When Compassion Casts a Shadow – The Dark Side of Caring (blog 2 of 3)

In the first blog of this series, I defined compassion fatigue and the factors that make caring industries at risk for compassion fatigue.   You can read that blog here: https://auraecoaching.ca/2017/11/13/when-compassion-casts-a-shadow-the-dark-side-of-caring-blog-1-of-3/

This blog is going to briefly discuss how compassion fatigue can progress into abusive and cruel behaviour, as well as define the difference between the two.


** YOU DO NOT need to read article below, as some of the information can be considered disturbing.  The article is only to show a single example of the cruelty that can be found within various care industries.

October 25, 2017 – Nursing Home Abuse Statistics in Nova Scotia



I would like to be completely clear: I am not EXCUSING this type of behaviour. People who feel no remorse when they mistreat, abuse, neglect, violate or even kill (as in veterinary medicine) those they are professionally delegated to look after should not continue in their profession without seeking professional help. People who enjoy this type of behaviour should NEVER work in ANY care industry. EVER. If someone has broken the law, they should be held completely responsible under the law.

My Stages of Compassion Fatigue

I am calling this “my stages” because this is how my own compassion fatigue progressed, and how I have witnessed compassion fatigue progress in others.  I don’t know if others have documented the progression of compassion fatigue differently elsewhere.


compassion fatigue flow chart


I have summarized briefly how each of the steps in the chart can present.  This is NOT an all-encompassing list of signs and symptoms:


  • Stress – coping mechanism, normal part of life, our response to external pressures and tension
  • Burnout – unresolved stress, seems like there is not enough time in the day anymore, overwhelming feeling with exhaustion, start working at a faster pace, workaholism


  • Vicarious Trauma – exposure to things most people don’t deal with (not the actual victim though) – witness abuse, disease, injury, death, euthanasia – experiencing this repeatedly hardens a person emotionally. People who consider themselves not emotional or not squeamish possibly have suffered trauma or vicarious trauma sometime during their life.
  • Compassion Fatigue – dissociation to cope with vicarious trauma and emotional distress, decompensation from the pace of burnout, running out of caring and trying to conserve what’s left


  • Hyper-compassion – over sensitization to vicarious trauma, occurs just prior to depression or can happen concurrently with depression, the last ditch effort of the body to signal to the mind that something is wrong!
  • Depression – hopelessness, melancholy, cynicism, pessimism, genuine complete lack of caring, excessive drug or alcohol usage


  • Abuse (unintentional) – neglect, not noticing decline or suffering of others, doing things that may be considered humane within the profession but are actually considered distasteful by the general public (over-sedation of nursing home residents), difference in opinion on the definition of quality of life
  • Cruelty (intentional) – workplace bullying, self-abuse (self harm), physical abuse or torment of people, children, elders, or animals without apparent remorse, taking pleasure from aforementioned activities, euthanasia**, murder

** Euthanasia is part of animal care industries and is growing in human medical care. In MOST instances euthanasia is a GIFT that we can give to those who are suffering.  Euthanasia is necessary, and I believe euthanasia of human beings who are suffering has a place in medicine. In my decades of work in animal care and veterinary medicine I never became completely immune to the emotional effects of euthanasia, although I can say with honesty that some euthanasia did not affect me emotionally.  Euthanasia is ONLY a problem when someone prefers to perform euthanasia over treatment when treatment is possible, or looks forward to and enjoys performing or participating in euthanasia procedures.

Why do people become abusive and cruel?

First of all, these blogs are not to imply everyone in the care industries is capable of killing people in cold blood, or enjoy torture.  THAT IS ABSOLUTELY NOT TRUE.  Most caregivers start off with an ABOVE average level of caring and compassion.  They ARE NOT and DO NOT become people who gain enjoyment in the harm of others in this blog. The point I am trying to make is that things that are considered abusive and cruel by society, are not as difficult and distasteful to people who suffer long term emotional distress.

Abuse is considered unintentional mistreatment of another.  An example of this would be neglect and failure to notice distress in those you are caring for.  It could also be something that society views as distasteful, but caregivers may have a different viewpoint. In nursing care or special needs homes, using drugs to control patients is an idea that society finds horribly unpleasant.  In veterinary medicine, we call that same act “chemical restraint” and we use it frequently.  Not only is it legal, it is often preferable because it is safer and more humane than causing an animal the undue fear and pain that will occur during handling and physical restraint.

Cruelty is intentional mistreatment.  However, that doesn’t mean it is enjoyable to the person performing it.  In veterinary medicine, we don’t hesitate to consider euthanasia rather than prolong suffering for patients that are terminally ill or in extreme, unmanageable, chronic pain.  Euthanasia in the human medical field is very controversial, and even viewed as murder by many people in society.  Euthanasia is always considered murder when it is done by someone who is not authorized to perform the procedure, or performed in a country or state where euthanasia is not legal.

Cruelty in itself can be slightly subjective in care industries.  Many of us would not consider workplace bullying as cruelty.  However, bullying is it the repeated, intentional infliction of emotional or physical pain on someone else without apparent remorse for them.  That is the textbook definition of cruelty.

People who work in care industries are extremely stressed.  They are over worked, under paid and relied on constantly by the rest of society.  They are emotional people who are taken for granted for the work they do.  They deal with constant exposure to trauma, verbal assault, disease and injury, emotional distress, and even death as part of their job.


Without realization, they slowly drift from loving and caring, to exhausted and emotionally numb.  Some people realize this downward spiral and leave their profession completely.  There are people, in desperation, who opt to suicide as a means for escape.  However, what happens to the people who remain in an emotionally distressful career for a long period of time without recognizing a need to monitor their behaviour (or worse, don’t know what problem behaviour even looks like)?  These are the people who are at higher risk for participating in abuse or cruelty.

In my last blog in the series, I will talk about how my career in veterinary medicine helped erode my own compassion to the point where I was capable of abuse and cruelty. You can read that blog here: https://auraecoaching.ca/2017/11/22/when-compassion-casts-a-shadow-the-dark-side-of-caring-blog-3-of-3/


If you are concerned about compassion fatigue or have questions about how to prolong a caring career in a healthy manner, Aurae Wellness Coaching can guide you. We also help with bullying issues. If you are aware of behaviour that is dangerous to yourself or others, please contact a mental health professional immediately.  If you have (or know someone who may have) broken the law, the first step to recovery is to contact law enforcement and accept there are legal consequences to those actions.


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