Living with someone who is suffering from a mental health problem can be challenging to say the least. Whether the individual is formally diagnosed or you’re noticing a shift in their moods, the ripple effect it has on the home is significant. One in five people are living with a mental health struggle, and with such a high occurrence rate, family members deserve some support and strategies. Compassion fatigue is a huge consequence when it comes to mental health. We care so much about a person and we give, give, give until we get to the point of feeling burnt out. It’s really scary to get to this point. As much as we’d love to continue supporting the relationship, we feel a level of caution. We question how our words will be interpreted or whether there will be repercussions in reaching out. We don’t know how to fix the situation, or make things better. Suggestions seem to be dismissed or addressed with anger. 

Compassion fatigue is a result of well-intentioned efforts to help our loved ones. We try as much as possible to express reassurance, but this can become disheartening after repeating the same conversation 30 times. It can feel overwhelming when you are experiencing yet another power struggle or argument. Rather than our usual supply of empathy and nurturing, we instead experience apathy and anger. While all of this might sound strange, it is natural to feel weighed down by our good intentions of helping. 

There are many ways to address compassion fatigue, and I’d like to focus on one particular strategy today. Fixing things, taking over another person’s responsibilities, being a constant cheerleader, and similar roles can lead to exhaustion. Instead, the following interpersonal and communication strategy will help your loved one feel supported, without you experiencing compassion fatigue.

Using validation

I had previously written about validation and how it can help us become better communicators with our loved ones. Validation is the skill of acknowledging how another person’s opinions, emotions or behaviours makes sense given the context. It means finding even a small morsel of detail that you can appreciate. For example, let’s say you arrive home from work and your partner is cantankerous. Validation involves looking at the context (perhaps a stressful day at work, time spent with the children, being caught in traffic, etc) and trying to appreciate how someone may be in a bad mood after being in this situation. Validation is NOT approval. It does not mean agreeing to what the person is saying or doing. Validation does not mean problem solving. You are not trying to come up with a solution or assess whether a situation is right or wrong. You are simply letting the other person know you get why they’re thinking or feeling a certain way. 

Why is this so important? When we validate, it helps the other person go from 100% cantankerous to perhaps 50% annoyed. For your loved one, someone has finally acknowledged that they are not wrong, bad, unintelligent (or any other negative, critical comments they think about themselves). Instead, with validation, our family members feel understood for the first time. When the individual can calm down to a 50% of emotional intensity, she/he/they may be able to problem solve independently. Alternatively, your family member may drop the issue all together because it doesn’t seem as important when the intensity goes down.

Validation does not cure the issue. You may have to validate a few times in a row before your loved one can hear your words. However, validation allows for you to have a better relationship with the person without experiencing compassion fatigue. It helps the other person feel less isolated so that they have the capacity to a) reach out for help from a professional or b) think more clearly and problem solve on their own or c) drop the issue all together if it’s not really important.

Levels of Validation

There are six different ways that you can validate someone. In DBT, we refer to these points as the six levels of validation. It goes from the easiest way in which you can acknowledge someone’s perspective to increasing complexity. Choose whichever skill feels right for you given your own comfort zone and your emotional capacity in that moment. 

Level One: Being Present

• Give your undivided attention. This means putting away your phone and turning towards the person to pay attention.
• Check in on your body language: Are you facing your family member? Do you have a defensive posture (e.g. arms crossed)? Can you maintain eye contact?  
• Listen without providing comments. This is a tough one for those who love to “fix” and offer solutions. As you stay quiet, and show that you simply care, your family members are able to become more grounded. At this point, they are better able to problem solve and regulate on their own. If they need help, trust that they will come out and ask you directly. 
• You’re working on the skill of being present with an intense emotion. You don’t have to do anything about the emotion other than simply letting the other person know you are not scared off by them. 

Level Two: Reflect Back 

• This involves summarising what the person is saying. 
• You are not guessing what the other intends to say but just repeating or paraphrasing their words 
• By reflecting back their statement, you show that you are paying attention and care enough to clarify. 
• Remember to use a non-judgemental tone when reflecting back.
• E.G. “So I hear you saying that you’re angry about your test scores.”  

Level Three: Reading Minds

•  This skill involves paying attention to facial cues and body language to help you consider how they may be experiencing the situation. 
• Consider what you know about the person already. How would they typically feel, think or behave in this type of circumstance?
• You will sometimes be off about your guess work, and that’s okay. The other person will correct you when this is the case. The beauty in doing validation is simply letting the other person know you are trying to hear them out. 
• E.G. “You look a bit tired. I’m guessing the kids weren’t giving you the easiest time this afternoon.”

Level Four: Understanding based on their history 

• Consider the person’s history or recent life events. How might these factors be affecting their perspective? 
• What about their response makes sense given the ways in which they have grown up? 
• If you were in these similar positions, how would you react? 
• E.G. “Since you didn’t do as well as you had hoped on your last test, I can understand that you feel really anxious going into this exam.” 
• E.G. “It makes sense that you’re scared to go to the store right now given that we’re in a pandemic and everyone is practising physical distancing.”

Level Five: Acknowledge the Valid

• Consider the current context that the person is experiencing. How does their responses or emotions make sense given the situation? 
• Valid responses are logical and fit the facts of the current situation. Your loved one is reacting in a “normal” way, and other people would be feeling, thinking or behaving similarly in the same situation. 
• Normalize the person’s response, and explain how others would have felt, thought or behaved similarly. 
• E.G. “I get that you were panicked in that fire. I would have also wanted to get out as quickly as possible.” 
• E.G. “Being up all night with the baby is tough. I hear moms talk about these struggles all the time, and it’s not easy.”  

Level Six: Be Genuine

• If you truly appreciate what the person is experiencing, express it! Don’t try to sugar coat, patronize, or fragilize the other person. Be yourself, and treat the other person as an equal. 
• Be genuine about your empathy towards their feelings, thoughts, and behaviours. 
• This involves being attuned to the person, and expressing that attunement via words and body language. 

When it comes to compassion fatigue, there are a lot of ways to address this difficult issue. One means of preventing compassion fatigue from taking place is shifting the relationship you have with your family members to one of support and validation. Moving away from a sense of responsibility to take care of another person or resolve their struggles can help create more space for you.

Every family is unique. If you would like to address some of the details mentioned in this post, please feel free to reach out.

Take care,

Kasi