Turning Empathy Off?: Reflections on the Hazards of Compassionate Presence
As people in the helping professions, is it ever ok–ethically, humanly–to allow ourselves to look away from another’s suffering? To turn empathy off?
A few years ago, when my daughter was a teenager, she was drawn into a whirlpool of human need. She had been volunteering at a soup kitchen in our neighborhood, and one of the attendees latched onto her. He was physically disabled, very alone in the world, and struggled with mental health challenges; he had a house that suffered from years of neglect. She offered to help him clean his debris-covered yard, which led to an unending number of requests.
The child of not one but two social workers, she has an expansive compassion. When she was little, whenever we passed an unhoused person on the street or in our car, she would complain if we looked away or didn’t give them money or food. She criticized me if I didn’t pay attention, and I had to try, however fitfully, to explain myself. When I listened to the words out of my mouth, it didn’t make sense.
For my teenage daughter, there was such enormity of unmet need, and he was such a likable, kind man. Having a degree of privilege, she felt a principled obligation to pitch in. Seeing her growing overwhelm, we wanted to protect her. But there was no suggesting any limits. Weekend after weekend was consumed with trying to help her friend, until eventually she broke down in tears, flooded, exhausted, and depressed.
How was she to make sense of her limitations when she cared so deeply?
This year I’m back to teaching advanced clinical practice to graduate students. Last week the topic was “Empathy and Attunement,” and I had a weird thought. We’re teaching students to maximize a sense of safety and trust in their work with people, to use the non-verbal (most important) and verbal skills that facilitate connection. Most students is social work are already intuitively good at this–that’s what led them to the field–and many get exponentially better when they have a more explicit understanding of the nuances.
We spend so much time helping clinicians learn how to “turn it on,” accelerate, pedal to the empathic metal. But do we ever talk with them about how, with intention, to turn it off? The longer I am in this field, the more I recognize that this–the inability to turn off empathy–is a professional hazard. Why is this important?
So many professionals with whom I work feel a deep, principled desire to do well in their jobs, to serve their clients who need so much, to help their agencies achieve their mission and to please their bosses. They struggle to reconcile the expansiveness of their concern for their clients–this is a feeling, I am convinced, that is rooted in deep, maybe endless reserves of love–with the limitations of their human bodies.
Loss of self.
To further complicate matters, I hear from many practitioners that they feel locked into a professional stance with people in their personal lives, that they struggle with centering their own feelings and needs, that they default to these same professional attuning skills without thinking. They do it so well and people love them for it. And it gets worse. I’ve heard from helping professionals that they’ve tolerated unhealthy behaviors from loved ones–in the same way sometimes that we must tolerate maladaptive behaviors from clients to help them–until the dynamics reach such a pitch that the personal relationship is unbearable. We have stopped using our own needs and feelings as a guide to our own relationship health.
More troublesome than exhaustion, for many helping professionals, they risk losing a sense of who they are. They feel empty inside.
These attuning skills are embedded in a distinctly mammalian part of our nervous system called the ventral vagal: herd- and tribe-oriented ways of communicating to others that we are safe and can be trusted. Think about what message we send, on such a powerful but subtle level, when our gaze is soft and direct, when we nod, when our voice is calm and our breath is even and slow, when the muscles in our face and body convey a relaxed openness, when we can listen so closely that we reflect back what we’ve heard accurately and with feeling. For most people who gravitate toward the helping fields, these nuanced gestures and movements are autonomic; we do them without thinking. When we train to be professional helpers, however, we begin to do them frequently and with intention, as part of our role.
In workshops with professionals, when I explain this aspect of the nervous system, I am always acutely aware that everyone is looking at me intently, nodding, smiling, deeply attuned. “See, you’re doing it right now!” I say. The head-bobble of compassion never ceases.
From my whip-smart former graduate student Jenna Nevills Napier, MSW, QMHP, CADC II, who’s now a manager: “It’s sort of like gaining any new skill but we all need to have so much intention around how we turn on and turn off and being better at communicating what we need when turned off and how often we need to turn off. Many of us might not get enough opportunities to fully and intentionally turn off and that can negatively impact us, particularly relationships at home when we don’t always have to be on. And then we can feel guilty for ever having turned off in the first place.”
