The myth of
'compassion fatigue'
Anuradha Vittachi finds herself in conversation with a voice in her head.

Oh no, not another disaster, not before breakfast. Switch off the news, I haven't got my defences up yet.

You don't imagine you're suffering from 'compassion fatigue', I hope.

I might be. Everyone else seems to be.

Nonsense. Compassion doesn't make you feel tired. It enlivens you. Remember when you saw that woman knocked into the air by the drunk driver and thwack down onto the car bonnet.

What about it?

I remember your heart pounding, speeding all that extra oxygen into your legs so they could race over to her. Your adrenaline level was rocketing. And your mind side-stepped what you were preoccupied with at the time - a cheese and tomato sandwich, as I recall - and started whirling around, working out the fastest way to get her an ambulance. Didn't seem like fatigue to me.

I don't remember the sandwich. Anyway, that was just once. Compassion fatigue is what comes over you when you keep coming across disasters. If I saw it happen every time I stepped out in the street...

Well, obviously! If you kept solemnly racing to the phone for ambulances because you saw women being thrown into the air every time you opened your front door, you'd need the ambulance. Complete with people in white coats.

Well, it's true. If there were that many accidents I would try to think up a better response than just phoning for an ambulance.

Exactly. It wouldn't be 'compassion fatigue' that stopped you phoning. It'd be common sense. You would have seen the need to put in a bit of long-term thinking to solve the problem, instead of just operating a quick fix.

What is this elaborate metaphor of yours supposed to teach me?

That you have begun to realize that your old remedy for coping with global tragedies - sending a few dollars to charity every month or so - simply isn't enough on its own. It's a calling-the-ambulance response. Your despair at the pointlessness of sending more dribs and drabs of money means that you have finally recognized it's time for a re-assessment, a deeper diagnosis.

I suppose it would be rather neurotic to go on reacting in an old way after I have recognized it's no longer effective.

It's a definition of behaving neurotically. Or if it isn't, it should be.

So what would a more useful response be, when I am facing so many terrible disasters?

How should I know? There isn't a ready-made, generally recognized response to this scale of problem.

But I can't sort out by myself all the factors that come together to make a disaster, like international politicking or macro-economics or global weather variables. It's all too much to cope with. Isn't there anyone who has sorted out how to cope with these huge global dilemmas?

Not really. On the whole religious leaders and politicians are too sectarian to care that much about people outside their constituencies; journalists rarely bother to investigate what is really going on. International charity workers are probably the best placed to know what kinds of structural changes need to take place but they are expressly forbidden to 'meddle in politics'.

So charities are forbidden to help enough; the government doesn't care enough; ordinary citizens don't know enough...

No wonder people hesitate and despair.

Perhaps I should rename 'compassion fatigue' something like 'misery-at-realizing-the-ineffectiveness-of-our-range-of-responses fatigue'.

Not quite as catchy, is it?

'Powerlessness fatigue'? 'Hopelessness fatigue'?

Still not catchy, but they do pinpoint the problem. It's not feeling compassionate that you get tired from, it's feeling helpless. People don't like that.

No more do I. Houndering in bog and fog without any clear path out of it: it's a real recipe for depression.

And depression is more fatiguing than anything else.

Odd, isn't it? When I'm depressed I do much less work and I fall asleep a lot - so why should I be more tired?

Because, even though you're not using up your energy to work, you are consuming it doing something else: pushing those dark, painful feelings like hopelessness down below the level of consciousness, keeping them hidden and denied.

Like pressing down a jack-in-the-box lid with your thumb. Hey I'm depressing the lid - I never thought of the word so literally before.

Metaphors are wonderfully literal.

Oh, please, paradoxes before breakfast are too much.

Sorry.

So I am left to work out a response to these global tragedies by myself - and then hopelessness and depression drain off my creative energies before I've begun to think.

It would help if you didn't try for some global panacea, but you could figure out some useful small-scale responses.

You mean I don't have to solve everything all by myself!

It may not really be your ignorance that is stopping you - though that is considerable...

Thanks a lot.

