of mind while they recover from their circumstances and become prepared for a new home.
“Your pets are, in fact, very observant of your emotional state, which they can pick up via your voice, body language and other subtle clues. It’s in their best interest to do so, as being able to decipher your emotional expressions gives him a leg up (pun intended!) in evaluating your motivations and intentions. Are you friendly? Are you a threat? Is it a good time to ask for a belly rub? Your dog may pick up your mood not only for her own devices but also for your benefit. Dogs are known, for instance, to respond to people when they cry.” (Becker, 2016)
Shelter workers in particular, also have to deal with public perception and scrutiny of what they do – not every shelter is no-kill, for many reasons, and euthanasia not only brings with it the heartbreak and emotional distress of ending a life, but also the external pressures added by the public, who do not always understand the reasoning behind some of the decisions the workers have to face.
“These animal-shelter workers, managers, veterinarians, veterinary technicians, and veterinary staff continue in their work because they care. In fact, they care so much that their work becomes their lives. While at work these professionals experience joy and satisfaction, but they also experience incredible pain and suffering. Their work their jobs hurts, yet they persevere.” (Figley & Roop, 2006. p. xi)
Compassion Fatigue in the Animal Care Community is a book, by Charles R. Figley and Robert G. Roop, and was written in 2006. It is a comprehensive and detailed study of CFS and its occurrence within the animal care sector, which has tables and charts to measure stress levels in workers, and information on recognising and dealing with compassion fatigue, specifically in animal care, and ends with self-testing resources and suggestions for relaxation and avoidance techniques, to help the sufferer overcome their CFS. While it was written for the animal care professional suffering with CFS, I feel it may be pretty hard going for someone with CFS to get through – the book is quite long and drawn out before it gets to any useful suggestions, focusing on data and surveys up to a point. However, if a person was to read the book before ever developing symptoms, it could be a great help in seeing off the worst of the condition, before it really takes hold of the reader.
Figley has written over 20 books on CFS including Compassion Fatigue: Secondary Traumatic Stress Disorders in Those Who Treat the Traumatized (1995); Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder (1995); Burnout in Families: The Systemic Costs of Caring (1997); Brief Treatments for the Traumatized (2002); and Treating Compassion Fatigue (2002) and is considered one of the world’s foremost experts on the subject. Roop holds a master’s degree in community counselling psychology and a doctorate in human resource management. He leads Humane Society University, which offers professional development opportunities to the animal-care and -control community. A CFS specialist, he has taught courses in management at several universities across the USA.
In Compassion Fatigue in the Animal Care Community, Charles R. Figley and Robert G. Roop describe the pressures on shelter workers in particular, with external factors such as:
- Public perception and lack of understanding
- Relationships with other humans and animals
- Friends and family who do not understand the work
- Government regulation and administrators
- Negative media
- Requests for special favours from politicians and friends
And also describing internal factors such as:
- Staffing levels
- Volume of animals
- Hours of operation
- Adoption rates
- Financial health of the shelter
- Nature of the work
- Mentality of indispensability
- Board of directors
- Relationships with co-workers (Figley & Roop, 2006, p.43-44)
From this we can ascertain that some of these shelters feel anything but a nice place, the kind of place these people wanted to create, in order to make lives better for animals. One of my interviewees, Jane*, a rescue shelter worker and behaviourist reported that often small things blow out of proportion and can become big dramas in the shelter where she works. Much like trigger stacking in animals, the workers can find themselves taking on more and more, and more stress, more distress, and the tensions rise until something blows. One particular recollection of hers, that stood out to me, was that of workers arguing over Lady Gaga’s meat dress. A revolting piece of tailoring yes, but a person had left their job over it! – Of course, it was not the dress that made them quit, but the melting pot of emotion and tension that had been building up, it was the straw that broke the camel’s back. (Locke Interviews, 2018)
Behaviourists and Trainers can also feel pretty despondent from time to time. When they feel as if their advice is falling on deaf ears, that the handler is not responding as they had hoped, and as a result the dog is not behaving how they had expected, they can quickly lose compassion for the handler. They feel as if they just don’t care anymore – and then they worry because they feel like that, because they want to care. They find themselves irritated with the handler and becoming more and more stressed.
Dianne* tells me she has actually put her behavioural business on hold because of it – because she felt so burnt out.
