Friday, February 27, 2009

The Silencing Response - A Symptom of Compassion Fatigue

Working in highly charged, disturbing environments and with people who have been seriously injured, ill or traumatized, exposes us to experiences, stories, thoughts and feelings that are potentially overwhelming because they are beyond our scope of comprehension, our desire to know or our sense of competency. When we become overwhelmed in this way, our ability to remain present and to listen to the pain of others is compromised and we are likely to draw on the Silencing Response (SR) for our own protection.

The Silencing Response is defined by traumatologists, Anna Baranowsky and Eric Gentry, (2006), as "a reaction ...which guide(s) the caregiver to redirect, shut down, minimize or neglect the disturbing information brought by an individual to the caregiver." In other words, when we are already emotionally overwhelmed, we find ways to silence others' painful stories so that their pain doesn't add to our trauma load. This is an effective form of self protection in one sense but in another, it can add to our feelings of guilt and shame as we realize that we are not the empathic listeners we used to be. And it keeps us from being effective helpers.

Here are some signposts, taken from the work of Baranowsky and Gentry, that can help us to determine whether we are using the Silencing Response as a defense in our conversations:

1.  Changing the subject away from painful material

2.  Avoiding a topic

3.  Providing pat answers

4.  Minimizing others' distress

5.  Wishing/suggesting that the other would "just get over it"

6.  Being angry or sarcastic with care recipients

7.  Using humour to change or minimize the subject

8.  Faking interest or listening

9.  Fearing what the client has to say or feeling numb before an interaction

10.Blaming or not believing others for their circumstances

11.Not being able to pay attention to what the person is saying or feeling bored

The up side to behaviours like the Silencing Response is that they act as smoke detectors to warn us of the need for action before the fire of Compassion Fatigue gets out of control. When we use this warning to motivate an investment in extreme self care and some good trauma therapy we can begin to recover, both for ourselves and those we serve.   


Wednesday, February 18, 2009


I am back, refreshed, from a wonderful retreat at the Bethlehem Retreat Center in Nanaimo, BC. The weather was crisp and sunny and Westwood Lake was covered with ice. I balanced my time between being quietly alone at the guest house and attending community prayers and dinner with my friends at the House of Bread Benedictine Monastery. As always, my body and mind relaxed completely in the quietness and the concerns and busyness of life in the city seemed far away.

Early on my last morning there, I sat by the window watching the sun rise to bathe the peak of Mount Benson and to awaken the three llamas sleeping under the bare fruit trees in the field behind the guest house. I drank a cup of tea and thought about the community of women who had created this lovely place of peace and about the importance of community in all our lives.  

Some people define  community as a group of interacting people in a common location (this was obviously prior to the internet!) and others define it as a group that is organized around common values. Whatever our definition, we all belong to a number of communities -  our personal community of friends, the soccer community, our faith community, the caregiving community, the university community, the equestrian community, the environmental community, and so on.  

We are hardwired for community, for belonging, and when we lose our sense of community our health suffers. Dean Ornish, MD, President and Director of the Preventive Medicine Research Institute at the University of California's School of Medicine in San Franscisco, spent his life studying heart disease and wrote a book called, Love and Survival: The Scientific Basis for the Healing Power of Intimacy (1997). In an interview with Bill Moyers, he said, "I am coming to believe that anything that promotes isolation leads to chronic stress and, in turn, may lead to illnesses like heart disease. Anything that promotes a sense of intimacy, community and connection can be healing."

So, what do we do when life's busyness makes connecting with loved ones seem difficult or impossible? How do we maintain this piece of our mental, physical and spiritual health?

The first step is intention; we become clear that we want to maintain certain relationships (- and that we may need to let go of others  for a while). Then we make a realistic plan for keeping in touch. My husband developed what he called his Keeping in Touch (KIT) List. On it were the names of the 4-6 people with whom he wanted to stay in touch, even if life was very busy. He kept the list on his desk and made sure that every 10 days to 2 weeks, he sent them a note or called them on the phone or had lunch or a cup of tea with them. Sometimes, all he had time for was a quick voice mail message or a quicker prayer but he honoured his intention to stay connected.

Family caregivers in the Well Spouse organization in the US send each other round robin letters or emails with short or long entries written when they have a free moment and then sent on around the circle. It doesn't have to be much, just as long as whatever you do allows you to feel connected with your community. As the Sufi poet, Rumi, said in the thirteenth century:

There is a community of the spirit.
Join it, and feel the delight
of walking in the noisy street, 
and being the noise...
Why do you stay in prison
when the door is so wide open?

