A New Book for Your Fall Reading:

Hi Everyone!

I'm just back from a walk at the lake where I could see my breath for the first time this fall and where I wished I had thought to bring along a pair of gloves! As I walked in the early morning light, I was thinking about compassion fatigue and chronic sorrow resilience and how important basic information is to our ability to heal and come back from the secondary trauma and accumulated grief of our helping work.

In the early 1980's, complex trauma author, Jane Middelton-Moz, called basic information about trauma and grief healing, a cognitive life raft. A cognitive life raft is an intellectual understanding of the healing process that acts as a secure base when the experience, itself, feels overwhelming. It reminds us that our feelings and responses are natural and understandable within the context of our experience.

This week, an excellent book by Boston-based psychiatrist and trauma expert, Bessel van der Kolk, became available, adding a new source of information for building our cognitive life rafts. The book is called,  The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma. I'm about half way through it and couldn't wait to let you know how good it is.

Reading like a novel, this well-reviewed book (the "Advance Praise" pages read like a Who's Who of the trauma and mindfulness worlds) covers Dr van der Kolk's evolution in understanding of trauma over 30 years as a clinician and researcher. It explores the world of trauma healing under headings such as:

1.  The Rediscovery of Trauma

2.  This is Your Brain on Trauma

3.  The Minds of Children

4.   The Imprint of Trauma

5.   Paths to Recovery

The chapter on recovery includes sections on trauma language, the legacy of inescapable shock, EMDR, trauma-sensitive yoga, self-regulation, rewiring the brain, finding your voice through theatre, and making choices about trauma treatment as a society. There is an emphasis on the individual nature of treatment - one size does not fit all and psychopharmacology, in particular, should only be an adjunct to a larger individualized recovery plan.

This book is a great starting place for trauma survivors, their families and support systems. It offers a clear "big picture" of current trauma understanding and treatment practices in language that is utterly accessible and pleasurable to read. It is a great synthesis of history, research, neuroscience and story, written in the voice of a true story-teller. It begins like this:

The Tuesday after the Fourth of July weekend, 1978, was my first day as a staff psychiatrist at the boston Veterans Administration Clinic. As I was hanging a reproduction of my favourite Breughel painting, "The Blind Leading the Blind", on the wall of my new office, I heard a commotion in the reception area down the hall. A moment later a large, disheveled man in a stained three-piece suit, carrying a copy of Soldier of Fortune magazine under his arm, burst through my door. He was so agitated and so clearly hungover that I wondered how I could possibly help this hulking man. I asked him to take a seat, and tell me what I could do for him.

His name was Tom. Ten years earlier he had been in the marines, doing his service in Viet Nam. He had spent the holiday weekend holed up in his downtown Boston law office, drinking and looking at old photographs, rather than his family. He knew from previous years' experience that the noise of fireworks, the heat, and the picnic in his sister's backyard against the backdrop of dense early-summer foliage, all of which reminded him of Viet Nam, would drive him crazy. When he got upset he was afraid to be around his family because he behaved like a monster with his wife and two young boys. The noise of his kids made him so agitated that he would storm out of the house to keep himself from hurting them. Only drinking himself into oblivion or riding his Harley-Davidson at dangerously high speeds helped him to calm down...  

and the last page includes these words:

Trauma constantly confronts us with our fragility and with man's inhumanity to man but also with our extraordinary resilience. I have been able to do this work for so long because it drew me to explore our sources of joy, creativity, meaning and connection - all the things that make life worth living. I can't begin to imagine how I would have coped with what many of my patients have endured, and I see their symptoms as part of their strength - the ways they learned to survive. And despite all their suffering many have gone on to become loving partners and parents, exemplary teachers, nurses, scientists and artists...

... Trauma is now our most urgent public health issue, and we have the knowledge necessary to respond effectively. The choice is ours to act on what we know ... 

Go out and buy or borrow a copy of this book. You won't regret it.

  

A New Study: Mindfulness for Mothers of Severely Disabled Children ...

Mindfulness is like that - it is a miracle which can call 
back in a flash our dispersed mind and restore it

to wholeness

so that we can live each minute of life.

Thich Nhat Hanh

Are you caring for a child with severe disabilities? Family caregiving can be hard work at the best of times but caregiving for a child or adult child with a severe disability takes an extra toll. Mothers of children with autism or other neurodevelopmental disabilities report high levels of stress, burnout, compassion fatigue, chronic sorrow, depression, and anxiety, all of which can have an impact on your wellness and resilience and on the way you care for your child.

