Compassion Burnout
(original post February 25, 2014)
  
Last evening I was looking through some sobriety books that I had purchased shortly after my withdrawal journey started in October 2009. At that time, I was focusing on the certainty that the horrid mental symptoms I was experiencing were from post-acute withdrawal from alcohol. There are numerous similarities between benzo withdrawal and alcohol PAWS, and  last night I thought I could get a little better understanding of PAWS and relate it to benzo withdrawal. As I leafed through some of those books, I found lots of different written notes I had made early in my withdrawal, emails from others who had been through withdrawal, portions of underlined text, and cards from various individuals that had been sent to me over the course of my withdrawal experience.
 
Three months after my withdrawal started, I found myself under suicide watch in a local mental health institution for three weeks. During that time, several people (close friends and family) had sent me get well cards. I read some of them last evening. I even had a few visitors while I was in the hospital. As I reflected on that period of time in my withdrawal, I realized that I heard very little from most of those individuals after the first few months. The reason for that (I believe) is that they simply didn’t know what to say. How do you start a conversation with someone who is in a state of mind that you have never experienced and don’t understand? How do you respond to statements about feeling depressed, anxious, derealized, and having bizarre physical symptoms - other than making some irritating suggestion? Even if you do listen patiently, you will soon find yourself being brought down. After all, you have your own problems.  I understand why some people “lose interest” in us fairly quickly.
 
Over the course of my withdrawal, my daughter gave me cards for Father’s Day and my birthday. These were the ones that touched me the most – both when she gave them to me and last evening when I reread them. The first of those cards was in my 8th month of withdrawal. I wasn’t even off the Klonopin yet. It was a card about a father’s love being forever, and she wrote: “I love you Dad. Come back soon. I miss you.” I remember sobbing uncontrollably when I got it. I wanted to return desperately but had no idea how to do it. I missed me too.
 
The next card was three months later when I was a month off. I was an absolute terrified, depressed mess then. She wrote: “Love you Dad. No matter what, you’re still the best.” In some ways, it felt like she had resigned herself to the likelihood that I would never return. After all, it had been nearly a year since the whole ordeal started.
 
A year later came two more cards from her. They also seemed to have the “I know you aren’t coming back, but I still love you” theme. I was close to 14 months off then. The funny thing was that the very next week I started to feel pretty well.  
 
Nine months later came Father’s Day and another card. She wrote: “I’m VERY glad to have you back. You were missed A LOT. Thank you for hanging in and being a great Dad.” Amen. I was back. It was so very sweet, but seeing her amazed joy made it even sweeter. The “thank you for hanging in” was an acknowledgment that she knew that what I was saying about withdrawal all along was correct. Dad was not insane after all. Sweet.
 
My daughter has always abhorred illness. It makes her extremely uncomfortable. During my withdrawal, I rarely saw her (except in the first few months). She couldn’t bear to see me in such a sickened state. Sometimes, when we are in withdrawal, I think we read others’ absence as a “not caring” attitude when, in reality, they are “grieving” in a way. They may be “writing us off” – not because of an uncaring attitude but rather as a defense mechanism. They want us back, yet they think we won’t be back because of the seemingly eternal duration of withdrawal.
 
Compassion burnout is something a bit different I believe. It seems to be reserved for those who are very close to us and who would be our caretakers. For me, it was my wife. In the first several months of my withdrawal, she hung on pretty well – expecting me to “snap out of it” in time. When it became obvious that this was not going to be the case, she started making “suggestions” about “trying harder.” That went nowhere and only made me worse. When we would sit and talk, all that I did was go over my symptoms ad infinitum. I was wearing her down. She was burning out mentally and emotionally, and her compassion was dwindling rapidly. We basically agreed to stay in different parts of the house and not talk much. She would not have to hear my whining. I would not have to hear her suggestions.
 
Years earlier I had also gotten a taste of compassion burnout. About 5 months after our second child was born, my wife (who had always had some symptoms of schizophrenia since her early 20s) started acting bizarrely. During the 5 previous months, I would sit for hours with her every evening trying to convince her that all the strange things she was thinking were not true. It took a mental and emotional toll on me. Our discussions never did any good. We talked and talked about everything. No matter how hard I tried to convince her, nothing changed. One weekend, she lost it completely and ended up in the hospital. I was completely burnt out. I had a toddler and an infant whose mother may never return home in any condition to raise them. In some ways, I had written her off with the thought “what if she’s never normal again?” Fortunately, her condition resolved in a few more weeks – just as mine did (except mine took much longer).
 
I believe compassion burnout is simply a defense mechanism. Compassion requires a lot of mental and emotional energy. Once we have spent all we have, we “turn off” the switch until we  can re-energize. We simply have nothing left. Part of the re-energizing is receiving compassion from our loved ones (or, in the absence of loved ones, others). If the loved one is the one on whom we are spending our compassion, it is much more difficult for us to resupply our own compassion. I think that is what makes benzo withdrawal so extremely hard on close relationships. One side is capable of giving compassion. The other side can often only take – even though they know they should also give…but they just can’t do it…yet.
 
It is important for the giving side to know that, once the withdrawal fades, he or she will be rewarded with a very grateful and compassionate spouse/partner/mate/friend.
 
It is a certainty, but it can be a long time of doling out compassion without getting any in return.