PRESENTATION BY GREG CARLSSON, L.M.F.T. THE CLINICAL SERVICES COORDINATOR FOR THE HOUSING AUTHORITY OF THE COUNTY OF LOS ANGELES (562)

Transcription

1 VICARIOUS TRAUMA: IT SEEMS TO BE TAKING OVER MY LIFE! PRESENTATION BY GREG CARLSSON, L.M.F.T. THE CLINICAL SERVICES COORDINATOR FOR THE HOUSING AUTHORITY OF THE COUNTY OF LOS ANGELES (562) PRIVATE PRACTICE PASADENA CALIF. (626)

2 ACTIVITY PART 1 MINDFUL BREATHING: MINDFULNESS IS PAYING ATTENTION, IN A PARTICULAR WAY; ON PURPOSE, IN THE PRESENT MOMENT, AND NON JUDGMENTALLY. JON KABAT-ZINNN, SCIENTIST, AUTHOR AND EDUCATOR. NOTICE YOUR BREATHING. GAZE IN FRONT OF YOU, ON THE FLOOR OR ON THE WALL AND FIND A SPOT THAT IS CALMING, PEACEFUL OR NEUTRAL. NOTICE YOUR BREATHING, AS YOU FOCUS ON THE RESOURCE SPOT. ADAPTED FROM BRAINSPOTTING: THE REVOLUTIONARY NEW THERAPY FOR RAPID AND EFFECTIVE CHANGE, DAVID GRAND PHD

3 OBJECTIVES 1. UNDERSTAND THE WORKING DEFINITIONS OF: PRIMARY TRAUMA SECONDARY TRAUMA VICARIOUS TRAUMA COMPASSION FATIGUE BURNOUT 2. UNDERSTAND THE PARALLEL TRAUMA PROCESS BETWEEN STUDENTS, CLIENTS AND CARE PROVIDERS. 3. GAIN A BETTER UNDERSTANDING OF WHERE TRAUMA IS HELD IN OUR BODIES. 4. LEARN CLINICAL TOOLS TO HELP ADDRESS IDENTIFIED TRAUMAS.

4

5 TO BE TRUSTED WITH ANOTHER S TRAUMA IS NOT TO BE TAKEN LIGHTLY. TRAUMA MAY NOT BE WHAT WE SIGNED UP FOR... BUT IT S PART OF THE JOB. IF WE ARE TO CONTINUE WITH THIS WORK, WE MUST EMBRACE OUR REACTION TO TRAUMA, LEARN FROM IT AND MOVE FORWARD.

6 TRAUMA, FATIGUE AND BURNOUT.

7 PRIMARY TRAUMA: A TRAUMATIC EVENT THAT HAS HAPPENED TO YOU. PRIMARY TRAUMA CAN HAPPEN AT WORK OR STEM FROM OUR PAST TRAUMA HISTORY. AS HELPING PROFESSIONALS IT S IMPORTANT THAT WE ADDRESS OUR OWN TRAUMA HISTORY. RESEARCH SHOWS THAT ABOUT 60% OF HELPING PROFESSIONALS HAVE A TRAUMA HISTORY OF THEIR OWN. ONEʼS OWN TRAUMA HISTORY MAY PLAY A ROLE IN WHY WE BECOME INVOLVED IN A HELPING PROFESSION. IF OUR OWN PAST TRAUMA IS NOT ADDRESSED, WE MAY BECOME MORE VULNERABLE WHILE DOING THE WORK. ADAPTED FROM THE COMPASSION FATIGUE WORKBOOK: CREATIVE TOOLS FOR TRANSFORMING COMPASSION FATIGUE AND VICARIOUS TRAUMATIZATION, FRANCOISE MATHIEU

8 SECONDARY TRAUMA: YOU ARE NOT AT THE EVENT BUT LEARNING ABOUT IT AT A LATER DATE. SECONDARY EXPOSURE REFERS TO NOT EXPERIENCING THE TRAUMA FIRST HAND BUT HEARING ABOUT IT, READING A REPORT DESCRIBING IT, OR MAYBE SEEING PHOTOS OF THE TRAUMATIC EVENT. BOTH PRIMARY AND SECONDARY TRAUMA CAN CAUSE POST TRAUMATIC STRESS DISORDER (PTSD). ADAPTED FROM THE COMPASSION FATIGUE WORKBOOK: CREATIVE TOOLS FOR TRANSFORMING COMPASSION FATIGUE AND VICARIOUS TRAUMATIZATION, FRANCOISE MATHIEU.

