Sunday, January 24, 2010

Recognizing Respite...

According to the Concise Oxford Dictionary, respite - pronounced RES-pit, not re-SPITE, incidently - means "an interval of rest or relief" and, thus, is one of the most important aspects of self care for helpers who want to increase their resilience to burnout and compassion fatigue.

But what constitutes respite? A vacation away? Sending our kids away and staying home doing nothing? Time in our own gardens? An hour with a good book? A night on the town? Not answering the phone when the office calls about overtime this weekend? A soak in a hot tub? A regular early morning run?

The answer is "all of the above" - and more. We are learning, through conversations with many kinds of helpers, that respite is a highly individual experience. What provides "an interval of rest or relief" for one person can be an exhausting energy drain for another.

Much of what constitutes respite for a given person arises from his or her personality type. For example, an introvert, (someone who finds refreshment in the inner world of thoughts, feelings and mental images when depleted), will have very different respite needs from an extravert (someone who is drawn to the external world of people, places and things for renewal).

I am an off-the-scale introvert and when I am tired, what I need most is uninterrupted time alone in a quiet, peaceful environment. During the years that I was balancing a trauma therapy practice with family caregiving, I was told, seemingly continuously, about how important it was to "get out" and to "interact with people" in order to "reduce my isolation" and "get a break". That was the last thing I needed or wanted! What I ached to do was to spend time quietly alone, puttering in my own flower garden.

Unfortunately, respite-as-outcome or, put another way, respite as whatever makes YOU feel better, was not well understood in those days and home care regulations required that I leave our home whenever the home support worker was there to care for my husband. Not the best solution for my introverted soul.

It took a while, but eventually I sorted out a compromise that respected the rules but didn't wear me out. That compromise was to spend one full morning a week, alone, at the local Market, sitting at a small table, sipping a latte, and reading, writing letters or just staring out at the sunshine on the water and the happy red and white of the tugboats tied to the dock. It was a perfect solution for me - sights and sounds to feed my soul but absolutely no need to contribute my energy to anything. I didn't have to care for anyone but myself. It was sheer joy- such a wonderful gift, in fact, that I continue to do it once a week to this day.

What about you? What would create "an interval of rest and relief" in your life? It doesn't matter whether someone else would recognize it as such. It just matters that YOU would find rest and refreshment in that situation.

Photo by D Kirby.

Tuesday, January 19, 2010

Journalists as First Responders...

Health care and allied professionals are not the only caregivers to feel the effects of traumatic stress in their work. What happens when journalists, as first responders, are thrust into the role of temporary caregivers, responding to calls for assistance, helping to find resources, calming wounded trapped under the rubble?

We have seen the effects of traumatic stress in the faces and stories of countless reporters, camera operators, drivers and translators over the past week in Haiti. They are as much at risk for Compassion Fatigue as are the medics and the rescue teams. Perhaps more so, in some ways, because they are not trained or equipped to actively save lives, causing profound feelings of helplessness. Apart from the trauma of being physically present in such a disaster, they also live with the ongoing conflict between the responsibility for doing their jobs, getting the story out, and actively participating in the rescue.

Fortunately, despite the machismo for which journalism is famous, there is a growing awareness of the need for CF prevention and resiliency within the field, an awareness championed by such organizations as the Dart Center for Journalism and Trauma, a project of Columbia University Graduate School of Journalism. Their excellent website is well worth a visit by any journalists affected by the tragedies upon which they report and also by those who love and support them.

As physician, Rachel Remen, MD, says:

The expectation that we can be immersed in suffering and loss
daily and not be touched by it is as unrealistic as expecting to be able
to walk through water without getting wet. (1996)

Friday, January 15, 2010

Haitian Earthquake...

My heart goes out to the people of Haiti and to all who wait in an agony of uncertainty for news of loved ones. As the horror of the Haitian earthquake reverberates around the world, two important thoughts come immediately to mind:

First, that the way we can best help to ease suffering in that impoverished, broken but courageous land is to donate as much as we are able to established organizations such as the Canadian Red Cross who are able to make on-the-ground assessments and to purchase, in bulk, what is needed most.

Secondly, that it is important not to create a population of the secondarily traumatized here at home through our over exposure to scenes of injury and devastation in the media. Here are some suggestions for mediating the effects of this exposure:

1. Reduce the trauma exposure wherever possible.

Especially for those who are already trauma survivors, TV coverage of major traumatic events can have a magnetic pull. This is a time to consciously limit your trauma exposure based on your body's responses. If you notice that your heart is pounding, your muscles are rigid and you are holding your breath as you watch TV, that you're becoming frightened about your own safety or irritable with family and friends, that you're sleeping poorly or having intrusive images or nightmares like the ones in the media, it might be time to turn off the tube for a while. (Pacing your exposure before any of these symptoms occur is a good "ounce of prevention" as well).

