Empathy burnout affects many ‘helping professions’ such as healthcare professionals, social workers, firefighters, psychotherapists and other types of work dealing with the trauma of others. For healthcare professionals, this tends to be in specialties such as palliative care or intensive care.

While patients benefit from an emotional connection with their healthcare providers, the exposure to the pain and suffering of patients can lead to burnout. This fallout is called secondary trauma. Unlike classic trauma, secondary trauma occurs not in response to the events that happen to us, but rather what we see others go through.

Secondary trauma has very real effects on the lives of the people who suffer it. Medical students report lower levels of empathy as their training progresses. Extended periods of burnout can lead to health-care professionals underestimating patients’ suffering and even displaying blunted signs of empathy for pain.

1. Recognise burnout

Occupational burnout is a type of psychological stress characterized by exhaustion, lack of enthusiasm and motivation, feelings of ineffectiveness, and also may have the dimension of frustration or cynicism, and as a result reduced efficacy within the workplace. The first step in treating empathy burnout will be to recognise it.

Recognising burnout is never easy. For doctors, most are immersed almost immediately in chronic low level stress as a house officer, and some may begin to treat that as new normal. Those that are more in tune with their emotions may notice a change in their mood or thoughts, while others may only take note when they show other signs such as increased illness, changes in appetite, fatigue, forgetfulness or psychosomatic symptoms.

2. Maintain a healthy lifestyle

Getting enough sleep, eating healthily and having a social support network are all protective against the ill effects of burn out. People who are sleep deprived often have impaired judgement, lower levels of patience and reduced empathy.

3. Be concerned but not distressed

A psychologist in the late 1980s performed experiments where subjects saw others receiving mild electric shocks. Some participants reported feeling distressed, while others were concerned or sympathetic. Given the chance to help the other person by trading places and taking the shocks on their behalf, people who experienced more distress than concern were less likely to help. The study concluded that people who became distressed ended up turning inwards to help themselves feel better, while those who were concerned were focused on others.

4. Discussing with patients and their families their goals are and what makes life meaningful to them

Being honest about the limits of modern medicine can help to temper expectations of the patient and their families. Knowing that they have done all they can often helps to allay the guilt and anxiety felt by families. Getting to know what is meaningful in life to the patient can help to minimise needless prolonging of life and futile care.

Prevention is always better than cure and given the cost of burn out in practice, these measures can make a difference. MIMS

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