I was describing the emotional toll that ministry takes on pastors while they are encouraging and counseling people who experience especially difficult times. The person I was speaking to had received training for this very thing as an emergency medical technician. He said, “That’s compassion fatigue.”
I had never heard the term and was not familiar with the concept. When he explained it, lights came on. People in helping professions, including medical personnel, social workers, and clergy, are repeatedly exposed to deep and complicated problems in the course of their work. They can develop a mindset of detachment that reflects diminished compassion for the person they are helping. When I heard this description I recognized it in my own experience.
I also recognized another phenomenon he described to me – vicarious trauma, or secondary trauma. This occurs when a helper walks through a traumatic experience with someone, such as a church member or counselee, and bears much of the impact that comes with that traumatic scenario. For example, a man’s wife leaves him for another man, or another woman. Or a young couple is killed in a tragic accident, leaving an orphaned child. Or a woman addicted to drugs is destroying her family. The pastor ends up pouring time and energy – physical, emotional, and spiritual – into these situations. These life-altering, cataclysmic scenarios are on his mind day and night and are the subject of many conversations with his spouse. Bearing this weight takes a toll. The secondary trauma puts a strain on him and can lead to compassion fatigue.
The primary problem with compassion fatigue is losing the ability to care. Pastoral care is not only a set of practices. It requires an attitude of genuine care for individuals. We are commanded to love others. This strongly implies that we are genuinely concerned for their well-being. Compassion is the ability to feel with someone who is hurting. If we become desensitized to the point of detachment, the element of love is removed. We are in danger of performing pastoral work in a clinical, professional, or mechanical manner.
A secondary effect of compassion fatigue is we feel guilty about it, which can turn into a downward spiral of discouragement. A pastor one day realizes he has lost his capacity to feel people’s burdens with them. He catches himself listening to a church member unburden himself and wishing he could be somewhere else. He drags himself to another pastoral visit. He dreads another counseling appointment. He can’t bring himself to write down another church member’s prayer request and intercede for them at the throne of grace.
He knows he should be compelled by love and find joy in serving others. He feels guilty for his reluctance and becomes discouraged about ministry when he feels the urge to run away from hurting people rather than move toward them.
Origin and Definition of the Term
Dr. Charles Figley is the Tulane University Distinguished Chair in Disaster Mental Health and Associate Dean for Research and Director of the Traumatology Institute. He authored Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized. Figley has published numerous additional articles and anthology chapters on this and related subjects.
Figley defines compassion fatigue as “a state of tension and preoccupation with the traumatized patients by re-experiencing the traumatic events . . . It is a function of being witness to the suffering of others.”
The term was first used in a study of burnout in nurses conducted in 1992. A description of this study states, “Multiple environmental stressors, such as expanding workload and long hours, coupled with the need to respond to complex patient needs, including pain, traumatic injury, and emotional distress, resulted in nurses feeling tired, depressed, angry, ineffective, apathetic, and detached.” The description goes on to say, “Nurses are particularly vulnerable to compassion fatigue. They often enter the lives of others at very critical junctures and become partners, rather than observers, in patients’ healthcare journeys. Acute care nurses in particular often develop empathic engagement with patients and families. This, coupled with their experience of cumulative grief, positions them at the epicenter of an environment often characterized by sadness and loss. Nurses are frequently enmeshed in existential issues surrounding life and death.”
Three faculty members of the University of Ulster in Northern Ireland published a study on compassion fatigue among clergy. Elements of the study address the impact on clergy of ministering to people affected by the 9/11 attacks. The effect included “significant levels of compassion fatigue.” They warned, “There is a price being paid as a result of vicarious involvement within the course of the daily pastoral ministry that entails seemingly less major events . . . but which involves daily exposure to the pain of others.”
Pastors experience mini-9/11s on a regular basis. The call that sends you to the emergency room to comfort a family in shock, the family breakup, runaway teenager, adultery exposed – you carry the pain of others in your heart and feel the anguish in a similar way as they do. And this is multiplied times the number of people you have in your church.
