When caring becomes heavy: Recognizing compassion fatigue in occupational therapy practice
We are all a bit too familiar with burnout. You may have experienced it yourself from a demanding job, school, or both. Maybe you’ve seen countless posts in occupational therapy social media groups about people feeling drained by productivity standards or overwhelming caseloads. But have you ever heard of compassion fatigue? I hadn’t until I started experiencing it myself. The American Psychological Association (APA, 2018), defines compassion fatigue as, “the burnout and stress-related symptoms experienced by caregivers and other helping professionals in reaction to working with traumatized people over an extended period of time.”
I am currently completing my second Level II fieldwork in an inpatient spinal cord injury unit— a setting that is both inspiring and emotionally demanding. Patients often arrive after life-altering injuries, often traumatic ones. They share their frustrations, their longing for their previous selves, and the grief of losing the ability to perform everyday tasks we often take for granted. Witnessing these struggles has been profoundly eye-opening. I’ve found myself imagining what life would be like in their position: What if I couldn’t hold my son again? What if every shower required three transfers? The physical and emotional weight of their realities can be overwhelming. At times, I’ve felt inadequate teaching someone with paraplegia how to dress, an activity that I usually perform automatically (hello, activity analysis!). Beyond clinical skills, my thoughts often spiral to their futures; whether they’ll regain independence, resume meaningful roles, and receive the support they need post-discharge.
Eventually, the emotional load became too heavy to manage alone, so I opened up to my clinical instructor. She reassured me that my feelings were valid and normal, explaining that, with experience, you learn how to “let go.” Clay (2022) references psychologist Heidi Allespach, who encourages medical professionals to develop a semi-permeable membrane around their hearts: a shield that allows empathy in but prevents total emotional absorption. In occupational therapy, our compassion drives us to care deeply, to connect, and to restore function. Yet, in doing so, we sometimes risk losing a piece of ourselves. Recognizing compassion fatigue is essential. Common symptoms include loss of productivity, depression, intrusive thoughts, jumpiness, tiredness, feeling on edge or trapped, and difficulty separating personal and professional life (Clay, 2022).
If these sound familiar, you may be experiencing compassion fatigue rather than burnout. Fortunately, there are steps to protect your well-being while continuing to provide meaningful care:
- Recognize your signs and symptoms. Awareness is the first step toward intervention. Notice when you’re feeling drained, irritable, or disconnected. Catching these signs early makes it easier to take action before things get worse.
- Speak up! Reach out to colleagues, family, or trusted friends. Sharing what you’re going through can help lighten the load and remind you that you are not alone.
- Prioritize self-care. Make it non-negotiable. Make time for things that recharge you— sleep, movement, hobbies, or quiet time. Treat self-care as something you have to do, not just for when you have time.
- Set boundaries. Learn to separate work from personal life. It’s okay to say no, to unplug and protect your downtime. It helps you to show up better in the long run.
- Seek professional help if needed. If stress or fatigue feel overwhelming, talking to a counselor or therapist can make a big difference. Getting help is a sign of strength, not weakness.
As new occupational therapy practitioners and students, our compassion is our greatest strength, but it must be protected. By acknowledging compassion fatigue and practicing intentional self-care, we not only preserve our well-being but also ensure we can continue showing up for our clients with the empathy and energy they deserve.
References
American Psychological Association . (2018, April, 19). Compassion fatigue. APA Dictionary of Psychology. https://dictionary.apa.org/compassion-fatigue
Clay, R. A. (2022, July, 11). Are you experiencing compassion fatigue? American Psychological Association. https://www.apa.org/topics/covid-19/compassion-fatigue
Julamy Serrano Arocho is a third-year occupational therapy student at Brenau University in Georgia. Prior to occupational therapy school, Julamy served in the U.S. Air Force as a Nuclear Operations Officer and continues to serve in the Georgia Air National Guard as a Logistics Officer. Julamy holds a Master’s Degree in Exercise Science – Clinical from Liberty University. Her main occupational therapy interests are pediatrics and neuro rehabilitation. Outside of occupational therapy school, Julamy enjoys spending time with her family, exploring different outdoor parks, and watching true crime shows.