“For me, it’s just when I am feeling over worked – when there are a series of really heavy cases, especially when a client isn’t really doing their part, the kind of clients who just want to complain about their dogs, and they have this very ‘oh poor me’ attitude, that really gets me there faster than anything else. For me it’s the human in the equation (that annoys her) much more than the dogs…. …. I get symptoms of anxiety – they just come up for absolutely no reason… …It’s very much compassion fatigue – you just run out of compassion… ….When you get fatigued, you just don’t have any energy left to care – and you want to care” (Locke Interviews, 2018)
Jennifer A. Bough wrote To Save a Starfish in 2016, a workbook of suggestions, resources and methods to ease the severity of compassion fatigue, including tips on mindfulness, self-empowerment, developing creativity and having hobbies and interests that promote a sense of wellbeing and satisfaction, personality tests and more. A far easier read than the work of Figley and Roop, with a much more easy, relaxed style of writing, and as a modern read is complete with internet links to various resources too. This book is almost like having a chat with a friend, rather than struggling to understand too much science while attempting to help one’s self with CFS. Jennifer is the owner of Deepwater Counselling, based in Michigan, and has membership of Michigan Mental Health Counsellors Association, Michigan Counselling Association and Association for Pet Loss and Bereavement.
From To Save a Starfish we learn that Compassion Fatigue doesn’t happen overnight. In fact, it is more of a spectrum on which a worker can find themselves. Bough tells us that Baranowsky and Gentry suggest that CFS falls on a trajectory of five progressive phases:
Zealot phase –
- The carer is enthusiastic and excited about their work.
- They are committed and looking very much forward to making a difference to the lives of the animals.
Irritability Phase –
- The carer begins to be less keen, to cut corners.
- They start to make a few mistakes.
- They begin to distance themselves socially
Withdraw Phase –
- The attitude of the carer has changed to one of anger, and bitter feelings.
- They begin to neglect self-care and their loved ones.
- They begin to feel defensive.
Zombie Phase –
- The carer feels disconnected from their own thoughts and feelings, and no longer feels as if they care about the things they were once passionate for.
- They are running on autopilot, going through the motions, and feel like they can’t be bothered.
Pathology & Victimisation Phase Versus Maturation & Renewal Phase –
- The sufferer either becomes so fed up and consumed with CFS that they leave the field.
- Or they develop resiliency skills and begin to fight back against their CFS. (Bough, 2016, p.17-p.19)
In My End of the Leash: Compassion Fatigue from a Pet Sitters Perspective (2016), Holly Cook writes a beautiful biographical account, about how her early experiences with bullies as a child, her broken home life, her seeking out animals for comfort and solace, and then her ability to empathise with animals who felt afraid or were themselves bullied, led her to being more vulnerable to Compassion Fatigue whilst caring for them. She experienced an early trauma, with her pet dog giving birth to 7 puppies, but only 5 survived, and it affected her well into adulthood. CFS was not a sudden problem for her, it was one that mounted up over the years, and it is the same with most people who suffer with CFS.
She became attached to the animals she worked with and their owners too, and as client came and went, with each one she felt a little heartbreak. With each bit of charity work she did, or each time she helped an animal in need, it broke her a little more. Bit by bit, the process of caring, then losing the client, while seeing animal after animal suffer chipped away at her until she succumbed to Compassion Fatigue.
“I couldn’t sleep that night and had nightmares about Lena (a dog who she had been sitting, who was taken ill and put to sleep in her care). During the following days, I started having flashbacks about the scene in the kitchen and what happened at the vet’s office. It was relentless, and I was struggling. I didn’t know it at the time but I was suffering from moral distress. I knew what had to be done, but I was powerless to help Lena without her parent’s approval. This ordeal with Lena was the beginning of my battle with compassion fatigue. At the time I had no idea what was happening to me so I continued work.”(Cook, 2016, p.65)
From Holly Cook’s very personal account of CFS, we discover how negative experiences and trauma can build up throughout a person’s whole life, to a point where it changes how they can cope with their lives, an issue which can lead to CFS in those who are in the caring industries. We also learn by example, that it is often the most empathic and kind people, the ones who care the most for other being’s welfare, that are the ones who struggle the most when it comes to processing primary and secondary trauma. (Cook, 2016)
Compassion Fatigue Syndrome can affect anyone from the part time cleaner of the kennel at the daycare centre, to the professionals at the highest levels of their careers. Dr. Sophia Yin DVM was a high profile animal behaviour pioneer. She was well liked and well respected among her friends, family, peers and colleagues. (Zimlich, 2014)
“Sophia’s vision was to educate and provide veterinarians, trainers, animal behaviorists and pet owners with a variety of low-stress behavior-modification methods through science-based training for handling and treating animals which, inevitably, would produce an improved relationship between humans and animals. Her vision included the desire of showing, enabling and helping pet owners, animal handlers and veterinarians ways to have a better understanding of, and relationship with, animals. She was able to change a lot of people’s lives and their viewpoints on their pets’ behavioral traits.” (Zimlich, 2014, para 32.)