The Biblical Counseling Center, located in the Chicago area, says on this topic, “In clinical settings, compassion fatigue is sometimes referred to as ‘secondary trauma’ or ‘vicarious traumatization.’ It may also be considered similar to a type of PTSD that affects those who provide soul care to trauma victims.”
The American Institute of Stress defines compassion fatigue as “the emotional residue or strain of exposure to working with those suffering from the consequences of traumatic events.” One counselor says, “Generally, it is caused when one has become so involved in providing care to others that they become emotionally and spiritually exhausted” Compassion fatigue is sometimes described as the cost of caring.
Manifestations of Compassion Fatigue
There are numerous lists. Some symptoms sound like normal human struggles, or even fleshly responses to people and situations. However if these are a pattern, especially several of them together, and become more pronounced over a period of time, possibly in a way that is noticed by people who know you, you may want to consider that compassion fatigue is a factor. I’ve selected some of the more prominent, noticeable symptoms:
- Physical – Fatigue, lack of endurance, loss of strength, difficulty sleeping, somatic problems (headaches, colds, ulcers)
- Emotional – Irritability, anger, anxiety, depression, apathy, cynicism, becoming jaded, hardened to people and their problems, discouragement, feeling overwhelmed, attitude of hopelessness
- Behavioral – Aggression, callousness, pessimism, defensiveness, loss of interest in behaviors once enjoyed, withdrawal from family or friends
- Spiritual – Decrease in discernment, disinterest in introspection, lack of spiritual awareness, poor judgment
- Intellectual – Boredom, disorderliness, weakened attention to detail
- Work-Related – Absenteeism, tardiness, avoidance of intense patient situations, impersonal communication 
The bottom line is, “You can’t hear other people’s pain without being affected by it. If you aren’t affected, that’s a true sign of compassion fatigue.”
Scriptural Solutions for Compassion Fatigue
The pastor who recognizes compassion fatigue can experience recovery and renewal by meditating on these biblical realities.
- We are all called to bear one another’s burdens.
Galatians 6:2 Bear one another’s burdens, and so fulfill the law of Christ. This is a normal part of Christian fellowship and ministry. So we should not withdraw ourselves from helping others through their trials and tragedies.
- There is a cost of ministering to others.
Paul wrote, So, affectionately longing for you, we were well pleased to impart to you not only the gospel of God, but also our own lives, because you had become dear to us (1 Thess 2:8). And to the Corinthians, And I will very gladly spend and be spent for your souls; though the more abundantly I love you, the less I am loved (2 Cor 12:15) Jesus came not to be ministered to, but to minister, and to give his life a ransom for many (Mark 10:45). He is our model for servant leadership, and it cost him his life. So we need to count the cost and be willing to pay a price.
- God can strengthen us for the rigors of ministry work.
Paul encouraged Timothy, You therefore, my son, be strong in the grace that is in Christ Jesus (2 Tim 2:1). Paul himself labored to exhaustion, but received strength from God: Him we preach, warning every man and teaching every man in all wisdom, that we may present every man perfect in Christ Jesus. To this end I also labor, striving according to His working which works in me mightily (Col 1:28-29).
We need to regularly receive strength from the Lord through dependence on Him in prayer and being nourished from the Word of God and Christian fellowship. If we let these go, we will be quickly depleted and overwhelmed by the burden of caring for the souls of others.
- Remember we are finite beings with human limitations.
Although God empowers us for ministry work that exceeds our natural ability to perform, He does not eliminate the need for normal human sustenance such as food and rest. And we can reach our capacity for handling major, traumatic scenarios. There is a point where we reach overload. It’s ok to say, “I need help with this.”
- Rest in God’s omniscient, omnipotent, omnipresent involvement in people’s traumatic life events.
God is present and active in people’s lives all the time. I can do my best do deal with a hard situation, then go to bed at night and know that, although I’m not with that person, God is and He is at work – comforting, providing, sanctifying.
- Trust in the process of inner progressive sanctification through the Word and the Holy Spirit.