9 SYMPTOMS MIGHT BE CHARACTERIZED BY: NIGHTMARES HAVING INTRUSIVE THOUGHTS ABOUT THE TRAUMATIC EVENT DEPRESSION THE LACK OF INTEREST IN IMPORTANT AREAS OF LIFE, OR BECOMING IMMOBILIZED IN CERTAIN PARTS OF YOUR LIFE

10 . VICARIOUS TRAUMA: THE PROFOUND SHIFT THAT YOU MAY EXPERIENCE IN YOUR WORLD VIEW WHEN YOU WORK WITH INDIVIDUALS WHO HAVE EXPERIENCED TRAUMA YOU MAY BEGIN TO SEE THE WORD IN A DIFFERENT WAY. VICARIOUS TRAUMA ALSO OCCURS WHEN THE STORIES WE HEAR TRANSFORM US IN A WAY THAT ALSO TRAUMATIZES US. WE FIND IT DIFFICULT TO RID OURSELVES OF THE STORIES WE HAVE BEEN TOLD. THESE IMAGES AND EXPERIENCES CAN STAY WITH US FOR A VERY LONG TIME. IT IS NOT SOMETHING THAT CLIENTS DO TO US; IT IS A HUMAN CONSEQUENCE OF KNOWING, CARING AND FACING THE REALITY OF TRAUMA. ADAPTED FROM SAAKVITNE K.W., PERMAN, L.A., & STAFF (1996) P. 25

11 COMPASSION FATIGUE: A GENERAL EROSION OF OUR EMPATHY, HOPE AND COMPASSION FOR LIFE MAY BEGIN TO SURFACE. A REDUCTION IN OUR ABILITY TO BE GENUINELY COMPASSIONATE MAY OCCUR. WHO: TEACHERS, PSYCHOLOGISTS, NURSES AND OTHER HELPING-PROFESSIONALS SYMPTOMS MAY INCLUDE: A PROFOUND EMOTIONAL AND PHYSICAL EXHAUSTION A BITTERNESS TOWARDS WORK CHANGES IN OUR PERSONAL AND PROFESSIONAL LIVES. BECOMING PART OF A TOXIC WORK ENVIRONMENT. ADAPTED FROM THE COMPASSION FATIGUE WORKBOOK: CREATIVE TOOLS FOR TRANSFORMING COMPASSION FATIGUE AND VICARIOUS TRAUMATIZATION/ FRANCOISE MATHIEU.

12 ADAPTED FROM THE COMPASSION FATIGUE WORKBOOK: CREATIVE TOOLS FOR TRANSFORMING COMPASSION FATIGUE AND VICARIOUS TRAUMATIZATION, FRANCOISE MATHIEU. BURNOUT : PHYSICAL AND EMOTIONAL EXHAUSTION THAT WORKERS CAN EXPERIENCE WHEN THEY HAVE LOW JOB SATISFACTION, FEEL POWERLESS AND OVERWHELMED AT WORK.

13 EXHAUSTION, IRRITABILITY, AND ANGER, CAUSED AT WORK, MAY BE TRANSFERRED TO YOUR LOVED ONES. YOU MAY FEEL AS THOUGH THEY SHOULD BE AS COMPASSIONATE AS YOU ARE! WHY DONʼT THEY SEE THIS WORK AS IMPORTANT AS I DO. YOUR BODY MAY ALSO TAKE THE IMPACT.