To the outside world she had it all, and was happy and enjoying her work and making a difference – which still continues today – to the lives of many animals. But a couple of her closest friends have described how they thought she seemed overwhelmed by her work, and pulled in different directions (Zimlich, 2014, para 31.). However, nobody realised the extent to how poor Sophia was feeling. Sadly Dr. Sophia Yin DVM was found dead on Sept 28th 2014, aged just 48. The coroner recorded the cause of death as “Asphyxia by Hanging”, and a verdict of “Suicide” was given.
“I never realized her own insecurities and feelings,” says Yin’s longtime mentor Jim Wilson, DVM, JD. “She was enthusiastic and upbeat, and underlying that wasn’t the curtain of depression and the inability to do anything. Those often are the cases where friends and colleagues miss the cues that might help us figure out how to help.” (Zimlich, 2014, para.7)
Sadly, her case is far from unique. Many sufferers suffer in silence, without other people realising how they are feeling inwardly. Two-thirds of veterinarians have suffered from clinical depression and veterinarians are four times more likely than the average person to commit suicide and twice as likely as other healthcare professionals. (Zimlich, 2014, para 23.)
Anna Jane Grossman writes in article for The Huffington Post:
“Recently I was at my vet’s office and I asked him his thoughts on the matter (- of Compassion Fatigue Syndrome). He pointed to the long hours and relatively low pay in a field that many enter with high student-loan debt, all coupled with the fact that there are more veterinarians graduating from school than ever before, making job placement and expectations about workplace performance all the more stressful. He stopped his explanation to weigh my sickly cat. It turned out that she had gained a pound. “Yay!” he said, all 6-foot-6 of him nearly jumping up and down. He truly was thrilled, as was I: thrilled to have found a vet who cares so much.
It occurred to me that that genuine feeling — those peaks — so often have equally intense valleys.” (Grossman, 2014, para. 4)
Grossman goes on to describe how the vet may be affected by the day to day peaks and troughs experienced in his/her surgery, and at shelters too. Of course other animal care industries, like dog walkers, pet sitters and so on all have regular caring contact with animals and so are also will feel affected by the bad times and experiences.
“I thought about the day, perhaps not too far from now, that he will tell me that there is no more that can be done for my cat. Will he feel my sadness so intensely? It’s a sadness that I’m sure is only compounded when faced with clients who can’t or don’t want to invest in their pet’s medical care, or people for whom no longer having a pet would just be the more convenient option. These things happen every day at vets’ offices and shelters around the world.” (Grossman, 2014, para 5.)
Patricia Morris wrote Blue Juice: Euthanasia in Veterinary Medicine in 2012. Blue Juice is a “behind the scenes” book about euthanasia in veterinary medicine, and offers an exploration into the mind of the vet, as he goes about his daily duties, and home life, while dealing with the effects that having to perform euthanasia can have. Although this book does not deal with CFS directly, it is known that those that perform euthanasia may be at more of a risk from developing it, alongside other mental illness such as depression, and burnout. (Bough, 2016, p.23)
My methods were mainly qualitative – “Qualitative data collection is a method in which the characteristics, attributes, properties, qualities, etc. of a phenomenon or thing is described. It is the description of data in a language rather than in numbers.” (DifferenceBetween.net, 2018) – and included interviews held in person with professional colleagues, in the canine sector, a questionnaire that my colleagues filled in and passed on to other colleagues of their own, and I also had informal chats with people over social media.
I asked to hear from both people who had suffered with CFS, as well as those who hadn’t as I hoped to find some answers on how to avoid it, as well as how to recover.
In total I received 8 responses to my questionnaire, plus a phone conversation complete with consent, a zoom (webinar platform) chat – also consented, and a lot of comments and private messages over social media (of which I received 4 further signed consent forms upon request), giving me a total of 14 respondents who had signed consent forms allowing my use of their material. All other information that I was given has been discounted and disregarded for the purposes of my writing, in accordance with confidentiality and data protection laws. The adults who took part in the questionnaire had the consent form and data protection information attached to their questions, and the adults whom I spoke to over social media and by mouth had a copy of the consent form and data protection information without the questionnaire added to it. I did receive a lot of feedback from people using Facebook, however not everyone would/did sign a consent form and so I only used the experiences of the people who returned their forms to me.
All of the above participants were given details of my dissertation with what it was about, what its aims were, and then they were asked to sign and return the consent form which I had prepared and had ISCP ethical approval, (see appendix), detailing their permission for me to use their experiences and information about CFS, alongside relevant details of the data protection act, and a declaration that I would protect their identity and that of their clients by changing any names and identifying details during my writing, and that any information held would be between myself and the ISCP, and destroyed upon the completion and passing of myself on this advanced diploma course. I informed them that I could only use their contribution on receiving the signed forms.
