Advancing Compassion Resilience. Jason Mims Parklawn Assembly of God and Emptrain Sue McKenzie WISE and Rogers InHealth

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Advancing Compassion Resilience Jason Mims Parklawn Assembly of God and Emptrain Sue McKenzie WISE and Rogers InHealth smckenzie@rogershospital.org

Goals 1. Explore compassion and the experience of compassion fatigue from individual and systems perspective 2. Analyze the impact of trauma on providing compassionate care 3. Learn skills of compassion resilience

Relevance

What is Compassionate Action? Combined from the works of Monica Worline and Jon Katzenbach, Carolin Oelschlegel, and James Thomas 1. Notice Be present in the moment and able to recognize signs of distress. 2. Self-check - Be aware of your emotional resonance and initial cognitive appraisal. 3. Seek to understand Suspend appraisals. Listen for understanding. Move towards generous interpretations of another s behavior. 4. Cultivate compassion Genuine concern develops based on what you come to understand. This leads to a growing desire/intention to help. 5. Discern best action Work with the person to figure out what would actually be helpful to them rather than what you think would be helpful or was helpful to you in past, similar circumstances. 6. Take action Be aware that intention alone is not compassionate action.

Compassion Fatigue Secondary trauma and burnout Gradual lessening of compassion over time Avoid trying to understand what people face Become less effective in our roles Life satisfaction decreases 5

Compassion Fatigue s Path Leave Profession Compassion Resilience Renewal vs Pathology Zealot We are committed, involved, and available, Ready to problem solve and to make a difference, We are willing to go the Irritability extra mile and often do so without prompting Overwhelmed, Leaving the profession, Somatic illness, Chronic symptoms or Hardiness, Resiliency, Transformation Zombie Anger and cynicism, Diminished creativity, Sadness, Feeling helpless or hopeless Withdrawal A sense Inability that you to can t embrace complexity, ever do enough, Chronic exhaustion, Inflated Physical sense of illness, importance, Difficulty empathizing, Hyper-vigilance/ Feeling numb to other s pain, Sleeplessness, Absenteeism Sense of persecution (Cycle is from work of Eric Gentry, PhD 2012)

Important Reminder Compassion fatigue is a NORMAL response to complex and overwhelming circumstances.

Complications of Trauma Prefrontal Lobes Rational thoughts What can I learn from this? Limbic Emotions Am I loved? Brain Stem Survival instinct Am I safe?

The Cycle of Trauma

If I really wanted to do something, I would be able to. self esteem I am not good. sense of efficacy I am not able. Avoidance, anger and apathy So, why try! Feelings of Shame

How does compassion fatigue show up? In you? With whom or in what situations are you most challenged to approach with compassion? Where do you see compassion fatigue in your organization? ProQOL

System Drivers of Compassion Fatigue

Building Our Compassion Resilience The power to return to a position of empathy, strength, and hope after the daily/hourly witnessing of the challenges people face. To be able to feel optimistic in an imperfect world

Strategies to Build Compassion Resilience: 1. Realistic expectations of yourself and others What is enough and what can I hope for? Exposure to recovery! 2. Compassionate boundary setting 3. Culture of connection with colleagues, others in community, and clients natural supports 4. Self-care strategies Mind, Spirit, Strength and Heart

Expectations 1. What positive role do expectations play? 2. What impact has your unrealistic self-expectations had on your well-being? 3. What has the impact been of others unrealistic expectations of your capacity? 4. How do you assess if expectations are being set at a helpful aspirational level?

Expectations: Remind ourselves of the resilience in our clients and colleagues

What do we know about our colleagues? When do you feel most alive, most like yourself? What are you doing? What or with whom are you surrounded?

And then I learned the spiritual journey had nothing to do with being nice. It had to do with being real and authentic. Having boundaries. Honoring and respecting my space first, others second. And in this space of self-care, being nice just happened, it flowed not motivated by fear, but by LOVE. By Michelle Olak Section 6: Compassionate Boundaries

Tips for Setting Compassionate Boundaries 1. Know what you want to say Yes to in your life (values and priorities). 2. Be proactive. Have meetings to discuss boundaries. Structure offers safety for both sides. 3. Just say it! Don t make them guess. Use simple and direct language. 4. Reinforce by pointing out the violations or near violations IN THE MOMENT. 5. Give explanations that are specific, relevant to the other person, and offer shared solutions. 6. Back up your boundary with action. If you give in, you invite people to ignore your needs.

Group Culture - Connect with colleagues and others in the community Do we have a culture agreement? What are my limitations (my role, skills, current capacity, etc.) to meet the person s expressed desires/perceived needs? What organizations or colleagues can offer services that I cannot? What is my level of belief in the capacity of others on my team? What do I need to do to increase my knowledge of and belief in the capacity of others?

A Mindfulness Strategy Commonalities Step 1: Just like me, this person is seeking happiness in his/her life. Step 2: Just like me, this person is trying to avoid suffering in his/her life. Step 3: Just like me, this person has known sadness, loneliness and despair. Step 4: Just like me, this person is seeking to fill his/her needs. Step 5: Just like me, this person is learning about life.

Care for Self

HEART Relationships: create and maintain healthy connections with others in your life Emotions: express your emotions and receive others emotions in a healthy way MIND Work: get the most out of educational, volunteer, and employment opportunities Organization: manage time, priorities, money, and belongings SPIRIT Core Values: develop a personal value system that supports your sense of meaning and purpose Rest & Play: balance work and play to renew yourself STRENGTH Stress Resilience: deal positively with the challenges of life Care for My Body: build healthy habits around your physical well-being, and to end unhealthy habits

Out of Balance? 1. Say no to someone or Physical Your first clue something 2. New perspective 3. Adjust lifestyle Emotional

Self-Compassion Extending kindness to ourselves in instances of perceived inadequacy, failure, or our own general suffering. http://self-compassion.org Kristin Neff

Reversing Shame and Blame When I am Known, Included and Supported Compassion fatigue I am good I am able I care for myself & others

A Break for our STRENGTH Pausing The Breathe Video https://www.youtube.com/watch?v=rva2n6tx2cg

Next Steps Building My and My Organization s Capacity for Compassion Resilience Knowledge How is this information shared with colleagues? Recognition Use of ProQOL and Self-Care Assessment on a regular basis? Response What expectations need clarified and modified? How do I regularly expose myself and my colleagues to resilience of those we serve? What boundaries need to be discussed, re-assessed, reinforced, revised? What do I need to know about organizational and community resources? What can I say no to in order to say yes to that which sustains my selfcare balance? What would meaningful support of self-care look like in my organization?

Thank-you for the relationships you build and the strategies you implement that improve the present and future lives of children, adults, and families. Compassionresiliencetoolkit.org WISEwisconsin.org Resilience clips found at: RogersInHealth.org