Some Definitions. Loss = the thing that happened. Grief = the reaction to the loss. Shock, sorrow, anger, guilt

Transcription

1 Some Definitions Loss = the thing that happened Death, divorce, being fired, moving, Grief = the reaction to the loss Shock, sorrow, anger, guilt Mourning = set of grief rituals whether formal or informal Funeral, wearing black, looking at photos, playing the same sad song over and over and over and over

2 Normal vs Complicated Grief We live in a quick-fix society Speedy Alka Selzer fast fast fast relief We have little tolerance for grief What used to be normal is now pathological A year of normal mourning has turned into about 6 weeks Look for suicidal ideation or ongoing despondence Make appropriate referrals

3 Social Changes in Rituals Consider funerals and memorials Psalms, tears, all black replaced by celebrations of life Death/dying/grief rituals once handled by family are now big business and handled by strangers You can t bury your loved one in your back yard Separating ourselves from death and our grief emotions creates more griefrelated pathology

4 Loss is a NORMAL Part of Life Developmental losses are necessary for growth Necessary Losses Judith Viorst Normal childhood losses Normal adolescent losses Normal adult losses Losses associated with aging

5 Our Clients Losses Losses associated with substance use What are they? Losses associated with HIV What are they? Compare and contrast

6 Existentialism Existential philosophy Post WWII There is no divine meaning Suffering is a normal part of the human experience Everyone suffers sometime We provide the meaning The meaning we provide either increases or decreases our own suffering Do you think there is meaning in suffering?

7 Existential Grief Work or Is There Meaning in Suffering? If suffering has meaning, what is it? Viktor Frankl from Man s Search for Meaning We have choice and responsibility Ram Dass on suffering

8 Existential Grief Work with Clients Help clients make meaning out of their own suffering Each client s story is unique How have these experiences changed you? What have you learned? We cannot undo the past but we can use it to shape the future

9 The Meaning of Life Can be Discovered in 3 Ways: According to Frankl we can discover the meaning of life: 1. By what we give to the world in terms of our creation 2. By loving someone or something in an authentic way 3. By the attitude we take toward unavoidable suffering

10 Telling Your Story Telling Listening Being the kind of case manager that you would want to have as your case manager The power of empathy revisited

11 What is Burnout? Term and construct originally developed in field of psychology in 1970s Now used across professions Marked by emotional exhaustion diminished interest in work reduced sense of personal accomplishment and satisfaction

12 Give Me a Definition The condition of someone who has become very physically and emotionally tired after doing a difficult job for a long time A person who suffers burnout The time when a jet or rocket engine stops working because there is no more fuel available Merriam-Webster Online Dictionary

13 Compassion Fatigue Also referred to as secondary trauma or secondary traumatic stress (STS) Who s at risk? YOU ARE!!!

14 Compassion Fatigue vs Burnout Gradual decrease of compassion over time Often called secondary traumatic stress (STS) Common in people who work with trauma victims/survivors Nurses/physicians First responders Social/mental health workers Case managers? First diagnosed in nurses in 1950s

15 Whatever We Choose to Call It In human services it can have profound negative effects on both the providers and the people they serve Media bombardment of tragedies can produce 2ndary trauma, followed by numbness, followed by compassion fatigue in a community or nation Oh, another earthquake/tsunami Oh, another school shooting

16 Manifestations Emotions Health Behavior Attitude Relationships

17 Emotional Inability to concentrate Increased anger Increased tension Increased time spent fantasizing Emotional distancing from others who don t understand

18 Emotional Depression Anxiety Loss of meaning Loss of hope Feeling helpless Feeling trapped Martyrdom

19 Health Frequent exhaustion Frequent headaches GI disorders Sleep disturbances High blood pressure Frequent injuries/accidents Back/neck pain Weight gain/loss Frequent colds Increased PMS

20 Behavior Decreased use of: Tobacco Sugar Alcohol OTC/RX drugs Illicit drugs Over/under-eating High risk behaviors Extreme mood swings and erratic behavior

21 Criticism Boredom Grandiosity Attitude Hyper-critical attitude toward institution Distrust of management, supervisor, peers Frequent expressions of hopelessness Sick humor aimed at/about clients

22 Relationships Increased problems in interpersonal relationships, particularly intimate family relations Spouse/partner Children Distancing/over-bonding with other staff Frequent conflicts with other staff Responding to clients in mechanical way Phoning it in

23 Use the 3 Rs Self-Care Recognize watch for warning signs Reverse undo the damage by managing stress Resilience build your resilience to stress by taking care of your physical and emotional health Helpguide.org

24 Self-Care Ask for support when you need it Family Friends USE SUPERVISION! Use each other Use more experienced peers and colleagues Make time to do the things you enjoy/don t neglect your personal life

25 Letting Go Part of what has made you who you are, what has made your story your story has been your pain and suffering Letting go can be part of the future of your story

26 Resilience People are constantly adapting, evolving, and capable of affecting their environment and circumstances, not simply reacting to them

27 Resilience Despite their problems and tragedies, the clients you see are survivors So are you Each of us has a story

28 Hope Combines with resilience Help clients create personal meaning that incorporates optimism about the future You believe in the client until s/he can believe in self

29 Hope Hope is tomorrow s veneer over today s disappointment Evan Esar