It sounds more like 'helplessness fatigue' because you think you have to solve it all. Gautama Buddha couldn't solve it all, Jesus Christ couldn't, Mahatma Gandhi couldn't, but you feel bad because you can't.

Well, okay. But even if I can't do everything, I need to feel confidence that I can make some useful contribution, even if it is small. That's the way I get my strength and hope back.

You are such an achievement addict! If you don't get your daily fix of feeling you've 'made a difference', you're miserable.

It's not just me, it's the whole culture I live in. It's so end-gaining, goal-oriented; so heroic, macho, performance-conscious.

I assume that, by this appalling jargon, you mean you have become dependent on seeing quick and measurable results for your efforts.

Well, the quality of being doesn't count in present-day society, even though all the greatest sages and wisest prophets were preaching about being: only doing counts. You can't be a be-er. The word doesn't even exist. You can only be a doer - or a don't-er.

But you seem to have bought the culture's view that you have to be either a total fixer or a total failure.

I suppose that's right. If I think I'm not going to be able to fix something, like a huge crisis on the other side of the world, I imagine I'll be better off avoiding it altogether. So I switch off the news.

The combination of high drama and helplessness isn't easy to live with, I admit. And total denial is the simplest method of avoidance. A subtler method is participating in an illusion of useful action.

You mean like green consumerism? People's fears about global warming are soaring so companies calm them down by offering them lists of so-called environment-friendly' products to buy. Then people could carry on consuming happily in the illusion that they were actively healing the planet.

Living in a consumerist trance. And what about husbands who promise to be faithful 'next time'? Their wives believe them because they want to - may need to - go on believing in the illusion of marital fidelity, stay in the trance. Just as we have gone on buying the illusion that drips of charity here and there can help, until it has been finally borne in upon us by the sheer scale of the disasters that charity is just not enough. Then the veil of illusion is torn, and we see reality for a moment, that charity has to give way to justice.

But if justice is your answer it won't get very far: we don't like the idea of having to make serious sacrifices. And we won't: it's not human nature to give up privileges.

So you are framing the only two choices available to us as avoidance or selfishness.

I suppose so.

In other words, a refusal to face the problem - or a refusal to face the solution! If that's the case, you really are admitting that 'compassion fatigue' doesn't exist - because compassion doesn't exist.

Well. I think it does exist - it's just hard to get at.

It's hidden behind the barrier of our fears. I know what you most fear.

Loneliness and destitution.

Which is why you get so upset when you see people who have nothing and belong nowhere. You don't really see the other person at all - all you see is your fear. 'There but for the grace of God go I,' you mutter as you hurry away.

Actually, this reminds me of a strange experience I once had. It sounds very corny...

Spit it out!

It was a bit like being in a dream, though I was wide awake. I felt like I had this black mess of pain and misery inside my stomach, which I had to 'vomit' out. I remember heaving and retching, and though nothing actually came out, I could 'see' in my mind's eye the black mess at my feet - and I knew that it was everything I most feared. I also knew I could choose to avoid it again, by running away from it or swallowing it down out of sight. Or step right into it. Which I did. And then I saw these destitute people all around me. I was surrounded by them! But suddenly, instead of feeling terrified and claustrophobic, I felt completely one of them. It was wonderfully peaceful and joyful, like I belonged with them all.

Your brothers and sisters.

Well, actually, yes. I wonder if that's why nuns and priests take the vows of poverty and are called 'Sisters' and 'Brothers': perhaps it is so they have this experience of being the sisters and brothers of the poor...

'Com-passion' means being with the suffering - not disliking them and scattering largesse at arms' length to make the sufferers and their problem go away. The proper meaning of 'charity' is love - and what love does is connect. You should try connecting with your compassion next time you see someone or something painful on the breakfast news.

It might even stop me suffering from compassion fatigue'...

Anuradha Vittachi is a former NI co-editor and author of Stolen Childhood: In Search of the Rights of the Child (Polity Press).

