Compassion Fatigue
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Cordelia Anderson, MA
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Compassion Fatigue
- 1. Cordelia Anderson, MA www.cordeliaanderson.com Sensibillities, Inc. Cordelia@visi.com
- 2. Exposure to Trauma has an impact on the most highly skilled professionals “Trauma stewardship” is ethical issue (Laura van Dernoot Lipsky) Occupational hazard of the work ◦ “toxic stress” Organizational & Individual Strategies both matter Sensibillities, Inc. Cordelia@visi.com
- 3. No magic pill; No ONE thing There are symptoms: Pay attention ◦ to what “degree” - normal to ‘feel it’ – ◦ “NORMALIZE the difficulty of the topic & situation” Figure out your current level of stress: ◦ Stress (helpful/good stress or at least not harmful) ◦ Over stressed (Pay attention) ◦ Burnout ◦ Dis-ease (Crispy, Crossed Over) (TOXIC) Sensibillities, Inc. Cordelia@visi.com
- 4. As a catalyst to do what you can about any toxic conditions Define the extent of the problem, restoration or transformation & practicing prevention Important to start with yourself Sensibillities, Inc. Cordelia@visi.com
- 5. Cordelia@visi.com • Concept of “Trauma Stewardship” &Resource • Look for more resources on traumastewardship .com
- 6. Issue: What is an individual vs situation/systemic problem? Sensibillities, Inc. Cordelia@visi.com
- 7. Most “stress” from organization/political/systemic issues Toxic exposure Overload from multiple sources Sensibillities, Inc. Cordelia@visi.com
- 8. The exhaustion of physical and psychological resources caused by excessive striving for unrealistically high expectations (Update on Human Behavior, Vol 7, No. 4, 1987) Sensibillities, Inc. Cordelia@visi.com
- 10. Burnout is a grief response Grief that you aren’t as effective as you want to be Sensibillities, Inc. Cordelia@visi.com
- 11. Preoccupation with work-related problems or job security * a depressed immune system * stomach problems * lack of appetite * insomnia * high blood pressure * Irritability * sadness •Anxiety * chemical excuse/abuse Sensibillities, Inc. Cordelia@visi.com
- 12. * Overtime * Negativism * Cynicism *** * Pessimism * Hopeless is hip * If "seasoned", then cynical Sensibillities, Inc. Cordelia@visi.com
- 13. Burnout & Secondary Trauma = Compassion fatigue (Figley) ◦ Empathy is key to induction ◦ Response is to shut down emotionally Sensibillities, Inc. Cordelia@visi.com
- 14. Intrusive symptoms Avoidance symptoms Arousal symptoms (Figley, 1995) Sensibillities, Inc. Cordelia@visi.com
- 15. Sensibillities, Inc. Cordelia@visi.com Use to need adaptive reaction that’s now a maladaptive response
- 16. Release of powerful chemicals Only intended to be used for extreme emergencies Not intended to experience repeat life threats PTSD = constant/chronic release of brains emergency warning system Learned response to warning signs & associations Reflex happens from sensory stimuli in absence of real threat Sensibillities, Inc. Cordelia@visi.com
- 17. Sensibillities, Inc. 2005 Cordelia@visi.com “Is what is coming at me really coming from me?” Lo Lo
- 18. 1995-1997 data collection, 17K, 1st published in ’98; 2013 MN ACES Data “What creates health and life success?” Develop a common language about the problem, risks, protections and compassion ACES, neurobiology, stress and resilience Plan together in a new way Adversity add up & creates enduring effects ACES are common, UNACCEPTABLE, the earlier exposure the more the harms, yet they Sensibillities, Inc. Cordelia@visi.com
- 19. Clients/Students you work with You/Other Staff Sensibillities, Inc. Cordelia@visi.com
- 20. Do you prioritize time/energy/relationships? ◦(partner, friends) What is the affect/effect on intimacy? Sensibillities, Inc. Cordelia@visi.com
- 21. Are you suspicious of everyone? Do your children wish they had a “normal parent” that didn’t always see/expect the worst? Are you increasingly “protective?” Sensibillities, Inc. Cordelia@visi.com
- 22. Sensibillities, Inc. Cordelia@visi.com Diminished emotional responsiveness to a negative or aversive stimulus after repeated exposure to it. -To make less sensitive -NUMB
- 23. Sensibillities, Inc. Cordelia@visi.com Impact of Technology
- 24. Be Intentional Ecological/ Strategic Personal &Institutional Not a Technique but a way of life “CHANGE OF HEART” Sensibillities, Inc. Cordelia@visi.com
- 25. Exploited Child Unit Study of Impact; Proactive weekly group meetings Opportunities for private sessions Hiring assessment based on learnings Debrief at departures (Occupational Hazard) Sensibillities, Inc. Cordelia@visi.com
- 26. www.shiftwellness.org; Research shows the impact Innocent justice Foundation with OJJDP, ICAC’s and MH expert in CSA Images developed “Supporting Heroes in MH Foundational Training (SHIFT) ICAC BCA MN – Own Program Sensibillities, Inc. Cordelia@visi.com
- 27. 28 federal LE who investigate Internet CP High % of STSD (secondary traumatic stress disorder) & Cynicism STSD & burnout scores related to: ◦ Increased protectiveness of family ◦ Turnover intentions ◦ Reliance on co-workers (not outside of work) ◦ General distrust Sensibillities, Inc. Cordelia@visi.com
