Is moral fatigue making you tired?

It was only a few months ago when shopping for groceries was a simple, if mundane task. Suzanne Savell recalls those days with fondness. Before the coronavirus pandemic, the Portland resident didn’t give it a second thought to stop for one or two items after work. Now, it’s a stressful event that requires both planning and fast-thinking.

“I find going to the store exhausting. I’m putting it off more,” said Savell. “When you’re walking through a store and you come around the corner where there’s another person, it’s a moment of indecision: ‘should I back away and wait, or proceed down the aisle?’”

That’s one of many calculations Savell has to make every day now. It’s something we’ve all been doing since the globe was swept by the coronavirus (COVID-19). Deciding whether we really need to go to the post office, order takeout, ride public transit or walk in the park has implications that could truly affect others. We’re constantly weighing the cost of our actions and it takes a toll on our mental and physical health.

This is what’s known as moral fatigue, or compassion fatigue, a term that defines difficult situations where the “right thing” to do is unclear and fraught with “what-ifs.” It’s commonly used in reference to healthcare providers because of the nature of their work, which often requires making decisions that can have consequences for a patient.

But according to Keilah Pomeroy, licensed independent clinical social worker with Swedish, the operational definition of moral fatigue is changing based on new understandings. “It’s being expressed in different ways,” she said.

“As it relates to COVID-19, every day we make these decisions around what is right and what is wrong, and that’s not totally black and white. There’s a lot of gray area”, said Pomeroy. “Within the context of a pandemic, the gray area is much more expansive. Maybe it was always that way, we just didn’t choose to look at it before.”

Old routines, new rules

What we’re experiencing in our everyday lives is a new landscape, with very different rules of engagement. Before the pandemic, the decisions around picking up groceries might have been based on time, money and needs. Now it’s potentially all those things plus: Is it safe? What’s my risk tolerance level? Is buying pasta worth me possibly spreading the virus to somebody else or potentially bringing it home to my family?

“So, you see how decisions that were once arbitrary or not emotionally intense become morally intense. The weight that is now carried in these tiny decisions add up. It’s exhausting,” said Pomeroy.

Having to make seemingly no-win decisions is troubling.  It’s also disorienting because the rules change daily, and not everyone subscribes to the same ones. For example, some people choose not to wear a mask or follow the 6-foot distancing recommendations. “They’re just making decisions in different ways,” said Pomeroy.  Still, someone making a choice to not wear a mask can be interpreted in other ways and summon feelings of anxiety or even anger.

“But you don’t have control over other people, and who knows what the other person’s situation is,” said Pomeroy, adding that we’re all navigating the same gray space at the moment. We need to remind ourselves that everyone is making their choices in a different way based on their personal situation, they’re frame of mind at the moment, or even their frame of reference.

How do you manage in the meantime?

Pomeroy recommends a number of ways to help navigate feelings of being overwhelmed by the uncertainty of events and all the decisions required to get through a day.

  • Try to rely less on external circumstances to direct your emotions and allow yourself to feel what you feel at the moment, take note of it with as little self-judgment as possible, and then make a choice. If you want to be happy, make the choice to be happy in any situation. If you want to experience sadness, then choose that, happiness and sadness as feelings are both so incredibly valuable. Acknowledge the suffering; this is the world right now. Acknowledge the beauty, this is the world right now too.
     
  • Lean into your fear. This might sound counter-intuitive, like the opposite of positive thinking, but it isn’t. It’s prepared thinking. Imagine the worst-case scenario for the future, the one that’s taking away your joy or calm in the present. What does it feel like? What does it look like when you picture it play out in your head? When you’re there, imagine what parts you can control and what parts you can’t. Focus on the parts you do have some control over and prepare mentally or practically. That worst-case scenario only has a possibility of happening, but if it does happen, you are more prepared for whatever that looks like in the future by what you are doing in the moment, and that brings a little more peace to the moment.
     
  • Try not to complain or judge harshly how someone else is dealing with the current events. We’re all trying to figure it out. How someone acts when they’re afraid is very different than how that same person acts when they feel safe. The better we get at extending generosity in our judgments, the better we become at compassion. This is how we’re all going to get through it. Shame is not going to move us forward together.

Pomeroy gives her clients suggestions on creative ways to help them work through feelings of uncertainty and fear associated with the pandemic. Here are a couple exercises she recommends for building resilience and the antidote to fear: courage.

  • Try improv comedy – Do it at home with family, or play around with some improv games over a virtual hangout. You can Google “Who’s Line Is It Anyways?” for some ideas to try. This exercise encourages you to play in the realm of uncertainty, where there isn’t a wrong decision and there’s room for levity. It helps to create psychological flexibility, which is a key part of the resilient brain. When there is flexibility, there is more courage.
     
  • Pour different colored crayons or pens in a bag, pull one out at random, draw or color with it a bit, draw another, and another, give yourself 5-10 seconds with each color. Create something. Pomeroy calls this “creating beauty out of randomness.” You can do this activity with kids, teens and adults. Use different mediums like paint or found objects to create art, or even random things in your kitchen to create an unexpected and maybe delicious meal. This idea teaches your brain how to create meaning or value out of anything, even suffering – a key part of the resilient brain. When there is meaning, there is more courage.

There’s a silver lining

Although it’s exhausting, there’s a positive outcome associated with all the decisions we’re making throughout our pandemic days: We’re taking our time to reflect on how the seemingly smallest actions affect others. Pomeroy thinks we needed a “revolution of thought.” She said the pandemic seemed like a boulder in everyone’s path. But sometimes the boulder is the path. What we do during this time defines who we will be when we get to the other side of this pandemic.

We’re here to help

If you need information or would like to find a Swedish behavior health specialist, don’t hesitate.

Find a mental health care provider here.

 

This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.

News & Information From Our Experts

Get the latest Covid-19 news, important information and updates from Providence experts.