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Gillian Wortley • Apr 19, 2024

A Shift in Terminology Describing Caregiver Burnout

Recently, I was at a conference where a new term was introduced, at least the term, “empathic strain”, was new to me.


The concept of compassion fatigue has long been acknowledged as a challenge for paid and unpaid caregivers. Recent discussions among researchers and experts have led to a significant shift in terminology, and our understanding of its impact and affects. The growing emphasis on the term empathic strain reflects a deeper understanding of the distinct neural processes involved in empathy and compassion and our understanding the difference between the two.


Empathy, the ability to sense or share others' pain, and then compassion, the recognition of suffering accompanied by a desire to alleviate it, form the foundation of caregiving roles. Empathic strain refers to the toll taken on individuals regularly exposed to others' suffering without adequate support.


The signs and symptoms of empathic strain are varied and profound, impacting both professional performance and personal well-being. The neural networks involved in empathy are the same as those connected to the experience of pain. Interacting on a regular basis with the suffering of others, compounded by an inability to effectively alleviate, causes our brain to react the same way it would to pain, with avoidance and self-protection. Those experiencing empathic strain often grapple with profound physical and emotional exhaustion, making even the simplest tasks seem daunting. This exhaustion is coupled with a notable decrease in empathy, rendering it challenging to connect with and understand the emotions of others. Heightened levels of anger and irritability become more frequent as emotional reserves are depleted, and some may turn to increased substance use or simply shutting down as a coping mechanism.


Those affected may find their satisfaction at work greatly diminished, leading to a desire for isolation from colleagues and clients. Persistent worry and stress become constant companions, exacerbating emotional volatility, and impairing decision-making abilities. Absenteeism may also manifest as individuals struggle to muster the energy to fulfill their professional responsibilities, further blurring the boundaries between work and personal life.


To address empathic strain, we need a comprehensive and multimodal approach. One of the most effective, and simple ways is to engage in mindful self-compassion practices, available through courses, online resources, and apps. It begins with training and mindfulness practices that fosters a compassionate attitude towards oneself amidst challenging circumstances. Room 217 offers musical self-care resources


It is critical to acknowledge and validate one's feelings, an essential first step while navigating emotional complexities effectively. This is significant because it helps us to develop awareness of environmental stressors and enables us to set up proactive management of triggers.


Prioritizing self-care and establishing clear boundaries safeguard against emotional depletion, while cultivating mental calmness and equanimity through mindfulness practices enhances emotional resilience. Addressing past trauma and seeking professional help are crucial steps in healing and restoring emotional balance.


From my perspective, empathic strain offers a nuanced perspective on the emotional toll experienced by caregivers. By acknowledging its signs and proactively implementing preventive strategies, such as fostering connections with music, we can effectively mitigate its impact and promote holistic well-being within caring professions. This approach not only safeguards individual mental and emotional health but also enhances the quality of care provided to those in need.


“The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as being able to walk through water without getting wet.”

 - Rachel Naomi Remen, Kitchen Table Wisdom, 1996


By Shelley Neal 08 Mar, 2024
I initially trained with MUSIC CARE to work with Seniors in Long Term Care who were experiencing dementia and Alzheimer’s Disease. This is the path I travelled with my mom. My training with Music Care and Room 217 supported capacity building in selecting music that was played on my harp or chosen recorded music. The music centered on the care of the individual and their specific needs. My job was to determine the individual’s specific and select music to address these needs. The music selected helped to build community, support sleep, talk about life experiences, create a background landscape of sound, support connection to decrease isolation and loneliness, as well as coming alongside people dying. My training with Music Care helped me understand how to support people “where they were” physically, emotionally, and spiritually. Through using beat, tempo, melody, and timbre, I could cater the music and desired support required for individuals or small groups. My profession is teaching. I am a special education teacher and use music in my primary teaching as a method for learning, practicing language skills, transmitting information about science studies or math equations, as well as having fun and creating our own songs. My teacher toolkit married exceptionally well with the knowledge and skills provided by the Music Care Certification training. Recently, my work with students has involved individual programming for the medically fragile children and the palliative children. I use music (repeating the chorus several times) to engage and connect with the kiddos. We use music to "talk" about feelings (our communication is through eye gaze, eye blinks, and squeezing hands), and content material. I use music to enjoy our relationship of being together. At times, due to medication for seizures, my little ones can be very sleepy. I increase the tempo, engaging in tapping the beat on her hands and using silly action songs. The giggles and wiggles make it magical. I also use music to tell stories (my students have CVI, cortical vision impairment, so visual perception is difficult). This helps the child to engage in the story arch and adventures. Music is my conduit for reaching out and being with the students. Recently, I had the sacred journey of visiting one of my children in ICU at Sick Kids. I was invited to come to say "goodbye". A dear friend who was an ICU nurse in a different department told me (AKA, insisted) that I bring my harp with me. I wasn't sure if this would be appropriate for the family. However, with the permission of the mom, I bravely packed my harp up and took it to the Unit. It was a beautiful evening of talking with their mom and dad about how special their child was in my life. I played the kiddo's favorite songs and then ended with "The More We Get Together". The little one opened their eyes and stared at me. We hugged, and I left. They passed the next morning. I consider this time to be a sacred gift. Music Care Certification has given me the confidence and toolset to work alongside people and to journey together. It is a time a beautiful, difficult, or sacred time that I have been honoured to participate in.  Thank You
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