The ABCD's of Compassion Fatigue ...

Hi everyone!

Despite having spent a number of years teaching compassion fatigue workshops, I'm always surprised to discover how many people believe that compassion fatigue is "a form of burnout" to be "cured" with relaxing bubble baths and hikes in the woods. So, in today's post, I'd like to spend a little time going back to the ABCD's, the basics of compassion fatigue:

A definition:  

Compassion fatigue is exactly what the words say it is:  fatigued compassion. It is the symptoms of posttraumatic stress, diminishing empathy and emotional disengagement that arise from helpers' exposure to others' suffering and trauma.

CF occurs when primary traumatic stress (the trauma we experience directly in our own lives) converges with secondary traumatic stress (the trauma we experience indirectly through knowing about trauma and suffering in others' lives) in the presence of burnout (the chronic stress of perceived workplace demands exceeding perceived resources).

Compassion fatigue is essentially a trauma issue, a normal and expectable response to caring for others in pain. It is a condition of people who care deeply about the suffering of others and who work hard to alleviate it. (You don't find compassion fatigue in people who don't care.)

Compassion fatigue lies at the far end of the stress continuum. If left unattended, can lead to physical and mental illnesses including clinical depression.

 Beware of these warning signs:

The warning signs of compassion fatigue include, but are not limited to:

• loss of sense of humour 
• emotional numbness
• incivility / emotional reactivity (compulsive or impulsive reactions to perceived threats) 
• difficulty relaxing 
• difficulty separating work from personal life
• lowered frustration tolerance / increased outbursts of anger or rage
• dread of working with certain individuals
• negative changes in worldview - tendency to see the world as an unsafe place and others as "victims" or "predators"
• ineffective or self-destructive self-soothing behaviours (eg overuse of alcohol or other drugs, compulsive spending/exercising/eating etc)
• hypervigilance (constantly scanning the environment, looking for danger to self or others)
• decreased feelings of work competence
• diminished sense of purpose/enjoyment in career
• diminished functioning in nonprofessional areas of life (eg marriage, parenting etc)
• silencing response (consciously or unconsciously preventing others from sharing painful information with you because you just can't bear to hear it anymore)
• feeling depressed
• loss of hope 

  Any one of these warning signs could indicate the presence of compassion fatigue.

Create coping skills:

Because compassion fatigue is a trauma issue, healing and resilience-building must focus on helping us cope with the intersection of primary traumatic stress, secondary traumatic stress and burnout, at home (family caregivers) and in our workplaces (helping professionals and volunteers). Empowering compassion fatigue resiliency skills can be developed in each of the following areas:

• Self-regulation:  learning to intentionally control the activity and intensity of our fight/flight/freeze response while engaged in daily living.
• Intentionality:  learning to respond intentionally (vs reacting compulsively or impulsively), in keeping with our personal values and beliefs, in response to perceived threats.
• Maturing perceptions:  learning to shift the degree of perceived threat we see in the working environment.
• Connection and support:  developing an environment or network where we feel supported, heard and cared about by colleagues.
• Self-care and revitalization: becoming stronger and more mature so we are not diminished by witnessing and absorbing the pain of those for whom we care.

 Do something about CF resilience:

If you recognize yourself in these descriptions of compassion fatigue, NOW might be the time to do something about it. Why not JOIN US for the following workshop in Vancouver, BC to discover more and to build your own resilience plan:

• Caring On Empty: Creative Tools for CF Resilience (For helping professionals and volunteers):  June 16th and Nov 8th, 2014 

 You can email me for a brochure and registration form at caregiverwellness@shaw.ca  

          

The Work As Self Care ...

Hi everyone!

Many of us think of self care as something we do away from our caring work, in order to refresh and refuel. However, whether we're helpers in a professional workplace or family caregivers whose work lies within the walls of our own homes, there are things we can do while at work to rejuvenate and enhance our resilience.

Sometimes self care at work can be as simple as pausing for a few moments in the day to take some deep mindful breaths, eat a healthy snack, drink some water, go to the bathroom, wash our face and hands, rest quietly while gazing out the window at the natural world, connect deeply with a co-worker or go for a run up the stairs.