14

15 VICARIOUS TRAUMA, COMPASSION FATIGUE & BURNOUT ARE NOT EXCLUSIVE AND CAN BUILD ON EACH OTHER. WE CAN BEGIN TO FEEL ALIENATED AT HOME AND NOT FEEL SUPPORTED BY OUR FAMILIES OR FRIENDS.

16 RISK FACTORS THAT CAN CAUSE ONE TO BE MORE VULNERABLE TO S.T., V.T.: 1. A HISTORY OF CHILDHOOD TRAUMA 2. DIFFICULT LIFE CIRCUMSTANCES 3. THE USE OF VICES MAY BE USED TO ESCAPE THE OVERWHELMING SADNESS COMING FROM THE TRAUMA; FOOD DRUGS EXCESSIVE WORK EXCESSIVE ALCOHOL SEX...

17 Activity Part II 1. THINK OF A SITUATION THAT MIGHT APPLY TO ONE OF THE ABOVE AREAS. 2. TAKE THREE MINUTES, TURN TO YOUR NEIGHBOR, AND SHARE YOUR STORY. 3. DONʼT GET TOO GRAPHIC. 4. WHILE SHARING, REFLECT ON YOUR FEELINGS.

18 YOUR BODY CAN BE A BAROMETER; SCAN YOUR BODY, NOTICE WHERE IN YOUR BODY YOU HOLD THE TENSION, (THE ACTIVATION SPOT) AS YOU WERE SHARING YOUR STORY, DID YOU FEEL PARTS OF YOUR BODY TENSING UP? FIND THE ACTIVATION SPOT IN YOUR BODY.

19 ACTIVITY PART III MINDFUL BREATHING & BODY ACTIVATION SPOT/RESOURCE OR GROUNDING SPOT

20 1. COMPLETE THE MINDFUL BREATHING AGAIN WHILE PAYING ATTENTION TO YOUR BREATHING AND GAZING AT YOUR EXTERNAL RESOURCE SPOT. 2. SCAN YOUR BODY, NOTICE YOUR ACTIVATION SPOT. 3. WHILE BREATHING IN, FOCUS ON YOUR EXTERNAL RESOURCE OR GROUNDING SPOT. AS YOU BREATH OUT LET GO OF THE TENSION FROM YOUR ACTIVATION SPOT. 4. NOTICE IF YOU ARE HOLDING ON TO THE TENSION. ADAPTED FROM BRAINSPOTTING: THE REVOLUTIONARY NEW THERAPY FOR RAPID AND EFFECTIVE CHANGE, DAVID GRAND PHD

21 WHEN HEARING ABOUT STRESSFUL SITUATIONS FIRST HAND, NOTICE IF YOUR BODY BECOMES TENSE.

22 SELF AWARENESS - THE RELATIONSHIP BETWEEN PHYSICAL AND EMOTIONAL HEALTH IS PARAMOUNT TO UNDERSTANDING OUR RELATIONSHIP TO TRAUMA AND STRESS.

23 SELF AWARENESS IN THE PRESENT SELF AWARENESS OF THE PAST SELF AWARENESS FOR THE FUTURE.

24 SELF AWARENESS IN THE PRESENT: UNDERSTANDING HOW CURRENT TENSION IN OUR LIVES EFFECT OUR PHYSICAL AND EMOTIONAL WELL BEING. SELF AWARENESS OF THE PAST: THE INFLUENCES THAT OUR PAST LIFE EXPERIENCES - GOOD AND BAD HAVE HAD ON OUR CURRENT WORK AND LIFE CHOICES. SELF AWARENESS FOR THE FUTURE: MAKING CHANGES NOW THAT WILL EFFECT OUR FUTURE PHYSICAL AND EMOTIONAL WELL BEING.

