July 10, 2025 • 36 mins
With so much negativity bombarding us through the media, it is easy to feel like showing compassion to others is becoming harder. On this episdoe, Eddie and Justin dive into the concept of compassion fatigue. They list the causes, signs, and things you can do to combat it.
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Episode Transcript
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Speaker 1 (00:02):
Welcome to MMHC, your go to mental health podcast.
Speaker 2 (00:06):
I'm Dikoreo, a licensed professional counselor.
Speaker 1 (00:08):
And I'm Justin Romano, a Board certified Child an Adolescent psychiatrist.
Speaker 2 (00:12):
We created MMHC to give listeners evidence based information directly
from professionals who work in mental health.
Speaker 1 (00:18):
We're not influencers, we're not trying to sell you anything.
We just want to bring love, empathy, and understanding of
mental health into this world.
Speaker 2 (00:26):
And we really think that learning about mental health should
be fun, interesting, and most importantly honest.
Speaker 1 (00:31):
So thanks for tuning in. This is a show by
two millennials, but it is intended to be for everyone.
We hope you enjoy the show. Welcome to MMHC, your
go to mental health podcast.
Speaker 2 (00:46):
I'm Dikoreo, a licensed professional counselor.
Speaker 1 (00:49):
And I'm Justin Romano, a Board certified Child and Adolescent psychiatrist.
Speaker 2 (00:53):
We created MMHC to give listeners evidence based information directly
from professionals who work in mental health.
Speaker 1 (00:59):
We're not in unswers, we're not trying to sell you anything.
We just want to bring love, empathy, and understanding of
mental health into this world.
Speaker 2 (01:06):
And we really think that learning about mental health should
be fun, interesting, and most importantly honest.
Speaker 1 (01:12):
So thanks for tuning in. This is a show by
two millennials, but it is intended to be for everyone.
We hope you enjoy the show. MMHC is a production
of Speaker from iHeartMedia, I Heart so Eddie. It's summer break.
You've been off for a couple of weeks. Now what
(01:32):
from zero to one hundred? What's your level of compassion
fatigue and burnout?
Speaker 2 (01:39):
Oh? Today's episode is about compassion fatigue, right, And I
think when I was writing it up, but we were
putting this together, I really had to think to myself,
like I think this is I feel like I should
have maybe titled it separately. It's less about compassion fatigue
when it comes to like my work, and I think
(02:00):
it's been more of compassion fatigue towards like regular towards
other people. I don't know, does that make sense? Like
I just feel like, man, like, so much shit has
gone on in six months, and I think it's really
put a lot of people on edge. But I and
and not to like make us seem like we're these special,
like all knowing people. But I feel like it's put
(02:21):
like quote helper profession people in like a really tough
spot because you not only do you have to care
about yourself and like your family and the people you
care about and the people around you, but then you
have to care about like the people you're serving in
your job. That's where I've had a really hard time.
Like I feel like I'm at a spot right now.
Maybe it is because of the work that I do
(02:42):
where I feel like I'm caring about other people less.
Does that make sense, Like I just don't have it's
it's just a really tough spot. I really don't have
a good way to describe it other than to like
ramble about it. But yeah, I just figured we should
we should talk about compassion for do a little bit,
because it's very real. I think it's one of those
(03:03):
things that probably gets talked about when you're in school
and in training. But like unless like you're you're feeling it,
like you don't really know what to do, right. It's
just like with burnout too, like unless you're like unless
you're actively burnt out, or it's really been drilled into
like this is how to avoid burnout, or like these
are the things you need to do to take care
of yourself. You're not really paying attention to it until
(03:25):
like you're really into it. I don't know, unless you're
like really experiencing it. So I guess that's really what
I wanted to talk about today. I think we try
not to be too political. I say that like kind
of backhandedly, because I'd be saying the fucked head cruise
all the time. But the United States is a tough
spot right now. You know, the it's July third, at
(03:47):
seven twenty two Pacific standard time, what like nine hours ago,
eight hours ago, the quote unquote big beautiful bill just
got passed, you know, and people are very happy about it,
for me, for Justin, for other helpers, and you know,
audience of the show. We understand that it's going to
impact a lot of people that we care about and
(04:09):
that we work with, and like, I think that part
really makes it hard to care about other people that
don't understand how much is going to impact the people
we work with, you know. So I think that's really
what's put me in the spot recently of just like
I care so much about my students and my clients
and people that I work with, and then it's it's
hard to care about others when we're kind of put
(04:31):
into the spot. I think the other piece that's really
weighed on me has just been how this it's not
a surprise, but I think, you know, this administration has
really run on tax cuts, tax breaks, and but the
other really big piece to it has been increasing or
their their quote unquote mass deportation. And you know that
really that's something that sists with me a lot, you know,
(04:51):
being someone who is Mexican, who is the son of
two Mexican immigrants, that's something that I think about a
lot when they talk about these mass deportations and trying
to really like dehumanize people and like make it seem
like we need these people out of our country. Right.
Just recently, the who I don't want to name was
in Florida and they were at this place like out
(05:12):
in like the Everglades or whatever, and they're calling it
Alligator Alcatraz. Did you hear about this?
Speaker 1 (05:16):
Yeah?
Speaker 2 (05:17):
And then a temporary basically deportation center. You know, there's
gonna be this many million new people at Alligator Alcatraz.
The really shitty part is that the number that they
used was the exact same number of Latinos that they
are in this country. So essentially what they're saying is
we're gonna get all the Latinos out of here, you know.
So it's just so much has gone on, you know,
(05:39):
the ice raids, the things that are happening in la
It's just so much has gone on. It's just like
really tiring. But then the hard part too is that
we have to also understand that because we are in
this like healing profession and we're here to help people,
sometimes it feels like we don't necessarily get the choice
to like take a break from it and take a
step back from it because we are kind of in
it our clients and patients, I think, So that part's
(06:03):
really hard. You think about what's going on in Palestine
and the genocide and war going on there, that's really
hard too. I think I've talked to you about it
justin where like as a state organization we made a
statement to offer up our support for the Palestinians, we're
quickly met with like the opposite of like, well this
is you know, you're saying this and you're shitting on
(06:27):
us and this and that. I'm like okay, so like
I guess what I'm trying to go with that of
like with that situation is it really made me think
of like, Okay, we are in a very different space
where it's like we can have these thoughts and these feelings,
but then we also have to there's a power, there's
a level of power and privilege that comes with these
roles that we have where we can always say certain things.
And I don't know. All that to say is the
(06:48):
empathy levels are are low. I'm tired, not for my kids,
not for my students, not for my my clients or anything,
but maybe towards the rest of the world. So that's
I'll take a break, right and Rent go ahead, just.
Speaker 1 (07:03):
Well, I feel you. And it does feel like there
is so much emotional stuff and there is so much
emotional content going on in the media where they are
trying to get an emotional reaction out of you that
it's working, I know, right, And on the grand scheme
of things, I would say like, you're more of an
(07:25):
emotional person than your random average man in this country.
And I think that's a wonderful thing. I think that's
a good thing. I think it's one of the things
that makes you such a good therapist and a counselor.
Is that you are emotional, you do connect with people,
you do want to see people well. But it's hard
to see so many terrible things going on in the
world and to make it feel like no matter what
(07:46):
you're doing, there's just going to be these horrible things
going on all around you. Like you do you agree?
Do you think that I'm on the right path there?
Speaker 2 (07:52):
Yeah? Yeah, And I think too, like the you know,
I want to feel for these people that are about
to lose their insurance medicate things like that happening a
lot of people because of like this bill that just
got passed, are going to really be impacted negatively, and
I know you think about it, and I think about
another like helping professionals think about it. But then unfortunately
(08:14):
it's the same people that turn around and be like,
you know, there's exactly what I voted for. Get the
Mexicans out of here. I'm like, well, how am I
supposed to feel for you and feel concerned for you?
And like this is kind of what you voted for
in a roundabout way, you know. And again, not to
make it super political, but I think of like, you know,
when when all the things were going on about like
federal spending or feral federal money being taken away from
(08:37):
schools towards like special education and things like that. When
you look at the charts and you look at like
what states get the most federal funding for these student services,
the then diagram of the states that get the student
services all this money and that voted for in this
direction is essentially a circle, so like, these states are
going to be impacted educationally, Like it's it's really hard,
(09:01):
you know, And it's hard to to continue to care
and feel for people like that and I don't know
it almost like being a therapist, you hear the term
like jaded a lot. You hear the term like like
I don't care anymore, Like I can. You know, it's
not a big deal. I've seen worse, and it almost
makes you feel like, am I like jaded right now?
