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What
Missionaries Ought to Know About ...
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What Missionaries Ought to Know about Compassion
Fatigue
Dr. Ronald Koteskey
download this as a pdf file
 Bill
has been an effective and dedicated missionary for a decade, but now, in
his mid-30s, his missionary service seems more like labor than a labor
of love. He used to enjoy interacting with nationals and feel deep
satisfaction in his friendships with them. Although he continues to
spend time with them, he becomes annoyed at what he sees as their
increasing demands.
From all appearances he is a successful missionary that others
respect and even envy a bit; however, internally he is exhausted, feels
isolated, and seems spiritually depleted. Even talking with his
supportive wife does little to help. Bill is suffering from what has
recently come to be called compassion fatigue.
What is compassion fatigue?
An article in Family Practice Management published by the American
Academy of Family Physicians defines compassion fatigue as “a deep
physical, emotional, and spiritual exhaustion accompanied by acute
emotional pain”
http://www.aafp.org/fpm/2000/0400/p39.html.
Compassion fatigue is a combination of burnout and secondary
trauma. In classical burnout missionaries cope by withdrawing and
becoming less compassionate; however, missionaries with compassion
fatigue continue to give fully to their work with nationals. They often
feel like they are being pulled irresistibly down by a whirlpool, and
they are powerless to stop. These people may be viewed as incredibly
dedicated and successful missionaries by others, but they often do not
feel that way about themselves. Here are some of their major
symptoms.
- Feelings of depression and hopelessness
- No feelings of accomplishment and joy
- Blaming and complaining about others
- Increasing irritability and anger
- Nightmares and other sleep problems
- Startled by unexpected sounds
- Personal and professional life not separate
- Intrusive frightening thoughts
Neither burnout nor secondary trauma are approved medical diagnoses,
rather they are lay terms, as is “compassion fatigue. ”Compassion fatigue
is also sometimes used to describe an organization characterized by high
absenteeism, turnover, and interpersonal conflict, or to describe the
decrease over time of a whole country’s donations to victims of
disasters such as earthquakes or floods. Here it is used to describe
individuals showing signs of burnout and secondary trauma.
What does the Bible say about compassion fatigue?
The Bible never uses the term “compassion fatigue,” but Moses
is a good example in that he continues for years until he finally breaks
under it. Moses was not a missionary, but he was a Third Culture Kid who
was leading a group of cross-cultural workers as they transitioned from
one culture to another. At about the time of receiving the Ten
Commandments, he shows tendencies toward compassion fatigue.
- Exodus 18. Only a couple of months out of
Egypt and before receiving the commandments, Moses’ father-in-law
told him, “What you are doing is not good… you will only wear
yourself out. The work is too heavy for you; you cannot handle it
alone” (vs. 17-18).
- Exodus 32. A few weeks later as he was
coming down Mt. Sinai with the commandments, Moses became so
angry with the people that he destroyed the tablets on which God had
written them.
- Exodus 34 and Deuteronomy 9. Moses went
back up Mt. Sinai and spent nearly six weeks prostrate before God
interceding for the people, but neither eating bread nor drinking
water. A plague on the people followed.
- Numbers 11. On their way from Mt. Sinai
to Kadesh Barnea the people complained, so God sent fire on
them. Moses again interceded and then told God, “I cannot carry all
these people by myself; the burden is too heavy for me… put me to
death right now—if I have found favor in your eyes—and do not let me
face my own ruin” (vs. 14-15).
One would think that Moses would change. However, 40 years later at
Kadesh Barnea he was again leading the children of those he led at Mt.
Sinai. The people were again complaining. Moses and his brother
interceded, and they left the tent following God’s directions. However,
when Moses spoke to the people he struck the rock twice with his staff
rather than speaking to it as God had told him. This disobedient
outburst resulted in Moses not being allowed to lead the people into the
promised land (Numbers 20).
Do I have compassion fatigue?
