Rock Bottom Is Not the End: The Wisdom of Compassion Fatigue

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By Dr. Edward M. Smink

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I have chosen this topic not only as one who has survived the trauma of compassion fatigue but one who has gained wisdom from my experience. I am not only a survivor but one who has chosen to live my life fully and to its greatest potential. It is this hope I now share with you. Even if caregiving is not your primary archetype, you can overcome your compassion fatigue. You are not alone. You can regain your balance and love of caregiving. Yes, it is true, believe me, I am living proof.

I am grateful to Dr. Carol Pearson,who kindly shared how my book, The Soul of Caregiving, helped her overcome compassion fatigue.

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Reaching Rock Bottom

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I had reached rock bottom. There was no difference between me or a drug addict lying on the street seeking his next fix. Nor was I different from the alcoholic trying to squeeze the last drop out of an empty whiskey bottle. I was addicted to perfectionistic behaviors. According to Marion Woodman, these behaviors stem from the desire to meet unreachable goals and impossible ideals, which are often derived from a hunger for spiritual fulfillment.[1]

As any addict would do, I displaced this hunger for spiritual fulfillment with my conscious and unconscious obsession with perfectionism. I was caught up in the cultural vortex of workaholism that most caregivers fall prey to, and I thought I was invincible. My Caretaker possession was reinforced by the American folklore myth of rugged individualism: I don’t need any help; I can do it all by myself. This was the pitfall or shadow side of my caregiver strengths. I wasn’t aware of how dormant the warrior strengths within were and how I could be openhearted and tough minded.[2] When compassion fatigue finally caught up with me, I had already been a caregiver for over twenty years, working as a registered nurse, chaplain, and executive healthcare leader.

The stranglehold of compassion fatigue was unrelenting. I had bought into the dangerous idea that I should not trust my own experience, should not talk about my story, and, most importantly, should not be in touch with my feelings, of which I was deeply afraid. Compassion fatigue was like being imprisoned in a self-created prison. I operated under the delusion that painting the bars of my jail cell gold by doing everything was better than using the key in my hand to unlock the door. Funny how easy it is to remain safe behind the bars of our own making, until one day, enough is enough.

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Enough is Enough

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I remember the day when I finally cried out in anguish, “I’ve had enough.” I was at a retreat for a group of leaders, a potluck of sorts, and I had been asked to prepare a main course. Well, that was easy, Ilmio cuore e Italiano (my heart is Italian). Initially, I was excited to make the sauce; I used fresh ripe tomatoes, olive oil, garlic, and basil, as well as a lamb chop to sweeten it. As I stirred, the fragrant aroma of the sauce reminded me of a better, happier time, during a visit to Rome. The city enchanted me. Over three thousand years of history asked to be explored by my adventurous heart. But the different mom and pop trattorias (restaurants) intrigued me most of all. One in particular I frequented many times. Momma sat in a chair near the cash register observing every action. Her three sons—one the cook, one the maître d’, and one the server— all welcomed me as family.

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Tears for Spaghetti Sauce

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As I stirred my sauce and remembered the warmth of their welcome, tears began to fall; the tears became sobs, the sobs became a torrent. I was yearning for caring from others, not always giving of myself. Floodgates opened as I wailed, bent over in anguish. I knew I needed to add more water to the sauce—little did I expect it would come in the form of my tears. I knew it then. I had had enough. No more stuffing my feelings, no more not trusting myself or others, no more withholding my story. I had to use my GET OUT OF JAIL FREE card. Or rather, I needed to use the key that had been in my hands all along.[3]

There were too many conflicting events and situations, some bordering on abuse, some resulting from an utter lack of appreciation of my contributions, some of which were stolen and attributed to one of the other coordinators of the project I was working on and my lack of understanding regarding my personal boundaries. My inability to say “No,” and my need to take on more than I could handle finally brought me to this turning point. The well of caregiving had run dry.

After the dam broke, all I remember is telling the co-directors I had to leave. They argued with me because I was responsible for some part of the program. But I had given too much already, and I was numb, almost paralyzed with the fear of continuing. I don’t remember how the spaghetti was served; all I knew was I was leaving.

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Rediscovering My Caregiver Strengths and the Warrior Within Me

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Slowly, I realized that within each of us there is a spark that seeks healing. After all, isn’t addiction an attempt to seek some form of relief? If only I have another fix, all will be well. If I have another drink, I can bury my pain. If I kissup to others, seek their approval, and try to be a perfectionist and workaholic, everyone will love me. I was so focused on what I thought others wanted instead of what I needed to do for myself. Unfortunately, the disease of addiction leads only to more suffering. Yet the innate desire for healing is still there. Was the Caregiver archetype making himself known? What about the dormant warrior who was seeking a voice? The same caregiver strengths and skills I used for others, I can now use on myself. The Warrior allowed me to refocus and move forward. How did I believe it was possible to seek help at his time? I consider it a grace, part of who I am and part of my faith, that I discovered that reaching rock bottom is not the end. Like a spark in me, I suddenly remembered the words of a kind friend and counselor. A year before,when I was directing another retreat, he said, “Ed, if you ever need any help, give me a call.” I felt his compassion, which encouraged me to call him. His name was Leo.

At the time,I didn’t have a clue what was going on. I just felt numb. I remember walking up the steps to his office and being greeted by a smiling and welcoming host. I struggled to put words to what I was experiencing. Being vulnerable was new for me, as it is for most caregivers. Over the years, anytime I wanted to talk about my experiences with my other two coordinators, I was ridiculed and shamed. “What do you mean ‘You need to rest?’ We all need rest. Don’t let us down, just get on with it.” And I did just “get on with it,” which was the source of my problem: caring for others at the expense of caring for myself. When I left that afternoon, I upset the applecart. There was a real division in the leadership group. I became an outsider,one who disagreed with the methods being used, one who broke out of the dysfunction I was addicted to, of not caring for myself.