(09:22):
Like do I not care about people? I know it's
not true because I still care, you know, and I
still hurt for these people. But yeah, it's a tough
spot to be in. So I think when it comes
to our jobs and our roles and the work that
we do, I think capassion fatigue is a very real thing,
and I think it's something that we kind of sweep
(09:43):
under the rug a lot, you know, don't. We don't
talk about it enough, and yeah, so I think that's
that's why I wanted to talk about it today.
Speaker 1 (09:51):
Yeah, me too, And I feel it sometimes as well.
The compassion fatigue where end of a long day, after
a long week, after a long year, I'm like I
get into with my last visit of the day and
I'm like, oh, I am just having a hard time
sitting here and being compassionate with this patient that I
know I should be, but it's just like it's hard.
(10:11):
So we want to give you a specific definition of
compassion fatigue, and it is the physical, emotional, and psychological
impact of helping others, especially those experiencing stress or trauma,
that can lead to exhaustion and reduced ability to empathize
or feel compassion. So pretty self explanatory name, but always
(10:32):
nice to have an elaborated definition.
Speaker 2 (10:35):
Yeah, we do also want to talk about how compassion
fatigue is different than burnout. I've used both words already
in our first ten minutes of the episode. Burnout is
essentially like systematic work stress, so because of things like
workload or lack of control, micromanagement from upper level management
people things like that, whereas compassion fatigue is that empathetic overload,
(10:57):
like the it's basically the emotional cost of care, like
the feeling depleted to the point where like you don't
care anymore. I guess it's like the easiest way to
say it. Why this is important is it's just people
like us, justin are just at a higher risk for it. Therapists, nurses, doctors,
social workers, first responders, we're just at a higher risk
(11:18):
of developing something like compassion fatigue, which is really hard
because our job is to care. I don't know if
you've ever had it, but I've had kids tell me
in the past, like you only care because this is
your job, and it's like, yes, my job is to care.
But if I didn't care, I would do something else,
man Like I would figure something else out to do
as a job. I would not be in this field
(11:39):
their career if I didn't care. We're paid to care,
we have to care, we want to care, and then
sometimes it's just really hard to care. So I think
because of that it oftentimes it gets overlooked in our jobs.
Speaker 1 (11:51):
I wanted to throw in teachers in there too, Yeah,
damn it, Yes, you know, I love teachers. Man, Sorry,
he works in the school and he's not.
Speaker 2 (12:08):
That's my bad. I'll take that. I'll take that.
Speaker 1 (12:11):
So for some of you listening out there, this may
be the first time you've heard this term of compassion fatigue.
So we want to give you a list of some
of the symptoms to watch out for. So, some of
the emotional symptoms would be numbness or detachment, irritability or
mood swings, or decreased sense of accomplishment.
Speaker 2 (12:32):
Some physical things you might see or things like fatigue, headache,
sleep issues. For sure, I think I've started to notice
when I get like headaches more often, or when I
just start to like feel kind of iffy. If I
think back and realize I think I'm just a little stressed,
and I start to think about that and process that
a little bit, it's almost like the symptoms go away
a little bit when I start to really be like, no, no, no,
(12:54):
I don't think anything's wrong. I think I'm just stressed.
I need to take care of that.
Speaker 1 (12:57):
And then some professional symptoms of compassion fatigue could be
dreading client or patient interactions, difficulty concentrating, feeling cynical, jaded,
or hopeless.
Speaker 2 (13:08):
As much as we like to ramble here and like
to just say whatever comes out, we do want to
have some stats because that's important in the age of misinformation.
We do want to have some stats in fact. So
here's what we got for you. The first one is
that up to seventy eight percent of mental health professionals
report moderate to high levels of compassion fatigue at some
point in their careers, and that's from the National Institutes
(13:30):
of Health from twenty twenty. A twenty twenty three survey
of nurses found that fifty two percent experience symptoms of
compassion fatigue, with many citing emotional exhaustion as the top
factor affecting their care quality. And this is from the
American Journal of Nursing in twenty twenty three. During COVID
COVID nineteen the pandemic the big c rates of compassion
(13:50):
fatigue among healthcare workers increased by over thirty percent compared
to pre pandemic levels. This is from the Journal of
Clinical Nursing in twenty twenty two, which I think makes
total sense. Life and work and everything was already hard
and then you throw in COVID fuck man exponentially harder.
Last couple of stats we have is in a twenty
twenty two study of social workers, nearly seventy five percent
(14:14):
reported moderate to high risk of compassion fatigue, with higher
risk in those working in trauma trauma heavy settings, so
things like childware, welfare, hospice, emergency care. And this is
from the Social Work and Healthcare Journal in twenty twenty two.
And then finally, only forty percent of healthcare professionals said
their organization provided adequate resources or training to manage compassion fatigue,
(14:38):
and that is from the American Psychological Association in twenty
twenty one. Yeah, so, I mean we're not alone obviously,
as much as sometimes it feels like we're not alone.
A lot of us deal with this. A lot of
us go into these professionals because we care and we
want to help people, but sometimes we don't think about
like that other piece to it. It's like, this is
a very real risk that comes with the work that
(15:00):
we do, and I think it's just hard in the
jobs that we do. My job is to help. So
to admit that I'm having a hard time, does that
make me shitty at my job? If I'm not able
to help myself, how can I help other people. I
think that's I think that's where a lot of us
get stuck. I think it's hard for us to admit
that something's wrong. I think as helpers, healers, whatever term
(15:20):
you want to use, we just we carry this weight
of feeling like we need to have our shit together
all the time in order to help others. I know,
especially for me early on in my career as a
therapist working with teens, trying to stress the importance of
like good sleep, good diet, exercise, all this stuff, and
then just not doing any of that was like a
hard thing for me to manage. Now I do a
(15:42):
much better job with all of that, but I think, yeah,
I think that was a hard thing for me to
pay attention to or to know that was going on.
But yeah, I think I think it's hard for us
to feel like, how can I help others if I
don't know how to help myself or I don't have
my shit together. I think it's also feeling like maybe
we're not good enough in our job if we admit
that something's wrong. Right, we just I talked, I said it, right,
(16:02):
But yeah, it feels like I am inadequate if I
don't know how to help myself or if I'm struggling,
how can I how can I possibly help other people.
I know it's not the case, but I think it's
a thought that a lot of us have at some point.
Speaker 1 (16:15):
Totally. We always want to be superman. We want to
be the one who can take it all. We want
to be the one who doesn't get jaded, who can
just be powering through it and doing well. But I
think it's even more important and it shows more strength
to be able to recognize it and work on it
instead of just ignoring it and trying to move forward.
(16:35):
Because this is I would say this is probably the
thing I preach the most clinically with my patients that
like the number one topic is that you can't just
ignore your problems and pretend like they don't exist. You
have to be mindful of it, recognize it's happening, and
then work on trying to actually make it better. So
(16:57):
I think it's a cool thing that we're talking about
it to be able to try and understand these things
and ourselves better so that we can be better at
treating it. So that if you do start to feel
some compassion fatigue, there can be some different things that
you can do to work on it to make yourself
feel better, and if things work for you in the past,
you can go back to that well and continue to
(17:19):
use those those same things to help you feel better
and get through the compassion fatigue instead of just saying like,
I'm fine, I'm fine, I can do this, it's okay.
I'm feeling this. How do I recharge my batteries? How
do I get my mojo back?
Speaker 2 (17:33):
The hard part, too, is that when we try to
tell ourselves that we're fine and things are okay, people
around us understand that things are not okay. People can
just see it. So I think you might as well
help yourself. I tell kids all the time when they're like, no,
I don't want to tell my parents, like I don't
want them to worry about me. News flash, buddy, they
are ready. They're worried. They know something's going on. I
(17:56):
tell kids this all the time, like, I just don't
want them to I don't want to be a burden.