25 BE AWARE OF YOUR OWN PROCESS. EXTERNAL: THE WAY YOU INTERACT WITH THE REST OF THE WORLD (SECONDARY TRAUMA, VICARIOUS TRAUMA, POST TRAUMATIC STRESS DISORDER). INTERNAL: THE WAY YOUR BODY HOLDS THE TRAUMA EXAMPLES: ACTIVATION SPOTS IN PARTS OF YOUR BODY. UNABLE TO FALL ASLEEP AT NIGHT. LACK OF APPETITE. BINGEING ON COMFORT FOODS. A ADAPTED FROM TRAUMA STEWARDSHIP: AN EVERYDAY GUIDE TO CARING FOR SELF WHILE CARING FOR OTHERS, LAURA VAN DERNOOT LIPSKY WITH CONNIE BURK. ADAPTED FROM BRAINSPOTTING: THE REVOLUTIONARY NEW THERAPY FOR RAPID AND EFFECTIVE CHANGE, DAVID GRAND PHD

26 IN BOTH THE PERSONAL AND PROFESSIONAL REALM, MINDFULNESS IS ABOUT THE ABILITY TO RECOGNIZE AND BE AWARE OF YOUR PHYSICAL SYMPTOMS OF STRESS AND ANXIETY, AND YOUR BREATHING.

27 THE PARALLEL PROCESS WHEN A TRAUMA IS SHARED BY A GROUP, EACH PERSON HAS THEIR OWN TRAUMA HISTORY WHICH MAY IMPACT THEIR REACTION TO THE CURRENT TRAUMA. BASED ON OUR TRAUMA HISTORY, WE MAY SHARE SIMILAR OR DIFFERENT REACTIONS TO THE TRAUMA WITH THE PERSON WE ARE HELPING. THIS PROCESS MAY PARALLEL THE STUDENT OR CLIENT S PROCESS. BE AWARE OF YOUR REACTIONS INTERNALLY AND EXTERNALLY TO THE TRAUMA.

28 WITH SOME TRAUMA SITUATIONS, YOU MAY NOT HAVE THE LUXURY OF PROCESSING YOUR OWN NEEDS, IF YOU ARE RESPONSIBLE FOR HELPING OTHERS. USE THE BREATHING TECHNIQUES TAUGHT EARLIER TO HELP CALM YOURSELF AND FOCUS ON THOSE YOU ARE HELPING. NOTICE YOUR GROUNDING OR RESOURCE SPOT TO HELP YOU STAY FOCUSED. ADAPTED FROM COMPASSION FATIGUE, THE CRUCIBLE OF TRANSFORMATION 2002 ARTICLE, ERIC GENTRY DAVID GRAND BRAIN SPOTTING: THE REVOLUTIONARY NEW THERAPY FOR RAPID AND EFFECTIVE CHANGE

29 ACTIVITY PART IV PEACEFUL PLACE, PERSON OR ANIMAL: 1. PICK A PLACE WHERE YOU FEEL CALM AND PEACEFUL, LIKE THE MOUNTAINS OR THE BEACH. 2. IF YOU DON T HAVE A REAL PLACE YOU CAN MAKE ONE UP. IF THIS SEEMS TO BE DIFFICULT, TRY IMAGINING A FAVORITE PET OR A SPECIAL PERSON WHO BRINGS YOU COMFORT. 3. MAKE SURE YOU DO NOT EQUATE YOUR PLACE WITH ANYTHING BAD. 4. CLOSE YOUR EYES GENTLY AND BE AWARE OF YOUR BREATHING AS YOU THINK OF YOUR PEACEFUL PLACE.

30 NOW TAP ON THE TOPS OR SIDES OF YOUR KNEES (BILATERAL STIMULATION), THINK ABOUT YOUR PLACE, PERSON OR ANIMAL. NEXT, DECIDE ON A WORD THAT REMINDS YOU OF YOUR SPECIAL PLACE. YOU CAN USE YOUR WORD TO RECALL YOUR SPECIAL PLACE.

