Compassion Fatigue

I Couldn’t Watch Documentaries. 

One of my favourite ex-colleagues of all time used to recommend these amazing documentaries to me. She would be full of inspiration and righteous anger about injustices in the world, the state of humanity, the way the government was treating people, misogyny and inequality… I could see the impact for her was to inspire and challenge and she was full of interesting perspectives; I learned so much from her. However, I couldn’t bring myself to watch the documentaries. Or the news. Or films ‘based on a true story’. 

What I discovered was a kind of exhaustion that had seeped into my soul. Not the tiredness that came from a bad night’s sleep, or even the busyness of a long day. I’m talking about the weariness of having cared too much for too long without proper support. One day I realised I had nothing left to give but I was still trying to pour from a cup that was bone dry.

This is compassion fatigue.

Also known as secondary traumatic stress, it often shows up in people who support others for a living, or for love. Therapists, teachers, social workers, nurses, carers, parents, partners, activists. Anyone who sits in the fire with others. Anyone who’s said, “I’ll hold this for you,” even as their own hands began to burn.

What Is Compassion Fatigue?

While burnout often stems from systemic overwhelm (too many demands, not enough resources) compassion fatigue is the cost of caring deeply, empathically, and repeatedly without adequate recovery. And it’s not just emotional. It’s neurological.

Neuroscientist and clinical psychologist Dr. Sarah McKay, based in Oxfordshire, believes that compassion fatigue is “not about a lack of empathy—it’s a result of sustained empathic engagement without emotional regulation or recovery time.” Our brains are wired for connection, but they’re also wired for protection. When we’re exposed to others’ pain too often without support, the brain begins to downregulate to keep us safe—numbing us, flatlining joy, and disconnecting us from meaning. 

For me, it wasn’t safe to watch documentaries. They never told fun, happy stories. Even nature documentaries had too much jeopardy and ethical trauma in them when the animals would fight or eat one another, or as humans we were destroying their planet through our greed. It was too much. I just couldn’t engage. 

Professor Suzanne O’Sullivan, a London-based neurologist and author of The Sleeping Beauties, explores how emotional and relational stress manifests in the body. She notes that compassion fatigue is not “in your head”—it’s a neurobiological response to relational overload, activating the same stress circuits as physical danger. The result? A frazzled amygdala, low-grade inflammation, and reduced access to our higher reasoning centres (i.e. pain in our body, snap decisions and brain fog).

In other words, the brain begins to sacrifice nuance in favour of survival. And when you’re constantly scanning for other people’s distress, your own body begins to code empathy as threat. 

This showed up for me in a hardware store when I asked the sales assistant to show me how to set a mouse trap. He hit it with a piece of paper and the bang and the thought of a dead mouse engaged my threat system and the next thing I knew I was crying on the pavement with a free mousetrap! I think I traumatised the man in the shop! 

Signs You Might Be Experiencing Compassion Fatigue

It doesn’t always shout its presence, sometimes it’s more of a soft withdrawal. But the signs are real and need to be taken seriously: 

• Feeling numb or indifferent to stories that once moved you

  
  
  
  

• Persistent tiredness that doesn’t lift with rest

  
  
  
  

• Emotional outbursts or irritability over small things

  
  
  
  

• Dread at the thought of helping others

  
  
  
  

• Withdrawal from friends, clients, or loved ones

  
  
  
  

• Cynicism or hopelessness (“What’s the point?”)

  
  
  
  

• Difficulty sleeping or feeling deeply rested

  
  
  
  

• A low tolerance for emotional vulnerability; yours or others’.

  
  
  
  

These signs aren’t failures. They’re flags. Messages from your nervous system saying: I need care, too.

How Therapy Can Help

Therapy can act like a warm bath for the overstimulated nervous system. A space where, for once, you’re not the one holding. You’re being held.

From a person-centred perspective, we might gently explore what happens when your empathy outpaces your own self-regard. Are there parts of you that feel only worthy when you’re helping? Have you internalised the idea that everyone else’s needs come first? Here, empathy (real, attuned, containing) meets unconditional acceptance and begins to soften that inner critic who says, “Don’t stop. Keep going. People need you.”

Through a psychodynamic lens, we might wonder where this pattern began. Did you become the family caretaker early on? Was love linked to being useful? Therapy creates space to notice these old relational blueprints and try on new ones—with boundaries, rest, reciprocity.

And neurobiologically? Therapy can literally help rewire your brain. When you experience consistent co-regulation in a safe relationship, your nervous system begins to recover its flexibility. You move from chronic stress into states of safety, connection, and creativity.

What You Can Do to Begin Reversing It

Compassion fatigue doesn't mean you’re broken. It means your beautiful, caring brain and body have been running too hot for too long. Here are some ways to begin turning toward recovery:

1. Name it. Sometimes, just saying “I’m experiencing compassion fatigue” out loud can lessen its grip. It’s a response, not a character flaw.

   
   
   
   

2. Tend to the nervous system. Warm baths, weighted blankets, humming, walking slowly outdoors, breathwork. Anything that signals I am safe helps restore balance.

   
   
   
   

3. Schedule input, not just output. What delights you, nourishes you, makes you laugh till your stomach hurts? Seek it. Regularly.

   
   
   
   

4. Protect your yes. Every “yes” to something is a “no” to something else. Choose consciously. Let your nervous system, not your guilt, guide your boundaries.

   
   
   
   

5. Therapy, rest, community. Let others care for you. Find spaces where you don’t have to be the strong one. Rest is not selfish. It’s sacred.

   
   
   
   

You don’t have to stop caring. You just don’t have to do it at the expense of yourself. The world doesn’t need more burned-out carers. It needs more nourished ones; people who can feel, connect, hold, and refill.

If your cup is cracked and leaking, please know: repair is possible. Replenishment is your birthright. And you are still worthy, even when you’re not the one pouring.