Don't worry. They've known something's wrongast two weeks, man, Like,
let's just this is actually gonna make them feel better,
And in a similar way, this is going to make
ourselves feel better if we can acknowledge and understand that
if something's wrong, it's okay, let's try to let's try
to fix it. But one thing I wanted to cover
(18:18):
is something that we can just ignore in the spirit
of acknowledging and before we get to like, what can
we do to make this better? You know why are
helping professions at risk for developing compassion fatigue? I think
it's it's it's d all of the above. The first
thing is long hours understaffing. I think of all the
therapists and the clinical mental health or community mental health
(18:41):
clinic I can I can assume the same for doctors
and nurses in some kind of like or social workers,
and then some kind of community healthcare clinic. There's a
high emotional emotional demand that comes from the work. Other
things could be personally a personal history of trauma or
unresolved grief. If you have an empathetic personality, tend to
be someone who kind of just absorbs other people's pains.
(19:03):
That's why people come to you because they know if
I speak with you, or if I check in with you,
if I meet with you, I'll feel better because you
help me kind of deal with it and the big
thing that's really shifted in the last five years I
mentioned earlier, but the big sea, I mean, COVID really
fucked a lot of things. And it's this is not
going to be a thing that goes away quickly. It's
it's been I don't want to say, it's been five
(19:23):
years and it's gone. It's been five years since everything
started and things it's hard to fix things and get
back to where they were before. Not that we were
really living in a great way before if we really
are on it. But anyway, let's let's get to the
positive parts. How do we how do we fix this?
How do we work on this stuff?
Speaker 1 (19:41):
So some ways that you can prevent compassion fatigue include
things like setting boundaries, learning to say no, not taking
work home. Mentally, this is something that I've really had
to work on too. Just to give you a little
personal story, Sometimes people at the hospital will you'll like
text me or call me at all hours of the
(20:03):
day and night and be like, hey, I got a
patient for you to see, and yeah, I want to
be superman. I want to jump in and say like, yeah, sure,
what do you need, Let me help, let me come
into the hospital. But I realized that when I do that,
I just stretch myself too thin and I am just
on a path for compassion fatigue. So I had to
learn how to say like no, like my hours are
this time to this time, Like I would love to
(20:24):
help you. I'll get them into the clinic, but I
can't come and come in the middle of the night
to see patients, because like in the mental health and
psychiatry world, that's just brutal, especially after like already putting
in a ten hour day and then you get a
call from the hospital saying like come into the emergency room.
I'm like, ah, I can't, Like I just I can't
force myself to do it.
Speaker 2 (20:44):
The other piece of that, too, is that like if
you do start to say yes and then finally you're
like trying to say no, there's the guilt of like,
well you used to like you're shitting now, you know.
So it's better to try to have those those firm boundaries.
Speaker 1 (20:58):
Especially because I'm the only try out psychiatrists who is
practicing in Southeast Wyoming. Like, if I give an inch,
people will take a mile, and I don't blame them.
Everyone needs help, and there is just such a lack
of care from child psychiatrists. But if I don't protect myself,
no one will.
Speaker 2 (21:16):
Some other stuff for prevention, I mean supervision and consultation.
It's a good way to vent and to process what's
going on. You can do some of the stuff yourself too,
some self awareness, some check ins, asking yourself how you
feel after a certain client, after a certain shift. I
think those are important. I think your point earlier of
not taking work home mentally, I do this a lot
(21:37):
less now, but I know I've definitely had it. I've
had points where sometimes I'll just drive home in silence
day and I just need to. I need to this.
This drive home is going to be my way of
being able to separate work from the house. And if
I can drive in silence and I get home, I
could pick up where I left off the next day.
That helps a lot.
Speaker 1 (21:57):
Doing things like mindfulness and grounding practices. Sometimes that can
be writing home in silence right your giving your emotions
and feeling some time some you know you don't have
any distractions, You're just kind of sitting in how you feel,
letting it happen, letting the wave wash over you and
then leave. I think that's a really important thing, and
(22:18):
it's so funny. I do the exact same thing. I'll
drive home in silence. Man, Sometimes sometimes I might cry
a little bit, you know, sometimes I might scream a
little bit, and just if I've got a lot of frustration,
I'll just grab the steering wheel and ah, get it out,
address it instead of trying to just shove it all down.
Speaker 2 (22:37):
One of the things for me is, I think because
of what's going on in the country, for me, it
feels like it ties so much into my work that
I feel like I have to know what's happening or
have to have an idea of what's going on. And
sometimes for me, the boundary is I just won't listen
to the news for a little bit. Yes, I have
a few news podcasts that I listened to that keep
(22:59):
me up to date on things, and sometimes I just
take a break from them. Sometimes I just won't listen
to them just because it's like I need to I
need to listen to something else and not listened to
anything at all. So it's another way.
Speaker 1 (23:11):
Yeah, it's nice to have that mindless stuff. Not I
have to just be bombarded with bad news from the
news all the time.
Speaker 2 (23:18):
Sometimes Big Booty Mix twenty is all I need.
Speaker 1 (23:23):
Two Friends, Big Booty.
Speaker 2 (23:26):
Look at number twenty is the one, man. I think
that's the one, you guys, the very first one you
sent me in that that was a life changer.
Speaker 1 (23:34):
If people have not listened to Two Friends Big Booty Mix,
it is some of the most fun music you will
ever listen to.
Speaker 2 (23:41):
But did I tell you that?
Speaker 1 (23:42):
We went to Two Friends and they're Big Booty Mix
at Red Rocks like in April.
Speaker 2 (23:47):
I know, what the fuck? That's tight?
Speaker 1 (23:49):
I know, I forgot to tell you. So we went,
but it was pouring rain at Red Rocks outdoors, and
so we're just like in the rain, just shaking and shivering.
It was like forty degrees the freezing, right, We're just
trying to dance and get ourselves warm. But it was
it was totally worth it.
Speaker 2 (24:07):
But we were wrenched. It was. It was a party.
So do yourself a favor. If you haven't yet, look up,
look up Big Big Booty Mix Two Friends. They do
some great sets. It's awesome. It's awesome music to listen
to in the background.
Speaker 1 (24:22):
And if Two Friends, everyone wants to collab with us,
you know, slide into Eddie's DMS. Ben and eli we
are ready for you.
Speaker 2 (24:32):
Yes. In terms of management with something like compassionate fatigue,
I think debriefing with your peers. I think I've worked
in enough settings where just having coworkers that understand what
you're doing helps a ton, helps to just kind of
get it out. Prioritizing rest of recovery, I mean justin
talks about it. A lot of sleep is important. I
(24:53):
know sleep is important. Breaks, vacation and like a real break,
not just like I'm gonna get lunch at my desk
while I read three emails, like go take a walk
or something if you haven't already. Therapy is great, peer
support groups, professional support groups, and then just normalizing self compassion.
I think a lot of the times when I work
(25:13):
with kids and teens, they'll tell me that they prioritize
other people because they don't want to them, They don't
want to be a burden on other people with this,
and that I think we end up doing the same thing.
We prioritize the people around us. We prioritize our clients,
our patients, and sometimes we need to talk to ourselves
the way that we would to a client or patient.
We need to give ourselves some self love too, So yeah,
(25:35):
so what I got. So compassion fatigue is real. We're
still gonna chug along and make the difference we.
Speaker 1 (25:41):
Can big booty mix slaps.
Speaker 2 (25:44):
Big and it's okay if sometimes it's hard to give
a shit about other people because of the way things are,
just if you can give a shit about yourself, I
think that's that's a good enough start.
Speaker 1 (25:56):
You gotta love yourself if you can love someone else.
So I like that advice. You know, some other discussion
questions that we wanted to bring up, just talking about
our own personal experiences. When did you first start seeing
a little compassion fatigue in yourself?
Speaker 2 (26:09):
What do you think at some point between when I
graduated with my masters and now just doing the work,
and actually probably before when I was doing internship, at
some point just understanding that it is it's really it
can be really tough to help other people. It's rewarding, fulfilling, great,
wouldn't want it any other way, But sometimes it could
(26:30):
be really hard.
Speaker 1 (26:31):
I noticed that earlier in my career, like right when
I started working with kids, and even like the first
year of working as an attending it was hard, and
there were a lot of those days where at the
end of the day, I was just drained and I
was having a silent car rides home or crying on
the ride home. It's gotten better with time, and I'm
(26:52):
grateful for that, just because I think you get a
little resilient over time to it. I think it does
get better. But boy, when you're first starting out and
trying to manage all the emotions of working with kids
who have been through a lot of significant traumas, it's hard.