Of course, you can look at the major symptoms above to get a general
idea. Fortunately, the best measure of compassion fatigue is available
online free of charge at http://www. proqol. org/ProQol_Test. html. It is
available in about a dozen languages and is called the ProQuol,
Professional Quality of Live Scale. The English version comes in a
self-scoring format which includes scales for both burnout and secondary
trauma. This test has high internal reliability but no research on
validity. When scoring the test, be sure to reverse the scores for the
items indicated on the burnout scale. Your scores will tell you if you
are low, average, or high on both burnout and secondary trauma.
What causes compassion fatigue?
The major causes of compassion fatigue are not having time to do what
needs to be done while serving others who suffer from many sources of
traumatic stress. Missionaries may find that their time is taken by
trying to meet the demands of headquarters, committees, field directors,
nationals, governmental red tape, families, etc. They are serving people
who suffer from illness, violence, poverty, alcohol, corrupt government,
etc.
Missionaries try to get more time by eliminating things that would help
them cope. They often engage in less and less of the following:
- Prayer, meditation, reading the Word
- Breaks through the day, and restful lunch (they read
email, return phone calls, etc. )
- Time with friends, spouse, and children
- Exercise, sleep, and relaxed meals
- Hobbies and other outside interests
Everyone has exactly 24 hours in every day, and each person has to
decide how he or she is going to use that time. Missionaries who spend
all their time doing “God’s work” should remember that going beyond a
certain point, the harder they work the less they accomplish. Coffee
breaks were not given because employers cared for the workers, but
because research showed that people who took them accomplished more than
others who did not. During World War I Britain required people to work
seven days a week, until research showed that people who worked six days
a week (i. e. enjoyed a Sabbath)and had a day of rest accomplished
more than those who worked seven.
Things to do to get over compassion fatigue?
The logical place to begin is with what Moses’ father-in-law
suggested. First, Jethro listed Moses’ roles: be the people’s
representative before God, teach them the decrees and laws, show them
how to live, show them their duties. Second, Jethro told Moses to select
men who were capable, feared God, were trustworthy, and would not take
dishonest gain. Then Moses was to appoint these men as officials in a
hierarchy over groups of 10s, 50s, 100s, and 1000s (Exodus 18:19-23). In
other words, delegate much of the work to others.
Later when Moses was complaining to God about the heavy load of
carrying the people, God told Moses to choose 70 elders who were leaders
and officials. Moses was to bring them to the Tent so that God could put
the Spirit on them to help carry the burden of the people (Numbers
11:16-17). This was the same advice Jethro had suggested long before.
This is still great advice today, especially for people like Moses
who seem to think that saving the world depends on them alone. All of us
need others. Here are some further suggestions.
- Reaffirm your commitment to Christ, including daily time in the
Word, meditation, and prayer as well as a weekly Sabbath (Matthew
22: 37).
- Reaffirm your commitment to others, including time for family,
colleagues, and nationals (Matthew 22:39).
- Reaffirm your commitment to maintaining the temple of the Holy
Spirit (your body), including eating right, getting daily rest, and
exercising daily.
- Clarify your personal boundaries.
- Share your feelings with colleagues who can share theirs with
you.
- Follow God’s call on your life even when it means saying “no” to
good things.
- Develop a support system of people around you who listen well
and care.
Things to stop doing to get over compassion fatigue?
 In addition to doing the things mentioned above, one should
- Stop blaming others. People at headquarters,
your field director, or your principal may act in ways that you
disapprove of, but people are not responsible for how you react.
- Stop complaining. When you talk with other
discontented people, it only makes you feel worse. You may have heard
that misery loves company; it should be stated that “misery loves
miserable company. ”Discontented people do not want others spreading
cheer.
- Stop making big decisions. Do not decide
to quit being a missionary, buy a luxury car, get a divorce, or any
major life decision. You will be doubly sorry later.
- Stop looking for a quick fix, such as an
affair, drugs, etc.
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