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How to Avoid Empathy Burnout When Surrounded by Pain

It seems there could never be enough empathy and compassion in our world, but we are starting to dis...

It seems there could never be enough empathy and compassion in our world, but we are starting to discover that our capacity to share the emotions of others and take their perspective comes with a bit of a sting if we're not careful.

by Josh Richardson

If we get caught up on the misfortunes of others without understanding life's processes, it can make us angry and unhappy.

So where do we draw the line between tuning into empathy and tuning out perceived resolutions that will leave everybody empowered?


Fortunately, work on locating the root of empathy in the brain has also led to the discovery that with the right training, we might be able to tune how much we let others' emotions affect us. This could allow us the best of both worlds — to care, without letting it consume us.

While culture might be socializing people into becoming more individualistic rather than empathic, research has uncovered the existence of "mirror neurons," which react to emotions expressed by others and then reproduce them.

Understanding how others are feeling is a bonding mechanism that we are finding in an increasing number of animals.

In humans, primatologist Frans de Waal of Emory University in Atlanta, Georgia, has suggested that being affected by another's emotional state was the earliest step in our evolution as a collaborative species.

The very nature of being empathetic, involves looking past one's own perspective in any given situation and understanding as best as possible the needs and experiences of another person.

People who are empathetic tend to be more purpose driven and they intentionally succeed in their academics not because they are looking to make good grades, but in most subjects their goal is to understand the subject material and to utilize the knowledge as one of their ever increasing tools.

But the pitfalls of empathy will be apparent to anyone who has been in a room full of babies. If one starts crying, pretty soon, they're all at it. Babies don't understand the difference between their own emotions and those being felt by others, and so what one feels, they all feel.

Negative and positive emotions alike spread like a virus. As our sense of self develops, we learn to distinguish other people's emotions from our own, although a variety of experiments, most recently studying our behaviour in online social networks, indicate we are not entirely free of the risk of emotional contagion.

Many studies have confirmed that this "empathy for pain" network exists, and that it doesn't distinguish whether the pain you're observing is physical or psychological.
"The basic principle is the same," says Tania Singer, who is now at the Max Planck Institute for Human Cognitive and Brain Sciences in Leipzig, Germany.
What's more, over the past few years it has become apparent that we don't just catch pain from those we are intimate with. The first hints came from people in care-giving professions who often see the stress and pain of others, such as hospice staff, nurses, psychotherapists and paediatricians.

Since the early 1990s, a kind of empathy burnout has increasingly been documented — given names including "secondary traumatic stress" and "vicarious traumatisation".

Symptoms include lowered ability to feel empathy and sympathy, increased anger and anxiety, and more absenteeism. Various studies link these symptoms with an indifferent attitude to patients, depersonalisation and poorer care.

It's perhaps unsurprising that empathy burnout can affect people frequently surrounded by other people's pain, especially in hospice staff. If you're looking for someone to empathize with your pain, talk to a woman in her 50s.

Although most brains are hard-wired for empathy, the over-50 female crowd are able to express it more than others. There lies a subgroup of the population who also begin to experience empathic distress more than others.

Caregivers need to be empathetic, but empathy is not one thing. Both neuroscience and psychology have uncovered an important distinction between two aspects of empathy: Emotion contagion, which is vicariously sharing another person's feeling, and empathic concern, which entails forming a goal to alleviate that person’s suffering.

Whereas contagion involves blurring the boundary between self and other, concern requires retaining or even strengthening such boundaries.

Learning to practice one but not the other could be the best example of how caregivers can simultaneously look out for patients and for themselves.

Doctors can particularly experience empathy burnout in the beginning of their practices and then become numb to patient complaints.

A doctor-patient relationship built on trust and empathy doesn't just put patients at ease — it actually changes the brain's response to stress and increases pain tolerance, perhaps even more than the medication itself.
"The relevance and statistical correlations of patient-centered relationships and health outcomes is now part of medical curriculum in many institutions", said Psychologist, Dr. Sophia Tranter.