I only asked consenting neurotypical adults, and none under the age of 18 to take part in my research. I did this because I felt that it would not be appropriate to ask adults who may have reduced capability to process emotion, or who might be unable to address any issues that arise within themselves as a result of my asking them about their experiences. I did not ask any children or young adults under the age of 18, as it was not applicable to do so in this instance. As far as I am aware, not too many children would be working with animals in a capacity which I aim to be writing about in this essay, and if they did, then again it would not be appropriate for me to risk bringing up uncomfortable feelings of Compassion Fatigue Syndrome in a child.
Nor would it be appropriate for me to expect an adult who was not neurotypical, or a child to be able to vocalise exactly what it was they had been feeling, and then I would be running the risk of “putting words in their mouth” while I made sense of what I was being disclosed. A neurotypical and responsible adult would be able to point it out if I had got something wrong or misread their experiences, and then be able to set me straight, in order to pass on true and accurate details of their experience.
That being said, there are many thousands of children who care for family members and other beings, who should not be forgotten and need as much, if not more support in their capacity as a carer. If a young person would seem to be struggling, I urge anyone involved with the child to contact Carers UK.
“Young carers are children under 18 with caring responsibilities, and their rights to be assessed come mostly from the Children Act 1989 and the Children and Families Act 2014.
If there is an adult being looked after, then the local council has a duty to consider whether there are any children involved in providing care, and if so, what the impact is on that child.
The local council have a duty to assess ‘on the appearance of need’ (ie without a ‘request’ having to be made). They also have a more general duty to ‘take reasonable steps’ to identify young carers in their area.
The local council must involve the child with caring responsibilities, their parents and any other person the young carer requests in the assessment process. The assessment itself must look at whether or not the young carer wishes to continue caring, and whether it is appropriate for them to continue caring. When doing this they have to take into account any education, training, work or recreational activities the young carer is or wishes to participate in.
Where a young carer’s eligible needs are identified as requiring support, local councils will have to:
- provide support directly to the young carer or
- demonstrate that the ‘cared for person’s’ assessment has provided adequate care and support to prevent inappropriate care being required from the young carer” (Carers UK, 2014)
I explained to participants before their taking my questionnaire and giving interviews that sometimes talking about, or reliving an experience can cause a relapse of the symptoms of CFS, so should any unpleasant feelings or CFS related symptoms surface (or resurface) as a result of relaying information to me (or at any other point), they should seek help, by speaking to their GP, through seeking out work related or sponsored programs, or to look up The Compassion Fatigue Awareness Project which has many relevant resources to help them through it. I also pass on details of reading material I have found useful in this context.
As I write this dissertation, I am very aware that I too could fall victim to secondary trauma, or CFS, through the context of studying the distressing experiences had by others and attempting to process the information into an understandable piece of writing, and should I begin to feel any of the associated symptoms, not only will I take a break from writing about them, I will seek help if the symptoms begin to affect me further.
I also have conducted extensive research in books, and on the internet, to find relevant information and data, and I reference this in my writing. There are several books on Compassion Fatigue Syndrome available on kindle – (my reading method of choice – especially good for reading on the go, between jobs and school runs) – although these are largely aimed at CFS in the human care industries. However, there are a few books that are targeted specifically at those in the animal care industries, largely aimed at shelter workers and at vets. All of these books have descriptions of symptoms, and mostly contain advice on coping mechanisms and/or on avoidance techniques, and a lot of the advice given can be cross – referenced across the industries. I have cited some of the more useful, and easily digestible books that I have found, and details can be found in the reference section of this essay.
Results & Discussion
Of all the 14 participants who answered my survey and signed consent forms, only three claimed to have never suffered with CFS, and only one didn’t feel they had ever had any of the symptoms at all. One participant, Peter*, had symptoms of CFS, but had only just realised that there was a name for how he was feeling, stating “I never really thought of it as being a condition. I just put it down to the work I was doing and the natural stress of life. A recurring theme throughout my interviews was that people didn’t always realise when they were suffering, or beginning to suffer with CFS, passing it off as just par for the course, or attributing headaches, aches and pains to other reasons, such as the heat or running around doing daily chores. (Locke Interviews, 2018)
Of the remaining 11, all claimed to have had sleep problems, mostly reporting they had difficulty falling asleep – often mentioning that they couldn’t switch off, or stop thinking about events that had happened either over the day or a traumatic event. Nightmares were a common theme, and feeling unable to get up at all the next day was mentioned in one particularly affected case, when the poor carer had suffered a dog being put to sleep, who had been in her care. Tiredness was a recurring theme too, as a result of the lack of quality sleep at night (Locke Interviews, 2018).
