Compassion Fatigue: When Is It OK To Stop?

I am a physician, which means I help people. I’m also a parent, so the “helping people” thing doesn’t stop when I leave work. I am also a Christian, which means I’m supposed to help people in my free time as well. Despite this, I will admit that sometimes I just don’t have it in me to help people. Is that OK?

I will never forget one night in residency (no, it’s not like Grey’s Anatomy) that broke me and made me rethink all of this ‘helping people’ stuff. I had a difficult overnight shift in the ER. I tried to hold it all together emotionally, between the people dying and the people yelling at me, and the people throwing chairs. (Maybe this part was kinda like Grey’s). No matter how hard I worked, I kept getting further and further behind.

I took a few minutes to sit and regroup, but the sick people kept coming. I had a realization. “People will never stop needing help. I can’t help them all. I need to leave them in their suffering for a bit.” It felt like a selfish thought. I felt guilty for thinking it.

Then I wondered, did Jesus ever get up, walk out, and say, “I can’t even with all these needy people right now?” Did He?

Yes, He did.

It probably didn’t look that emo, but he most definitely walked away from people who wanted his help. The book of Mark (one of the books about the life of Jesus) tells a story of a time that Jesus did this. Chapter 6, verses 31-32, says:

Then because so many people were coming and going that they did not even have a chance to eat, Jesus said to them, “Come with me by yourselves to a quiet place and get some rest.” So they went away by themselves in a boat to a solitary place.

Time-out: Who wants to go somewhere, look at the chaos, say “nah,” and then walk away to get on a boat?? Sign me up.

Later in the chapter, the crowds kept gathering, and Jesus went back to them out of compassion. But let me focus on the “I’m out” portion of the story.

How do we know when we reach the point where our personal needs out-weigh our desire to help? If we do not recognize this, we develop what the world calls “compassion fatigue.”

Compassion fatigue happens when we help people so often that we grow numb to their suffering. Umm, that doesn’t sound like a place God wants us to be. Compassion fatigue has the potential to happen in any role which requires us to repeatedly help people. Maybe you work in healthcare, or ministry, or education, or you are an essential worker, or you work in retail over the holidays (I will pray for you now), or you’re a parent. When is it OK to walk away? Is it selfish?

Compassion fatigue is the natural consequence of repeatedly providing more care than you receive. We are all susceptible to it, but it is not how God designed us to operate.

When we break it down, there is suffering in the world because the world is broken. Regardless of your faith background, we can all agree that the way the world works is not what we signed up for. We can disagree on how it should work and why it doesn’t work. But we can all agree that this (broadly gestures at everything) isn’t it.

And when people need help—they are sick, they get divorced, they have financial troubles, they are trying to return the ugly sweater Aunt Mabel gifted them and didn’t have a receipt, the kids are fighting—it is because of the brokenness in the world. Something isn’t working how it’s supposed to work, they want it fixed, and they want your help fixing it. So now their problem is also your problem, which means the brokenness in the world is partially your problem to fix. We should absolutely help. But, these problems are not our burdens to bear, alone, forever.

This brokenness is sin, and only God can ultimately restore the world to the way it was meant to be. Do you know who isn’t supposed to take on all these burdens to restore the world single-handedly? You. Me. Us. Humans. We weren’t designed for it. And that is why we break, emotionally, when we try to do it.

The verse about Jesus getting away from the crowds tells us how to recognize when it is time for us to get away. They did not even have a chance to eat. When the disciples no longer had time to meet basic human survival needs, Jesus took them away to rest.

Are you taking care of yourself? God makes it clear that we are supposed to take care of the place God lives—in us. 1 Corinthians 3:16 says, Don’t you know that you yourselves, are God’s temple and that God’s Spirit dwells in your midst?

Haggai 1:9 says, You expected much, but see, it turned out to be little. What you brought home, I blew away. Why?” declares the Lord Almighty. “Because of my own house, which remains a ruin, while each of you is busy.”

Some subtle clues that we’re not taking care of ourselves:

• Do you usually work over your lunch break? Or get drive-thru because you’re short on time? Or just skip eating like it’s not a required element of survival?
• Do you repeatedly feel sleep-deprived? Do you need coffee just to function?
• Are you too busy to exercise?
• Are you too busy to take a day of rest once a week?
• Are we letting our own temples fall into disarray because we are too busy making the world a better place?
• Is our work fruitless because we are neglecting the place where God says he lives (in us)?