A new study in the journal Pediatrics suggests that both mindfulness and positive psychology techniques can help to reduce your stress. Researcher, Elisabeth Dykens, and her colleagues randomly assigned 243 mothers to a six-week group treatment program employing either mindfulness techniques like deep-belly breathing or to a group using positive psychology exercises focused on building virtues like gratitude and patience. Trained mentors who also had children with disabilities led the weekly hour-and-a-half sessions. The mothers completed mental health assessments before, during and up to six months after the study. 

Before the study, 85% of the mothers reported significant levels of stress. Forty-one percent suffered from anxiety disorders and forty-eight percent were diagnosed as clinically depressed. (Chronic sorrow was not assessed perhaps altering the number seen as depressed.) 

In the mindfulness group, mentors used the Mindfulness-Bassed Stress Reduction Program (MBSR) developed by Jon Kabat-Zinn to teach breathing awareness, movement and meditation techniques. The specific techniques taught included breathing exercises, self-observation without self-judgement, loving-kindness meditation and Qigong (an ancient Chinese health care system integrating gentle movement, breathing techniques and focused attention) among others.

The positive psychology group learned techniques for dealing with feelings of guilt, worry, and pessimism. The techniques included exercises for identifying character strengths and fostering gratitude, forgiveness, grace and optimism.

Both treatments worked. Participants reported fewer feelings of anxiety and depression and fewer unhealthy parent-child interactions. Mothers slept better and experienced greater life satisfaction during and after the six week groups.  Some continued to improve over time.

Some differences were also noted in the effectiveness of the two groups. The mindfulness group showed more immediate improvement in anxiety, depression and insomnia, possibly due to the immediacy of the autonomic nervous system shift from fight-flight-freeze response to relaxation response. The positive psychology group, on the other hand, took longer to show results but the improvements in life satisfaction and depression were greater.

The study concluded that because both groups saw significant improvement, programs integrating both meditation and positive psychology should be developed.

I think this study provides evidence of a hopeful and practical means of calming the nervous systems of family caregivers, building resilience and improving quality of life. But many of you will look at it and say, "So, who has time to fit this into my already crowded day?!" And you will be right. Few caregivers can "find" the time for new practices like these. It will be more a matter of "carving out" time - giving up something else in order to make room, doing two things at once (eg meditating for the 20 minutes it takes to cook your potatoes), or asking a friend to be with your child as you practice.) However you do it, I think the benefits of adding practices like these to your life might just be worth a try...

*** Caveat:

Please remember that there are those who should not practice mindfulness meditation without first being assessed by their family physician or therapist. They include those who:

• have a history of mental illness or posttraumatic stress
• with thoughts of suicide
• misuse alcohol or other drugs
• are in the first year of addiction recovery
• are troubled by trauma triggers
• have difficulty maintaining a strong sense of self when quiet or alone.

The Rhythms of Nature ...

(

The summer ends and it is time

to face another way.

Wendel Berry

Hi everyone!

It's a beautiful autumn day here in Vancouver - warm and sunny but with a edge to the breeze that reminds me of cooler days to come. This week, I've been taking an online course on the relationship between nature and spirituality and I was struck by this description of the rhythm of the seasons:

When we pay attention to the rhythm of the seasons we learn a great deal about the rise and fall of life, about emptiness and fullness. Spring invites us to blossom forth, summer calls us to our own ripening, autumn demands that we release and let go, and winter quietly whispers to us to rest, to sink into the dark fertile space of unknowing, releasing the demands of productivity and calendars and to do lists and to simply be.

                                                                                                      Christine Paintner

I don't know about you, but that's not the normal pattern of things for me. Autumn and winter are far more likely to be times of compressed do-ing than quiet be-ing. And yet, what a gift we would give to our spirits and bodies if we could follow the natural rhythms of nature and allow a time of fallow, a period of rest that restores our ability to bear fruit.

What if the fall and winter months brought with them an invitation to be less busy, to move inward to a time of quiet, introspection and re-creation?  What if we decided to hibernate, to restrict our kids to a single outside activity per season, said no to recreational screen time and graciously refused a few of our social invitations. What if we made more time for quiet reading, conversation, long walks in the woods and hot drinks by the fire? What if there was sufficient spaciousness for deep reflection, heart connection and even the odd nap?

Now, for some of us, a season of surrender and hibernation could be terrifying. I heard in a CBC radio interview this week that someone had done a study offering participants the choice between a mild electric shock and the boredom of fifteen minutes in a quiet environment and a large percentage actually preferred the electric shock! Are we becoming a society hooked on busyness and stimulation? Perhaps a return to the patterns of nature might allow us to shift our nervous systems back from chronic sympathetic ("flight or flight") arousal to a calmer relaxation response.