But how many of us think of the work, itself, as a means of self care, purpose and meaning? Many of us can forget that we chose the work we do because, at its best, it was so energizing and life-giving. As Rachel Remen, physician, healer and author of, Kitchen Table Wisdom, says:

No question that the medical system (in the USA) is seriously broken, but Medicine itself is not. Even on the most stressful and pressured of days there are moments in which we can experience something else, moments in which we connect to people on a very intimate level and make a difference to them and they to us. Times when, despite everything, we experience compassion, give and receive love, ease suffering and fear and are profoundly trusted. Instances when the greatness and courage of an ordinary person is suddenly revealed and we know ourselves to be in the presence of a hero. Or we recognize that we ourselves are heroes. No question that these experiences are brief, but they happen daily. And often they are life-giving - like taking single breathes of pure oxygen in the middle of a deep-water dive. There is a deep river of meaning that runs through the work of every health professional. It can sustain us in difficult times.

Rachel's wisdom does not apply only to those engaged in healthcare. The same could be said of first responders bringing people to safety, teachers reaching out to children who've been abused or neglected, clergy comforting the bereaved, therapists helping to heal emotional wounds, interpreters easing communication in a new land or family caregivers coordinating and providing care for loved ones.

If we can be mindful of the golden moments of human connection and compassion that brought us to our work in the first instance, and that are still available to nourish our hearts and souls today, we will both build our compassion fatigue resilience and bring a greater degree of humanity and caring to those we serve.

I think John O'Donohue understood this when he wrote his Blessing For Work:


May the light of your soul bless your work
with love and warmth of heart.

May you see in what you do the beauty of your soul.

May the sacredness of your work bring light and renewal
to those who work with you
and to those who see and receive your work.

May your work never exhaust you.

May it release wellsprings of refreshment,
inspiration, and excitement.

May you never become lost in bland absences.

May the day never burden.

May dawn find hope in your heart,
approaching your new day with dreams,
possibilities, and promises.

May evening find you gracious and fulfilled.

May you go into the night blessed,
sheltered and protected.

May your soul calm, console and renew you.

Music to Soothe the Savage Breast ...

             

Musick has Charms to soothe a savage Breast,

To soften Rocks, or bend a knotted Oak.

William Congreve 

 The Mourning Bride

(1697)

Do you want to calm the cacophony of thoughts and feelings filling your head and your "savage breast" after a long day at work -  or an even longer day's caregiving at home? Researchers say that making or listening to music can help calm your nervous system, boost your mood and reduce your anxiety. In fact, according to a review of 22 research articles, music alone and music-assisted relaxation exercises can significantly decrease nervous system arousal due to stress.

It doesn't seem to matter what kind of music you listen to. The important thing is that the music is a good fit for your individual musical preference, previous music experience, and the sort of stress response you're experiencing. (ie Upbeat music will energize you when you're feeling down and soothing music will calm you if you're feeling anxious.) That said, several studies have acknowledged the particularly effective soothing power of classical music.

We're not sure how music works its magic. Perhaps it is its ability to absorb our attention; perhaps, its capacity to distract us; or perhaps, its tendency to connect us with our emotions. However it works, adding music to our days can have a profound effect on our sense of well-being.

Over the years, I have compiled an eclectic list of musical pieces that is my go-to list for relaxation or a little cheering up. It includes, (and I'll really date myself here!):


To Calm and Soothe:

1.  Ladies in Lavender Soundtrack 

2.  Mozart for Mothers-to-Be

3.  Carolyn McDade's As We So Love

5.  The (British) National Trust's  "Time for Tea" Collection

6.  Enya's A Day Without Rain and Watermark

7.  Gloria: The Sacred Music of John Rutter

8.  Daniel Kobialka's  Fragrances of a Dream

9.  John Lennon's Imagine

10. Simon and Garfunkle's Bridge Over Troubled Waters

11.  Truly, Madly, Deeply Soundtrack

12.  The Rankin Family's We Rise Again 

13.  At Christmas:  Marty Haugen's Night of Silence ... 

  

 To Energize:

1.  Mozart's Clarinet Concerto

2.  Schubert's Trout Quintet

3.  Ketelbey's British Light Music

4.  Abba's Mamma Mia

5.  Simon and Garfunkle's 59th Street Bridge Song (Feelin' Groovy)

6.  John Denver's The Essential John Denver

7.  The Beatles

8.  The Beach Boys

9.  Carole King's Tapestry

10. Bach's Brandenburg Concertos 

What about you? Do you have favourite music for relaxing and getting recharged? How long is it since you've had a listen?

