Can Compassion Lead To Caregiver Burnout?

It’s hailed as the cornerstone of quality care.  According to patient surveys, it is one of the most significant needs in healthcare.  The AMA code of Ethics states that physicians should provide all competent medical care with it and in New Zealand patients even have a right to receive it!  I’m talking, of course, about compassion – the ability to bear with someone’s sufferings while having the desire to alleviate it.  But beware, compassionate care can quickly burn you out!

Finding a Healthy Level of Compassion

Practically every day I hear someone stress the importance of showing compassion to patients.  Patients and their families need compassion.  You need to be more compassionate!  Would we have this problem if you were a bit more compassionate?  Being compassionate indicates being more engaged.  Undoubtedly, exhibiting compassion is a vital component of quality patient care but what is the best way to “bear with someone’s sufferings?” 

Most answer the above question by suggesting we move beyond sympathy and demonstrate empathy.  But I find that two problems arise with this advice:  1) People don’t know the difference between the two or 2) People don’t realize how to protect themselves from the pitfalls of empathy.

Understanding the Difference Between Sympathy and Empathy

For simplicity, sympathy shares and empathy wears.  Sympathy is sharing or conveying the emotions for someone.  It’s suffering together with and for the other.  Empathy wears or suffers in someone else’s shoes.  It images yourself in the situation of another.  Both relate to the other, but empathy takes the relationship to a deeper level and lives vicariously through the other if even for a brief moment.  Genuine compassion is empathetic – recognizing me in you.  If one is not careful, this can quickly lead to burnout.  But it’s not inevitable.  Lessons from the dramatic arts provide insight.

The best empathizers in the world are actors.  Actors don’t pretend to be someone else.  They become someone else.  In his seminal book “Stop Acting”, Harold Gushkin emphasized that actors should not adhere to a single acting method but be more instinctual.  Actors shoud stop thinking so much about the role and become the character.  However, becoming a character can have detrimental effects.  Actors can experience “emotional hangovers” if they fail to separate themselves from their parts.  Sometimes, the hangovers linger for years.  

Recently, Jim Carrey reflected on playing Andy Kaufman in the 1999 movie “Man on the Moonin a Netflix documentary, “Jim and Andy:  The Great Beyond.” He admitted that during the performance he did not know where Andy Kaufman ended and Jim Carrey began.  In other words, he did not adequately set boundaries for himself.  He stayed in character even between takes.  Subsequently, Carrey descended into a deep emotional hole where, in my opinion, he continues to struggle.  This same mistake causes many healthcare workers to burnout.

Recognizing Your Patient’s Story is NOT Your Story

Accomplished actors become other characters, but they don’t stay other characters.  They don’t “lose themselves” in their role.  Similarly, healthcare providers can lose themselves in their patient’s lives.  Empathy requires becoming the patient on a certain emotional level.  But to prevent burnout, we have to escape from staying at this level.  We do this by reminding ourselves that our patient’s story is not our story.

How do you deal compassionately with the young father who just lost his toddler in a car accident?  In what way can you empathize properly with the college girl who has stage 4 cancer?  What is the best way to delicately explain to the teenager that he will not finish high school but rather go into hospice care?  The answer:  You remind yourself that it is not Your story.  Use phrases like, “I can’t believe this happened, to you.”  “I would have reacted the same way if I were you.”  Both statements are subtle ways to remind yourself that their story is not your story.

Losing Yourself in Caregiver Compassion

Compassion is essential to quality patient care.  Empathy is an indispensable ingredient to the recipe.  But boundaries need drawing.  Remind yourself during and especially at the end of the day that your patient’s story, as painful and traumatic as it may be, is not your story.  You can suffer with and share in your patient’s emotions but do not stay there.  If you do, you and your patients will suffer unnecessarily and you may lose yourself in their story.

To learn more about the role empathy plays in caregiving and how to draw healthy boundaries, read about our Keynote and upcoming courses at

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