On Compassion Fatigue: An Endemic in the Internet Age

Excerpted from “Numb: How the Information Age Dulls Our Senses and How We Can Get them Back” by Dr. Charles Chaffin. Dr. Charles R. Chaffin is a researcher, speaker, and educator focusing on the attention economy. He writes on a variety of topics related to cognition, attention, and human behavior. His research has focused on multitasking and its relationship to human performance in a variety of settings. He is currently the host of The Numb Podcast and based in Washington, DC.

NUMB will be available on June 16, 2021 from Wiley and will be available on Amazon and everywhere books are sold.

Cole started his career as a resident physician in Atlanta in the mid-1980s. During that period, an increasing number of patients were diagnosed and treated for what had recently been identified as HIV/AIDS. It was a period when a diagnosis almost certainly meant death. As a resident physician, Cole began to see firsthand how many of these patients were treated while in the hospital. As Cole describes it, “When AIDS patients were in ICU rooms, meal service workers would shove their meals under the door and push the tray with a broomstick into the middle of their room. They did not want to be close to these patients. Nurses were terrified. Everyone was terrified.” This fear of the unknown led to poor treatment of these patients, particularly those who were gay and, in many cases, alienated from their families during the last and very painful ends of their lives. It was during that time and witnessing the suffering of these patients that Cole realized that he wanted to devote his professional career to helping AIDS patients.

During the first 10 years of his career, there was no known cure or even much of a treatment for HIV/AIDS. “My role was to try to make their remaining days as comfortable as possible.” Cole worked to comfort these patients as best as he could, listening to their fears and concerns in the absence of family and friends. “Some doctors were known as ‘skateboard doctors’ that would fly in and out. They would see 10–12 patients an hour. I wanted to listen to each patient so I might see only four or so per hour. . . .One day I saw a patient in the ICU alone and crying. I walked in and just held his hand as he died. . .I would hug every patient. They were part of the family. They would bring their partners, friends, and in some cases parents to my office. Everyone on the staff all wanted to be there. And they were the warmest people that I ever met.” Throughout this time and with out effective treatment, Cole was guided by compassion in helping these patients through the most difficult and final days of their lives.

Years passed without a cure but with an abundance of new patients. Cole decided to try to protect himself emotionally from the impact of treating these terminally ill patients. “I reached a point where I could not attend anymore memorial services. It was just too hard. I could not take it anymore. I had to protect myself from the pain,” he said. “I can remember a nurse who I worked with coming to me and crying one day saying, ‘I just can’t do this anymore. It’s too much.’ She found another job in healthcare that was not as emotion ally taxing. We helped these people as best as we could, but it took an emotional and physical toll on all of us.”

Compassion fatigue is a state of emotional and physical exhaustion from repeated exposure to some element of human need or suffering. The term, sometimes also referred to as the negative cost of caring, is usually associated with first responders, therapists, and healthcare workers who are in regular contact with people during extraordinarily difficult periods in their lives. In many cases, the very trait of compassion that attracts a professional to a helping career can erode, particularly if they are unable to exercise self-care both physically and emotionally. Individuals who are primary caregivers can also experience compassion fatigue as they are constantly helping someone, perhaps a loved one, who has an intense and constant need for care. Journalists who are regularly on the scene to cover tragedy can become desensitized to the realities that they are reporting. Symptoms can include anxiety, exhaustion, sleep disorders, and emotional disconnection. In the case of Cole, he was constantly treating people who were experiencing intense suffering, and unfortunately had limited tools to help alleviate the cause of their suffering. The response to human suffering can take an emotional toll on the ones who raise their hands to help.

unnamed.png

Playing to Our Empathetic Side

We are hardwired to be empathetic. As Charles Figley, a pioneer in the area of research on compassion fatigue, states, “We are born with compassion. It is part of the human condition. Understanding the world from another person’s perspective is critical to our collective survival.” Having a sense of life “in other people’s shoes” is critical in order to help those who are suffering, as well as to address issues of social and economic disparity. If we have no sense of the lived experience of other people, we are living life as if the only worldview is ours. “I am doing fine so everyone else must be as well.” At the same time, if everyone lacks empathy, we may have difficulty getting help when we need it as well. Professionals like Cole can experience compassion fatigue when there is still a strong desire to help, but they feel powerless to help, either because they do not have the tools or because the need is overwhelming. As Figley states, “compassion fatigue becomes an issue when our abilities to help are low yet our expectations regarding the outcome are high.”

If empathetic professionals like Cole can experience compassion fatigue due to regular access to human suffering, it stands to reason that so too can the average consumer of news and information. The news cycle is dominated by threats of war, violence, natural disasters, and all kinds of human suffering. We see the human toll of violence and the aftermath of those lost to crime and disaster. Every day brings bad news, or at a minimum a threat of some sort, which is dissected in endless detail on cable news and social media. The availability of video content from a myriad of sources means we are even more accessible to graphic news from anywhere in the world. As we all know, there are very few news stories where the reporter on the street says, “All is well here. Everyone is happy and healthy. Back to you in the studio.” By its very nature, news in many regards is bad.