Interestingly out of the 11 participants who had replied to my appeal for experiences, only two had sought the help of their GP, both being administered medication as a result. Perhaps this is indicative of the seemingly common belief that CFS is par for the course, and also the passing off of symptoms as being the result of something else. A problem which was mentioned on several occasions to me was that the sufferer can feel ashamed of how they are feeling – they want to be there caring for and helping the animals in their charge, but they instead might begin to feel apathy, or even frustrated with the animals and their co –workers instead. Susannah* describes it as “I have felt myself emotionally becoming more distant from the constant cries for help as it seems never ending” (Locke Interviews,2018). They feel embarrassed that they are not coping, and that they are feeling this way, and they feel like they would be judged if they bring it up or ask for help (Locke Interviews, 2018). This could be another reason for not seeking help from the GP. Perhaps seeing the GP would mean “admitting” that actually they may not be feeling how they believed they should about their job, and their animal charges. Perhaps by seeing the GP they would then have to confront this uncomfortable truth within themselves?
Sally* a veterinary student describes her lambing experience while suffering with apathy:
“I’ve been on a pretty bad lambing placement a few years ago. I was pretty much expected to work 24 hours a day. Working both day and nights. After two weeks of surviving on about 4 hours of broken sleep a night, it was like all compassion and empathy had totally gone. I’ve always loved pet lambs. Loved bottle feeding them, completely adored them. By about half way through the placement I had just stopped caring, stopped giving them the attention they deserved. It made me feel awful that I couldn’t find it within myself to care about the little lambs anymore and I just couldn’t really understand why I just couldn’t find it within me to care about them anymore. I sort of was just doing the job to the absolute bare minimum. It’s really hard to describe as it makes me sound so awful. Every other lambing placement before and after since I’ve never felt this way and always really prided myself on keeping the pet lambs in particularly to a really high standard. So I can only put my loss of compassion down to pure physical exhaustion. I feel this is something a lot of vets probably do experience. it’s a tough one, it’s so easy to become desensitised to things.”(Locke Interviews, 2018)
Peter* wanted to add that not everyone feels apathy, he felt his moods were more like that of depression but he adds “However, you never feel good about a bad situation, but it only takes a good experience to change your mood.” (Locke Interviews, 2018)
In agreement with the Jennifer A. Bough’s writing regarding CFS symptoms falling along a trajectory in her book To Save a Starfish (Bough, 2016, p.17-p.19) not one of the 11 who have suffered/do suffer with CFS felt that the CFS came on suddenly. They all agree that it builds up gradually over the course of weeks, months, even years, chipping away at the person’s enthusiasm for their work, slowly taking away the joy and pride in what they do, and replacing it with a feeling of it “never ending” or just becoming a pointless exercise. But as Cara* points out, “I think one of the most important things to remember is we see dogs when things go wrong. We don’t often see dogs when things go right, because then they don’t need our help.” Pauline* a rescue shelter manager, when asked about whether it was a sudden or gradual process, says:
“I guess it creeps up on you without realising it, as you get so involved in rescuing, taking dogs in- in most cases finding somewhere safe to take it or end up taking it home, then finding funding, vet runs, trying to find a family, assessing it, introducing it etc etc etc you just wake up one day realising you are absolutely exhausted, with pains & aches from all the juggling around such as work, family, everyday chores, cleanings, dogs etc.” (Locke Interviews, 2018)
Some felt that they were simply letting down the dogs, and were somehow to blame for things going wrong with the dogs, or with euthanasia. Behaviourist and trainer Emma* had been through a terrible time, seeing two dogs, from two families with whom she had done extensive work, and was making progress, as well as her own dog, all put to sleep – for health reasons and not behavioural reasons – within a few weeks of each other. She had done everything right by these dogs, and made a massive difference to their lives, but she could only see that she had let them down, even though she had no blame in any of these three cases. She shut down emotionally, and became quite sick. She described how “everything hurt” even though there was no physical explanation for it (Locke Interviews, 2018).
Headaches and migraines were very common among my participants, although some put it down to other reasons such as the heat where they lived, and all the early starts. Anxiety symptoms were also a problem, although not as often as the headaches. (Locke Interviews, 2018).
Dianne* reports that “At times I have gotten anxiety from it. I am actually not an anxious person by nature, it’s because of the stress for sure. Symptoms of anxiety come up for absolutely no reason, they are not really connected to anything at all – I’ll just feel them… and they are very chronic when that happens – it’s just all the time… That’s a big sign for me that I need to take some time for myself.” (Locke Interviews, 2018)
All of the 11 respondents who felt they had experienced CFS said they felt, or had felt differently about their jobs as a result of the CFS, and all had seen their jobs in a negative light. All respondents seemingly felt that their jobs had taken over their lives to some extent, and that they were disillusioned with the life they were leading.
