Dr Bevyn Rowland Licensed Clinical Psychologist Faculty Counselor

Dr. Bevyn Rowland Licensed, Clinical Psychologist Faculty Counselor and Professor, Clark College (Vancouver, WA) Perfectly Imperfect Human constantly in search of AFGOs

§ Understand human brain function in the grip of stress and how it informs behavior § Identify indicators of well-being/burn-out § Recognize the nexus of capacity/ethical obligation/self-care § Create personalized list of sustainable self-care behaviors § Establish a plan for self-care practice for 7 days

§ If passion/strong interest led you to this work, identify the 5 Ws of your Passionate Purpose/Meaningful Intent: § WHO (are you in this work for; who are your supports)? § WHAT (do you love/enjoy about this work)? § WHERE (do you want your work to have impact)? § WHEN (does your work end and your life begin)? § WHY (do you get up and do this job every day)?

§ The human brain evolved in reaction to stress § When we are faced with a stressor a fairly predictable set of brain events occur: § A complex hormonal cascade ensues, and the adrenals secrete cortisol. § Cortisol prepares the body for a fight-or-flight response by flooding it with glucose, supplying an immediate energy source to large muscles. § Cortisol inhibits insulin production in an attempt to prevent glucose from being stored, favoring its immediate use. § Cortisol narrows the arteries while the epinephrine increases heart rate, both of which force blood to pump harder and faster. § The individual addresses and resolves the situation. § Hormone levels return to normal. (From: Cortisol: Its role in stress, inflammation, and indicators for diet therapy. Dina Aronson, MS, RD (2009)) § This response is meant to keep us alive/moving forward for about 5 minutes. § How many stressors do you have that are of 5 minute duration?

Reading Videos § Robert Sopolsky’s seminal work on § Nat. Geo: Summary of stress science § NIH Foundational article on stress and § Kelly Mc. Gonigal TEDTalk: Compelling impact of stress on humans; 539 pages health; 12 pages (still vetted despite 2008 filming); 56 minutes 2013 stress studies; 15 minutes

…and their correlates.

§ Increase in energy saving activities § Frontal lobe function = v. high energy demand § Our brains automatically take more short-cuts in grip of stress § Marked increase in negativity bias § Baseline: “The human brain is Velcro for negative experiences and Teflon for positive ones. ” (Rick Hanson, Ph. D) § Due to presence of ambient glucocorticoids, our already Velcro brain gets even stickier for negative information § Increase in confirmation bias § Incorporate only information that fits our existing schemas § Amplification of implicit racial biases § Especially overcrowding/excessive load (Dr. Tiffani Johnson’s group: 2016 Study of ER physician racial biases)

§ Wellness Assessment by Rand Health § 36 -item Health Survey § Self-care Assessment by NAMI § 5 domains: Physical, Psychological, Emotional, Spiritual, Professional § Implicit Bias Measurements by Project Implicit (Greenwald, Banaji, Nosek, Teachman, and Nock. Hosted by Harvard University since 1998) § 15 areas of unconscious bias measured and compared to norming groups § Watch this Ted. Talk right after you take these (18 minutes)

§ Professional Quality of Life Scale (Pro. QOL) § 30 Items; Rated 1 to 5 § 1=Never, 2=Rarely, 3=Sometimes, 4=Often, 5=Very Often § Offered in 24 languages (including English) © B. Hudnall Stamm, 2009 -2012. Professional Quality of Life: Compassion Satisfaction and Fatigue Version 5 (Pro. QOL). www. proqol. org. This test may be freely copied as long as (a) author is credited, (b) no changes are made, and (c) it is not sold. Those interested in using the test should visit www. proqol. org to verify that the copy they are using is the most current version of the test.

§ 1. I am happy. § 2. I am preoccupied with more than one person I [help]. § 3. I get satisfaction from being able to [help] people. § 4. I feel connected to others. § 5. I jump or am startled by unexpected sounds.