Speaker 2 (27:08):
Yeah. I think for this next question you probably have
an interesting perspective too with like med school, But do
you think there's a pressure in our field to power
through rather than to admit that we're overwhelmed? And I
bring up med school because I hear that so much,
whether it's on social media, TikTok, YouTube, whatever, of just
this like competition. Everyone's competitive, everyone wants to be the best.
(27:30):
You're studying hours on it, Like it's just it's like
the hunger games in med schools. What it sounds like. So,
what's been your experience with the power in through, whether
professionally or while you're still a student.
Speaker 1 (27:42):
It kind of depends on the field you're going into.
Like to give you a very basic example, surgeons are
very much a power through shut up, don't complain. Yeah,
but I noticed that a lot of the psychiatrists that
I was working with, they were very much more compassionate.
They wanted to know how you were feel They wanted
to make sure you weren't overloaded. I even remember, like
(28:04):
some of the psychiatrists working I was working with in
medical school, they were like, you know, the tests at
the end doesn't matter because usually in most rotations, like
the test you take at the end is huge. If
you fail, you got to like redo the whole rotation, YadA, YadA, YadA.
But in psychiatry they're like, it's past fail, you just
have to pass it. We want to make sure that
you learn. We want to make sure that you like
(28:24):
maintain your personhood throughout this rotation.
Speaker 2 (28:27):
Yeah.
Speaker 1 (28:27):
And it just seemed like such a complete different focus
than the entire rest of medicine. And I thought, this
is a breath of fresh air. This is something that
I want to gravitate towards. And I appreciate that people
are doing this in mental health and psychiatry, and it
was a big reason why I went into mental health.
Speaker 2 (28:45):
And this is just my experience, but I think like
my internship supervisor and my supervisor towards licensure were amazing. Great,
this has nothing to do with them, so we can
take them out of it, Sandra TONI don't worry about it.
This hasn't I do with you. I'm more looking like
system wides because they took care of me, and I
think just having them was so helpful and I'll be
(29:06):
forever grateful Systematically, though, I feel like, I don't know,
it always felt like when they talked about self care
and boundaries, it was just this canned like, yeah, take
care of yourself. Here's ten new clients, see them all
next week, right, like, yeah, self care, let's write down
(29:28):
and no bullshit, we did this write down on this
post to note what you can do for self care. Eddie,
I need you to do three new assessments this week,
like fuck man. Like, I don't know. Maybe it was
just the settings I worked at, and I think I
can't really speak to it in my current setting. I
don't really think it's I'm so one of one in
my job that I just take care of myself and
(29:49):
I'm cool. I'm all good. My last job at the hospital,
my manager sucked so I can totally see that there
wasn't really a take care of yourself kind of thing.
And then in my first job, yeah, I felt like
a so much of what we were told was so
canned and like felt like bs that I just I
don't know, but I'm glad you had a good.
Speaker 1 (30:10):
And if you can try and gravitate more towards those
jobs that are more compassionate are wanting to give you
that time. But because I mean in America, we're production based, right, Like,
if you're not seeing patients, you're not making money, you're
a drag on the system. I feel incredibly lucky that
right now in my current job, they let me see
(30:32):
like forty minute follow ups, which is kind of like
unheard of in the psychiatry world. It's usually like twenty
maybe thirty minute follow ups, and it's like shit, So
I actually get to have one on one time with patients,
ask them how they're doing, really get to like connect
with people, and A boy, am I so grateful for
that And I think that helps me a lot with
(30:52):
the compassion fatigue, because if I had twenty minute visits,
I would be so worried about staying on time and
not getting behind that I would be the least compassionate
provider anyone's ever seen.
Speaker 2 (31:02):
I don't prescribe medication or do any type of psychiatry,
so I'm just I'm just doing my best. Guess. But
how am I supposed to check in with a patient,
get an idea of how they've been, check in with
whatever vital signs, or whatever else you gotta do. How
am I supposed to do all that while also trying
to come up with some type of treatment plan or
or next step in twenty minutes.
Speaker 1 (31:20):
Yeah it's brutal.
Speaker 2 (31:22):
Yeah, well, I mean shit that. Our next question is
what system changes do you wish employers or organizations would
make it the better? Did well be longer appointment slots,
not be soap production based, actually care about the well
being of And I mean you always got to like
take it. I don't even I don't understand the whole
(31:44):
taking with a grain of salt, but I'll just say
you got to dig it with a grain of salt
because it's like you're more likely to hear about the
negative experiences, right you go to look at like a
review of like a restaurant, like, yeah, there's gonna be
people that just yeah, a five star five star, but
like the longer reviews, people want to give the negative
kind of feedback more willingly. So you know, I've talked
(32:05):
about my shitty experiences. It's not to say that's the
experience everywhere. But I would say if organizations just kind
of operated with those kind of typical things that they
would provide, I think would be in a much better
space for providers.
Speaker 1 (32:18):
So if you could go back and give your younger
more handsome self, more handsome I mean less handsome, some
like the new to the field self advice about compassion fatigue,
What would you say.
Speaker 2 (32:33):
It's really important that you take care of yourself. I
think that's yeah, yeah, yeah, because I think you kind
of touched on it too, like you always want to
be I think you've probably felt it too, but you
kind of want to be known as like I'm always
ready to help, I'm always helpful, I can always do it.
But sometimes you can still do that, but you got
(32:54):
to take care of yourself. I think I can, you
can still be the go to, but you got to
take care of yourself, I think is the biggest thing. Yeah,
I wrote this up, or maybe you wrote up the question.
I don't know, but I've known about the question, and
I feel like I should have a better answer, but
I think it's really just you got to take care
of yourself. And I think that's what I really enjoyed
(33:14):
about teaching. And actually, this upcoming fall, I'm going to
get to teach practicum seminar, which is specifically for students
that are in their internship year, and I get to
be with them for the whole year. And I'll get
a group of you know, six to eight students of
my own to just meet with and supervise for a
whole year, which I'm really excited about. But that's why
I like teaching so much and working with therapists and training.
(33:37):
I can tell them the things that I wish I
would have known or the things I fucked up on
so they don't have to fuck up on. So I'm
sure I have some better thoughts, but would just do
that one? You gotta take care of yourself, Yeah, what
about you?
Speaker 1 (33:48):
I think I said something similar on the Burnout episode
a while back, but use all of your time off,
Like in America, we're terrible at taking all of our
time off. Most Americans don't use all of their time
off like it's looked down upon other countries like take
pride at how much time they can take off and
go explore life and go spend time in nature. But
(34:09):
the Americans were just work, work, work, work, work. But
your compassion is like a battery, and the more you
do it, the more it drains.
Speaker 2 (34:17):
More.
Speaker 1 (34:17):
It drains more, it drains time off, and the things
that you love that refill that battery help you be
a better clinician, help you be a better doctor. And
so don't fall into the American trap mindset. Take your
time off.
Speaker 2 (34:35):
Did you know every year there's about two billion dollars
worth of time off that people don't use. I believe
it totally, like I made that up, but it sounds believable.
Speaker 1 (34:50):
All right, Well, now I got a look. I see
Google I as an answer for me.
Speaker 2 (34:54):
What's Google? Gentlemen?
Speaker 1 (34:55):
I got oh American workers forfeit and estimated six six billion,
oh shit benefits each year by not using all of
their allotted vacation time.
Speaker 2 (35:08):
I believe no I had a supervisor or a manager
years ago, who I think because I was talking about
my pay and be like, bro, I gotta get paid more.
I do so much more shit than other people in here,
and he's like, oh, I just you know how part
of the benefit is the time off, and like, you know,
I'm really hoping that when I because I don't take
(35:29):
time off, and I'm just hoping that by the time
I retire, you know, they're going to have to pay
me out all this money. And now looking back, that's
fucking sad man taking time off. What the fuck you
need it? It's good for you, man. You best believe
I'm taking my other days off of every year, So
take your time, damn it.
Speaker 1 (35:51):
Yes, it's healthy doctor's orders.
Speaker 2 (35:53):
That's right. Oh can you write that up for me
on one of those fancy prescription pads. Sure, nice, I'll
take it that.
Speaker 1 (36:00):
You might get laughed at if you take it to
a pharmacy, but you know that's why.
Speaker 2 (36:07):
Well, justin thank you my friend for letting me. Uh,
this might have been more for me, just event for
a little bit, but I appreciate you being there for me.