From my friend Alyssa Gasca, an organizational development consultant: “For those of us whose work is based on empathy, we can burn ourselves out by over-using the thing that makes us effective at our work. How do I unburden myself from the desire to prevent another’s pain when I can so clearly see I can help, but it is not my responsibility to do so (and may not be what the person wants).”
From another former student and kick-ass therapist, Michelle Harvey, LCSW: “I don’t know if it’s the ‘feeling’ that is exhausting as much as the sense of helplessness that can accompany those feelings, because we can’t ‘fix’ it and therefore make ourselves feel less uncomfortable.”
Recently, in a clinical supervision group I run, someone was complaining about overwhelm. Their caseload at a residential treatment facility had just spiked and the acuity level felt unbearable. Time became meaningless as they were swept from one emotion-drenched conversation to another. This is someone with deep, seemingly boundless, reserves of empathy.
As they talked about the near-impossibility of their job, an image came to my mind. I wondered what would happen if this person, a deeply compassionate soul, framed every conversation at work with a time limit, “I have fifteen minutes and I’d really like to check in….,” and really held to that limit. It would feel unnatural, sure, but would it possibly be good enough?
Some of you know that I love fiction. As I was thinking about the hazard of compassionate presence, I flashed on characters in the novels of Virginia Woolf. Woolf lost her mother early in life and her fiction often explores how the mother’s presence holds together a house full of people by the centrifugal force of caring. Here’s a line from her semi-autobiographical novel, To the Lighthouse, that could have been written about a helping professional at the end of the day:
“For now she need not think of anybody. She could be herself, by herself. And that was what now she often felt the need of – to think; well not even to think. To be silent; to be alone. All the being and the doing, expansive, glittering, vocal, evaporated; and one shrunk, with a sense of solemnity, to being oneself, a wedge-shaped core of darkness, something invisible to others… and this self having shed its attachments was free for the strangest adventures.”
But there’s an intersectional lens to consider when we talk about the hazards of compassionate presence. My friend Tori Lopez, LCSW, piped up on the Facebook conversation: “As a POC who has POC family and friends I find we often have to be the supports for each other. Because for many of us the systems of care we work in are still terribly white-centered. It’s about finding balance and being willing to be there for one another as best we can. It’s the ability to say a word or just a nod and know ‘we get it;’ no explanation needed.”
As a white cisgendered male from an educated, middle class background, I have been given more permission/privilege than most to turn empathy off, to trust that others, particularly women, will take up the emotional work of any household or an agency where I belong. But as the burden on me lessens, it increases for them. That isn’t fair. Certainly one solution to the emotional drain and the havoc it wreaks on the bodies and souls of the compassionate is for those who are stepping back–i.e. especially men who look like me–to step more frequently into relationship in this caring way.
Most helping professionals are placed into impossible situations — let me repeat that word: IMPOSSIBLE — and we must do our best. We begin in innocence and must quickly move toward wisdom to survive. We must become our own consciences and seats of integrity. That’s why I so often question my supervisees about what is ‘good enough,’ and is their personal standard of care realistic given the enormity of the work? What’s the right dose of compassion? How can we pace ourselves, so that we can make a sustained and meaningful contribution? How can we draw on other people, personally and professionally, for sustenance and validation?
People who don’t do this kind of work never believe me that it is deeply physical work. But when we do it right, we throw ourselves in, body and soul. And our bodies are finite. We can only work so hard before we need to rest; our energy and attention flags; we lose touch with our own feelings compass. Human life is finite: We have only so many waking hours in a day and a limited number of years that we can spend in productive work. To transcend burnout, we have to accept, really embrace, a paradox: the near-infinite expansiveness of our love and care for the people that come to us for help, balanced against the finite nature of our bodies and lives.
“Sustaining Trauma-informed Teams: Tools to Create a Mindful Culture” (Friday, March 6, 2020, Eugene and Thursday, May 7, 2020 in Portland)
“Mindful Supervision: Trauma-informed Tools and Strategies” (Friday, April 17, 2020, Bend)
“Clinical Ethics in Close Quarters: Navigating Dual Relationships” (Thursday, June 4, 2020 in Portland)
“Debriefing Critical Incidents, Creating Healing Spaces” with Andrew Laue, LCSW (Thursday, May 14, Corvallis, co-sponsored with Benton County Health Department)