I wonder which season would describe your life experience this fall? Are you in sync with the natural flow? Can you be? What (if anything) might you want to change to create a closer parallel between your life and the seasonal rhythm?

Summer Harvest: Or What I (Re)Learned On Summer Vacation ...

Hello, everyone!

I'm back from an unexpectedly busy summer and enjoying the quickening of heart and mind that always seems to accompany this time of year. As the days of summer shorten and I gear up for fall workshops, I find myself reflecting upon the things I've learned (or re-learned) this summer -  the fruits of my summer harvest.

1.  Remember to rest: 

This year's vacation began with two wonderful weeks at Kahshe Lake in northern Ontario. There, my body relaxed and I was reminded, once again, of the importance of rest and respite. Sitting on the deck, doing nothing, wrapped in the piney fragrance of sun-warmed trees is one of the most restorative things I can imagine and yet I can lose track of my need for this deep rest once I move into the busyness of the teaching season.

This year, I've decided to build rest days into the calendar in advance. On these days, I will stay at home by the fire, be silent, avoid screen and phone time, eat pre-prepared meals, perhaps read bits of poetry or fiction, and mostly, just rest. (I did learn this lesson more than ten years ago when my husband was ill but it seems that it takes intentionality and commitment to remember to use it during my busiest times.)

Perhaps you'd like to join me in honouring our universal need for rest and re-creation this fall? If your life won't accommodate a full rest day, perhaps a half day, or a couple of hours, or 30 minutes every morning or a 10 minute power nap in the afternoon would be a place to start ...? The important thing is to choose what works for you and then protect the time to do it.


2. Recommit to a spiritual practice:

As I've said elsewhere, most people believe that we have a spiritual life to tend as well as physical and psychological ones. After a very full late summer with considerable family caregiving and much writing, I found that I had lost the rhythm of two of my much-needed spiritual practices. I was falling asleep during (or sleeping right through) my early morning meditation/prayer time and I was skipping my treasured walks at the lake. (Not a good sign when fall's busyness hadn't yet begun!) Fortunately, I was able to get some rest, and with rest came the desire to refocus on this vital piece of self-care.

Research tells us that developing and maintaining a regular spiritual practice is important for our wellbeing if we want to work with people who are traumatized. Spiritual practice creates space - space for healing and transformation and space for building resilience. Whether you meditate, practice centering prayer, commune with nature, write a gratitude journal, read inspirational writings, dance or sing, or practice a nightly examen, consciously attending to your spiritual life can go a long way toward mitigating compassion fatigue.

If you have had a regular spiritual practice in the past but have let it slip away, why not consider beginning again this fall? First, take some time to consider why you are not practicing now. Has your life changed? Did you become bored with the practice? Was it not a good fit in the first instance?  Once you know why you stopped, begin again or do some exploring to discover new possibilities. Be sure to choose a practice congruent with both your personality and your current life circumstances.

As I re-learned when I returned to my regular practices last week, taking the time to deepen your spiritual life positively affects every other aspect of your being.


3.  Make heart connections with supportive people:

Isolation is both a source and consequence of compassion fatigue. When we hide painful emotional responses to our work, either in the name of strength and stoicism or because there's no energy left to connect with our support systems, we increase the likelihood of being traumatized. And when we become traumatized, we are likely to isolate and hide our trauma for all the same reasons. Isolation becomes entwined in the experience of compassion fatigue and healing involves connecting or reconnecting with loving, responsive supporters.

I felt a measure of this isolation recently, first as I supported an elderly friend for five weeks following emergency surgery and then, as I companioned extended family following a loved one's life-threatening post-transplant lung infection. In the days before I knew about compassion fatigue, I might have spiralled into a state of exhaustion and depletion. Fortunately, these days I can recognize when my early warning signs are saying, "Enough!"  One of those early warning signs is realizing that I haven't had contact with anyone on my KIT (Keeping In Touch) List.

My husband introduced me to the idea of keeping a KIT list. He kept a list of 6 or 8 good friends front-and-centre on his desk and committed to contacting each one at least once a month so that his important relationships could be regularly nourished. Sometimes, he wrote them "proper letters" with envelopes and stamps; sometimes they had coffee or lunch; sometimes they went for walks, hikes or a bike rides; and sometimes they just enjoyed short or protracted phone conversations. The point was that he was intentional about having regular heart-to-heart connection with people who mattered to him. It is this kind of connection that reduces stress and protects both our physical and emotional health. If the idea appeals to you, why not give it a try?


So, these are a few of the summer's lessons for me. What about you? What has been your summer harvest?

Mid-Summer Messages 2014 ...