I appreciate our listeners being here. You know where to
find this Apple podcast Spotify. Leave us a five star review,
leave us a comment. We'd love to see it on
social media at Millennial MHC and our website millennia IMH
Welcome to MMHC, your go to mental health podcast.
Speaker 2 (00:06):
I'm Dikoreo, a licensed professional counselor.
Speaker 1 (00:08):
And I'm Justin Romano, a Board certified Child an Adolescent psychiatrist.
Speaker 2 (00:12):
We created MMHC to give listeners evidence based information directly
from professionals who work in mental health.
Speaker 1 (00:18):
We're not influencers, we're not trying to sell you anything.
We just want to bring love, empathy, and understanding of
mental health into this world.
Speaker 2 (00:26):
And we really think that learning about mental health should
be fun, interesting, and most importantly honest.
Speaker 1 (00:31):
So thanks for tuning in. This is a show by
two millennials, but it is intended to be for everyone.
We hope you enjoy the show. Welcome to MMHC, your
go to mental health podcast.
Speaker 2 (00:46):
I'm Dikoreo, a licensed professional counselor.
Speaker 1 (00:49):
And I'm Justin Romano, a Board certified Child and Adolescent psychiatrist.
Speaker 2 (00:53):
We created MMHC to give listeners evidence based information directly
from professionals who work in mental health.
Speaker 1 (00:59):
We're not in unswers, we're not trying to sell you anything.
We just want to bring love, empathy, and understanding of
mental health into this world.
Speaker 2 (01:06):
And we really think that learning about mental health should
be fun, interesting, and most importantly honest.
Speaker 1 (01:12):
So thanks for tuning in. This is a show by
two millennials, but it is intended to be for everyone.
We hope you enjoy the show. MMHC is a production
of Speaker from iHeartMedia, I Heart so Eddie. It's summer break.
You've been off for a couple of weeks. Now what
(01:32):
from zero to one hundred? What's your level of compassion
fatigue and burnout?
Speaker 2 (01:39):
Oh? Today's episode is about compassion fatigue, right, And I
think when I was writing it up, but we were
putting this together, I really had to think to myself,
like I think this is I feel like I should
have maybe titled it separately. It's less about compassion fatigue
when it comes to like my work, and I think
(02:00):
it's been more of compassion fatigue towards like regular towards
other people. I don't know, does that make sense? Like
I just feel like, man, like, so much shit has
gone on in six months, and I think it's really
put a lot of people on edge. But I and
and not to like make us seem like we're these special,
like all knowing people. But I feel like it's put
(02:21):
like quote helper profession people in like a really tough
spot because you not only do you have to care
about yourself and like your family and the people you
care about and the people around you, but then you
have to care about like the people you're serving in
your job. That's where I've had a really hard time.
Like I feel like I'm at a spot right now.
Maybe it is because of the work that I do
(02:42):
where I feel like I'm caring about other people less.
Does that make sense, Like I just don't have it's
it's just a really tough spot. I really don't have
a good way to describe it other than to like
ramble about it. But yeah, I just figured we should
we should talk about compassion for do a little bit,
because it's very real. I think it's one of those
(03:03):
things that probably gets talked about when you're in school
and in training. But like unless like you're you're feeling it,
like you don't really know what to do, right. It's
just like with burnout too, like unless you're like unless
you're actively burnt out, or it's really been drilled into
like this is how to avoid burnout, or like these
are the things you need to do to take care
of yourself. You're not really paying attention to it until
(03:25):
like you're really into it. I don't know, unless you're
like really experiencing it. So I guess that's really what
I wanted to talk about today. I think we try
not to be too political. I say that like kind
of backhandedly, because I'd be saying the fucked head cruise
all the time. But the United States is a tough
spot right now. You know, the it's July third, at
(03:47):
seven twenty two Pacific standard time, what like nine hours ago,
eight hours ago, the quote unquote big beautiful bill just
got passed, you know, and people are very happy about it,
for me, for Justin, for other helpers, and you know,
audience of the show. We understand that it's going to
impact a lot of people that we care about and
(04:09):
that we work with, and like, I think that part
really makes it hard to care about other people that
don't understand how much is going to impact the people
we work with, you know. So I think that's really
what's put me in the spot recently of just like
I care so much about my students and my clients
and people that I work with, and then it's it's
hard to care about others when we're kind of put
(04:31):
into the spot. I think the other piece that's really
weighed on me has just been how this it's not
a surprise, but I think, you know, this administration has
really run on tax cuts, tax breaks, and but the
other really big piece to it has been increasing or
their their quote unquote mass deportation. And you know that
really that's something that sists with me a lot, you know,
(04:51):
being someone who is Mexican, who is the son of
two Mexican immigrants, that's something that I think about a
lot when they talk about these mass deportations and trying
to really like dehumanize people and like make it seem
like we need these people out of our country. Right.
Just recently, the who I don't want to name was
in Florida and they were at this place like out
(05:12):
in like the Everglades or whatever, and they're calling it
Alligator Alcatraz. Did you hear about this?
Speaker 1 (05:16):
Yeah?
Speaker 2 (05:17):
And then a temporary basically deportation center. You know, there's
gonna be this many million new people at Alligator Alcatraz.
The really shitty part is that the number that they
used was the exact same number of Latinos that they
are in this country. So essentially what they're saying is
we're gonna get all the Latinos out of here, you know.
So it's just so much has gone on, you know,
(05:39):
the ice raids, the things that are happening in la
It's just so much has gone on. It's just like
really tiring. But then the hard part too is that
we have to also understand that because we are in
this like healing profession and we're here to help people,
sometimes it feels like we don't necessarily get the choice
to like take a break from it and take a
step back from it because we are kind of in
it our clients and patients, I think, So that part's
(06:03):
really hard. You think about what's going on in Palestine
and the genocide and war going on there, that's really
hard too. I think I've talked to you about it
justin where like as a state organization we made a
statement to offer up our support for the Palestinians, we're
quickly met with like the opposite of like, well this
is you know, you're saying this and you're shitting on
(06:27):
us and this and that. I'm like okay, so like
I guess what I'm trying to go with that of
like with that situation is it really made me think
of like, Okay, we are in a very different space
where it's like we can have these thoughts and these feelings,
but then we also have to there's a power, there's
a level of power and privilege that comes with these
roles that we have where we can always say certain things.
And I don't know. All that to say is the
(06:48):
empathy levels are are low. I'm tired, not for my kids,
not for my students, not for my my clients or anything,
but maybe towards the rest of the world. So that's
I'll take a break, right and Rent go ahead, just.
Speaker 1 (07:03):
Well, I feel you. And it does feel like there
is so much emotional stuff and there is so much
emotional content going on in the media where they are
trying to get an emotional reaction out of you that
it's working, I know, right, And on the grand scheme
of things, I would say like, you're more of an
(07:25):
emotional person than your random average man in this country.
And I think that's a wonderful thing. I think that's
a good thing. I think it's one of the things
that makes you such a good therapist and a counselor.
Is that you are emotional, you do connect with people,
you do want to see people well. But it's hard
to see so many terrible things going on in the
world and to make it feel like no matter what
(07:46):
you're doing, there's just going to be these horrible things
going on all around you. Like you do you agree?
Do you think that I'm on the right path there?
Speaker 2 (07:52):
Yeah? Yeah, And I think too, like the you know,
I want to feel for these people that are about
to lose their insurance medicate things like that happening a
lot of people because of like this bill that just
got passed, are going to really be impacted negatively, and
I know you think about it, and I think about
another like helping professionals think about it. But then unfortunately
(08:14):
it's the same people that turn around and be like,
you know, there's exactly what I voted for. Get the
Mexicans out of here. I'm like, well, how am I
supposed to feel for you and feel concerned for you?
And like this is kind of what you voted for
in a roundabout way, you know. And again, not to
make it super political, but I think of like, you know,
when when all the things were going on about like
federal spending or feral federal money being taken away from
(08:37):
schools towards like special education and things like that. When
you look at the charts and you look at like
what states get the most federal funding for these student services,
the then diagram of the states that get the student
services all this money and that voted for in this
direction is essentially a circle, so like, these states are
going to be impacted educationally, Like it's it's really hard,
(09:01):
you know, And it's hard to to continue to care
and feel for people like that and I don't know
it almost like being a therapist, you hear the term
like jaded a lot. You hear the term like like
I don't care anymore, Like I can. You know, it's
not a big deal. I've seen worse, and it almost
makes you feel like, am I like jaded right now?