Animal care working, be it in behaviour, training, veterinary or shelter work is emotional work. The carers tend to be among the most empathic of people. Figley and Roop write “Empathy, according to most dictionaries, is the identification with and understanding of another’s situation, feelings, and motives. Empathizing is impossible if one does not have the ability to empathize” (Figley & Roop, 2006, p.3).
Bough tells us that some people are very sensitive, and have extreme empathy. She says:
“The ability to identify so strongly with the suffering of animals is often what leads us down this career path, but it also causes us to put the needs of others ahead of our own. Indeed many of us who work with animals would describe it more as a calling than a career choice.” (Bough, 2016, p.12)
She advises taking a self-test to see if you are a highly sensitive person too, at http://hsperson.com/test . By learning if you have a sensitive personality type, you can learn if you need to be even more aware of your emotions and your susceptibility to CFS. Of course not all people who develop CFS are highly sensitive, and not all highly sensitive people will develop CFS, but it is worth bearing in mind. She also recommends taking a personality test, to see what your qualities are at http://www.humanmetrics.com/personality/type for the same reason. (Bough, 2016, p.13 – p.14)
The carer becomes attached emotionally to their clients, and they judge themselves on the way things work out for the animal. They become invested in the outcome of the client’s tale, and they work hard to make it a successful one. CFS sufferers can become so invested in their work that it becomes all consuming. Cath* tells me in her questionnaire, that she is so invested in the situation that she is emotionally and mentally drained. She often feels distracted and rarely relaxes enough to have a normal conversation, which doesn’t involve dogs. This has affected her personal relationships which only adds to the pressure. (Locke Interviews, 2018). Similarly, Holly Cook (2016, p.73) writes of the beginnings of her symptoms, after finding herself uncharacteristically frustrated while waiting for some dogs in her charge to go toilet, and she unknowingly began to let her work and her CFS take over her life:
“Something had changed in that moment, and that thought hung on for some time, although I refused to let it have any power. Instead of introspection, I stubbornly worked even harder. Everything had to be perfect. I couldn’t say no to my clients and I isolated myself from my family. I had trouble deciding what to wear, what to eat, which core to do first. My insomnia became a constant. I couldn’t sleep through the night if I was lucky enough to fall asleep at all. I didn’t want to talk to anyone except my dogs. What I later learned was compassion fatigue tightened its grip on me.”
What did these people do to help themselves feel better? What advice do the books give? How is it possible to learn to cope with the strains of the animal care sectors, while maintaining a degree of satisfaction and happiness both in the job and in the spare time?
One of the first thing that jumps out from all the questionnaires I received back, along with advice in books and chats with interviewees is the feeling of isolation that comes with CFS. Along with feeling frustrated, anxious or experiencing apathy, it seems to be the start of the CFS path. (Locke interviews, 2018; Bough, 2016, p. 17 –p.19). Knowing when to speak to a peer or a doctor about how you are feeling is vital – as is checking in on your colleagues and asking them how their day is going (if you are feeling up to it – there is no point making yourself feel worse if you are already struggling.) A good and supportive relationship with peers is paramount to seeing off, or recognising the start of any issues with CFS.
Jane* said to me during our interview that her team are all very conscious of keeping an eye on each other. She says “having a good team, who you can trust, around you is vital. Internalising everything, and isolating makes the problem worse. You need to be able to talk and get it all off your chest, or small things quickly escalate into bigger problems.”
Knowing when to take time out is also important. Jane* advises that it is essential to be able to compartmentalise the work, and be able to walk away from it. “Take time off if need be, and have a good team of people who will cover for you – and you help them when they need it.” (Locke Interviews, 2018)
Dianne* agreed with this: “I find myself needing serious time off work… I’ll get so tired – I won’t want to talk to anyone, I pull way, way back and that can last for a while, but then in time I get rested, and I go back to work.” (Locke Interviews, 2018)
Figley & Roop state that: “A positive work environment includes workers who care about each other and show it. They genuinely like one another, and they may joke around and/or pitch in when needed and often without being asked to do so. They pick up on even the most subtle mood changes of fellow workers and ask about them in a caring and supportive manner” (Figley & Roop, 2006, p.10).
