Beyond Kale and Pedicures PRESENTATION TITLE Presenters Name

Beyond Kale and Pedicures PRESENTATION TITLE Presenter’s Name, Presenter’s title Reflections on Compassion Fatigue Date Jennifer Oldham Location October 13 th, 2016

Say what you will… • Cost of Caring • Contributing Factors • Strategies to Address Compassion Fatigue and Vicarious Trauma – Four Steps to Well-being • • Because it happens Take Stock Enhance self-care Develop resiliency Commit to change Because it’s possible

“The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet. ” - Rachel N. Remen, M. D. 4

Predicting Compassion Fatigue • Prevalent characteristics of helping professionals at risk for developing compassion fatigue: – They have a strong desire to help others – They possess a good deal of idealism – They are optimistic about the ability of people to change – They are curious about human behavior. 5

Compassion Fatigue and Burnout • Psychological – Irritability, isolation, preoccupation, detachment • Physical – Headaches, muscle tension, increased blood pressure and sugar, sleep problems • Behavioral – Hyper alert, restless, trouble making decisions, reduced sex drive, forgetfulness • Cognitive – Suspicion of others, feeling vulnerable, loss of control, bitterness or cynicism, external locus of control Compassion Fatigue • Physical exhaustion • Emotional exhaustion – Depression, hopelessness, depersonalization • Mental exhaustion • High workload and few rewards • Feelings of moral distress Burnout

Costs and consequences of Compassion Fatigue • “We are not referring to • A real and expected the most difficult story result of working with you have ever heard, we people who have or are talking about the experiencing trauma first thousands of stories you hand don’t even remember hearing. ” (Francoise Mathieu, 2011)

Causes and Contributing Factors • Feelings of inadequacy relative to one’s own expectations • Feeling pressure to “fix” others or the problem • Conflicts with other staff and problems with clients • Lack of positive reinforcement • Longevity in the field; long term persistence of the problem • Interruptions in family and personal life • High levels of empathy 8

“The capacity for compassion and empathy seems to be at the core of our ability to do the work and at the core of our ability to be wounded by the work. ” – C. Figley “Empathy is a double-edged sword; it is simultaneously your greatest asset and a point of real vulnerability. ” – D. G. Larson

Professional Quality of Life Scale (PROQOL) http: //www. proqol. org/ 10

Assessing Risk q q q q q I have a lot of empathy I don’t have a strong support system I think I ought to be able to help people effectively It’s hard for me to change my thinking about suffering I like to think I can figure things out myself and I hesitate to seek supervision or support I don’t think my employer takes compassion fatigue very seriously I’ve heard a lot of stories that disturb me I tend to work in isolation I have a personal trauma history I have work for more than 10 years in the field 11

Yet, we continue to ignore our own self -care! • Why is that? 12

Self Care as a Moral Imperative • • While the curriculum across the country in most…training programs contains a course in ethics, little attention is paid to the issues of self-care and risk factors. Walsh, Nichols, and Cormack’s (1991) study…revealed that most were reluctant to use their colleagues for personal support at work. Foremost among their reasons was the belief that they would be stigmatized for their problems, and their perception of colleagues as untrustworthy. Brown (1994) admonished us that self-care does not merely mean dutifully following a set of prescribed activities like exercise and meditation, it means ‘‘to continually ask whether and how one is practicing this principle’’(p. 213). In the words of one therapist: ‘‘Your competence as a therapist cannot exceed your competence as a human being’’ (Moursund, 1993; p. 217). – The Moral Imperative: Self-Care for Women Psychotherapists (Lynne Carroll, Paula J. Gilroy, Jennifer Murra, 1999 by The Haworth Press, Inc. 133) 13

Self Care as an Ethical Imperative • We are naïve to think that the occasional CEU workshop is sufficient to fulfill our professional responsibility to ourselves and our clients. • In spite of all the letters after our names, it remains difficult for professional caregivers to embrace the importance of taking care of ourselves. The irony is, we sit back and give expert advice without considering that we might practice what we preach. Self-care in a professional caregiver is not a choice; I see it as an ethical imperative. - Dr. Jamie Huysman, LCSW 14

Strategies to Address Compassion Fatigue • Disclaimer: Some ideas are better than others

10 Signs you are suffering from Burnout 1) You’re so tired you now answer the phone “Hell. ” 2) Your friends call to ask how you’ve been, and you immediately scream, “Get off my back!” 3) Your garbage can is your inbox. 4)You wake up because your bed is on fire, but go back to sleep because you just don’t care. 5) You have so much on your mind you’ve forgotten how to pee. 6) Visions of the upcoming weekend help you make it through Monday. 7) You sleep more at work than at home. 8) You leave for a party and instinctively bring your briefcase. 9) Your phone exploded a week ago. 10) You think about how relaxing it would be if you were put in isolation right now. • anonymous

Put on Your Own Oxygen Mask First • Experiencing compassion fatigue is not the problem. It happens. I’m human. It is how I manage it that is important. I owe it to myself to do the best I can do for myself in this regard. • Self reflection • Identifying distress and stressors • Self assessment • Noticing beliefs and assumptions • Challenging automatic thoughts. Less catastrophizing and awfulizing. • Asking for support

Steps to Management of Compassion Fatigue Step Four: Commit to Change Step Three: Develop Resiliency Step Two: Enhance Self-Care Step One: Take stock 19

Moving toward compassion satisfaction • Developing self-awareness skills – In tune with stress signals – Recognizing role of our past on our present – Paying attention to selfsabotage Take Stock

Moving toward compassion satisfaction • The basics: • Developing self-awareness skills – In tune with stress signals – Recognizing role of our past on our present – Paying attention to selfsabotage Take Stock – Sleep, rest, proper diet, exercise, vacations • Renewal – Activities that replenish you • Working Part time • Nourishing activities every day • Access to a regular debriefing process • What is your reaction to this really about? Enhance self care

Moving toward compassion satisfaction • Principles and practices to grow in • “Compassion Fatigue: The resiliency Crucible of Transformation” by Eric Gentry, 2002 – Intentionality • Development of non-anxious presence – Mindfulness – Notice and control physical symptoms of stress/anxiety – breathing – Self-validation • Self care that is guilt free • Self care that is prioritized Develop resiliency • Personal Homework: – Change I could make in the next week/month/year – What do I need to get in place to make this happen? • Accountability Partner(s) Commit to change