Beat the quake, man Rich world disasters are not so disastrous. John Enbom reports from earthquake-aware San Francisco. April in California is earthquake-preparedness month. Around two million people statewide scramble under desks and tables at 10.10 in the morning on the first of the month in a special 'Duck, Cover and Hold Drill' to kick things off. The rest of April is set aside for various theme weeks - business awareness, home awareness, school awareness etc. The month's mascot, a groovy sunglasses-wearing cartoon creature in the shape of California, holds aloft a wrench and advises 'Beat the quake! Bolt it, brace it, fasten it down!' Such is life in the San Francisco Bay Area, where over five million people live and work astride two very active fault lines. Everyone knows the quakes are out there somewhere since the US Geological Survey has mapped everything extensively and can forecast probabilities with reasonable accuracy. The question is, what to do about it? The philosophy which has shaped the state's thinking lies along the lines of preventative dentistry - damage is riost easily fixed before it occurs. Richard Eisner is the director of the Bay Area Regional Earthquake Preparedness Project (BAREPP), a branch of California's Office of Emergency Services (QES). In his Oakland offices, surrounded by framed photographs of earthquake damage, he and his staff prepare for quakes yet to come. 'Outside this country we find tremendous life loss where construction is done with indigenous materials and has not been professionalized,' he says. 'But here we had seismic codes, a whole rash of them, utilized statewide, after the Long Beach quake in 1933.' As a result of these codes all public schools, hospitals, fire and police stations - those structures designated as 'essential services' - must pass a state design review and be constructed to withstand a quake. Additional codes since the 1971 San Fernando quake have set minimum standards for almost every type of building. Along with concerns for structural integrity, BAREPP's preparedness measures include a large dose of educational activities - hence the cartoon humanoid with the wrench. 'For a number of years now our emphasis has been on developing skills,' says Eisner, 'getting people to be able to fend for themselves for those magic 72 hours. We have been telling people not to depend on the Government for anything. For that period of time we are basically an underdeveloped country.' Of course the real test of any plan is the actual event you've been planning for. The Loma Prieta quake, 7.1 on the Richter scale, which struck south of the Bay Area on 17 October 1989, had been much planned for. A survey of the area in 1988 had determined there was a high probability of a quake within 30 years and had indicated, with a high degree of accuracy, which areas would be most vulnerable to damage due to ground movement. A simulated earthquake drill had been conducted three months before. Reaction to the quake was swift. At undamaged Candlestick Park, where the third game of baseball's World Series had been getting under way, no-one was really sure what had happened, although one sports announcer dug out the phone book and started reading the earthquake instructions over the radio. Over in the state capitol the OES people went scrambling for their State Operations Center, where they began putting together a picture of what had happened and figuring out who needed what. The phones were working so faxes were soon flying, sending out press releases and co-ordinating resources. With few exceptions, local police and firefighting rescue teams were able to handle emergencies in their own areas without need of assistance since their infrastructures were intact and the roads and hospitals usable. The 27,000-strong National Guard was on alert within 20 minutes and soon on its way to provide shelter, food and water to those in cut-off areas. The final Loma Prieta statistics - 62 dead, 3,757 injured and six billion dollars in damage - pale in comparison to the havoc wreaked by the earthquake in Armenia the year before, which was of similar magnitude but which killed 25,000 people. But no-one in the California earthquake game is satisfied. All eyes are now turned toward The Next One which, according to most counts, will be A Big One. 'We are going to have some real problems,' says Eisner, changing his tone of voice as they all do when discussing The Next One. 'The next event will probably be worst case.' To prepare for this eventuality, the earthquake people are doing all they can to squeeze lessons out of Loma Prieta. As is common for government agencies, however, OBS and BAREPP's vision far outstrips their resources. With California deep in debt, few of the ideas inspired by Loma Prieta will see the light of day soon. Eisner, who was hoping for a new satellite emergency communications system, must settle instead for a 30-per-cent budget cut. Unreinforced structures known to be dangerous are not being strengthened. The resources available for The Next One could very well be the same as they were in 1989. And that rubs many Californians, used to upgrading after each quake, up the wrong way. John Enbom works for the Pacific News Service in San Francisco.