Combat Compassion Fatigue

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Combat Compassion Fatigue

What is Compassion Fatigue?

  • A reaction experienced by care givers who suffer trauma from the event(s) that have traumatized their patients.
  • It is NOT “Burnout”, which results from increased workload and institutional stress.
  • It is NOT “Countertransference”.which refers to how our patients affect our lives, our social networks, our work, and our relationships. Countertransference may co-occur with Compassion Fatigue, however.

Just like Post Traumatic Disorder has several names, so does Compassion Fatigue:

  1. Also called “Vicarious Traumatization” and “Secondary Trauma”.
  2. With “Burnout” and “Countertransference” there may be no exposure to the trauma of others.
  3. With Compassion Fatigue, Vicarious Traumatization, and Secondary Trauma, the care giver suffers because of the trauma experienced by the patient.


  • Nurses
  • Doctors
  • Chaplains
  • Paraprofessional's—91Ws
  • Volunteers
Others who work in high intensity areas with severe trauma patients—Field Medics, ER's, ICUs.
  • Graves Registration workers
  • Body, body parts handlers
  • Mental health workers---it is not only physical trauma,
    but psychological trauma exposure that can lead to compassion fatigue


  1. Those who have a history of trauma are more vulnerable to compassion fatigue.
  2. Those care givers who are inexperienced, and fear not being able to do their jobs, who are afraid of what they might see!
  3. Care givers who are in danger themselves—field medics!

We have not been directly exposed to the trauma scene, but we hear the story told with such intensity, or we hear similar stories so often, or we have the gift and curse of extreme empathy and we suffer. We feel the feelings of our clients. We experience their fears. We dream their dreams. Eventually, we lose a certain spark of optimism, humor and hope. We tire. We aren't sick, but we aren't ourselves.


Care givers report the following signs and symptoms of Compassion Fatigue:
  • Bystanders guilt
  • Rage
  • Grief
  • Dread
  • Anxiety
  • Numbing—”I have nothing left to give.” Detached from the world around you.
  • Panic attacks
  • Alcohol abuse/drug abuse
  • Disturbed sleep
  • Nightmares
  • Spontaneous crying spells---”for no reason”
  • Irritable outbursts/Impatience
  • Difficulty concentrating
  • Chronically late for work
  • Depression


  1. First recognize that Compassion Fatigue is NOT a “mental illness”
  2. Accept support and non-judgmental listening when offered
  3. Avoid negative people
  4. Exercise, get out doors
  5. Make the opportunity to leave the ICU, ER, etc., and go see the progress soldiers are making in Physical Therapy and Occupational Therapy
  6. Take turns with the most stressful, sad tasks, like calling the patient's family
  7. Staff Support Groups
Within this web site you will find many stories and assistance dealing with trauma.

Samples include:

When you are making out your Christmas card list this year, please include the following:

A Recovering American soldier
c/o Walter Reed Army Medical Center
6900 Georgia Avenue,NW
Washington , D.C. 20307-5001

Please read the following story to gain great insight to "Caring for Others without Forgetting Self-Care." This is by Charles R. Figley, someone that I do trust to give good information!

The Struggle to Care for Wounded GI's!

Combat Psychologist Treats Trauma, Deals With Her Own

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