I think part of the problem is thinking I am the Savior, the one with ability to do all the things. If something’s going to happen, someone is going to change, someone is going to recover, gain hope – I am going to produce it or at least be the key to facilitating it. It comes down to our view of God, His sovereignty, and progressive sanctification.
“The foundation of prevention and healing is trust and rest in the work of Christ.. The hope that counselors extend to counselees is the same hope upon which their faith rests, namely, the gospel of Jesus Christ.”
“. . . only God is infinite. Only He, working in and through the power of His word and Spirit, is able to accomplish the goal of biblical soul care: sanctification.”
In addition to appropriating scriptural truths, there are practical ways to overcome compassion fatigue in ministry.
- Manage your weekly schedule.
Establish priorities and commit time to them. Build in “sabbath rest” – a rhythm of life that includes, not only sufficient sleep, but also regular breaks from ministry work.
- Block out times when you do not counsel (e.g., your day off, a heavy sermon prep day, and weekends, except for emergencies).
- Determine a realistic load of pastoral care for your role and enlist others to share the work.
Utilize your pastoral team, elders, retired pastors, deacons, or a biblical counseling center.
- Have someone you can talk to.
Find someone to help you carry your burden (Gal 6:2). Proactively involve someone else. Pastors naturally share a lot with their spouses, but it’s healthy to have another colleague or friend with whom to share ministry burdens.
- Steward your personal life and priorities for long-term ministry
This includes sufficient rest, healthful diet, regular exercise, consistent and meaningful personal devotion, spiritual growth, appropriate commitments of time, energy, and attention to marriage, family, ministry, and friendships, along with discernment in saying yes or no when necessary
- Practice an unhurried, pace of grace like Jesus.
Kathy Schoonover-Shoffner wrote in the Journal of Christian Nursing on the issue of compassion fatigue:
“Jesus followed the pace God set for him, rather than what people expected of him. He didn’t send away the Canaanite woman asking for help (Matthew 15:21-28); didn’t rush to heal Lazarus (John 11:6); and he stopped to help a sick woman when a centurion’s daughter was dying (Mark 5:22-34). Yet at the end of his life, he had completed everything God had given him to do (John 17:4, 19:30).
“Fadling [in book she’s referring to – An Unhurried Life: Following Jesus’ Rhythms of Work and Rest by Alan Fadling] calls this the “pace of grace” (p. 10), an unhurried, relaxed way of the heart that accepts what God thinks of us and follows Jesus’s lead. This pace of grace lets God guide what I should and should not be doing: to work or to rest. Fadling (says),
“ ‘Just as surely as God gives us ministry opportunities, he also gives us opportunities to rest with him and be restored.‘ ”
So let us learn to work when it’s time to work, rest when it’s time to rest, bear what we are meant to bear of our own and others’ burdens, and trust our all-powerful God, our ever-present Savior, and our continually-working Paraclete, the Holy Spirit, to accomplish the real work of comfort, restoration, and spiritual progress in people’s lives.
 Figley, Charles. “Compassion Fatigue. Psychotherapists’ Chronic Lack of Self -Care. Journal of Clinical Practice, 8. p 1435
Boyle, Deborah A. (2011) “Countering Compassion Fatigue: A Requisite Nursing Agenda.” The Online Journal of Issues in Nursing. Volume 16, Number 01.
 Hendron, J., Irving, P., & Taylor, B. (2014). “Clergy Stress through Working with Trauma: a qualitative study of secondary impact.” Journal of Pastoral Care and Counseling, Volume 68.
 “Help for Compassion Fatigue” BiblicalCounselingCenter.org
 “Compassion Fatigue.” Stress.org/military/for-practitionersleaders/compassion-fatigue
 Lackey, T. (2002) “Compassion Fatigue is Sign of Caregiver Burnout, Self Says.” Baptist Press, Posted May 5, 2002.
 Boyle, Lackey
 DeanHTaylor.com Is Self-Care Selfish: Stewarding Your Personal Life for Long-Term Ministry
 Schoonover-Shoffner, Kathy. (April/June 2015). “Hidden Component of Compassion Fatigue?” Journal of Christian Nursing, Volume 32, Issue 2.