Sharing life, no matter how difficult, eases the stress and lightens the load. Try it and see.... 



Thursday, February 12, 2009

Going on Retreat...

Tomorrow I leave Vancouver for a four day personal retreat and I can't wait to go. There's nothing better than taking time apart from the busyness of day-to-day life to rest, to reflect, to clarify, and to renew.

I've been answering an inner call to retreat since I was very young. Whenever life became too hectic at home I would take an apple and my book and wander into the woods where I could spend hours walking my favourite paths, sitting in my favourite tree and just be-ing in the quiet. Eventually, I would return to the world, centered and at peace once more. 

Retreats come in all shapes and sizes. An hour pulling weeds in my rose garden. A few moments in the quiet darkness of my front porch, staring up at the night sky. A few days apart from my normal environs, surrounded by the beauty of nature, either with a pack on my back or in the comfort of a comfortable retreat house. Years ago, my husband had a regular arrangement with an elderly friend to spend a morning, once a month, in her spare room, resting, thinking, meditating and writing. At noon, Doris would tap on the door to announce that she'd made him a bowl of soup and a sandwich. They would have a quiet lunch together and then my husband would leave, refreshed, to go on with his life.

There are many times in life when a retreat can be helpful. During times of transition or celebration when we want to fully experience the moment. At times when we yearn for space apart to refresh and renew. During times when we seem to have lost our true selves and need to reconnect. When we feel stuck in making a decision or finding the right path. When we are longing for room for creative expression and inspiration. When our God seems far away. When we need time to grieve and to heal.

Whatever our reason for wanting a retreat, the major obstacle to accomplishing our intention is often in our own minds. How many of us have known, deeply, that we needed some time apart only to follow that thought with one of the following:

- I can't afford it.

- It would be selfish or irresponsible to take time for myself right now.

- My friends would think I'm crazy.

- I don't have the time!

- I haven't been alone for so long that it feels a little scary.

- If I leave my husband (child, wife, parent), something terrible might happen.

My personal experience is that if I commit to taking time away -ie choosing dates- I am able to find my way through most barriers that may arise. There will always be the fears of the unknown, but in the all years that I feared leaving my husband to get the rest I needed, nothing catastrophic happened. And if it had, it wouldn't have been because I had gone on retreat, but because he had severe heart disease.

So, take some time today to examine your own life.  Do you need a rest, some quiet moments to think or a geographical change to gain some objectivity? If you do, consider the type of retreat you would be able to undertake, choose a date and then make a commitment to follow through.  You might find, as I did, that after the allotted days are over you are still wanting more.

Photo by Janet Ritchey    




Tuesday, February 3, 2009

The Peace of Wild Things...

This has been a sad week.  A dear friend, who has had three strokes in ten days, is now paralyzed down her left side and is fighting valiantly against pneumonia. I grieve for her many losses and I grieve for her family and friends who can no longer communicate with her in familiar ways. I grieve for the possibility of life without her.

Normally, I would go and walk by the Lake to ease the sadness, knowing that Nature would draw me from my grief into her quiet embrace. Unfortunately, I have developed either a bone contusion or stress fracture in my right foot so I won't be walking at the Lake for a while. I yearn for the exercise, for calming scenes of beauty and for the healing peace of water and trees.

Thankfully, there is more than one way to connect with Nature. I have just finished reading one of my favourite poems, one that sustained me again and again as my husband was dying. Let me share it with you:

The Peace of Wild Things

When despair for the world grows in me 
and I wake in the night at the least sound
in fear of what my life and my children's lives may be,
I go and lie down where the wood drake
rests in his beauty on the water, and the great heron feeds.
I come into the peace of wild things
who do no tax their lives with forethought
of grief.  I come into the presence of still water.
And I feel above me the day-blind stars
waiting with their light.  For a time
I rest in the grace of the world, and am free.

Wendell Berry

For me, this is a poem of trust - trust that, regardless the complexities and pains of human existence, the peace of wild things is always available to soothe us, either in actuality or in memory. Trust that the day-blind stars are waiting with their light even, or perhaps especially, when we cannot see them in the daylight sky. Trust that even in our busiest, most grief-stricken days, if we breathe, and breathe again, we can return to rest in the grace of the world, and be free.