Keep a particular eye on what your kids are watching and reading. Research shows a positive correlation between children viewing traumatic scenes and the development of PTSD symptoms.

2. Practice exceptional self care.

During a time of shock and horror, there are few things more important than focusing on good self care. Get enough sleep. (I heard a friend say that he'd sat up to 1:00 in the morning yesterday, watching the news.) Eat balanced, low salt, low sugar, low fat meals. Get the stress out of your body with some large muscle exercise. Maintain your spiritual practices. Talk or write about your feelings.

3. Engage in some comforting activities.

Think of things that have helped you to switch from "fight or flight" to "the relaxation response" in the past and do them. Walk in nature. Meditate. Pray. Spend time with children. Gather together with people you love, in person, on the phone, via the internet. Create in this time of destruction. Garden. Knit. Do woodwork. Paint. Write poetry. Cook. Dance. Listen to music. Write music. Chop wood.

Monday, January 11, 2010

What's Up....?

Happy New Year, everyone! Just a note to share with you some of the exciting happenings coming up in late winter and spring 2010:

1. Over the past few months I've had the pleasure and privilege of corresponding with American author and Certified Instructor of Journal to the Self, Barbara Stahura, who writes an excellent blog for people affected by traumatic brain injury, Journal After Brain Injury. She asked if I would be willing to write an email interview on Anniversary Reactions for her blog and I'm happy to invite you to read that interview, in two parts, in her past two blog posts.

2. It appears that we will be engaging with the dreaded HST sometime this summer so I am hopeful that my Little eBook on Chronic Sorrow will be available in September at the latest.

3. Inspired by the continuing positive response to the Caring on Empty Compassion Fatigue Workshops, I am in the process of planning the first two of the new Compassion Fatigue: Going Deeper workshop series: Going Deeper I: Understanding Your Reactions Through the Enneagram and Going Deeper II: A Compassion Fatigue Journalling Workshop. I hope to be able to offer the first workshop in the Vancouver area in late April or early May - watch this space for details!

4. I have had several requests for an Retreat for family carepartners in the Vancouver area. I would love to offer an overnight retreat but haven't yet found a suitable venue at a reasonable price. If anyone has or knows of a quiet, comfortable, restful space for a one or two day retreat that is accessible to folks in greater Vancouver, I would be very grateful to hear from you....

5. The Spring teaching schedule is filling but there are still slots available so if you are looking to spend your end-of-the-fiscal-year education funds in a way that will benefit both staff and patients/clients/families I invite you to contact me for a Speaker's Information Kit with workshop details and rates at or (604) 297-0609.

That's all for now. Remember to do one good thing for yourself today!

Tuesday, January 5, 2010

Promise ...

For many, the New Year is a time of promise and expectation, one of hope and possibility. But for some carepartners - family, volunteer or professional - the New Year seems to bring with it only fear and worry. Times are uncertain. Will my loved one suffer this year, or even die? Will I have the energy to keep going? Will my job be "re-structured" out of existence? Will I be able to continue caring in the face of so much loss and trauma?

In her excellent book, Daily Comforts for Caregivers, speaker and author, Pat Samples, responds to the New Year anxieties of family carepartners this way:

Hope seems out of reach. Yet I'd like to find a way to
keep a brighter outlook...

The truth is, I can't depend on anything "out there"
to create a sense of promise. That's an inside job. It's
possible I can find hope if I trust in the generosity
of life. Not that I can expect any particular outcome just
because I want it. But I can expect to find gifts in every
situation I face, no matter how difficult the circumstances seem.
My window on the world determines whether or not I notice them.
I could start the year by cleaning my window
and looking above the clouds.

When I let in more light, I see more promise.

I think Pat Samples' wise words apply to all who provide care for others, though years ago, in the midst of great emotional pain and physical exhaustion, it was hard for me to recognize these words as anything other than "sentimental drivel". (Forgive me, Pat!). Fortunately, with carepartnering can come growth and, today, I have learned how important it is to look for gifts in even impossible situations, not because they necessarily cancel out the anxiety but because they provide a counter-balance to it and are, thus, a source of energy and hope for the hour, day or year ahead.

So, in this first week of the New Year why not take a moment to write down a list of the gifts - large or small - that you've received through your experience of caring in the past year. And then let yourself feel the promise for 2010...

With every good wish for the New Year!