UNDERSTANDING COMPASSION FATIGUE Taking Action to Prevent Parent Partner Stress Overload Beverly Kyer 2011 California Parent Partner Leadership Conference Topics that will be covered The damaging effects of Compassion Fatigue (aka) Stress overload Professional and personal impacts Stressful experiences taken for granted yet our bodies keep the score. Internal & external conflicts: self- regulation Recognize early warning signs of stress overload in yourself and others in your circle of colleagues, friends and acquaintances. Factors that cause CF and burnout Taking action; plan strategies for self care. Beverly Kyer 2 What is Compassion Fatigue? AKA Vicarious or secondary Trauma Compassion Fatigue is a syndrome which consists of various symptoms that mirror Post Trauma Stress Disorder (PTSD). PTSD is a disorder that affects people who have experienced extreme traumatic or violent events in their lives. People who have experienced natural or man made disasters; victims of violent crimes, domestic violence, child sexual or physical abuse. What is Compassion Fatigue? AKA Vicarious or secondary Trauma People who develop the disorder report episodes of fear, depression, confusion, helplessness, hopelessness, feeling out of control, extreme mood swings, avoidance behaviors, etc. It is a natural occurrence as the result of psychic injury and/or a life threatening event for most people. People who develop Compassion Fatigue have not been direct victims of trauma, but have associated with people who have. It is the cost of caring Beverly Kyer 3 Beverly Kyer 4 Who can get Compassion Fatigue? People who provide care assistance and support to others in pain, either physical or emotional, tend to be empathetic and compassionate. These necessary qualities that help them to do their jobs, place them in the direct path of experiencing secondary trauma AKA compassion fatigue reactions. Many helping parents and professionals as a result of listening to stories or witnessing the aftermath of traumatic events could develop many of the same symptoms associated with Post-Trauma Stress Disorder including symptoms that are more insidious. Burn out Stems from overwhelming demands of tasks. Does not come close to the impact of vicarious trauma The distinction is the sympathy/empathy caregivers experience from the suffering of others. Where children are concerned, this is often outside of the realm of what we expect as caring human beings Burnout has a better prognosis for recovery. Beware the combination of both CT and Burn out. Beverly Kyer 5 Beverly Kyer 6 1
Causes and Triggers of Compassion Fatigue Working with adults and particularly children who are victims of trauma or violence. Lack of training in dealing with issues of trauma or violence and it s s subsequent outcomes. High ideals of making a difference in the lives of children and adults. Personality traits of compassion and empathy. Past histories of trauma or victimization in the worker. Lack of consistent self-care behaviors and habits. Working with large numbers of traumatized and/or victimized people Stop and reflect on this If trauma is not quickly integrated and the changes in the anatomy, biology and neurology become chronic, it makes people more vulnerable to such events in the future. The body loses its natural rhythms for regulating arousal and relaxation; entering a seesaw between hyper arousal and hypo arousal; moving the person from explosive emotions to numbness fatigue, detachment and isolation. Let s share in a discussion to anchor your understanding Beverly Kyer 7 Beverly Kyer 8 Critical Brain Systems Orbitofrontal Cortex (Social/Emotional Control Center) Pituitary Gland Amygdala Neural Circuitry Brainstem (Lower Limbic/Reptilian) Hippocampus Spinal Cord (Lower Limbic/Reptilian) Adrenal Glands Beverly Kyer 9 The Professional Impact of Compassion Fatigue. Low morale Low motivation Avoiding task Obsession about details Apathy Negativity Lack of appreciation Detachment Poor work commitments Staff conflicts Absenteeism Exhaustion Irritability Withdrawal from colleagues Loss of confidence Beverly Kyer 10 Personal Impact of Compassion Fatigue COGNITIVE EMOTIONAL BEHAVIORAL SPIRITUAL INTER- PERSONAL -Confusion -Spaciness -Trauma imagery -Rigidity -Apathy -Self-doubt minimization -Anxiety -Emotional rollercoaster -Anger/rage -Numbness -Overwhelmed -Fear -Depression -Depleted -Sadness -Thoughts of -Survivor s self-harm or guilt harm to others -Disorientation -Clingy -Moody -Nightmares -Impatient -Appetite changes -Hypervigilance -Elevated startle response -Use of negative coping -Sleep disturbances -Loss of purpose -Anger at God -Questions -Prior religious beliefs -withdrawn -Over protective -Mistrust -Decrease in intimacy/sex -Isolation -Projection of anger/blame -Pervasive -Intolerance hopelessness -Loneliness PHYSICAL -Aches/pains -Shock -Dizziness -Breathing difficulties -Somatic complaints -Impaired immune system -Rapid heartbeat Beverly Kyer 11 Team Stress Feud Identify the Symptom 1. Poor concentration 2. Preoccupation with trauma 3. Overly sensitive 4. Accident proneness 5. Questioning the meaning of life 6. Increased interpersonal conflicts 7. Sweating 8. Chronic and intensifying physical illness 9. Perfectionism 10. Losing things 11. Mistrust 12. Loss of faith Beverly Kyer 12 2
The body keeps score of the small things especially Examine stressful scenarios Exercise on personal examples Our challenge Care professionals Care providers Care givers are often trapped in this role and personal identification which leaves us bereft of asking for help Beverly Kyer 13 Beverly Kyer 14 A POTENTIAL CONSEQUENCE OF WORKING WITH TRAUMATIZED PEOPLE Narrative The Road to Wellness The power of story and the restorative quality of personal self awareness clearly aids in rebuilding life quality. Let s s take the test The story becomes a component of the journey back to wellness. Herman,1992; Dietrich et al, 2000 Tell the story of why; the gift of your heart; the love A Beverly Kyer 15 Beverly Kyer 16 Cognitive Restructuring What we say to ourselves creates an internal environment in which we either flourish of flounder. We must challenge our internal dialog to create a peaceful inner world. call those things that be not as if they were Cognitive Restructuring 1 st line of defense: stress inoculation; a process to build up positive thoughts when negative events are encountered. The aim is to modify the internal dialog Focus on yourselves: where am I in the moment. Label your feelings and link to physiological response Regulate self with positive spin; block toxic thinking (examples) Look beyond the immediate and move to general themes and patterns: Beverly Kyer 17 Beverly Kyer 18 3
Cognitive Restructuring Phase 1: INPUT (sight or sound) Phase 2: PROCESSING INPUT conscious interpretation reasoning analyzing memory Phase 3: OUTPUT (action or behavior) You are making a conscious appraisal of the stimuli while blocking toxic thoughts Meichenbaum Developing a Therapeutic Community Reaching out to others who will: lift us and validate our self care habits hold us accountable for our self care support our sense of resilience not allow us to isolate who nurture us Who delightfully immerse us in humor Beverly Kyer 19 Beverly Kyer 20 Stress Reduction Stress relief: Funny Stress Management EXERCISE Creating Your Own Private Sanctuary to Heal Everyday Everyday strategies for self care Realize the mind-body connection Talk it out/process with someone Discharge and Recharge Self-sooth and pamper (sanctuary time) Breathing techniques (3 6 technique) Spiritual feeding and lifting Being accountable to someone who cares Beverly Kyer 21 Beverly Kyer 22 Preventing Secondary Traumatic Stress Disorder TOOLS FOR THE ROAD Personal Individual Professional Cognitive Negative Awareness Relaxation Mindfulness Journaling Creating Narratives Exercise Dance Therapy Classical Music The Arts Reading Feeding your Spirit Thera-play Nutrition Balance Boundaries/Limit Setting Getting Support/Help Physical Social Plans for Coping Body Work Social Support Professional Training Sleep Getting Help Evaluation of Own Healing Nutrition Activism Job Commitment Replenishment Psychological Life Balance Relaxation Contact with Nature Creative Expression Skill Development Meditation/Spiritual Practice Self-awareness Humor Environmental Beverly Kyer 23 Societal Education Strategies Coalition Building Legislative reform Social Action Work Setting Physical Setting Value system Job Tasks & Personnel Guidelines Beverly Kyer 24 Supervisory / Management Support Collegiality 4
Creating Your Own Sanctuary Take action Intentional and Structured Self Care Design your space and state your plans Beverly Kyer 25 5