A good sense of humour works wonders for yours and other’s morale. Being able to find a light in the dark can make all the difference. Jane* recounted a story where she and a colleague had been hard at work all day. As their working day came to a close, they were asked to transport some animals to the shelter. This took them much longer than they had anticipated and they arrived late at the shelter with the animals, long after they were supposed to be finished. Worn out, they thought they were finally going home, when the boss asked them to clean out the transport before they left. During transport, one dog had defecated everywhere while the other had vomited everywhere. As Jane* turned on the hose, and began to wash down the transport, she misjudged the direction of the water, and the splash completely showered her friend in vomit and faeces. Rather than be annoyed at Jane*, the colleague roared with laughter. What could have been the final straw, was in fact the funniest thing that had happened in ages. (Locke Interviews, 2018)
Vets and nurses, and euthanasia deliverers have been known to give Euthanasia injections more appealing names such as “blue juice”, in an unconscious attempt to make the drugs less unfriendly sounding, and sometimes distance themselves from the patient by referring to them by their problem – “my cataract at 12pm” or “my pyometra”. This distancing themselves from the horrors they can face, makes it slightly more bearable.
Patricia Morris writes in Blue Juice: Euthanasia in Veterinary Medicine:
“Away from patients, physicians sometimes use humorous or sardonic expressions to describe death or dying, such as “circling the drain”, “croaked”, “kicked the bucket”, “pushing up daisies”, “bit the dust” or “bought the farm”. Though veterinarians also use these dark euphemisms, they have unique terms to discuss the death of their patients, such as an animal “went paws up”, “was given go-go juice”…. Although dark or gallows humour is an important tool for creating distance from emotionally troubling aspects of some activities, researchers acknowledge that too much can tip the delicate balance between distance and connection.” (Morris, 2012)
Others turn to more pro-active methods to help ease their suffering. A hobby outside of work, preferably that has nothing to do with dogs, was suggested both to me, and in literature on several occasions, giving the brain a chance to focus on something else for a while.
Molly* says that she views her Canine work as a secondary career, choosing another job for the rest of the time. In doing her behavioural work this way, she feels like she has less pressure on her. She also supports dogs in a therapeutic setting, and some of her training involved self-supporting techniques as well as gaining support from others. “When I have had a tough therapeutic consultation, I can feel exhausted and need to recharge. As a Reiki practitioner and user of essential oils, Bach flower remedies and crystals I can use my knowledge and skill to rebalance.” (Locke Interviews, 2018)
Hopefully outside interests will also bring outside social opportunities too, the more you can stop your entire life revolving around your work, the better it seems, are your chances against CFS taking hold or sticking around for too long. Jennifer A. Bough in suggests in How to Save a Starfish suggests doing something active every day – even if it is just a stroll in your lunch break, though she does suggest a whole range of sports, and she then goes on to suggest that you write down each day what activity you did, time spent doing it, and how you felt afterwards. (Bough, 2016, p.55 -57) In doing this you will not only have a chance to develop a new hobby, with all the social opportunities and the brain space it will occupy, but you will get your body fit and healthy – and ultimately from a holistic point of view – help your brain to realise that there is life outside of work and so be less stressed in general. Creative hobbies are encouraged by Bough too – as the act of creating something can bring about a feeling of satisfaction, and pride which can spill over into other areas of life too.
Tanya*, a well-known behaviourist and trainer with many years in the canine world under her belt, who says she has never suffered with CFS, says one of the ways she achieves a home/work life balance is to never open work emails after 8.30pm. – have other things in your life (Locke Interviews, 2018)
One of the best ways, that has been mentioned to me frequently, of destressing would be that of practicing mindfulness. According to Bough, mindfulness is helpful for anxiety, depression, sleep and stress. She tells us that “Mindfulness, which has its roots in early meditation practices, has been backed by modern day scientists, and is now enjoying increasing mainstream popularity… …When we learn to be mindful, we can then let go of many of the negative thoughts and emotions that often prevent us from living a truly happy and fulfilling life.” (Bough, 2016, p.33 – p.34)
Kate* a vet nurse, would be inclined to agree with finding hobbies outside of work and active interests along with mindfulness, when I asked her what got her through her problems with CFS she answered “It is difficult to know what got me through it, reducing hours and taking time off helped. Reading about CFS and recognising that is what it was – and practising meditation and mindfulness activities, oh and yoga, helped the most.” (Locke Interviews, 2018).
Penny* who works with rescues, furthers the idea of separating work from home, and taking time out for yourself by adding:
“Don’t take on more than you can chew – don’t make your home a sanctuary (she means for animals, by all means make it your own sanctuary for you!). …You need time and space from it on a daily basis to last longer. There will be cases that stick in your mind and you can’t get them out, but you still need to switch off and unwind, to be able to have the strength to continue to do what needs to be done. – half burned out won’t help and you won’t have a clear head to enable you to come up with the best solutions, completely burned out won’t help anyone. So always have space for yourself and time outs.”