"What we are finding is that a doctor's relationship and orientation towards a patient and their well being correlates to a more significant degree than even the medication itself."
Empathy Overload

For those less prone to experiencing "empathic distress", it might be tempting to dismiss it as someone else's problem. That's shortsighted, says Olga Klimecki at the University of Geneva in Switzerland.

People who experience more empathic distress in their daily lives are more likely to become aggressive when provoked, "even towards an innocent person", she says.

The irony is that the effects of empathy overload might undercut the very things for which empathy evolved in us — mutually beneficial cooperation and collaboration.
"Even in the short-term distress transmitted via empathy leads just as much to a desire to escape a helping situation as it does to a desire to help," says Michael Poulin at the State University of New York.
If that's true, can we do anything about it? Perhaps, says Christian Keysers of the Netherlands Institute for Neuroscience in Amsterdam.
"Just like some people are better at regulating their own emotions, some are better at regulating empathy," he says.
His work suggests we're not stuck with the amount of empathy we are born with, but can adopt the strategies of others.

In 2014, Keysers and his colleagues looked at how people diagnosed with psychopathy, who are commonly thought to lack all capacity for empathy, react when they see images of people in pain.

In scientific studies, participants in high psychopathy groups exhibit significantly less activation in the ventromedial prefrontal cortex, lateral orbitofrontal cortex, amygdala and periaqueductal gray parts of the brain, but more activity in the striatum and the insula when compared to control participants.

One of the problems with corporate run entities thought to be spear-headed by individuals with psychopathic tendencies, is they do not directly witness the harm they cause to others.

The neural response to distress of others such as pain is thought to reflect an aversive response in the observer that may act as a trigger to inhibit aggression or prompt motivation to help.

At first, the team presented images without any instructions as to what to feel. The volunteers' brains showed, predictably, less activity in areas associated with empathy for sensations, and in the insula, than the brains of healthy people.

But then Keysers asked his psychopathic volunteers to consciously empathise, and something very different happened: their brain responses were identical to the control group's (Trends in Cognitive Science, vol 18, p 163).

In other words, even if your default empathy state is "off", you can turn it on when desired. That was an eye-opener, says Keysers: it seemed clear that a spectrum of empathy could exist in all individuals.

5 Strategies To Prevent Empathy Burnout

Appropriately dosed, empathy is undoubtedly a good thing, but we need to consider the strategies to protect ourselves if we are in professions that require high degrees of empathy.

1. Know Your Vulnerabilities

Each of us has a body part that is more vulnerable to absorbing others’ stress. Scan your body to determine yours.

Is it your neck? Do you get sore throats? Headaches? Bladder infections?

At the onset of symptoms in these areas, place your palm there and keep sending loving-kindness to that area to soothe discomfort. For longstanding depression or pain, use this method daily to strengthen yourself. It’s comforting and builds a sense of safety and optimism.

Remind yourself that the pain of others is not your own.

2. Surrender To Your Breath

Concentrating on your breath for a few minutes can dramatically alleviate energetic pain which manifests in the physical. It is centering and connects you to your power. Yoga is also excellent to facilitate this process.

3. Set Limitations and Boundaries

You don't have to be an open book all the time. Control how much time you spend listening to stressful people or their pain, and learn to say "no."

Remember, "no" is a complete sentence. If you are in a profession where you can't say "no," then try adaptive strategies that allow to set limits on and foster a balance between that which is negative and positive.

4. Develop A Support System

Build a network of positive influencers, acquaintances and professional contacts. Have the emotional intelligence to recognize when you need help and when your empathy is turning toxic to yourself.

When you find yourself becoming overly emotional, call a friend or mentor and calmly explain the situation. Often times an objective person can provide you with a different perspective or a new approach.

5. Embody The Philosophy That Everything Is As It Should Be

Some people will always have pain. That is their path and there will be nothing anybody else can do about it until that person that decides to do something for themselves.

Know that they are exactly where they should be at this point in time.

Comfort them, guide them and influence them, but nobody will ever change their situation but themselves. You are a conduit to their change, nothing more.

Dear Friends,
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