By Siri Brown, M.A., CCC Mind-Body Psychotherapist Compassion Fatigue Specialist “In dealing with those who are undergoing great suffering, if you feel “burnout” setting in, if you feel demoralized and exhausted, it is best for the sake of everyone, to withdraw and restore yourself. The point is to have a long-term perspective.” • - Dalai Lama My Story tears, chest pains, compulsive exercise, antidepressants, secret drinking & shame Exploring Internalized Beliefs about our Professional Selves Definitions: Burnout vs. Compassion Fatigue Burnout: physical and/or emotional exhaustion as a result of our work experiences and expectations. Occurs over time, leads to diminished enjoyment of both work and personal life. Compassion Fatigue: emotional, physical and psychological exhaustion experienced by one who helps others. A result of accumulated stress and trauma, can have rapid onset, leads to diminished capacity to function personally as well as professionally. Recognizing Compassion Fatigue Increased irritability with others, ourselves Sleep disturbances Low tolerance for others’ problems/emotions Depression (hopelessness, helplessness) Physically drained Decrease in hobbies/activities Increased isolation from others Feeling “numb” or emotionally disconnected Hypervigilance, hyperarousal Difficulty relaxing, sleeping, unwinding Increase in substance use Engaging in compulsive behaviours (food, sex, exercise, internet) (see www.proqol.org for free self-asssssment tool) Intrusive thoughts/images Anxiety Difficulty concentrating Increase in illness and absenteeism Decrease in work satisfaction Not feeling effective as a helper; loss of purpose, meaning Feeling burdened by client problems Preoccupation with client stories/issues Psychosomatic symptoms (chest pains, muscle tension, gastrointestinal distress, headaches) Deconstructing Compassion Fatigue “an interactive, or synergistic, effect among primary traumatic stress, secondary traumatic stress, and burnout symptoms in the life of afflicted care providers” (Gentry & Baranowsky) PTS + STS + Burnout = CF Primary Traumatic Stress: Result from anything traumatizing you have experienced directly including witnessing something happening to another/others. physical, emotional or sexual abuse injuries, accidents, medical/dental procedures natural disasters, wars, combat witnessing assault/suicide/homicide/death perceived or anticipated physical harm or death Results in latent vulnerability to Compassion Fatigue or Secondary Traumatic Stress (you are more easily “triggered” or “activated”) Secondary Traumatic Stress (Vicarious Trauma): When we experience traumatic stress symptoms hypervigilance/hyperarousal nightmares/intrusive memories numbing/dissociation as a result of listening to and/or being with another/others who have been traumatized*. * controlled empathy, nervous system regulation So the million dollar question is… How do we transform Burnout & Compassion Fatigue into Compassion Satisfaction & Vicarious Resilience? Spiritual Solutions for Healing from Burnout or Compassion Fatigue Write a mission statement - who you aspire to be both personally and professional Cultivate & actively practice Self-Compassion Connect! (to yourself, others, nature, the divine) Regular spiritual practice - yoga, prayer, gratitude list, affirmations, meditation, art, writing, dance, group gatherings Personal healing work - psychotherapy, esp. mind-body approaches such as sensorimotor, SRT, focusing, hypnosis, EFT; bodywork, energy work, visualizations Create nurturing space at work and home - rituals between sessions, maintaining a “non-anxious presence”, grounding, cleanse space, cleanse your energy field Call on your “Spiritual Support Circle” Creating your Spiritual Support Circle Final Thoughts… The work you do is amazing – undertaking the healing path of helping others takes courage, commitment and a generous heart. Therefore, take the time to honour and nurture yourselves, without guilt, and you will be able to continue on your helping journey with joy, energy, and compassion for all. With love & light, and in gratitude to all those who give of themselves, Thankyou. Siri Brown M.A., CCC Resources & References www.ccpa-accp.ca/blog/ www.compassionfatigue.ca www.compassionfatigue.org www.traumastressinstitute.org www.self-compassion.org www.psychologytoday.com/posts www.psychink.com (Traumatology Institute website) www.proqol.org (for Compassion Fatigue Assessment tool: Professional Quality of Life: Compassion Satisfaction and Fatigue (ProQOL) Version 5) Resources & References (cont.) Baranowsky, A. & Gentry, E. (2010) Compassion Satisfaction Manual: Compassion Fatigue Client Manual for the Accelerated Recovery Program Baranowsky, A., & Gentry, E. (2010) Compassion Fatigue Specialist Training Workbook (CFST) Accelerated Recovery Program Baranowsky, A., & Gentry, E. (2010) Treatment Manual for the Compassion Fatigue Accelerated Recovery Program Cox, D. (2006) “The Edwin Friedman Model of Family Systems Thinking” in Academic Leadership the Online Journal www.academicleadership.org vol.9 Issue 2 Spring 2011 Derr, M. (2008) The Use of Meditation and Mindfulness Practices to Support Military Care Providers: A Prospectus Hernandez, P. , Gangsei, D. & Engstrom, D. (2007) “Vicarious Resilience: A New Concept in Work With Those Who Survive Trauma” in Family Process, Vol.46, No.2 Mate, G. (2003) When the Body Says No: The Cost of Hidden Stress. Toronto: Random House. Matthieu, F. (2007) Transforming compassion Fatigue into Compassion Satisfaction: Top 12 Self-Care Tips for Helpers Rothschild, B. (2006) Help for the Helper: The Psychophysiology of Compassion Fatigue and Vicarious Trauma. New York: W.W. Norton & Co. Compassion Fatigue Trajectory (from the Gentry & Baranowsky Model of Compassion Fatigue) 1. The Zealot Phase - enthusiastic, committed, believers 2. The Irritability Phase - distancing, lose focus, mocking, judging 3. The Withdrawal Phase - neglectful (self, others), clients are “irritants”, blur together, exhaustion, “numbing” out 4. The Zombie Phase - disconnected to self, others; loss of compassion, no longer “present”, loss of meaning/value 5. Pathology vs. Renewal/Maturation - illness, take leave or change professions, ongoing distress/disatisfaction vs. hardiness, resilience, transformation