Our hearts are too full of grief to care.
Rachel Remen, MD
Kitchen Table Wisdom
Happy Autumn! And it's a busy one already with two workshops finished before the end of September. I hadn't actually realized how little I knew about the lives of funeral service professionals (medical examiners, mortuary technicians, funeral directors, embalmers, advance planners, crematory operators, cemetery operators and others) until I facilitated two Caring On Empty workshops for the wonderful folk of the BC Funeral Association this month.
Like many, I have to admit, I have occasionally endorsed stereotypes of money-hungry morticians out to bilk the public in their time of need and have participated in story-telling about crusty, unempathic, funeral personnel.
Now, I must say, my eyes are opened. I'm developing a deep respect for these professionals whose work involves constant exposure to loss, grief and trauma; who frequently work with insufficient resources; and who carry all the stresses of running either a 24/7 small family business or trying to provide empathic care within a large impersonal corporate structure focused on profit.
These death care professionals are rarely included in our lists of people at risk for compassion fatigue and yet their risk factors are great indeed. In a 2014 survey of 57 respondents from multiple countries done by author and blogger, Katie Hamilton, funeral directors identified the following emotional impacts of their work:
- Daily encounters with multiple traumatic images, smells and stories that are difficult to dispel.
- The stress of dealing with the emotionally-charged dynamics of devastated family members who may resent paying for funeral services or who cannot afford those services.
- Coping with the physical impacts of sleep deprivation and undervalued self care.
- Exhaustion due to 24/7 availability to clients and families and the subsequent sacrifice of their own family life - and the tension between the two.
- Dealing with inherent family tensions while trying to run a family business.
- Working for a large firm whose values do not align with your own and the resulting lack of support.
- The stress of dealing with multiple external professionals - clergy, physicians, coroners, police. (This is an issue of time, administrative details, interpersonal stress, and having to repeat death details multiple times thus increasing trauma exposure.)
- The profound sadness of certain deaths - gruesome circumstances, infants, children, young people, suicides. And the expectation that "professionals" will not show their emotional responses.
- Being socially isolated from the general population by the nature of your vocation.
Other stressors noted by those in the field include a lack of debriefing opportunities after a bad death, personally knowing those you tend or recognizing that they are a friend of your spouse or child, gender bias within the profession (women are "too emotional" to hire or promote and are relegated to paperwork and tidying / "real men" don't show tender emotions), and having to keep clients' family secrets - such as the nature of a death - especially in a small community.
These risk factors can result in the familiar signs of compassion fatigue and accumulated grief - cynical sarcastic humour (as opposed to healthy black humour), irritability and impatience, chronic sadness, defensive cheerfulness and hyperactivity, chronic physical complaints, heavy drinking, loss of empathy and compassion, family breakdown and emotional disengagement from co-workers and the very people you're trying to help. Ultimately, many decide to leave a once-loved profession or go on to depression and, rarely, suicide.
Some resilience strategies discussed in the workshops this month included:
- Creating an ongoing resilience plan and meeting regularly with a self-care buddy to review your progress and gain encouragement.
- Advocating for, and using, a good Employee Assistance Program, separate from the workplace, that understands the nature of your responsibilities.
- Making use of new technologies to reduce your time at work and on call - pagers and smart phones, informative websites, a good answering service to screen calls, software programs for obituary placement and death certificate filing.
- Delegating responsibilities - eg hiring an appropriate removal company.
- Balancing your death focus with a life focus - gratitude journalling, outdoor activities, nourishing hobbies, regular downtime with your family and friends, vacation time where you're geographically away from your workplace.
- Focusing on the joy you can find in the work (Compassion Satisfaction)
- Healthy eating and regular aerobic exercise.
- Monitoring alcohol intake and noticing when you're using it and for what purpose.
- Intentionally building and maintaining a nurturing spiritual life.
- Creating a professional support network of 4 or 5 people who will be consistently warm, accepting and supportive when called upon.
- Avoiding re-traumatizing each other with competitive story-telling at conferences and other gatherings. (ie Leave out the gory details!).
Serving and supporting others through their worst and most tragic days is a rewarding, but not necessarily an easy occupation. So, next time you see one of your neighbourhood death care professionals, why not take a moment to shelve any stereotypes and give them a smile. I'm sure they'd appreciate the support.