31 WHAT PERSONAL SET OF CIRCUMSTANCES, HELPED DEVELOP THE PASSION YOU HOLD FOR YOUR WORK? ONCE YOU UNDERSTAND AND EMBRACE YOUR PAST, YOU CAN USE IT TO STRENGTHEN YOUR CURRENT WORK SITUATION.

32

33 WAYS TO PROCESS YOUR TRAUMA HISTORY IF IT COMES UP: 1. MINDFUL BREATHING. 2. RESOURCE SPOT 3. WHERE IS THE ACTIVATION SPOT IN MY BODY? 4. BREATHING THE TENSION OUT OF MY BODY.

34 5. DEBRIEFING: WHAT DO WE SAY TO WHOM, AND WHEN. TALKING WITH A PEER, (WARNINGS OF THE CONTENT). 6. ASKING PERMISSION TO SHARE, LESS IS MORE DO WE REALLY NEED TO RECAP THE ENTIRE SESSION OR CAN WE JUST SAY, WOW! THAT WAS REALLY DIFFICULT FOR ME TO HEAR. 7. SEEK PROFESSIONAL HELP.

35

36 Transition time from work to home. Letting go of the work day and transitioning to your private time. 1. SPECIAL MUSIC FOR THE DRIVE HOME OR LISTENING TO A BOOK ON CD.. 2. STOPPING FOR COFFEE OR TEA BEFORE ARRIVING HOME. 3. TAKING A WALK FIRST. 4. GOING TO THE GYM FIRST. 5. STOPPING A BLOCK AWAY - MINDFUL BREATHING, RESOURCE SPOT, GROUNDING.

37 Self Care: Four Steps to Wellness. 1. TAKE STOCK IN YOUR BODY, YOUR HOME ENVIRONMENT AND WORK PLACE. BODY SCAN - WHERE IS THE TENSION? 2. LIFE /WORK BALANCE. WORK HARD... PLAY HARDER. 3. REFUELING DURING THE DAY: MINI BREAKS, PEACEFUL PLACE, MINDFUL BREATHING, SOOTHING MUSIC, SOOTHING SOUNDS, BILATERAL STIMULATION, PLANNING TRIPS FOR VACATION

38 4. RESILIENCY THROUGH RELAXATION TRAINING, WALKING, YOGA, OR MEDITATION TAPES. 5. MAKING A COMMITMENT TO CHANGE. 6. YOU CAN HOLD YOURSELF ACCOUNTABLE TO OTHERS. 7. WRITE DOWN AN AREA YOU WOULD LIKE TO CHANGE AND PLACE IT WHERE YOU CAN SEE IT EACH DAY. 8. CREATE A MANTRA THAT REMINDS YOU OF THE CHANGE.

39 STOP USING REWARDS AS A WAY TO PAY YOURSELF BACK - IN DOING SO, YOU MAY BE SETTING UP TENSION WITH YOURSELF THAT MAY BACKFIRE IF YOU WANT IT AND YOU KNOW IT S HEALTHY, THEN HAVE IT BECAUSE YOU WANT IT.

40

41 RECAPPING OUR STRATEGIES: MINDFUL BREATHING PAYING ATTENTION TO YOUR BREATHING EXTERNAL RESOURCE SPOT BODY SCAN - WHERE AM I HOLDING THE TENSION (ACTIVATION SPOT.) PEACEFUL PLACE, PERSON OR ANIMAL BILATERAL STIMULATION

42 WE NEED TO DEVELOP A SUPPORT SYSTEM FOR OURSELVES. WE CAN NOT WORK IN A CARING PROFESSION IN ISOLATION. WE MUST DEVELOP AND RELY ON SYSTEMS AND TOOLS TO SUPPORT US IF WE PLAN TO CONTINUE THE WORK FOR A LONG PERIOD OF TIME.

43 OUR CAPACITY TO HELP OTHERS AND THE ENVIRONMENT IS GREATEST WHEN WE ARE WILLING AND EVEN DETERMINED TO BE HELPED OURSELVES.

44 BE THE CHANGE YOU WANT TO SEE IN THE WORLD. - GANDHI.