Compassion fatigue is a real thing. It is devastating and results in many good people giving up. We forget to take time for ourselves to heal. We give and give and give until we have nothing left for ourselves. We feel that our work is never done.

This is the work of the yetzer hara, the Jewish idea of the “evil inclination”. It says that we have to do it all and save everybody. It says that if we lose one, we’ve failed completely. It says why even try if we can’t fix everybody?

But we don’t fix anybody. We are there to help, and they have to want it. They have to do the real work.

The longstanding idea is that a person has to hit rock bottom to get help, and that they have to ask for it. They have to bring themselves to treatment – it can’t be forced on them.

In a way, this is frustrating. We don’t wait to do CPR on a person who has a heart attack. We don’t ask a drowning person if they want to be rescued. We just do it. We don’t stop first and get them to sign a consent form.

But mental health, often intermingled with substance abuse, is different. To be truly mentally healthy requires not just a change in mindset, but a change in lifestyle. Everything has to shift to keep the process going correctly.

Thus it isn’t up to the caregiver or the facilitator or the mental health provider to “make” the person well. It is up to her or him to keep the ball rolling. The caregiver shows the path – the client has to walk on it.

They have to take their medicine. They have to go to their doctor’s appointments. They have to reduce stress. They have to eat well. They have to exercise daily. They have to get enough sleep. They have to do all the little things that add up to the big thing, the only thing – being stable and sober and well. Balance is hard to achieve. It takes a lot of work.

Getting mentally healthy isn’t like buying a new car. You want to get to “health” and you are tired of walking there. So you want to make a quick change and get there the fast way. You buy a new car and fill it up with gas. But when you get there that way, you still don’t know how to really get there on your own.

It is more like buying a piece of the car, a day at a time. Every day you work closer to the goal. Eventually you have enough pieces that you are able to learn how to put it together. Then you have to get lessons on how to drive it. Then you practice. Finally, you can do it.

It takes years, but all that hard work means that you know how to do this on your own. It means that when the car breaks down, you know how to put it back together. It means you know where the pieces come from. You learn that you have to maintain that car every day or it will break down.

You can’t be driven to mental health. You have to get there on your own.

It should be the goal of the mental health provider to show the client what pieces will work, how to maintain them, and how to use them. They aren’t there to drive the client but to teach them how to drive themselves.

Thus – don’t feel guilty if a person seems stuck on the road. They have to do the work. They have to want to get better. It seems frustrating to watch them struggle, but that struggle is what forces them to make a decision. Work on getting healthy, or go the easy route and stay sick? Pain is a strong motivator to make better decisions.

It is like a baby bird. If you help it get out of its shell, it won’t have built up the muscles to survive. It can’t get help flying either – it has to be strong enough to fly on its own. If you cheat it of the work, it will fail.

Meanwhile, as a caregiver, you have to take extra care of yourself. Don’t get pulled under by the drowning people. Take extra time for yourself. Focus on what you can do, not what you can’t. Focus on your successes. And remember, sometimes you can’t see results right away. Sometimes the result, the reward, of your hard work will “bloom” later, in a way you’ll never see. Trust the process.