It is worth pointing out here that professional burnout can be experienced by people in any form of work, but it has many similarities and shared symptoms with CFS. (Figley & Roop, 2006, p.19 – p.21).
Jane* suggested taking time to remember all the ways you have helped, all the dogs who’s outcome was made better because of you. She keeps photos of all the rehomed dogs on her phone, happy in their new homes with their owners, because she helped to get them there. Perspective when it all seems pointless is paramount to keeping a grip on CFS thoughts and feelings.
From the research I have done, and the information and experiences I have gathered together, I have found that Compassion Fatigue Syndrome is more prevalent than one would expect. When you take into account that some people are suffering without realising they have CFS, or reporting it to either their GPs or their work peers, then what initially seems to be a select few people who are not coping becomes an epic scale problem that needs addressing. If not for ourselves then for the animals we so wanted to help, when we started on this path, for it is they who suffer with us.
Avoiding/overcoming Compassion Fatigue Syndrome:
- Keep a balance between your life in work and your life out of work. When you are finished for the day, learn to mentally compartmentalise as much as you can, switch off your work phone, leave the emails, do not bring work home with you. This is your time, and you have done enough to help during your working hours – now you need to recharge and relax.
- Eat well, take regular exercise and have regular check-ups with your GP. You need to consider your health holistically – if one part is out of kilter, then you as a whole, and ultimately your mental state and work life will suffer. If you are not eating healthily, and keeping fit enough, then your body suffers at a cellular level – and that is before you even begin to work in a stressful setting. Your GP will not judge you for how you are feeling, and they will not inform anyone else that they have seen you – although you should try to talk to your peers about how you are feeling yourself. Your GP will not take that power from you though – they are bound by patient confidentiality, and besides – they see patients with mental issues day in day out, and know how best to access support, in your local area if you need it.
- Listen to your body. Are you becoming tired, frustrated, eating properly, sleeping well, keeping hygiene standards and taking care of yourself? If not, then it might be time to step back and seek help before it becomes a problem.
- Have regular check ins with work colleagues. Ask them how they are, and tell them how you are. Offloading to someone who understands instead of bottling feelings up can help prevent them becoming problematic. Take time out if you need it. Offer to cover for colleagues who struggle, and they do the same for you.
- Laugh when you can. Try to see the humour in life when it presents itself.
- Learn to practice mindfulness, do breathing exercises and meditate. Clearing the mind of all thoughts is like giving it a little holiday from the stress, will calm you and will help you to cope better. Some exercises can be practiced anywhere – even on a 5-minute toilet break!
- Have hobbies and interests. Things that do not involve dogs, preferably, but occupy space in your mind that might otherwise lend itself to CFS. As the saying goes “To avoid weeds, plant densely.”. Exercise is good for the body as well as the soul, so perhaps take up a sport. You do not have to be a brilliant sportsperson to take up most things, and perhaps your colleagues might be interested in joining you, benefiting both parties in and out of work? Maybe Yoga if you are less interested in being too sporty but still fancy reaping the benefits – although Yoga can be pretty wearing too! Less energetic types (like me) might enjoy researching their family tree, or doing a course in a new skill. Creative types can take up painting classes, learn instruments and join a band, join a choir, or even make and sell crafts and handmade goodies. A sense of achievement can be found in any of these activities, which will bolster the mood in general. A social life can be gleaned away from the doggy world, even by taking some colleagues along with you, you will meet other people and have new things to talk about between you.
- Learn to say no, and know your limits. You do not have to be the person that always says “yes” when asked to do everything. Do not let small annoyances become massive issues. Know what you are comfortable with doing, and set limits. If you do not want to stay back at work every night while others don’t take their turn, then do not get into the habit of doing so. Better to get it off your chest before it becomes an issue than after.
- Keep photos of your success stories. When you feel a little down, whip them out to remind yourself to be proud – You are making more of a difference than you realise.
- If you or your colleagues ever feel suicidal, or begin thinking about your own death, or find yourself thinking of harming yourself in any way, please stop what you are doing and get help. In the UK you can call The Samaritans on 116 123 from any phone. If you suspect somebody (including yourself) is in immediate danger, you can call the emergency services on 999, or in other countries call their emergency phone lines.
Recognise that you can’t solve every problem, all of the time. You are doing your best, and you are making a difference. When it feels like you are getting nowhere, think of the animals who are doing well because of you. To gain perspective, remember this story:
References and Bibliography
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Questionnaire and Consent form – https://1drv.ms/w/s!AhPbxlh89hiw2CWltQmAfOdPA3O7