Maintaining Compassion for Fibromyalgia Clients

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Having compassion for clients in pain seems like a no-brainer. However, compassion fatigue is a very real dilemma affecting professionals in the healthcare industry. Being less attuned to complaining may help some therapists cope with the challenges of providing healthcare. Unfortunately, compassion fatigue tends to alienate clients most in need – especially those with fibromyalgia.

About Fibromyalgia

An increasingly common syndrome that cannot be proven by any medical imaging test, fibromyalgia is a chronic condition characterized by widespread pain, tender points, fatigue, depression and sleep problems. Currently estimated to affect around two million Americans, descriptions akin to fibromyalgia have existed for centuries. As portrayed in the New Living Translation of the Bible, Job described his fibromyalgia-like suffering;

“I, too, have been assigned months of futility, long and weary nights of misery. When I go to bed, I think, `When will it be morning?’ But the night drags on, and I toss till dawn…And now my heart is broken. Depression haunts my days. My weary nights are filled with pain as though something were relentlessly gnawing at my bones.” (Job 7:3-4; 30:16-17 – NLT).

While the cause of fibromyalgia syndrome (FMS) is still unknown, researchers in the field have singled out its most likely origins:

Autonomic Nervous System Dysfunction – FMS may be caused by a problem with the brain’s autonomic nervous system. Problems with the hormones and neurotransmitters used by the autonomic nervous system can interrupt certain bodily processes, causing a number of fibromyalgia symptoms.
Sleep Disorders – A large percentage of FMS sufferers have difficulty sleeping. Though once seen as a fibromyalgia symptom, some clinicians believe that sleep disorders may be at the root of FMS. Affected people seem unable to reach the deepest stage of sleep, a problem that prevents injured muscles and nerves from being repaired.
Trauma – Many fibromyalgia patients have suffered from serious injury or muscle trauma (like a car accident), prior to the onset of FMS. Trauma can injure the central nervous system, which may increase sensitivity to pain, interfere with sleep patterns and disturb cognitive thought processes.
Infection – Infectious illnesses, including certain viruses, may be at the root of FMS. Certain infections attack the central nervous system, inhibiting the production of neurotransmitters that could cause fibromyalgia pain.

The Toll FMS Takes

Despite their recurring presentation of suffering, practitioners who acknowledge the immense pain of their clients with FMS can be a welcome source of comfort. These individuals are not just complainers looking for sympathy, they live a life drastically impeded by ongoing pain. In fact, an online survey conducted by Synovate Healthcare in March 2011 and developed by the National Fibromyalgia Association, the American Pain Foundation, and Pfizer Inc. demonstrates the far reaches of FMS.

Completed by over 2,500 people with diagnosed FMS, this survey brings the reality of living with this disorder to the public’s attention. The survey’s key findings include:

92 percent of respondents reported that their condition has had a major effect on life decisions, including whether to remain in a relationship, start a new one or change jobs.
68 percent of respondents say their pain limits their ability to care for their family.
95 percent of the 650 respondents with children under 18 say their pain affects parenting duties, making it difficult to manage their kids’ schedules, enjoy their kids’ milestones and manage their household.
98 percent of respondents indicated they have compensated for or attempted to compensate for their pain by changing their daily routine to make life easier or more bearable.

There is little doubt that the pain of FMS affects relationships, parenting duties and major life decisions. As such, acknowledging the depth of a client’s struggle with FMS can be extremely affirming – something they are not likely to receive elsewhere.

Compassion Fatigue

As a consequence of the work they perform, massage therapists can be particularly vulnerable to compassion fatigue. Day in and day out, massage therapists are likely listening to the misery and complaints of every person they interact with. Being the recipient of this seemingly endless supply of negativity can take its toll on practitioners and may precipitate a protective callousness when hearing of clients’ pain.

In an Acupuncture Today interview with the medical director of Moonview Sanctuary in Los Angeles, Terry V. Eagan, MD gives us this understanding of compassion fatigue:
“Many caregivers have been providing care since childhood. They may have had special attributes to which others were drawn in regard to problem-solving or advice-giving, or knew how to ‘lessen the load’ of others. Many of these individuals then find themselves in the helping professions. If they do not take special care of their own emotional/psychological/physical/spiritual needs, they may then be at risk for developing compassion fatigue, a syndrome where caregivers begin to experience some of the very symptoms of the clients they serve (for example, dealing with patients who have suffered extreme trauma may take an emotional toll on the caregiver). Caregivers are often self-sacrificing, overly identify with the suffering of others, and do not practice good self-care.”

Based on Eagan’s description of compassion fatigue, it is easy to see how previously caring therapists could evolve towards apathy. Practicing good self-care is where the hard work of maintaining compassion lies. In addition to being in a healthy physical condition, tending to emotional blockages and having a spiritual and/or creative outlet, the Four Steps of Energetic Separation for Bodyworkers can be extremely helpful for being able to remain present and compassionate with clients.

It is extremely frustrating to have a chronic pain condition that impedes nearly every part of your life, has no definitive cause or cure, can’t be seen by others and is not detected by traditional medical diagnostic techniques. Massage therapists who may have fallen victim to compassion fatigue are urged to take notice of this. In order to return to the compassionate caregiver that once defined them, prioritizing self-care is necessary. Without compassion, a massage therapist is likely to have a hard time connecting with fibromyalgia clients and be unable to provide the acknowledgement, understanding and support that are so desperately needed. When compassion is expressed, clients are more likely to feel seen, heard and recognized – essential ingredients for the true healing process to begin.

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