Overcoming Compassion Fatigue in Ministry

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.”[1]

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.”[2]

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.”[3]

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.”[4]

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.”[5] 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”[6] 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 [7]

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.”[8]

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.”[9]

Practical Solutions
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[10]
  • 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.‘ ”[11]                                                    

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.

[1] Figley, Charles. “Compassion Fatigue. Psychotherapists’ Chronic Lack of Self -Care. Journal of Clinical Practice, 8. p 1435

[2]Boyle, Deborah A. (2011) “Countering Compassion Fatigue: A Requisite Nursing Agenda.” The Online Journal of Issues in Nursing. Volume 16, Number 01.

[3] 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.

[4] “Help for Compassion Fatigue” BiblicalCounselingCenter.org

[5] “Compassion Fatigue.” Stress.org/military/for-practitionersleaders/compassion-fatigue

[6] Lackey, T. (2002) “Compassion Fatigue is Sign of Caregiver Burnout, Self Says.” Baptist Press, Posted May 5, 2002.

[7] Boyle, Lackey

[8] Lackey

[9] biblicalcounselingcenter.org

[10] DeanHTaylor.com   Is Self-Care Selfish: Stewarding Your Personal Life for Long-Term Ministry

[11] Schoonover-Shoffner, Kathy. (April/June 2015). “Hidden Component of Compassion Fatigue?” Journal of Christian Nursing, Volume 32, Issue 2.

Is Self-Care Selfish? Stewarding Your Personal Life for Long-Term Ministry

Self-care sounds like man-centered psychobabble. It feels inherently selfish, contradicting biblical concepts such as self-denial and self-sacrifice. Why would a ministry-minded Christian pay special attention to himself or herself?

Let’s learn what self-care is, then see if any part aligns with Scripture. Perhaps it belongs on the trash pile of worldly philosophies. Or possibly common grace has made mankind instinctively conscious of a healthy practice.

Understanding Self-Care
A helpful definition of self-care is “the self-initiated behaviour that people choose to incorporate to promote good health and general well-being.”[1] Simply stated, self-care is taking responsibility for your personal health and well-being.

Areas usually in focus are physical well-being – diet, exercise, and sleep; mental/psychological well-being, especially how one deals with stress; and relational well-being – harmony and satisfaction with family, friends, and others. As Christians, we add one more, spiritual well-being – communion with God and spiritual formation.

The Need for Something Like Self-Care
Two questions arise when relating self-care to people in ministry, particularly pastors. Does pastoral life increase the need for self-care? And is self-care a legitimate pursuit for a Christian in ministry?

“Self” denotes the care of one’s own person, but it also emphasizes the individual’s initiative in performing this care. One practicing self-care doesn’t wait for a medical professional, family member, or other outside entity to look after his well-being.

In the case of a pastor, he doesn’t rely on his deacons or his doctor to tell him he needs to cut back on seventy hour work weeks, eat more whole foods, and go for a bike ride with his family. He takes charge of his habits, schedule, and priorities. He orders his life to fulfill his pastoral role while maintaining personal health.

Herein lies the problem for pastors. The very nature of their vocation is to serve others. Their time and energy are poured out every day for church members and anyone else who seems to need assistance. One text message can disrupt a day or even a whole week depending on the degree of calamity it conveys.

Stressors are primary contributors to the need for self-care. A normal ministry week can produce vast fluctuations in a pastor’s stress levels. You can probably identify with this list from Faithful and Fractured: Responding to the Clergy Health Crisis:

Twelve hour workdays; supervisory relationships requiring managerial and delegation skills; unpredictable schedule; people seeking help with serious problems; unable to take extended breaks from ministry work, or guilt feelings when you do; numerous meetings; expectation of availability to church members; enlisting and overseeing volunteers; leading well; conflict resolution; working without appropriate skill set; working with political forces in the church; taking criticism; performing sacred work[2]

Here’s another list of stressors that Christian leaders experience:

Poor diet; poor exercise habits; career uncertainty; role ambiguity; role conflict  (between church expectations and personal or family needs); role overload (too many real or imagined expectations); lack of opportunities to ‘derole’ and be yourself, for a change; loneliness; time management frustrations; life-change stressors; temptations of all kinds (sexual, despair if your church isn’t growing, jealousy of the success of others, anxiety over financial problems, anger)[3]

On top of all that, Sunday’s coming!