(09:22):
Like do I not care about people? I know it's
not true because I still care, you know, and I
still hurt for these people. But yeah, it's a tough
spot to be in. So I think when it comes
to our jobs and our roles and the work that
we do, I think capassion fatigue is a very real thing,
and I think it's something that we kind of sweep
(09:43):
under the rug a lot, you know, don't. We don't
talk about it enough, and yeah, so I think that's
that's why I wanted to talk about it today.
Speaker 1 (09:51):
Yeah, me too, And I feel it sometimes as well.
The compassion fatigue where end of a long day, after
a long week, after a long year, I'm like I
get into with my last visit of the day and
I'm like, oh, I am just having a hard time
sitting here and being compassionate with this patient that I
know I should be, but it's just like it's hard.
(10:11):
So we want to give you a specific definition of
compassion fatigue, and it is the physical, emotional, and psychological
impact of helping others, especially those experiencing stress or trauma,
that can lead to exhaustion and reduced ability to empathize
or feel compassion. So pretty self explanatory name, but always
(10:32):
nice to have an elaborated definition.
Speaker 2 (10:35):
Yeah, we do also want to talk about how compassion
fatigue is different than burnout. I've used both words already
in our first ten minutes of the episode. Burnout is
essentially like systematic work stress, so because of things like
workload or lack of control, micromanagement from upper level management
people things like that, whereas compassion fatigue is that empathetic overload,
(10:57):
like the it's basically the emotional cost of care, like
the feeling depleted to the point where like you don't
care anymore. I guess it's like the easiest way to
say it. Why this is important is it's just people
like us, justin are just at a higher risk for it. Therapists, nurses, doctors,
social workers, first responders, we're just at a higher risk
(11:18):
of developing something like compassion fatigue, which is really hard
because our job is to care. I don't know if
you've ever had it, but I've had kids tell me
in the past, like you only care because this is
your job, and it's like, yes, my job is to care.
But if I didn't care, I would do something else,
man Like I would figure something else out to do
as a job. I would not be in this field
(11:39):
their career if I didn't care. We're paid to care,
we have to care, we want to care, and then
sometimes it's just really hard to care. So I think
because of that it oftentimes it gets overlooked in our jobs.
Speaker 1 (11:51):
I wanted to throw in teachers in there too, Yeah,
damn it, Yes, you know, I love teachers. Man, Sorry,
he works in the school and he's not.
Speaker 2 (12:08):
That's my bad. I'll take that. I'll take that.
Speaker 1 (12:11):
So for some of you listening out there, this may
be the first time you've heard this term of compassion fatigue.
So we want to give you a list of some
of the symptoms to watch out for. So, some of
the emotional symptoms would be numbness or detachment, irritability or
mood swings, or decreased sense of accomplishment.
Speaker 2 (12:32):
Some physical things you might see or things like fatigue, headache,
sleep issues. For sure, I think I've started to notice
when I get like headaches more often, or when I
just start to like feel kind of iffy. If I
think back and realize I think I'm just a little stressed,
and I start to think about that and process that
a little bit, it's almost like the symptoms go away
a little bit when I start to really be like, no, no, no,
(12:54):
I don't think anything's wrong. I think I'm just stressed.
I need to take care of that.
Speaker 1 (12:57):
And then some professional symptoms of compassion fatigue could be
dreading client or patient interactions, difficulty concentrating, feeling cynical, jaded,
or hopeless.
Speaker 2 (13:08):
As much as we like to ramble here and like
to just say whatever comes out, we do want to
have some stats because that's important in the age of misinformation.
We do want to have some stats in fact. So
here's what we got for you. The first one is
that up to seventy eight percent of mental health professionals
report moderate to high levels of compassion fatigue at some
point in their careers, and that's from the National Institutes
(13:30):
of Health from twenty twenty. A twenty twenty three survey
of nurses found that fifty two percent experience symptoms of
compassion fatigue, with many citing emotional exhaustion as the top
factor affecting their care quality. And this is from the
American Journal of Nursing in twenty twenty three. During COVID
COVID nineteen the pandemic the big c rates of compassion
(13:50):
fatigue among healthcare workers increased by over thirty percent compared
to pre pandemic levels. This is from the Journal of
Clinical Nursing in twenty twenty two, which I think makes
total sense. Life and work and everything was already hard
and then you throw in COVID fuck man exponentially harder.
Last couple of stats we have is in a twenty
twenty two study of social workers, nearly seventy five percent
(14:14):
reported moderate to high risk of compassion fatigue, with higher
risk in those working in trauma trauma heavy settings, so
things like childware, welfare, hospice, emergency care. And this is
from the Social Work and Healthcare Journal in twenty twenty two.
And then finally, only forty percent of healthcare professionals said
their organization provided adequate resources or training to manage compassion fatigue,
(14:38):
and that is from the American Psychological Association in twenty
twenty one. Yeah, so, I mean we're not alone obviously,
as much as sometimes it feels like we're not alone.
A lot of us deal with this. A lot of
us go into these professionals because we care and we
want to help people, but sometimes we don't think about
like that other piece to it. It's like, this is
a very real risk that comes with the work that
(15:00):
we do, and I think it's just hard in the
jobs that we do. My job is to help. So
to admit that I'm having a hard time, does that
make me shitty at my job? If I'm not able
to help myself, how can I help other people. I
think that's I think that's where a lot of us
get stuck. I think it's hard for us to admit
that something's wrong. I think as helpers, healers, whatever term
(15:20):
you want to use, we just we carry this weight
of feeling like we need to have our shit together
all the time in order to help others. I know,
especially for me early on in my career as a
therapist working with teens, trying to stress the importance of
like good sleep, good diet, exercise, all this stuff, and
then just not doing any of that was like a
hard thing for me to manage. Now I do a
(15:42):
much better job with all of that, but I think, yeah,
I think that was a hard thing for me to
pay attention to or to know that was going on.
But yeah, I think I think it's hard for us
to feel like, how can I help others if I
don't know how to help myself or I don't have
my shit together. I think it's also feeling like maybe
we're not good enough in our job if we admit
that something's wrong. Right, we just I talked, I said it, right,
(16:02):
But yeah, it feels like I am inadequate if I
don't know how to help myself or if I'm struggling,
how can I how can I possibly help other people.
I know it's not the case, but I think it's
a thought that a lot of us have at some point.
Speaker 1 (16:15):
Totally. We always want to be superman. We want to
be the one who can take it all. We want
to be the one who doesn't get jaded, who can
just be powering through it and doing well. But I
think it's even more important and it shows more strength
to be able to recognize it and work on it
instead of just ignoring it and trying to move forward.
(16:35):
Because this is I would say this is probably the
thing I preach the most clinically with my patients that
like the number one topic is that you can't just
ignore your problems and pretend like they don't exist. You
have to be mindful of it, recognize it's happening, and
then work on trying to actually make it better. So
(16:57):
I think it's a cool thing that we're talking about
it to be able to try and understand these things
and ourselves better so that we can be better at
treating it. So that if you do start to feel
some compassion fatigue, there can be some different things that
you can do to work on it to make yourself
feel better, and if things work for you in the past,
you can go back to that well and continue to
(17:19):
use those those same things to help you feel better
and get through the compassion fatigue instead of just saying like,
I'm fine, I'm fine, I can do this, it's okay.
I'm feeling this. How do I recharge my batteries? How
do I get my mojo back?
Speaker 2 (17:33):
The hard part, too, is that when we try to
tell ourselves that we're fine and things are okay, people
around us understand that things are not okay. People can
just see it. So I think you might as well
help yourself. I tell kids all the time when they're like, no,
I don't want to tell my parents, like I don't
want them to worry about me. News flash, buddy, they
are ready. They're worried. They know something's going on. I
(17:56):
tell kids this all the time, like, I just don't
want them to I don't want to be a burden.
Don't worry. They've known something's wrongast two weeks, man, Like,
let's just this is actually gonna make them feel better,
And in a similar way, this is going to make
ourselves feel better if we can acknowledge and understand that
if something's wrong, it's okay, let's try to let's try
to fix it. But one thing I wanted to cover
(18:18):
is something that we can just ignore in the spirit
of acknowledging and before we get to like, what can
we do to make this better? You know why are
helping professions at risk for developing compassion fatigue? I think
it's it's it's d all of the above. The first
thing is long hours understaffing. I think of all the
therapists and the clinical mental health or community mental health
(18:41):
clinic I can I can assume the same for doctors
and nurses in some kind of like or social workers,
and then some kind of community healthcare clinic. There's a
high emotional emotional demand that comes from the work. Other
things could be personally a personal history of trauma or
unresolved grief. If you have an empathetic personality, tend to
be someone who kind of just absorbs other people's pains.
