Compassion Fatigue: Trauma, Burnout, And Resilience Christen Kishel, PhD Psychologist
What is Your Vision?
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Why do we lose good people? Compassion Satisfaction Burnout Traumatic Stress
PTSD in Specific Populations PTSD PREVALENCE: 10-15% of Law Enforcement Personnel (see Everly & Mitchell, 1999) PTSD PREVALENCE: 10-30% of Those in Fire Suppression (see Everly & Mitchell, 1999) PTSD PREVALENCE: 16% Vietnam Veterans (Nat PTSD Study) PTSD PREVALENCE: ~12% Iraq War Veterans (NEJM, 2004) ~ 20-25% for PTSD, depression, and other problems combined, but: 2 nd deployment to Iraq/Afghanistan=19% 3 rd deployment to Iraq/Afghanistan=33%
CRITICAL INCIDENTS are unusually challenging events that have the potential to create significant human distress and can overwhelm one s usual coping mechanisms.
Tunnel Vision Common Responses During Critical Incidents Auditory Exclusion Visual Exclusion Time Distortion Pounding Heart Rapid, Shallow Breathing Nausea/wretching feeling
More common responses during critical incidents Quicker Reaction Time Heightened Visual Clarity Dissociation Temporary Paralysis (freezing) Automatic Behavior Insensitivity to Pain
Common Responses After Traumatic Events Insomnia, nightmares Fatigue Restlessness or nervous energy Headaches and other aches and pains Dizzy spells and/or heart palpitations Trouble concentrating Appetite change/stomach upset Jumpiness or being easily startled Irritability or anger Flashbacks or reliving the event Feelings of anxiety or helplessness Feeling vulnerable Feeling numb or detached Traumatic reactions usually grow less intense and may disappear within a few weeks.
Do s and Don ts of Coping with Do: Connect with your trusted supports- family, friends, peers, spiritual, etc. Give yourself permission to feel what you are feeling Take one thing at a time Eat even if you don t feel like eating Take refuge in routine Sleep (or at least rest) Exercise Know your limits and give yourself extra time to complete tasks Breathe Trauma Don t: Isolate or shut people out Make alcohol your primary coping tool Make major decisions right away Forget that you are not alone and that what you re experiencing is most likely normal and temporary
Factors contributing to burnout Public perception/disparaging media coverage Boredom On-the-job stress Physical threats Lack of support Organizational pressure The revolving door Giving, giving, and more giving Overtime Part-time jobs
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Contributing Factors Continued Family Problems Financial Problems Health Problems
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How do you know you re in burnout?
R.O.D. (Retired On Duty) Doing as little as possible while at work Jaded/cynical Fatigued Sick a lot High level of absenteeism Alcoholism/addiction of any kind Irritability Isolation Withdrawal Anxiety Suicide
Excessive blaming & complaining Bottled up emotions Poor self-care (i.e., hygiene, appearance) Re-occurrence of nightmares and flashbacks to traumatic event Legal problems, indebtedness Apathy, sad, no longer finds activities pleasurable Difficulty concentrating Preoccupied In denial about problems Can t leave work at work
Building Resilience: It may seem simple, but that doesn t mean it s easy! Keep things in perspective: do you live to work or work to live? Leave the job at work and become a normal human but your family needs to understand who you are as a firefighter, so you don t need to protect them from that. It s a tricky balance!
What Can You Do? When you can leave: Have a work-to-home routine Exercise Eat well Have friends in other professions Sleep See the doctor Avoid self-medicating Ask: Do I really need a part-time job? On-the-spot: Recognize and acknowledge your stress Take a moment to breathe Catch your thoughts & make a mental adjustment Take a few minutes to yourself Vent Laugh Remember that you are in control of your happiness
Questions you might consider: Self-Reflection: Why am I here? Are You Overcommitted? Are there Opportunities for Change of Duties? Are You Investing in Yourself? Are You Advocating for Your Needs? Do You Offer Positive Ideas? Are You Willing to Talk?
And What About Our Family? AAA Plumber, Electrician, Handyman Childcare Spousal Support Understanding vs. Excusing Vicarious Trauma Life in the First Year 30
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How to reach me: ckishel@spokanefire.org drkishel@gmail.com (509) 993-8301