The Hidden Cost of Compassion

There was a time when I felt apathetic, disinterested, and afraid of my own apathy and disinterest. Feeling this way tends to pose quite the problem when your entire job involves being non-judgemental, empathetic, and very much, interested. As a registered counsellor, I have encountered what many in helping professions face: compassion fatigue.

In South Africa, compassion fatigue is quietly taking a toll on those who give the most of themselves. Nurses, doctors, counsellors, and caregivers often find themselves emotionally drained by the daily weight of others’ suffering. While research on the exact prevalence remains limited, a study in Durban’s oncology departments revealed that around 75% of nurses reported experiencing average levels of compassion fatigue (Wentzel & Brysiewicz, 2018). Across Southern Africa, approximately 64% of healthcare workers show signs of compassion fatigue, with rates rising during the COVID‑19 pandemic (Kabunga et al., 2024). These figures are more than statistics; they reflect a workforce stretched thin and underscore the urgent need to support South Africa’s caregivers before their compassion runs dry.

In this article, we explore what compassion fatigue is, how it manifests, and strategies for coping.

What is Compassion Fatigue?

Though the term compassion fatigue has recently entered public discourse, it was first coined by nurse Clara Joinson in 1992 (Joinson, 1992). While traditionally associated with healthcare professionals, the concept applies more broadly to anyone who provides prolonged care under challenging circumstances, including family caregivers, parents of neurodivergent children, and others repeatedly called upon to be compassionate. It acknowledges that harsh working conditions, sustained exposure to trauma, and persistent demands for empathy and emotional resilience are taxing, often to the point of exhaustion.

Researchers have offered differing perspectives on compassion fatigue. Some equate it with secondary traumatic stress (Figley, 1995), others conceptualize it along a continuum that includes burnout (Valent, 2002), and still others view it as a distinct phenomenon in its own right (Thomas & Wilson, 2004). If you’re feeling confused, don’t worry, so are we all. All you need to know is that compassion fatigue is a more accessible term to describe some shared experiences. It need not necessarily be categorized as a “diagnosis” or “mental health disorder". 

At its core, compassion fatigue involves a reduced capacity or interest in bearing the suffering of others, often leaving individuals feeling tired, irritable, numb, or less able to empathize (Fu & Chen, 2011). Often referred to as the “cost of compassion,” caring for others can be deeply rewarding but emotionally demanding, particularly when sustained over long periods of time. 

What Does Compassion Fatigue Feel Like?

In my quest to try and describe what compassion fatigue feels like I read a study where one participant described feeling like a sponge that was full. So full that they couldn’t offer what they needed to offer (Stevens & Al-Abbadey, 2024). I think that describes compassion fatigue quite well. When one has to absorb all the pain, suffering, and difficulties of those around them, eventually they do not have the space to absorb any more. Similarly, Gustafsson and Hemberg (2022) reported a participant reflecting, “It was a deeper fatigue…which seemed to lie in the soul…it weighed on my soul” (p. 162). Beyond emotional and cognitive exhaustion, compassion fatigue can also have spiritual, physical, and existential effects (Pessin et al., 2015), highlighting that it is far more than ordinary tiredness.

Compassion Fatigue vs Burnout — What’s the Difference?

While the two can co‑occur, they are distinct concepts. Compassion fatigue arises when caregivers become emotionally and psychologically exhausted from exposure to others’ trauma or suffering, often with rapid onset and a direct link to empathic engagement. Burnout, in contrast, develops gradually and stems from chronic job stress and organizational pressures such as high workload, lack of control, or insufficient support. While the two can overlap, compassion fatigue is about the emotional cost of caring, whereas burnout reflects broader occupational stress (Slatten et al., 2011).

Can Compassion Fatigue Happen Outside of the Helping Professions?

Yes. Although much of the research has focused on healthcare and mental health professionals, compassion fatigue can occur wherever individuals are repeatedly exposed to the suffering of others (Noor et al., 2025). This includes family caregiving, especially for chronically ill or disabled relatives; emergency and disaster response; and social or legal services that involve trauma cases, such as attorneys working with victims. Compassion fatigue is therefore not confined to clinical environments but can occur anywhere deep emotional investment and exposure to suffering are sustained.

How Do You Recover from Compassion Fatigue?

Recovery generally requires restoring emotional balance, enhancing resilience, and reducing ongoing stress. Evidence supports several strategies. Mindfulness and self-compassion practices have been shown to help reduce compassion fatigue and improve overall well‑being. Peer support, reflective supervision, and structured debriefing help individuals process emotional burdens. Psychological interventions, including cognitive-behavioral therapy, have demonstrated effectiveness in reducing symptoms of compassion fatigue. Adjusting workloads, setting boundaries, and ensuring regular rest also contribute significantly to recovery (Lipsa et al., 2024). Recovery is not instantaneous and requires ongoing attention to both personal and environmental support systems.

Can Counselling Help with Compassion Fatigue?

Yes. Many experiencing compassion fatigue struggle with complex emotions, including apathy, guilt, and shame. Counselling can provide tools for emotional regulation, help process secondary trauma, and support the development of healthy boundaries and self-care strategies (Lipsa et al., 2024). 

Is Compassion Fatigue a Sign I Chose the Wrong Career?

No. Research does not consider compassion fatigue a sign of personal failure or a wrong career choice (Cocker & Joss, 2016). It is a natural response to prolonged exposure to others’ suffering, especially for those drawn to high-empathy roles. Professionals often enter caregiving fields precisely because they care deeply, which can paradoxically make them more vulnerable to compassion fatigue. What it signals is the need for structural support, personal boundaries, and self-care, not a lack of commitment or aptitude.