(19:03):
That's why people come to you because they know if
I speak with you, or if I check in with you,
if I meet with you, I'll feel better because you
help me kind of deal with it and the big
thing that's really shifted in the last five years I
mentioned earlier, but the big sea, I mean, COVID really
fucked a lot of things. And it's this is not
going to be a thing that goes away quickly. It's
it's been I don't want to say, it's been five
(19:23):
years and it's gone. It's been five years since everything
started and things it's hard to fix things and get
back to where they were before. Not that we were
really living in a great way before if we really
are on it. But anyway, let's let's get to the
positive parts. How do we how do we fix this?
How do we work on this stuff?
Speaker 1 (19:41):
So some ways that you can prevent compassion fatigue include
things like setting boundaries, learning to say no, not taking
work home. Mentally, this is something that I've really had
to work on too. Just to give you a little
personal story, Sometimes people at the hospital will you'll like
text me or call me at all hours of the
(20:03):
day and night and be like, hey, I got a
patient for you to see, and yeah, I want to
be superman. I want to jump in and say like, yeah, sure,
what do you need, Let me help, let me come
into the hospital. But I realized that when I do that,
I just stretch myself too thin and I am just
on a path for compassion fatigue. So I had to
learn how to say like no, like my hours are
this time to this time, Like I would love to
(20:24):
help you. I'll get them into the clinic, but I
can't come and come in the middle of the night
to see patients, because like in the mental health and
psychiatry world, that's just brutal, especially after like already putting
in a ten hour day and then you get a
call from the hospital saying like come into the emergency room.
I'm like, ah, I can't, Like I just I can't
force myself to do it.
Speaker 2 (20:44):
The other piece of that, too, is that like if
you do start to say yes and then finally you're
like trying to say no, there's the guilt of like,
well you used to like you're shitting now, you know.
So it's better to try to have those those firm boundaries.
Speaker 1 (20:58):
Especially because I'm the only try out psychiatrists who is
practicing in Southeast Wyoming. Like, if I give an inch,
people will take a mile, and I don't blame them.
Everyone needs help, and there is just such a lack
of care from child psychiatrists. But if I don't protect myself,
no one will.
Speaker 2 (21:16):
Some other stuff for prevention, I mean supervision and consultation.
It's a good way to vent and to process what's
going on. You can do some of the stuff yourself too,
some self awareness, some check ins, asking yourself how you
feel after a certain client, after a certain shift. I
think those are important. I think your point earlier of
not taking work home mentally, I do this a lot
(21:37):
less now, but I know I've definitely had it. I've
had points where sometimes I'll just drive home in silence
day and I just need to. I need to this.
This drive home is going to be my way of
being able to separate work from the house. And if
I can drive in silence and I get home, I
could pick up where I left off the next day.
That helps a lot.
Speaker 1 (21:57):
Doing things like mindfulness and grounding practices. Sometimes that can
be writing home in silence right your giving your emotions
and feeling some time some you know you don't have
any distractions, You're just kind of sitting in how you feel,
letting it happen, letting the wave wash over you and
then leave. I think that's a really important thing, and
(22:18):
it's so funny. I do the exact same thing. I'll
drive home in silence. Man, Sometimes sometimes I might cry
a little bit, you know, sometimes I might scream a
little bit, and just if I've got a lot of frustration,
I'll just grab the steering wheel and ah, get it out,
address it instead of trying to just shove it all down.
Speaker 2 (22:37):
One of the things for me is, I think because
of what's going on in the country, for me, it
feels like it ties so much into my work that
I feel like I have to know what's happening or
have to have an idea of what's going on. And
sometimes for me, the boundary is I just won't listen
to the news for a little bit. Yes, I have
a few news podcasts that I listened to that keep
(22:59):
me up to date on things, and sometimes I just
take a break from them. Sometimes I just won't listen
to them just because it's like I need to I
need to listen to something else and not listened to
anything at all. So it's another way.
Speaker 1 (23:11):
Yeah, it's nice to have that mindless stuff. Not I
have to just be bombarded with bad news from the
news all the time.
Speaker 2 (23:18):
Sometimes Big Booty Mix twenty is all I need.
Speaker 1 (23:23):
Two Friends, Big Booty.
Speaker 2 (23:26):
Look at number twenty is the one, man. I think
that's the one, you guys, the very first one you
sent me in that that was a life changer.
Speaker 1 (23:34):
If people have not listened to Two Friends Big Booty Mix,
it is some of the most fun music you will
ever listen to.
Speaker 2 (23:41):
But did I tell you that?
Speaker 1 (23:42):
We went to Two Friends and they're Big Booty Mix
at Red Rocks like in April.
Speaker 2 (23:47):
I know, what the fuck? That's tight?
Speaker 1 (23:49):
I know, I forgot to tell you. So we went,
but it was pouring rain at Red Rocks outdoors, and
so we're just like in the rain, just shaking and shivering.
It was like forty degrees the freezing, right, We're just
trying to dance and get ourselves warm. But it was
it was totally worth it.
Speaker 2 (24:07):
But we were wrenched. It was. It was a party.
So do yourself a favor. If you haven't yet, look up,
look up Big Big Booty Mix Two Friends. They do
some great sets. It's awesome. It's awesome music to listen
to in the background.
Speaker 1 (24:22):
And if Two Friends, everyone wants to collab with us,
you know, slide into Eddie's DMS. Ben and eli we
are ready for you.
Speaker 2 (24:32):
Yes. In terms of management with something like compassionate fatigue,
I think debriefing with your peers. I think I've worked
in enough settings where just having coworkers that understand what
you're doing helps a ton, helps to just kind of
get it out. Prioritizing rest of recovery, I mean justin
talks about it. A lot of sleep is important. I
(24:53):
know sleep is important. Breaks, vacation and like a real break,
not just like I'm gonna get lunch at my desk
while I read three emails, like go take a walk
or something if you haven't already. Therapy is great, peer
support groups, professional support groups, and then just normalizing self compassion.
I think a lot of the times when I work
(25:13):
with kids and teens, they'll tell me that they prioritize
other people because they don't want to them, They don't
want to be a burden on other people with this,
and that I think we end up doing the same thing.
We prioritize the people around us. We prioritize our clients,
our patients, and sometimes we need to talk to ourselves
the way that we would to a client or patient.
We need to give ourselves some self love too, So yeah,
(25:35):
so what I got. So compassion fatigue is real. We're
still gonna chug along and make the difference we.
Speaker 1 (25:41):
Can big booty mix slaps.
Speaker 2 (25:44):
Big and it's okay if sometimes it's hard to give
a shit about other people because of the way things are,
just if you can give a shit about yourself, I
think that's that's a good enough start.
Speaker 1 (25:56):
You gotta love yourself if you can love someone else.
So I like that advice. You know, some other discussion
questions that we wanted to bring up, just talking about
our own personal experiences. When did you first start seeing
a little compassion fatigue in yourself?
Speaker 2 (26:09):
What do you think at some point between when I
graduated with my masters and now just doing the work,
and actually probably before when I was doing internship, at
some point just understanding that it is it's really it
can be really tough to help other people. It's rewarding, fulfilling, great,
wouldn't want it any other way, But sometimes it could
(26:30):
be really hard.
Speaker 1 (26:31):
I noticed that earlier in my career, like right when
I started working with kids, and even like the first
year of working as an attending it was hard, and
there were a lot of those days where at the
end of the day, I was just drained and I
was having a silent car rides home or crying on
the ride home. It's gotten better with time, and I'm
(26:52):
grateful for that, just because I think you get a
little resilient over time to it. I think it does
get better. But boy, when you're first starting out and
trying to manage all the emotions of working with kids
who have been through a lot of significant traumas, it's hard.
Speaker 2 (27:08):
Yeah. I think for this next question you probably have
an interesting perspective too with like med school, But do
you think there's a pressure in our field to power
through rather than to admit that we're overwhelmed? And I
bring up med school because I hear that so much,
whether it's on social media, TikTok, YouTube, whatever, of just
this like competition. Everyone's competitive, everyone wants to be the best.