Self Care Ideas ...

Now that summer is here, the pace of life may slow enough that you can take time to assess and re-jig your self care plans. Here are some self care ideas assembled by the nursing and support staff from Alberta Children's Hospital - plus a few extras for good measure. See if there's anything here you might like to try or to share with your friends and family:

1. Meditate every day / do yoga

2. Meet a friend for coffee

3. Play frisbee with a pet / walk your dog

4. Spend some time in the mountains

5. Have a bonfire at the beach

6. Buy new lip gloss

7. Retail therapy

8. Have a hot bath with bubbles

9. Visit with someone you love by phone or on Skype/iChat

10. Snuggle under a quilt

11. Go to the airport early so you don't have to rush

12. Listen to loud music (or soft music)

13. Walk early in the quiet morning air

14. Get a haircut

15. Eat the samples at Costco

16. Work in a flower or vegetable garden

17. Go to Starbucks with a good book

18. Go for a long drive

19. Turn the TV off

20. Drumming

21. Have a clean house

22. Make popcorn

23. Mow grass or shovel snow

24. Plan a nice dinner

25. Hike or snowshoe

26. Have a family gathering (the functional ones)

27. Start a book club

28. Engage in a hobby - quilting, playing music, singing, knitting, reading, sports, painting, travel, writing, woodwork, car repair, digital photography, dancing, biking

29. Take a nap

30. Go away with friends

31. Clean the junk out of your pantry and buy fresh, healthy food

32. Laugh out loud - be willing to laugh at yourself

33. Notice and be grateful for the little things - your child's laughter, the colour of the sunset, the way your body moves

34. Plan your next vacation

35. Take yourself on a picnic

36. Be willing to receive

37. Make a list of 50 things that make you smile and post it where you can see it every day

38. Create a self care network of people who will encourage you as you improve your self care - your family, a self care buddy, members of a group to which you already belong

39. Spend an evening outside looking up at the stars

40. Explore ways to relax and become an expert

41. Create a special sanctuary at home - a room or a corner - where you can spend quiet time alone

42. Learn something new

43. De-clutter a closet or a drawer

44. Remember to breathe and breathe deeply

45. Make a gratitude journal and write down 5 things for which you're grateful every night before you go to sleep

46. Fly a kite

47. Roll all the way down a big grassy hill

48. Lie in tall grass and look at the sky

49. Pick flowers to make your surroundings look beautiful

50. Do some baking

51. Take a lovely bone china cup to work and have a quiet cup of tea and listen to soothing music for a few minutes every afternoon

52. Spend a day at the spa

53. Ask for a hug

54. Spend quality time with your partner

55. Tell someone you love them

86 Self Care Ideas...

Here are the top self care ideas from a great group of 60 social workers, mental health professionals and family caregiver supporters at today's Compassion Fatigue workshop.