§ 6. I feel invigorated after working with those I [help]. § 7. I find it difficult to separate my personal life from my life as a [helper]. § 8. I am not as productive at work because I am losing sleep over traumatic experiences of a person I [help]. § 9. I think that I might have been affected by the traumatic stress of those I [help]. § 10. I feel trapped by my job as a [helper].

§ 11. Because of my [helping], I have felt "on edge" about various things. § 12. I like my work as a [helper]. § 13. I feel depressed because of the traumatic experiences of the people I [help]. § 14. I feel as though I am experiencing the trauma of someone I have [helped]. § 15. I have beliefs that sustain me.

§ 16. I am pleased with how I am able to keep up with [helping] techniques and protocols. § 17. I am the person I always wanted to be. § 18. My work makes me feel satisfied. § 19. I feel worn out because of my work as a [helper]. § 20. I have happy thoughts and feelings about those I [help] and how I could help them.

§ 21. I feel overwhelmed because my case [work] load seems endless. § 22. I believe I can make a difference through my work. § 23. I avoid certain activities or situations because they remind me of frightening experiences of the people I [help]. § 24. I am proud of what I can do to [help].

§ 25. As a result of my [helping], I have intrusive, frightening thoughts. § 26. I feel "bogged down" by the system. § 27. I have thoughts that I am a "success" as a [helper]. § 28. I can't recall important parts of my work with trauma victims.

§ 29. I am a very caring person. § 30. I am happy that I chose to do this work

§ Add the following items: § 3, 6, 12, 16, 18, 20, 22, 24, 27, 30 The sum of my Compassion Satisfaction questions is So My Score Equals And my Compassion Satisfaction level is 22 or less 43 or less Low Between 23 and 41 Around 50 Average 42 or more 57 or more High

§ Add the following items: § 2, 5, 7, 9, 11, 13, 14, 23, 25, 28 The sum of my Secondary Trauma questions is So My Score Equals And my Secondary Traumatic Stress level is 22 or less 43 or less Low Between 23 and 41 Around 50 Average 42 or more 57 or more High

§ If your Secondary Traumatic Stress Score is over 30 § Please take 20 minutes to watch this amazing speaker: Laura Vandernoot Lipsky (2015) then… Read her book: Trauma Stewardship (2011) (New book available July 2018: The Age of Overwhelm: Strategies for the Longhaul (2018))

§ University professor (tenured) is the 4 th least stressful job in the U. S. ? (1 st Medical Sonographer/ 10 th Medical Lab Tech) § Career Cast ranked 200 professions (2018) based on: § Risk of injury § Tight deadlines § Physical demands § Working in the public eye § Travel § Competition § Immediate risk of another’s life

§ The cumulative burden on the human biome through daily response and adaptation to daily stressors. (Utility/Capacity reduction caused by daily wear & tear) § It is a significant risk factor for many diseases: § Cardiovascular disease § Metabolic disorders § Depression § Cognitive impairment § Disorders related to inflammation § Lower status in society = Greater allostatic load in individuals in non-dominant identity groups § § § Race Ethnic groups Gender LGBTQ Disability

Stressor + Real/Perceived Ability to Respond/Adapt = Idiosyncratic Stress Impact

§ In groups of no more than 4 § On your own (5 minutes): § Remember and reflect on an incident in your work-life that feels like a failure/growth opportunity. § Consider the life events that were happening for you at the time. § What was your stress level before and during that time? § To what extent did your stress load impact your ability to respond/react in the moment? § What is happening for you as you recall and reflect on this incident? (Physical sensations, thoughts, feelings) § If your best self could re-do this incident, what would be different? § In your group (10 minutes): § Share insights as your willingness allows. § What are the patterns/differences you notice in your shareout?