(27:30):
You're studying hours on it, Like it's just it's like
the hunger games in med schools. What it sounds like. So,
what's been your experience with the power in through, whether
professionally or while you're still a student.
Speaker 1 (27:42):
It kind of depends on the field you're going into.
Like to give you a very basic example, surgeons are
very much a power through shut up, don't complain. Yeah,
but I noticed that a lot of the psychiatrists that
I was working with, they were very much more compassionate.
They wanted to know how you were feel They wanted
to make sure you weren't overloaded. I even remember, like
(28:04):
some of the psychiatrists working I was working with in
medical school, they were like, you know, the tests at
the end doesn't matter because usually in most rotations, like
the test you take at the end is huge. If
you fail, you got to like redo the whole rotation, YadA, YadA, YadA.
But in psychiatry they're like, it's past fail, you just
have to pass it. We want to make sure that
you learn. We want to make sure that you like
(28:24):
maintain your personhood throughout this rotation.
Speaker 2 (28:27):
Yeah.
Speaker 1 (28:27):
And it just seemed like such a complete different focus
than the entire rest of medicine. And I thought, this
is a breath of fresh air. This is something that
I want to gravitate towards. And I appreciate that people
are doing this in mental health and psychiatry, and it
was a big reason why I went into mental health.
Speaker 2 (28:45):
And this is just my experience, but I think like
my internship supervisor and my supervisor towards licensure were amazing. Great,
this has nothing to do with them, so we can
take them out of it, Sandra TONI don't worry about it.
This hasn't I do with you. I'm more looking like
system wides because they took care of me, and I
think just having them was so helpful and I'll be
(29:06):
forever grateful Systematically, though, I feel like, I don't know,
it always felt like when they talked about self care
and boundaries, it was just this canned like, yeah, take
care of yourself. Here's ten new clients, see them all
next week, right, like, yeah, self care, let's write down
(29:28):
and no bullshit, we did this write down on this
post to note what you can do for self care. Eddie,
I need you to do three new assessments this week,
like fuck man. Like, I don't know. Maybe it was
just the settings I worked at, and I think I
can't really speak to it in my current setting. I
don't really think it's I'm so one of one in
my job that I just take care of myself and
(29:49):
I'm cool. I'm all good. My last job at the hospital,
my manager sucked so I can totally see that there
wasn't really a take care of yourself kind of thing.
And then in my first job, yeah, I felt like
a so much of what we were told was so
canned and like felt like bs that I just I
don't know, but I'm glad you had a good.
Speaker 1 (30:10):
And if you can try and gravitate more towards those
jobs that are more compassionate are wanting to give you
that time. But because I mean in America, we're production based, right, Like,
if you're not seeing patients, you're not making money, you're
a drag on the system. I feel incredibly lucky that
right now in my current job, they let me see
(30:32):
like forty minute follow ups, which is kind of like
unheard of in the psychiatry world. It's usually like twenty
maybe thirty minute follow ups, and it's like shit, So
I actually get to have one on one time with patients,
ask them how they're doing, really get to like connect
with people, and A boy, am I so grateful for
that And I think that helps me a lot with
(30:52):
the compassion fatigue, because if I had twenty minute visits,
I would be so worried about staying on time and
not getting behind that I would be the least compassionate
provider anyone's ever seen.
Speaker 2 (31:02):
I don't prescribe medication or do any type of psychiatry,
so I'm just I'm just doing my best. Guess. But
how am I supposed to check in with a patient,
get an idea of how they've been, check in with
whatever vital signs, or whatever else you gotta do. How
am I supposed to do all that while also trying
to come up with some type of treatment plan or
or next step in twenty minutes.
Speaker 1 (31:20):
Yeah it's brutal.
Speaker 2 (31:22):
Yeah, well, I mean shit that. Our next question is
what system changes do you wish employers or organizations would
make it the better? Did well be longer appointment slots,
not be soap production based, actually care about the well
being of And I mean you always got to like
take it. I don't even I don't understand the whole
(31:44):
taking with a grain of salt, but I'll just say
you got to dig it with a grain of salt
because it's like you're more likely to hear about the
negative experiences, right you go to look at like a
review of like a restaurant, like, yeah, there's gonna be
people that just yeah, a five star five star, but
like the longer reviews, people want to give the negative
kind of feedback more willingly. So you know, I've talked
(32:05):
about my shitty experiences. It's not to say that's the
experience everywhere. But I would say if organizations just kind
of operated with those kind of typical things that they
would provide, I think would be in a much better
space for providers.
Speaker 1 (32:18):
So if you could go back and give your younger
more handsome self, more handsome I mean less handsome, some
like the new to the field self advice about compassion fatigue,
What would you say.
Speaker 2 (32:33):
It's really important that you take care of yourself. I
think that's yeah, yeah, yeah, because I think you kind
of touched on it too, like you always want to
be I think you've probably felt it too, but you
kind of want to be known as like I'm always
ready to help, I'm always helpful, I can always do it.
But sometimes you can still do that, but you got
(32:54):
to take care of yourself. I think I can, you
can still be the go to, but you got to
take care of yourself, I think is the biggest thing. Yeah,
I wrote this up, or maybe you wrote up the question.
I don't know, but I've known about the question, and
I feel like I should have a better answer, but
I think it's really just you got to take care
of yourself. And I think that's what I really enjoyed
(33:14):
about teaching. And actually, this upcoming fall, I'm going to
get to teach practicum seminar, which is specifically for students
that are in their internship year, and I get to
be with them for the whole year. And I'll get
a group of you know, six to eight students of
my own to just meet with and supervise for a
whole year, which I'm really excited about. But that's why
I like teaching so much and working with therapists and training.
(33:37):
I can tell them the things that I wish I
would have known or the things I fucked up on
so they don't have to fuck up on. So I'm
sure I have some better thoughts, but would just do
that one? You gotta take care of yourself, Yeah, what
about you?
Speaker 1 (33:48):
I think I said something similar on the Burnout episode
a while back, but use all of your time off,
Like in America, we're terrible at taking all of our
time off. Most Americans don't use all of their time
off like it's looked down upon other countries like take
pride at how much time they can take off and
go explore life and go spend time in nature. But
(34:09):
the Americans were just work, work, work, work, work. But
your compassion is like a battery, and the more you
do it, the more it drains.
Speaker 2 (34:17):
More.
Speaker 1 (34:17):
It drains more, it drains time off, and the things
that you love that refill that battery help you be
a better clinician, help you be a better doctor. And
so don't fall into the American trap mindset. Take your
time off.
Speaker 2 (34:35):
Did you know every year there's about two billion dollars
worth of time off that people don't use. I believe
it totally, like I made that up, but it sounds believable.
Speaker 1 (34:50):
All right, Well, now I got a look. I see
Google I as an answer for me.
Speaker 2 (34:54):
What's Google? Gentlemen?
Speaker 1 (34:55):
I got oh American workers forfeit and estimated six six billion,
oh shit benefits each year by not using all of
their allotted vacation time.
Speaker 2 (35:08):
I believe no I had a supervisor or a manager
years ago, who I think because I was talking about
my pay and be like, bro, I gotta get paid more.
I do so much more shit than other people in here,
and he's like, oh, I just you know how part
of the benefit is the time off, and like, you know,
I'm really hoping that when I because I don't take
(35:29):
time off, and I'm just hoping that by the time
I retire, you know, they're going to have to pay
me out all this money. And now looking back, that's
fucking sad man taking time off. What the fuck you
need it? It's good for you, man. You best believe
I'm taking my other days off of every year, So
take your time, damn it.
Speaker 1 (35:51):
Yes, it's healthy doctor's orders.
Speaker 2 (35:53):
That's right. Oh can you write that up for me
on one of those fancy prescription pads. Sure, nice, I'll
take it that.
Speaker 1 (36:00):
You might get laughed at if you take it to
a pharmacy, but you know that's why.
Speaker 2 (36:07):
Well, justin thank you my friend for letting me. Uh,
this might have been more for me, just event for
a little bit, but I appreciate you being there for me.
I appreciate our listeners being here. You know where to
find this Apple podcast Spotify. Leave us a five star review,
leave us a comment. We'd love to see it on
social media at Millennial MHC and our website millennia IMH
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