A helpful resource that identifies areas of a pastor’s personal health needing attention, as well as recommended solutions, is Resilient Ministry: What Pastors Told Us About Surviving and Thriving. Regarding the need for self-care, the authors say, “If we combine the expectations of this role with the fact that most pastors are people-pleasers, we can understand how ministry can feel like a never-ending treadmill of trying to satisfy others whose expectations cannot be met.”[4]

In the past two years, a new source of stress has arisen in ministry. I don’t have to cite statistics for you to know that anxiety, depression, and resignation from ministry altogether have increased as a result of dealing with COVID-related issues in the church. Even before COVID, according to Barna Report’s The State of Pastors published in 2017, 1 out of 3 pastors were at risk of burnout and almost ½ have faced depression.[5]

Pastors are especially susceptible to work and lifestyle patterns that wear them down physically, mentally, emotionally, and spiritually. And, though many church members are affectionate toward their pastors, they are not likely to realize daily ministry is a threat to pastors’ health and well-being. It would be a very unusual setting in which the chairman of the deacons asks the pastor for a report of his schedule and says, “We want you to sleep more and spend more time with your family. The church needs to hire an assistant pastor. And by the way, this summer we’re sending you on a six-week rest and study sabbatical.”

A typical congregation isn’t aware their pastor is redlining until he’s in the ER with chest pain or suddenly resigns on a Sunday morning. Pastors must take responsibility for gauging their health indicators and maintaining their own routines to preserve and protect their well-being.

Does pastoral life increase the need for self-care? I think the answer to that is pretty clear. What about the second question? Is self-care a legitimate pursuit for a Christian in ministry?

Problems with the Concept of Self-Care
We’re good with terms like self-denial, self-discipline, and self-control. But self-care? It sounds like you’re taking yourself to a spa. Try this on your deacons: “I’m taking a few days off this week for self-care.” Right.

The common wisdom for Christian living, especially ministry, is anything that caters to self is bad. Self is the enemy, second only to the devil. Anything that appeals to self is automatically suspect. Self-indulgent practices are guilty pleasures. Soldiers of the cross endure hardship, and they’d better not be caught reading fiction or taking a nap.

How could self-care be legitimate for one called to the rigors of ministry? This is where a secular term can blur our perspective of a valid idea. Self-care sounds like you’re being soft on yourself, avoiding difficulty, and putting your own needs first. Of course all these are the opposite of biblical principles, especially love, which is giving yourself, not coddling yourself.

A Biblically-Based Perspective of Self-Care
Does self-care have any place in a pastor’s life? Viewed solely from a worldly perspective, it’s questionable. But through a biblical lens, self-care resembles the biblical concept of stewardship.

Viewed biblically, self-care is stewardship of our personal resources and priorities. It is managing the resources God has entrusted to us for eternal benefit. Several Bible texts containing either instructions or examples come to mind. 

The parable of the talents in Matthew 25:14-30 teaches us to invest the resources entrusted to us for the benefit of the Master.

According to 1 Corinthians 6:19-20, Your body is a temple of the Holy Spirit . . . you are not your own. For you have been bought with a price: therefore glorify God in your body. Our physical bodies are a means of glorifying God. We should treat them accordingly.

Peter exhorts, As each one has received a gift, employ it in serving one another as good stewards of the manifold grace of God (1 Peter 4:10). Each of us is to use our gifts not only in a way that benefits others, but as good stewards of what God has graciously entrusted to us.

Jethro guided Moses to radically alter his leadership style or he would burn out and hurt the people he was supposed to be helping (Exodus 18:13-23).

Jesus took his disciples on a self-care retreat. And He said to them, “Come aside by yourselves to a deserted place and rest a while.” For there were many coming and going, and they did not even have time to eat (Mark 6:31).

Paul told Timothy to pay careful attention to his personal life in order to have an effective public ministry in 1 Timothy 4:16.

He also told Timothy in 1 Timothy 5:23 to treat physical health issues and prevent them if possible.

And notice in 3 John 2 how one leader prays another would be both physically and spiritually healthy.

Here is a helpful definition of biblically shaped pastoral self-care: “The wisdom to ensure, as far as humanly possible, a wise and orderly work that conserves and lengthens a pastor’s ministry.”[6]

Resilient Ministry identifies pastoral self-care as “the ongoing development of the whole person, including the emotional, spiritual, relational, physical, and intellectual areas of life.[7]

I especially like how Nathan Foster describes it as “attending to and respecting the limitations and needs that God has designed for humans . . . respecting and attending to our human limitations and needs is simply caring for God’s crowning creation, the human machine.”[8]

The secular concept of self-care is the world’s recognition of what Christians already know. God endowed His creatures with sufficient yet limited capacity to serve and glorify Him. We are responsible to manage our lives in a way that sustains a lifetime of effective ministry. As one pastor quoted in Resilient Ministry said, “It’s about burning on, not burning out.”[9]

Stewardship is taking responsibility for maintaining areas of your personal life so you will burn on rather than burn out. You manage your life for long-term ministry. You see the need for it, you take the initiative, you make choices, and you live accordingly.