- 28. Cultivation of Organizational Support: ◦ Training prior to entry & supplemented ◦ Attention to cohesive collegial unit (COMMUNITY MATTERS) ◦ Enhanced support network ◦ Recruitment willingness and screening (wrong reasons for willingness) ◦ Past trauma, addressed ◦ Escape other duties What fits? What doesn’t? What else? Sensibillities, Inc. Cordelia@visi.com
- 29. Is the environment one in which the health, self- care of those who work in it is LIKELY? ◦ Why or why not? ◦ Who is responsible? ◦ What can you do? Are systems in place to help individuals/groups bounce back after harm? Are processes restorative/transformative? Is it Solution focused? Sensibillities, Inc. Cordelia@visi.com
- 30. To Counter Professional Negativity and Fatigue ask: ◦What are your successes? ◦What do you have to celebrate? (Do you mostly talk about your challenges?) Sensibillities, Inc. Cordelia@visi.com
- 31. Review of workplace practices and policies Do they include proactive measures at employee / volunteer health & well-being & organizational support for the reality of trauma? Are there reactive supports (debriefings, counseling support) Assessment upfront, proactive check-in’s, exit interviews Check for signs of health: moral, tone of ‘humor’ collaboration/support/creative thinking, physical wellness, mental health Sensibillities, Inc. Cordelia@visi.com
- 32. Sensibillities, Inc. Cordelia@visi.com “Make their day” Be present Choose your attitude Play > Have Fun
- 33. Sensibillities, Inc. 2005 Cordelia@visi.com Detaching Feeling Effective On The Job Past Childhood Experiences With Bonding
- 34. Name It Make a plan to change Make the change Build a team Evaluate Celebrate Success Sensibillities, Inc. Cordelia@visi.com
- 35. SIGN: Loose our ability to be present so we do not know the harm to self or others NOTE: How do we not add to the trauma we see? Sensibillities, Inc. Cordelia@visi.com
- 36. Focus and Identify what you can do to feel better at the really hard times; Impact can be TRANSFORMED by layering in new positive experiences; Mindfulness, Meditation & the neurobiology of trauma ◦ - studies show increased activation of frontal and pre-fontal cortical areas Sensibillities, Inc. Cordelia@visi.com
- 37. Sensibillities, Inc. 2005 Cordelia@visi.com Laughter is an instant vacation. Laughter: Reduces the level of stress hormones Perks up the immune system Relaxes muscles Clears the respiratory tract Increases circulation Eases perceived pain Feel good endorphins flow Laughter both stimulates and soothes
- 39. Sensibillities, Inc. Cordelia@visi.com We burn out because we’ve allowed our hearts to become so filled with loss that we have not room left to care. Grieving is a way of self-care, the antidote to professionalism. Health professionals don’t cry. Unfortunately.
- 40. Sensibillities, Inc. Cordelia@visi.com The difference between stumbling blocks and stepping stones is how you use them ~ Source Unknown ~
- 43. Cordelia Anderson Cordelia@visi.com www.cordeliaanderson.com; Sensibillities, Inc. Cordelia@visi.com
Notas del editor
- Frogs in Boiling Water story
- See next slide for examples
- “ Is what is coming at me really coming from me?” Lo Lo This is a transition to more ways to think about how much of the stress/burnout is from out there; how much is from inside of me.
- Secondary traumatic stress and burnout among law enforcement investigators exposed to disturbing media images. By Perez, Lisa M.; Jones, Jeremy; Englert, David R.; Sachau, Daniel Journal of Police and Criminal Psychology, Vol 25(2), Oct 2010, 113-124
- Seattle Fish Market – long hours, hard labor, tedious, repetitive “ Guy guys”
- Crossed Over: Needing to Renew Name it: Admit the problem. Admit the need for focused attention. (Note: think of how to host or respond to an “intervention.” Make a plan to change: Some of us need personal trainers or therapist to make a plan and follow through, others can do it on their own. Know which you are. Set short term and long term goals. Consider: work, spirit, physical, social, mental/emotional, sexual Make a change: Start the wheel in motion. You don’t need to do everything, but take a step. e.g., look at other job opportunities. Start to exercise. See a therapist. Begin to implement your plan. Build a team : There is no need, a potential harm in keeping this a secret. Pull in team members in your personal and professional life. Some may be helpers and doers; while others may be supporters. All check in on your progress. Consider who helps with which areas! Evaluate: Set dates for a progress check. Decide who monitors your progress in specific areas. Plan for “relapse.” Plan for success. Plan to adjust your plan. Celebrate Success: Don’t wait for the big changes, celebrate the small ones. Give yourself credit.
- The expectation 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. This sort of denial is no small matter. The way we deal with loss shapes our capacity to be present to life more than anything else. The way we protect ourselves from loss may be the way in which we distance ourselves from life. Protecting ourselves from loss rather than grieving and healing our losses is one of the major causes of burnout. People may not know they are “burned out” but may say, “I don’t care anymore” “I feel nothing.” Psychopaths, tyrants and dictators may not burn out, only people who care get to this point of numbness.