The push for attention from information sources of all kinds drives more graphic video. Many sources advertise that their coverage means you as the viewer “are there.” It is no longer enough to discuss the plane crash verbally. Instead, we see video footage of the wreckage and perhaps even watch rescue workers take bodies away from the debris. We see the graphic videos of the effects of violence and natural disasters up close. We see the faces of the victims, and in many cases the grief of the families. In most cases, these videos are showing people – some near, some far – at the most difficult moment of their entire lives. Given the ease of video transmission, we sometimes see raw footage, unedited but shown to get the story out there first. In a 30-minute period, we bounce around to multiple human tragedies, with each receiving their five minutes of “bad news fame.” Sensationalism brings with it vivid details of human suffering that hold our attention and keep us watching. Even from the vantage point of our couch, our hardwired empathy is affected on some level. With all of the human suffering and tragedy we see on our screens, the news cannot possibly be merely a factual experience. It is an emotional one that, over time, takes a toll.

Over half of Americans surveyed by the American Psychological Association say the news causes them stress. The repeated images of human and natural tragedies can cause as much stress via TV or social media as if you were actually at the event yourself. In a 2014 survey, researchers from UC Irvine found that individuals watching repeated videos of the Boston Marathon bombing on the news experienced more stress than those who were actually there when it happened. As Figley writes, “We have not been directly exposed to the trauma scene, but we hear the story told with such intensity, or we hear similar stories so often, or we have the gift and curse of extreme empathy and we suffer. We feel the feelings of our clients. We experience their fears. We dream their dreams. Eventually, we lose a certain spark of optimism, humor, and hope. We tire. We aren’t sick, but we aren’t ourselves.”

Back in the 1990s, Katherine Kinnick and her colleagues explored the presence of compassion fatigue as it relates to a num ber of social problems. They found that mass media contributed to compassion fatigue in two ways. First, viewers develop compassion fatigue through constant exposure to videos and images that viewers find difficult to view, creating avoidance. Second, there was a desensitization regarding several of the topics as viewers were exposed to repeated and negative stimuli. They also found that presenting social problems without a clear solution led to compassion fatigue. The media contributes to compassion fatigue by emphasizing the sensational, repeated bad news, examining the underlying problems with a lack of context, and presenting problems that do not have stated solutions. Over time, the constant exposure to the suffering of others without a clear path to assist can make one numb to the plight of others. In 2020, Facebook reached a $52 million settlement with current and former content moderators to compensate them for many of the mental health issues that they encountered through moderation of violence, rape, animal abuse, and other images of brutality that the moderators were responsible for viewing and ultimately removing. Many of the moderators stated that the images haunted them in their sleep and may have even contributed to PTSD – certainly a human response to the repeated exposure of the suffering of others.

The Power of Compassion

There can also be tremendous power in the media illustrating the plight of others to prompt action. In 2015, a photo of three-year old Alan Kurdi lying facedown on a beach in Turkey captured the attention of the world. The boy’s lifeless body washed ashore after his family’s boat carrying a group of Syrian refugees capsized as they were trying to reach Europe. Up until that time, the humanitarian crisis in Syria was not on the public’s radar. Alan’s photo grabbed the attention of the world, eliciting donations to the Swedish Red Cross 55 times greater in the week following the photograph than before. The plight of the Syrian refugee became part of the international conversation, with governments around the world discussing ways to help. When people saw Alan’s little lifeless body on the shore, the humanitarian crisis became very real. Considering that the picture showed Alan’s body facedown, some likely imagined him to have a face similar to a child in their own lives, making it even more powerful. Perhaps the image of a lifeless child was beyond our normal diet of sensational and graphic videos and jarred us into action. In a paper that analyzed the world’s response to the picture, Paul Slovic and his colleagues stated, “Alan woke the world briefly, providing a window of opportunity during which people and their governments began paying attention to the Syrian refugee crisis.” There are tangible benefits to hearing the story of human suffering if we can find ways both to manage how much of it we are exposed to as well as monitor our response to it all.

It is important that we are educated voters, knowing relevant issues that affect both our neighbors and ourselves. Whether we are conservative or liberal, it is in all of our best interests to hold elected officials accountable to the communities they serve. Having a sense of the news, and the plight of those who are suffering near and far, enables us to find ways to make the world a better place. With that said, we can manage the amount of news and information that we are exposed to on a daily basis. It is not healthy for us to sit for five hours to watch repeated videos, commentary, and opinion about violence, scandals, and natural disasters. We can self-monitor our own internal reactions to the news. We can make thoughtful decisions about the amount of news consumption that is best for us. If we are beginning to feel numb to news content, maybe we are seeing too much. We have the power to limit our viewing of 24-hour news channels as well as the number of push notifications from news media on our smartphones.

 It is certainly impossible to be compassionate about every tragedy with which we come into contact. The mere idea of showing compassion towards all the bad news in our world is nothing short of overwhelming, particularly if we do not have the power to affect change for all who are suffering. As Figley states, “We have to adapt to what we are compassionate about.” That adaptation comes in the form of causes and stories that are a priority to us or have touched our lives or our loved ones in a significant way. Like attention, our compassion is a finite resource, which requires us to make decisions about what is important and where we can impact the most change. We can select one cause that is most important to us and get involved. Maybe those who have a loved one who suffered from cancer might be inclined to volunteer or give to a cancer charity or research center. A family might make a commitment to support one natural disaster relief effort per year, hosting bake sales, clothing drives, and perhaps volunteering at shelters. We do not have to feel as if we should support everyone or everything, or even feel as if we should be compassionate about every single news story that comes across our screen. However, if we find one cause that is most dear to us and take action, not only can we avoid elements of compassion fatigue, but we can also feel like we are making the world a better place. We can feel empowered to do something for others in a real and tangible way. Experiencing anxiety and worry while passively sitting on the couch is not going to help anyone. Although the amount of compassion we each have is limited, there are no limits to the positive change that each of us can make if we channel our energy to the right outlet.