The term self-care can be legitimately used, but should be seen as a form of stewardship. It definitely requires a God-focused rather than a self-centered perspective. Consider these distinctions between self-care and stewardship:

SELF-CARESELF-STEWARDSHIP
Take care of yourself.Take care of yourself for long-term service to God.
Eat, sleep, and exercise to maintain physical health.Take care of your physical body with nutrition, rest, and exercise because it is the temple of God and for the purpose of long-term ministry.
Set boundaries to protect your personal life.Set boundaries to ensure you invest appropriate time in all priorities, relationships, and responsibilities for the glory of God.

For example, rather than allowing church members’ needs and expectations to determine a pastor’s daily schedule he establishes a reasonable plan for using time throughout the week. He prioritizes personal devotion, family time, exercise, and a date with his wife as well as sermon preparation, discipleship meetings, and hospital and homebound visits. A true emergency may alter his plans, but he works the usual requests for his time around the priorities he has established.

Balancing Servanthood with Stewardship
Servant-leadership is a biblical concept often associated with ministry, but it must be kept in balance. Some pastors think that because we are supposed to be servants, as Jesus taught in Mark 10:42-25, we should be available to anyone at any time. Other people’s needs or expectations take precedence. This concept has been instilled in us, possibly resulting in a diminished view of stewardship. Herein lies a tension in a pastor’s life – balancing servanthood and stewardship.

According to a servant mindset, pastors feel they must always be available to respond to needs, and whatever they’re doing is secondary. However, pastors need to understand and practice stewardship as well, proactively managing their time, energy, and abilities to honor God, serve others, and sustain long-term ministry.

As I thought through the tension between servanthood and stewardship, I developed the following comparison:

SERVANTHOODSTEWARDSHIP
Horizontal (others) and vertical (God)Vertical (God)
Need-focusedResources-focused – what has been entrusted to me and how should I use it
Puts others first, before yourselfPuts God first, above all – I am accountable to God first
RespondsTakes responsibility – not always responding to others’ needs
GivesManages, invests – How should I invest my time, gifts, energy?
ImmediateLong-term, eternal
Please peopleGive account to God
My time is yours – “open door”My time is God’s
May be motivated by pressure, guiltMotivated by wisdom – making wise choices, not based on guilt
What others seeWhat God knows – not controlled by expectations, real or perceived
Almost always says yes; hardly ever says noOften says yes; sometimes graciously says no
Lets others set agendaSets an agenda that includes others

Servanthood and stewardship are taught in Scripture, so both are valid approaches to life and ministry. It seems to me servanthood fits within stewardship. Culturally, a household manager (“steward”) was one of the servants. So a steward was in the position of a servant. His overall role was a steward. He carried out his responsibilities as a servant by being a good steward. Servants can be wise stewards, and stewards can be faithful servants.

Conclusion
Is self-care a legitimate pursuit for a Christian in ministry? If we’re not talking about self-indulgence, but stewardship, then yes. A pastor should ensure he rests adequately, eats healthfully, exercises regularly, grows spiritually, and prioritizes time and energy for his marriage, family, and other relationships. He should steward his personal resources for long-term ministry for the glory of God.

[1] Exploring the Meaning and Practice of Self-Care  by Mills, Ward, & Fraser

[2]Faithful and Fractured: Responding to the Clergy Health Crisis by Rae Jean Proeschold-Bell and Jason Byassee, 1-16

[3] Stress and Burnout in Ministry by Rowland Croucher

[4] Resilient Ministry: What Pastors Told Us About Surviving and Thriving by Bob Burns, Tasha Chapman, and Donald Guthrie, 62

[5] The State of Pastors: How Today’s Faith Leaders are Navigating Life and Leadership in an Age of Complexity, by Barna Group, 11

[6] Going the Distance: How to Stay Fit For a Lifetime of Ministry by Peter Brain, 24

[7] Resilient Ministry, 61

[8] Selfish Care, Self-Care, and Soul Care – What’s the Difference? by  Nathan Foster

[9] Resilient Ministry, 61