Compassion fatigue is ‘the new black’


  • Letters
  • Tuesday, 29 Sep 2020

In recent weeks, even the most cautious members of my family, as well as my friends and colleagues, have started to relax their stringent adherence to Covid-19 safety measures. They are arranging social gatherings, travelling across the country, returning to work, shopping with greater freedom, washing their hands less frequently and even leaving their homes without wearing a mask.

This is in stark contrast to the vigilance we exercised in the early days of our national lockdown under the movement control order. Remember when you would wash every item you brought back from the grocery store? Or when no more than two persons could travel in a vehicle, and the passenger sat in the back seat? Or when we ran in circles on our balconies and in our backyards to get our exercise?

Being careful seemed so important and necessary! After all, we were protecting ourselves, and others, from being infected with a possibly deadly virus.

Before Malaysia went into lockdown on March 18, we had only 532 reported cases of coronavirus infection. The first two Covid-19-related deaths were reported around that time. Understandably, we were shocked and afraid.

I am sure we can all remember the first time that we heard of a relative, friend or co-worker who was infected. Some of us have also had to suffer the loss of family and friends who succumbed to Covid-19. And of course, some of us are among the nearly 10,000 people who were infected with the virus and have recovered (11,034 people were infected as at Sept 28, 2020).

The pandemic is not only a health tragedy in Malaysia. It is also an economic disaster, putting further strain on an already faltering economy. The media has reported large-scale suffering globally from hunger, the brutality of increased gender-based violence, the loss of job security for many people, including Malaysians, and the failure of education systems that have left teachers vulnerable and learners even further behind in their schooling. It is likely to take decades to address some of these problems. This will almost certainly be hampered by ongoing corruption in both governments and the private sector.

Yet for the majority of Malaysians, life seems to be “returning to normal”. We have numbed ourselves to the images of frontline workers dressed in personal protective equipment caring for desperately sick people in hospitals. We hardly seem to notice when the daily news reports that another three or so people have died as a result of Covid-19 overnight, and that the death toll now sits at around 134 as at Sept 28, 2020. But these are no longer the faces of people – they are just a number.

Why have we stopped caring?

We are suffering from a condition known as compassion fatigue. Compassion fatigue is common among those who are constantly exposed to unresolvable suffering. It is most often reported among what are called the caring professions, like nurses, doctors, social workers, religious leaders.

Research has shown that when a person is constantly confronted by suffering, his/her response to the suffering becomes less pronounced over time. This is the body’s way of coping with the pain and trauma of witnessing and experiencing the suffering of others.

When we see someone suffer, or hear about someone suffering, a part of our brain is activated that causes us to recreate the experience of the other person in our own imagination. We feel something of their pain. This is a pre-cognate reaction – in other words, it happens in that deep part of our brain that responds to pain without thinking. This capacity for empathy is believed to have evolved in all mammal brains (to different degrees) to evoke the responses of care and the avoidance of danger.

When we imagine the suffering of another, we are instinctively motivated to avoid it ourselves. We also tend to shield those that we care for from harm. Similarly, when we see someone suffering, we are also instinctively prompted to help them ease their pain. The offering of care and the avoidance of pain serve to preserve life and so these reactions have become hard-wired into the functioning of our brains.

However, research shows that while our brains are wired for survival and the avoidance of pain and threat, they also adapt to avoid emotional pain and psychological threats. So over time, as we are exposed to the ongoing pain and suffering of others, we become less and less sensitive to it. Our emotional reaction to their pain is less severe. We rationalise what we hear and see, moving from the emotional centre of the brain to the cognitive and rational functions.

Over time, we are no longer shocked to hear that a number of people died in the last 24 hours from a virus that each one of us could be infected with. We are no longer thinking about 10,000 individuals – mothers, fathers, sons and daughters – who have been infected, we are thinking about a number, a statistic.

Research further shows that compassion fatigue can also occur in groups – such as communities or nations. For example, a community may become accustomed to certain forms of suffering, or abuse, and normalise them. In the United States, for example, the frequent killing of black people by the police is rationalised and diverted from painful experiences into political debates.

Compassion fatigue at a personal and a structural level can lead to a loss of perspective. It may cause us to mis-recognise the humanity of others, hindering us from adequately and effectively responding to suffering and pain.

But just as we would not want to be treated by an uncaring doctor or nurse, we also should not want to live in a society that does not care about the suffering of its citizens.

In his 1947 novel The Plague, Albert Camus tells the story of the arrival of a plague in the Algerian city of Oran. After facing great tragedy and hardship, the citizens of Oran start to normalise their lives. Camus, however, uses his novel to illustrate how abnormal some aspects of their "normal" lives actually are.

It is important that we recognise when compassion fatigue starts to set in. We must guard against it in our closest relationships, and also name it when we see it in our communities and social systems.

To show compassion requires an ongoing choice to recognise the humanity of those who suffer. It requires the courage to face pain and discomfort.

To create a more compassionate society, we will have to face the reality of our shared humanity, our shared frailty, and our need for one another. We will have to avoid the instinct to escape or simply ignore what causes pain and suffering.

In these difficult times we could all do with a little more care, with a more humane and compassionate society.

BENJAMIN IRFAN MOHD ILAHI

George Town

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Covid-19 , compassion fatigue

   

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