Last week, Maria stayed late at the clinic again.

After helping a client through a crisis, she kept replaying it in her head.

She was irritable with her colleagues, skipping lunch, and struggling to sleep at night. Even though she loved helping people, she felt exhausted. She often wondered: was she still making a difference?

What Maria was experiencing is common among those who care deeply for others – a state known as compassion fatigue (CF).

It’s important to note that compassion fatigue is a normal human response commonly seen in empathetic people. It isn’t a disease or an illness. It’s a temporary state – a spectrum – that you can shift further out of.

In this article, we'll explore the signs of compassion fatigue, possible contributing factors, and how to address it through mindset shifts and practical techniques.

Compassion Fatigue Symptoms

Common signs of compassion fatigue include:

• A sense of hopelessness
• Decreased ability to empathise
• Irritability and impatience
• Decreased productivity and job satisfaction
• A reduced ability to feel pleasure
• Trouble sleeping
• An urge to isolate yourself from others
• Self-doubt and reduced self-esteem
• Signs of anxiety such as breathing difficulties, muscle tension and digestive problems

The Professional Quality of Life Scale Screening test (PROQOL) assesses compassion fatigue symptoms. It’s available to download for free here.

Causes of Compassion Fatigue

Compassion fatigue is often described as the "cost of caring," and it runs deeper than simple burnout.

Being around other people’s pain day after day takes a real toll, putting steady pressure on your nervous system. How heavy that toll becomes depends a lot on practical factors like your workload, the culture of your workplace, and whether you’re given proper support.

At the same time, the way you think about your role can also make a difference. Here are four mindset factors that can add extra strain:

1. High Expectations of Work

Many helping professionals enter their fields driven by a desire to alleviate suffering, to right systemic wrongs.

However, when expectations become idealised rather than grounded, they set the stage for chronic disappointment. This mindset often ties into what psychologists call the fallacy of fairness: the unconscious expectation that life should be fair, that effort should automatically lead to reward, and that justice will always prevail. When reality repeatedly contradicts this, it can feel deeply disheartening.

To protect themselves from the pain of a broken worldview, professionals may numb themselves, losing the empathy that once fuelled their work.

2. The View that Self-Care is Selfish

Helpers may develop an identity deeply rooted in giving.

If they’re not in a state of sacrifice, they feel they’re not doing enough.

Without restorative practices, the helper’s reservoir of empathy runs dry. They continue to pour out compassion but have no means of refilling.

3. A Lack of Strong Personal Boundaries

Effective helping requires empathy, but it also requires the ability to compartmentalise.

Professionals with porous boundaries absorb the trauma of their clients as if it were their own.

They may ruminate on cases during off-hours and feel guilty for enjoying themselves when clients are suffering.

4. An Overdeveloped Sense of Responsibility

Closely related to boundaries is the issue of responsibility. They may begin to feel responsible for outcomes that are actually determined by the client’s choices, systemic barriers, or pure chance.

Addressing Compassion Fatigue

With the above factors in mind, here are three mindset shifts that may help you feel better:

1. “I’ll See the Good Whilst Accepting the Bad”

The highly empathetic, passionate and sensitive people susceptible to compassion fatigue often feel as though they’re carrying the whole weight of the world on their shoulders.

The key is releasing this overdeveloped sense of responsibility and learning to appreciate the good while accepting the bad. Suffering is, and always will be, a universal part of life. Developing mental resilience is how we navigate this reality.

This is about embracing the duality of your work – acknowledging the challenges while noticing the positive impact of your efforts. Reframe thoughts like, “The problems I see are overwhelming; I can’t make a difference,” into, “Even small actions provide support; I don’t need to solve everything.”

By recognising the small but meaningful ways you help every day, you cultivate compassion satisfaction: the sense of fulfillment that comes from making a difference.

The Two-List Exercise

At the end of each week, divide a page into two columns.

In the left column, write what you could not change, could not solve, could not fix.

In the right column, write what you did do. Being present for a client. Offering a listening ear. Witnessing someone’s story without judgement.

Over time, this exercise helps you shift perspective. It reinforces that your role isn’t to fix everything, but to show up with care, empathy, and attention.