“When I look back on mistakes I’ve made, They all have 1 thing in common: I was tired. ”

“When I look back on mistakes I’ve made, They all have 1 thing in common: I was tired. ”

§ Organizational hierarchy, race and gender play a huge role in how one engages in self- care (and how those behaviors are perceived stakeholders in the organization). § Self-care behaviors are often organized by gender § i. e. What are men expected to do for self care versus women? § Racism and sexism interact to make outcomes for women of color especially different: § i. e. Using Paid Time Off (PTO) is often viewed much more harshly and attributed to negative characteristics; § Because of stereotype threat, women of color are not empowered to engage in self-care behaviors § Your employer may not fully encourage you to engage in meaningful self-care § Compare/contrast your organization with the principles described in this article by Kelly & Kutch (2017)

§ Stress is contagious amongst humans § Documented in the classroom (2016) § Individuals who watch videos of people with varying levels of stress speaking into a camera, had similar ECGs (2017) § People with higher levels of empathy experienced these changes more quickly

§ “If you fail to care about people at a human level, at an emotional level, they’ll eventually leave you regardless of how much you pay them. ” (Mike Myatt, Leadership Advisor to Fortune 500 CEOs) § Acknowledge that we spend around 100, 000 hours of our life at work (between 25 -65 years of age) § Where, how, and with whom we work matters § Cultural change starts at the top and at the bottom § We must work to influence our administrators § We can more simply start with our immediate sphere of influence (ourselves)

From Mawiyah Patten (2017)

-Mawiyah Patten (What nobody tells you about self-care, 2017)

§ Biological = Understanding of and response style to physical needs (i. e. nutrition, movement, sleep, breathing, physiological tension) § Psychological = Understanding of and response style to self and internal processes (i. e. assertiveness, anger management, worry control, counseling, humor, acceptance and commitment, art) § Social = Meaningful and timely connections with others (i. e. spending time with friends/family with minimal sense of obligation, developing healthy relationships, having fun) § Spiritual = Connection to something greater than Self (i. e. faith community, meditation, volunteering, community activism, being in nature)

Rocketship Stress Busters Vespa Stress Busters (X)

Rocket Ship Activation/Chill Out Vespa Activation/Chill Out § Using chemicals to alter § Increasing serotonin and brain function § Caffeine, Et. OH, Cannabis, Sugar dopamine activity through exercise, humor, micronutrients like B 6, massage/bodywork § Sit or move in nature

Rocket Ship Sleep/Productivity Vespa Sleep § Sleeping really late on the § Tweaking your weekends § Staying up late to get things done bedtime/waketime to be consistent across the week § Keep naps brief (under 20 minutes)

Rocket Ship Boundaries Vespa Boundaries § Shutting out everything a lot § Spend time with 2 people of the time (and only working/and only numbing out) this week who I can be myself with/who get me/who I have fun with § Schedule 30 -60 minutes in my Shed, Man. Cave, Their. Lair

Rocket Ship Venting Vespa Venting § Really tearing into your § Identify what you need (Dean/President/Difficult Student: choose your own villain) with your colleague. support around from your colleague § “I kind of need to vent. Can I tell you what I’m struggling with? ” § Express gratitude for their active listening and offer to return the favor.

Use the BIO/PSYCHO/SOCIAL/SPIRITUAL Model to create a robust list of self -care behaviors

§ Biological = Understanding of and response style to physical needs (i. e. nutrition, movement, sleep, breathing, physiological tension) § Psychological = Understanding of and response style to self and internal processes (i. e. assertiveness, anger management, worry control, counseling, humor, acceptance and commitment, art) § Social = Meaningful and timely connections with others (i. e. spending time with friends/family with minimal sense of obligation, developing healthy relationships, having fun) § Spiritual = Connection to something greater than Self (i. e. faith community, meditation, volunteering, community activism, being in nature)

WHAT …why don’t we do it? (Tim Urban, Master Procrastinator: 14 minutes)

STARTING TODAY § Accountability Partner § Identify at least 2 people you can recruit* § Ideally: 1 person on campus and 1 person off campus § Rocketships (≈1) § <2 Rocketships (for the week) § Vespas (5 -7) § Identify smaller, manageable behaviors you can work into your daily routine -OR§ Choose 1 novel Vespa per day to try. SET A CALENDAR TRUTH DATE*: When/Who/How you will check in about your progress

BROWLAND@CLARK. EDU