1. Working out at the gym

2. Running with the dog

3. Cooking tasty, healthy food

4. Aromatherapy

5. Small gestures of giving to others

6. Doing nothing

7. Silence

8. Yoga

9. Singing

10. Massage

11. Listening to, and playing music

12. Watching a feel-good movie

13. Morning meditation

14. A bath with candles and music

15. Being in a library

16. Buy yourself flowers

17. Window shopping

18. Gardening

19. Playing

20. Spending time outdoors

21. Journal writing

22. Reading a good book

23. Accepting and honouring your feelings

24. Knitting and crocheting

25. Enjoying your first sip of morning coffee or tea

26. Chatting with a friend

27. Cleaning house

28. Baking

29. Aerobic exercise - biking, cross country skiing, swimming

30. Staying calm

31. Sitting by the fire

32. Living with intention

33. Good dental hygiene

34. Regular health checkups

35. Gratitude journal

36. Last thing at night - identifying the nicest thing that's happened that day

37. Leaving the computer off

38. Avoiding the newscast

39. Laughing and having fun

40. Inspirational reading

41. Being mindfully aware/in the moment

42. Regular meditation

43. Connect with your spiritual side

44. Dancing

45. Craft work

46. Create a support network

47. Eat cookies

48. Prayer

49. Storytelling

50. Travelling and planning it before hand

51. Purposefully doing superficial things

52. Stand-up comedy, sharing a joke

53. Quilting

54. Grouse Grind

55. Candlelight

56. Cooking when not under pressure

57. Being alone and contemplative

58. Going for a sauna

59. Pedicure/manicure

60. Sex

61. Having a facial

62. Debriefing with colleagues

63. Validating yourself to yourself and to colleagues

64. Attending workshops

65. Staying in your dressing gown all am when on a day off

66. Dancing in my kitchen

67. Buying only good wine

68. Long walks on the beach

69. Hikes in the woods with the dog

70. Making photocards

71. Kayaking and sailing

72. Playing a musical instrument

73. Landscaping

74. Sleeping in

75. Pet's unconditional love

76. Driving and road trips

77. Walking to and from work

78. Sitting in a sidewalk cafe, drinking a latte

79. Pausing to breathe

80. Time with your grandchildren

81. Stomping in rain puddles or piles of leaves

82. Validating your colleagues

83. Walking in the grass in bare feet

84. Looking at clouds

85. Letting the warmth of the sun soak into your back or your face

86. Eating chocolate

66 Self Care Ideas...

I spent this morning with a great group of helpers intent on identifying compassion fatigue in their lives and on learning new prevention and resiliency skills. Here are the self care strategies that came from their brainstorming sessions:

1. Playing with pets

2. Listening to, or making music

3. Walking/hiking outside in Nature

4. Yoga

5. Spontaneous dance with my child

6. Reading for fun

7. Chatting with friends

8. Taking time to eat without distraction 3 times a day (ie mindfully)

9. Going out on a motorcycle every weekend

10. Swimming

11. Gardening

12. Positive thoughts in sessions

13. Doing puzzles

14. Knitting

15. Painting

16. Shopping for yourself

17. Going to the museum or art gallery

18. Cultivating faith

19. Sleeping in

20. Watching cats playing

21. Holding pet every morning

22. Dream interpretation

23. Aerobics

24. Driving alone in the car

25. Book clubs

26. Girls' night

27. Playing/reading with the kids

28. Dressing up and going out

29. Going on a roller coaster

30. Making a list to get things out of your head

31. Cleaning my room

32. Cooking healthy food

33. Having someone cook for you

34. Taking part in social action

35. Photography

36. Karaoke

37. Regular massage

38. Leisure time - going for coffee or window shopping

39. Aromatherapy at home

40. Taking time to debrief with a supervisor or colleagues

41. Learning to say no

42. Lighting a candle

43. Trying a new recipe, kneading dough

44. Writing in a joy/gratitude journal

45. Write an email or in a journal to "get things out"

46. Go to a different place/ space, even in the work setting

47. Take a bubble bath, shower or swim - "aquatherapy"

48. Watch a funny TV show, youtube a comedian like Seinfeld or The Vinyl Cafe

49. Spend time with someone you know will lift your spirits

50. Take care of plants, nurture "at risk" plants

51. Remind myself that not everyone is going to get better; accept reality and respect other peoples' processes and their personal journeys

52. Sing in a choir / sing in the car / SING!

53. Do crafts

54. A quiet cup of tea

55. Reading something inspirational

56. Watching a bird feeder

57. Raking leaves on a sunny day

58. Meditating or praying

59. Sitting still (doing nothing)

60. Join a Laughter Yoga Club

61. Be in the moment - not thinking about the past or the future

62. Don't attach to stressful thoughts

63. Ritual

64. Change out of work clothes after work

65. Let go - leave perfectionism behind

66. Eat well