The Professional's Positive Emotions Journal

This tool inside The Professional's Mental Wellbeing Toolkit is specifically designed for helping professionals.

Its prompts guide you to cultivate positive emotions, reflect on small wins, and take proactive steps to support your wellbeing.

Example journal prompts include:

• It could help to talk to someone about...
• An intervention that went well was...
• A client who made a small step was...

By engaging in regular self-reflection with this tool, you can strengthen your mental resilience and feel a stronger sense of compassion satisfaction.

2. “Self-Care is Essential to Mental and Physical Health”

It’s essential to recognise the importance of self-care for both your mental and physical wellbeing.

Stress leaves a mark on the body, and self-care is your most effective tool for safeguarding yourself against the long-term effects of poor mental health.

As Mandy Stevens explains in an article in The Guardian, rising stress levels can creep up on us in slow and insidious ways:

“Despite 30 years’ experience as a registered mental health nurse I didn’t recognise, acknowledge or even notice the range of symptoms I had been experiencing, or how they had been affecting me. It was only when I finally cried at work that I realised something was wrong.”

The Non-Negotiable

Choose one self-care practice that you'll protect regardless of your workload.

Perhaps it's leaving by 5:30pm twice a week. Perhaps it's a 10 minute walk after dinner. Perhaps it's not checking emails after 8pm.

Write it down. Tell someone about it. Treat cancellations of this practice as you would a broken obligation to someone else.

3. “It’s Okay to Set Compassionate Boundaries”

“Compassionate people ask for what they need. They say no when they need to, and when they say yes, they mean it. They’re compassionate because their boundaries keep them out of resentment.” – Brené Brown

Compassionate boundary setting involves deciding what you will and won’t accept for your wellbeing, and it’s a skill you can get better at over time.

Saying no is a key part of setting compassionate boundaries. When you’re so focused on serving others, saying no can feel hellish at first. However, those who care for you and respect you will accept your need to step back.

Asking for Help

Another important way to set compassionate boundaries is to ask for help. Beverly Diane Kyer shares her personal experience with this in her book Surviving Compassion Fatigue:

“Helpers typically do not ask for help. Certainly not I. Perhaps hardest, was to reconcile how my service as a helping professional, service that I was called to and passionate about doing, was hurting me.

In the past, I could not fathom this and did not realise that I needed to take care of me while taking care of others.

I get it now. This is hard work, painful and distressing work. As important as it is, this work comes with a price, and so I need help to do it well and take care of myself in the process.”

Boundary Setting Scripts

Here are three compassionate boundary setting scripts you can adapt:

To a colleague asking you for a favour:

"I'm at full capacity this week and wouldn't be able to give this the attention it deserves. [Name] might have more availability, or we could revisit this next week."

To a supervisor who consistently assigns you overflow work:

"I want to do good work on my current caseload. Taking on additional cases means something else will receive less attention. Can we discuss what my priorities should be?"

To a client requesting additional time you don't have:

"I care about your situation, and I want to be fully present when we meet. To do that, I need to protect my energy when I'm not here. I can give you my full attention during our scheduled time on Thursday."

A Note on Systemic Responsibility

If you're working 50 clients when the recommended maximum is 25; if you're consistently assigned unsafe ratios; if your organisation treats self-care as a personal failing rather than an operational priority – these are not problems you can simply reframe away.

The three shifts above are tools for sustainability within imperfect systems. But recovery from compassion fatigue also requires collective action. For example, by advocating for manageable caseloads and demanding that self-care be treated as infrastructure rather than indulgence.

While systemic issues may be beyond your immediate control, the mindset shifts and techniques outlined above are ways you can support yourself within those constraints.

Summary

If you notice you’re experiencing the signs of compassion fatigue, here are three mindset shifts to focus on:

• "I’ll see the good whilst accepting the bad.”
• “Self-care is essential to mental and physical health.”
• “It’s okay to set compassionate boundaries.”

Using tools like the Two-List Exercise and The Professional's Positive Emotions Journal gives you a structured way to develop the mental resilience required for long-term sustainability and wellbeing in your work.

Remember: compassion fatigue isn’t a sign that you’re failing. It’s a sign that you’ve been caring deeply for a long time without enough support.

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