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Compassion Fatigue Is Like Being Bankrupt

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As I struggled to describe what I was experiencing, Leo said, “Ed, you are experiencing severe compassion fatigue on the verge of burnout.” (Many caregivers in the grips of compassion fatigue have a sense that something is wrong, but do not always have the words to articulate what is going on.) I was stunned; what the hell is compassion fatigue? He intuited my dismay and said, “You are bankrupt, Ed. You have to rest and pay back the loan.” Leo continued: “I want to see you three times a week. Get plenty of rest. Find ways to relax. Exercise, swim, get a massage.”

I, along with most caregivers I know, find it difficult to be vulnerable. Focusing on caring for others often becomes a barrier to admitting your need to care for yourself. Caregivers suffering from compassion fatigue need someone who will listen to their story. They need someone who can teach them to trust the inner promptings of their Soul. I cannot overestimate the importance of breaking the cultural taboo of silence: If you are struggling, you must reach out to a spouse, a partner, friend, pastor, coach, or counselor, anyone willing to listen to your story compassionately.

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Compassion Is the Key

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Back then, I didn’t understand Leo seeing me three times a week was his way of saying “I really care for you, and I am here for you.” Developing trust in yourself, and in another, is truly a countercultural act. Similarly, it is countercultural to be vulnerable enough to share the feelings elicited by traumatic events. Leo became the anchor for me when I was unmoored, and with his help, I was able to trust myself again, and to speak about my experiences without shame or hesitation. He helped me recognize that my feelings were both normal and appropriate. He helped me see that, in truth, there was nothing wrong with me. It is important to remember that I had normal feelings in response to abnormal  traumatic events.

After a month of seeing Leo three times a week, I asked him, “On a scale of 1-10, 10 being the worst, where was I on the burnout scale when I first started seeing you?” Leo said, “Ed, you were between 8 and 9, and I consider 10 to be irreversible.” I was shocked. Why didn’t I fall off the cliff? Why didn’t I remain unhinged? What, or who, saved me? This mystery leads me to gratitude as I also discovered the Warrior strengths that gave me the courage to move on. Leave-taking is also an important factor in healing. Damn, I wasn’t going to allow myself or others to discourage or mislead me. The armor of my inner truth was no longer tarnished.

I, like many caregivers suffering from compassion fatigue, forgot that within us, even in the midst of severe darkness and pain, is a spark of divine life that leads us forward. The words of James Hillman come to mind: “It is only in afflictions that the gods appear.”[4] Simply put, rock bottom is not the end.

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Freedom to Make Life-changing Choices

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Over time, three sessions per week with Leo became two sessions per week, then once per week, then every other week. Leo also helped me get in touch with my feelings, one of which was anger. I felt duped by others and had duped myself, and recognized that anger was an integral part of my healing process. Gradually, I broke through the cultural taboos that prevented me from developing self-care skills and compassion resilience.

Resilience is the ability to recognize both that you have experienced or are experiencing a traumatic situation and that you have the strength and interior resources to heal from it and move forward. Being heard, trusting, and getting in touch with my emotions allowed me to get in touch with the Seeker within me. I sought new adventures. I resigned from the leadership positions I had, took a sabbatical, and found myself studying in Rome.

My intention in sharing this story is to give hope to those who don’t trust their interior resources due to fear of judgment and cultural taboos. With Leo, I found that I was able to share my story, revealing the pain I had not been willing to face with someone I trusted, someone who really listened to me. According to Dr. Eric Gentry, learning to trust yourself and others are the first two steps of building compassion resilience.[5] The word “compassion” comes from the Latin com-,meaning “together with,” and passio,meaning “to suffer.” The one whom I needed to care for and suffer with was myself. At the end of our time together, Leo said, “Ed, there’s no reason to seek the ‘why’ of your experience. Suffering has made you a more compassionate person.” Humbly, I admit it has.

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Postscript

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I am pleased that my bog will be published during National Caregiver’s Month. The National Caregivers Association began promoting family caregivers in 1994. President Bill Clinton signed the first national proclamation promoting caregivers in 1997. Each successive president has made a proclamation during November. To celebrate this month, I chose to release the publication of my book The Soul of Caregiving, A Caregiver’s Guide to Healing and Transformation (revised edition) on November 1, 2021. A link to the visual zoom book signing is listed below.

https://youtu.be/qL4qMhkom6c

For more information about acquiring my book, go to my website, https://www.soulofcaregiving.com

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Dr. Edward M. Smink understands that compassion fatigue is like being in a self-made prison. He, along with most caregivers, continues to paint the bars of his prison cells gold instead of using his "Get Out of Jail Free" card. Dr. Smink shares the wisdom of nearly fifty years as a caregiver as a Registered Nurse, Chaplain, Ethics and Crisis Manager, and Healthcare Executive. He not only knows but has experienced the pitfalls of and the recovery from compassion fatigue.

[1] Woodman, Marion. Addiction to Perfection. Inner City Books, 1982.

[2] Pearson, Carol S. What Stories are You Living? Center for Applications of Psychological Type, Inc.,Gainesville, FL, 2021.

[3] Smink, Edward M. The Soul of Caregiving, A Caregiver’s Guide to Healing and Transformation, Revised Edition. Media Group, 2021 (story adapted from my book).

[4] Hillman, James. Re-Visioning Psychology. Harper Colophon, 1975.

[5] Gentry, Eric. Certified CompassionFatigue Professional. January 2018.

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