Untethered: When Caring Hurts Too Much

Chaplain Resident Michelle Jendry

I remember the first time I realized something was off with me. I was in my car driving to work. I was a chaplain intern at another hospital at the time. Nothing was unusual about that morning really. I remember my mind was running that day. As someone with anxiety, it’s not at all unusual for my mind to be churning on something, overthinking as usual. But this wasn’t overthinking as usual. Honestly, I barely remember having any one particular thought or one big thing I was worried about. It felt like, out of nowhere, I just fell into this confusing spiral of emotions and thoughts: about work, about school, about my patients, about the state of the world. I was surprised when I started crying seemingly out of nowhere. I didn’t even really know why I was crying. I was crying over everything, yet also nothing the same time.

I also started having problems sleeping. I had been a night owl for quite a long time (and was especially used to it as a grad student). Usually though, the physical challenge of working a 9-5, Monday through Friday schedule where I was often on my feet was enough to have me falling asleep right when I hit the bed. In the couple of weeks leading up to me crying in my car, I’d started having a hard time falling asleep even when I felt physically exhausted. It felt like I just couldn’t turn my brain off. Even when I felt physically about to fall over from exhaustion, I would lay in bed awake. Thinking about different things: about stories I’d heard from patients and staff, about events I’d witnessed recently, about what I might witness the next day…

Maybe a few days after the crying in the car incident, I almost passed out at work. I walked in that morning, extremely tired as usual but determined to tough it out. As I was looking at my patient lists for the day, I felt dizzy. I thought maybe I just needed to get some caffeine or something to wake me up, so I got up from my chair. Right away I felt like the world was spinning around me. I freaked out and called my boss, who told me to go home for the day. Though she strongly advised I find someone else to pick me up and take me home, I made the risky decision to drive myself home. Having someone else come get me felt like I was being a burden, like I was making a big deal out of nothing. Luckily, I made it home safe, and I slept the entire rest of the day once I got in bed.

I was overflowing with emotions and stories from my work, and I didn’t realize it until then. As a chaplain, the one thing I love the most is being able to listen to people’s stories and find a way to help them that’s spiritually meaningful. I love helping people. It’s my purpose in life. But I’d experienced too much without processing, without letting out my emotions in some way. I was bottling things up. I felt guilty that I wasn’t doing enough even though I was running on fumes. I was increasingly irritable. I would try to numb or deny my exhaustion by caffeine and constantly snacking on junk food and sugar. I had trouble concentrating in my visits and ran out of mental energy faster. I couldn’t stop thinking about patients and trauma and what heartbreaking situation I might encounter next, even when I wasn’t at work. I felt untethered in a choppy sea.

These are all signs of something called compassion fatigue. The Compassion Fatigue Awareness Project defines compassion fatigue as “emotional, physical, and spiritual distress in those providing care to another [that is] associated with caregiving where people or animals are experiencing significant emotional or physical pain and suffering.” Some common signs of compassion fatigue include (but aren’t limited to):

Cognitive

  • Lowered Concentration
  • Apathy
  • Rigid thinking
  • Perfectionism
  • Preoccupation with trauma

Emotional

  • Guilt
  • Anger
  • Numbness
  • Sadness
  • Helplessness

Behavioral

  • Withdrawal
  • Sleep disturbance
  • Appetite change
  • Hyper-vigilance
  • Elevated startle response

Physical

  • Increased heart rate
  • Difficulty breathing
  • Muscle and joint pain
  • Impaired immune system
  • Increased severity of medical concerns

I’m no doctor or mental health professional, and my intent isn’t to diagnose or treat. My goal is to help raise awareness through sharing my own personal experience. Compassion fatigue isn’t confined to what we typically think of as helping professions—healthcare, social service, public safety—either. Anyone who is exposed regularly to stories of people experiencing trauma can be at risk. Steven Petrow of The Washington Post wrote this article exploring compassion fatigue in those who care for family or friends with long-term illnesses. Elisa Gabbert wrote this piece for The Guardian exploring if our constant exposure to horrific news stories can cause compassion fatigue. These were both written before the current COVID-19 pandemic too, in which many of us have faced prolonged fear, exhaustion, and trauma.  

So, what can help? There are lots of resources out there with information on how to face compassion fatigue. For me, I needed to re-tether. To myself, to my community, and to my spirituality. A few things helped. The biggest overarching change was a change in my attitude: I realized that I needed to change the way I was living. I couldn’t spend my life running on fumes and still feel happy. I prioritized my needs: I made sure I took breaks during my day for relaxation and for making sure I was fed, hydrated, etc. I started journaling to process the events and emotions I was experiencing. I started working on getting more sleep. I came up with a ritual for starting and ending my work to help me not take work home with me as much. I eventually made time to see a therapist to help me work through things and make a self-care plan. It wasn’t one single overnight fix; it was a bunch of smaller changes I made to my life that had effects over time. It was not (and still isn’t) easy, but it’s so worth it to be able to do the ministry I love for the long-haul. To be able to give without losing all of me. To be able to reach out to help others while remaining securely tethered, connected to my own inner sense of home and self.

For More Information and Resources on Compassion Fatigue and Self-Care:

The National Child Traumatic Stress Network on strategies for taking care of yourself in the face of trauma

Overcoming Compassion Fatigue” in FPM, the journal of the American Academy of Family Physicians

The Michigan Medicine Wellness Office (for MM students, faculty, and staff)

The Michigan Medicine Office of Counseling and Workplace Resilience (for MM faculty and staff)

Michigan Medicine Spiritual Care Department’s Resource Page

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