“But all of this sounds totally normal and American.” Yeah, you and me both.

The US also has incredibly high rates of burnout. Clearly, we’re doing something wrong. This is what the Bible says about helping others.

• First, God wants to fill us. Psalm 81:10 says, I am the Lord your God, who brought you up out of the land of Egypt. Open your mouth wide, and I will fill it.
• Next, He wants us to overflow. Psalm 23:5 says, “You anoint my head with oil. My cup overflows.”
• Last, He wants us to serve from the overflow. 1 Thes 3:12 says, “May the Lord make your love increase and overflow for each other and for everyone else, just as ours does for you.”

How in the world are we supposed to serve from the overflow when we are empty? We can’t. And that’s why we burn out and stop caring about one another’s sufferings. Fasting is Biblical, but we can’t fast forever.

Jesus sometimes stayed up all night to pray, but he didn’t do it every night. Sometimes we have to sacrifice our own needs, but we can’t operate like this every day as our ‘normal.’ It is not a sustainable lifestyle when we repeatedly put another’s physical, emotional, and spiritual needs ahead of our own. God knows this, and he wants you to take care of yourself.

Here are a few ways we can deal with our compassion fatigue from repeatedly serving others. (FYI: There are clearly right and wrong answers here. I hope I don’t have to clarify which is which.)

1. Escapism: Just ignore the problem. This looks like binge-watching Netflix, mindlessly scrolling on our phones, shopping, over-eating, over-drinking, gambling, substance abuse. It makes us forget that we’re carrying someone else’s burdens, but it doesn’t make the burdens go away.
2. Grow calloused: Don’t let the problem in. Look, I love dark humor as much as the next person. But it doesn’t fix the problem, and it makes me rude. Then people stop inviting me to things because I tell insensitive medical jokes over food.
3. Internalization: Carry the burdens yourself. This leads to anxiety, depression, and self-harm.
4. Rest: Whether it is a day or a full vacation, this helps us reset and get perspective.
5. Community: We all have our scars. When we care for others who have similar wounds, it reminds us of our own. Sometimes it reopens them. We need people who can help us care for ourselves when they do.
6. Self-Care: Sometimes, this looks like escapism to an outsider. The difference is what happens internally. Self-care helps us process what we are dealing with. Escapism ignores it. It’s not about eating more kale and salmon. It’s about doing whatever you need to do in order to think through and process what you dealt with today. Maybe it looks like a run, a bubble bath, yoga, journaling, or coffee with a friend. Or maybe you just need to think quietly over a plate of kale and salmon.
7. Take it to God: I do “spiritual accounting” every evening, to take whatever problems the world dumped on me today and hand them over to God. I inventory:
   • Withdrawals—What did the day cost me today? Where did I make withdrawals for others? What did I spend on exhaustion, sorrow, anger, empathy, and pain for others?
   • Deposits - Where did people invest in me today? What did they do to bless me and encourage me? What filled me up?
   • Transfers - If I’m running a positive balance, I can go out and serve. If I’m running a negative balance, I need to turn to God. I need him to pay some of my bills, cover my withdrawals, and make some deposits. I can’t afford the lifestyle I’m leading and need his help.

This sounds like a good wrap-up, but I have one more gut-check for us. This one is usually the hardest. “I can’t get away and rest. If I don’t do the thing, then no one will do the thing, and then the world will fall apart because no one will help that person.”

That, my friend, is a lie. That is pride. It is another version of “the world needs me in order to function.” God knows you need to eat and sleep. He designed you to need food and rest. And God knows the other person needs the thing done. And when you say, “I can’t take care of myself because no one will help take care of that other person,” then you are saying it is your responsibility—not God’s—to meet that person’s needs ultimately.

No, I am not going to walk away from a person in full cardiac arrest because I’m hungry and it is Taco Tuesday in the cafeteria. That is ridiculous. But I am going to set some boundaries.

I am going to do everything in my power to help the people who God puts in my path. And when we reach a point where the situation is stable or outside of my abilities, I am going to pray and hand it off to God (or others) to take over from there. He doesn’t ask me to solve the problems of the world. He asks me to (1) go to Him and fill up, (2) pour out to the people in my path, within my skill set. Part of helping where I can also means I need to recognize when I’m empty, get away, and trust God to take over from there.

We are much more effective when we serve out of God’s fullness than our own emptiness.