Hello, everyone,

Just a brief midsummer note to pass along some important messages and to say that I hope you have been able to enjoy some respite time for rest and re-creation these lovely sunny days. Often, as I re-discovered this week, it's our willingness to look outside the box of our usual activities and schedules that allows us to carve out a little space for ourselves.

This is always a busy time of year for me - writing to do, workshops to advertise, handouts to update, registrations to organize. On top of that, for the past 5 weeks I've been carepartnering an 81 year old friend who had emergency surgery while I was away at the cottage this summer. It's been hectic and I find that I can get so caught up in the organized chaos that I can forget that the sun is shining out there and that I need to take advantage of this beautiful city before the rains come. That thought came to me (once again) in the early hours of yesterday morning and so, when my friend, Sandra, mentioned going to see Walking the Camino: Six Ways to Santiago at the VanCity Theatre last night, I bit the bullet and asked to go along.

What a great decision and what a wonderful evening! Not only was the VIFF-selected film beautifully photographed, written and edited, (and the theme of slowing down didn't hurt either!) but our walk through Granville Island, the ride across False Creek on the Aquabus as the sun was setting, and the further walk up Hornby, down Davie and up Seymour gave us the opportunity to see a broad cross-section of Vancouver's eclectic summer life. The trip back was just as lovely and made more so by our stop at the GI Gelato and Coffee House for a carmel ripple gelato cone to lick as we walked along the seawall and talked. It was such a good choice to make space for feeding my senses and spending time with a good friend, even though I thought I was "too tired"and "too busy".  This morning, I feel re-energized and ready to take on the world.

That said, I have some news for you:


1.  David Daniels (see my previous post) has done extremely well following his open heart surgery and is already attending Enneagram meetings so thank you so much for all the prayers and positive intentions that helped to carry him and his family through.


2.   Unexpectedly, I have had to change venues for my fall workshops and the change has caused an alteration in the workshop scheduling. The great folks at Christ Church Cathedral, in the midst of downtown Vancouver, at Burrard and Georgia Streets, have come to my rescue with the offer of their beautiful Park Room, but scheduling has suffered a little:

a.  The October 3rd family caregivers workshop will be moved to the New Year. (Date and venue tba)

b.  The Caring On Empty Workshop for Helping Professionals will be held on Saturday November 8 rather than Friday November 7 as previously scheduled.

c.  The Introduction to the Enneagram Workshop will still be held on Friday November 28.

I'm very sorry for the inconvenience for any of you who have already made plans around the original dates.


Brochures for the fall workshops will be available by the end of the month. If you wish to be added to the mailing list, please email me your personal email address at caregiverwellness@shaw.ca

Intentions for David Daniels ...

Hello, everyone,

A few posts ago, I wrote about the new Enneagram website at Enneagram Worldwide. In that post, I mentioned Dr David Daniels, professor of clinical psychiatry and behavioural sciences at Stanford School of Medicine, one of my beloved Enneagram teachers and mentors, and the author of The Essential Enneagram.

This evening I received an email from Terry Saracino, President of Enneagram Worldwide, sharing the news that David will be having a mitral valve replacement on Tuesday July 15th, his second open heart surgery in two years.

Terry has asked for our prayers and positive intentions for David and his family and I echo that request here. David is enormously grateful for the support already beginning to pour in from around the world. His family have requested that those of you who know David follow his progress in the journal entries on CaringBridge rather than contacting him directly. Just use the CaringBridge link and type in David Neil Daniels to reach his private webpage. (There are two David Daniels webpages so be sure to type in his middle name.)

David has touched many, many lives over the years through both his writing and teaching. Those of us in the Narrative Tradition community of Enneagram teaching have benefitted beyond words from his quiet wisdom, wry sense of humour and consummate skill at interviewing panel participants. Having had the honour of being a participant on two of his panels, I can say that they are nothing short of life-changing. We need many more years of his warm and loving presence among us.

Thank you so much for your support for David and his family,

Jan

ps I think the whole core team at Enneagram Worldwide - Terry, Helen Palmer, Peter O'Hanrahan, Marion Gilbert and Renee Rosario - could do with our warm intentions as well. David is one of the co-founders of Enneagram Worldwide and an important component in the glue that holds the team together.

Summer Camping for Family Caregivers ...

Hi everyone!

I'm back from a wonderful two weeks at the cottage and am beginning to take on the tasks of real life again. While standing in line at the grocery store this morning, I heard the mom of a disabled child commenting to a friend that camping was great but not exactly a rest for moms. Then, later in the morning, I received an email containing the following poem written by Luci Shaw from her book, Water Lines:

Camping

The river rushes along in a hurry
to get somewhere. Our tent is pitched close;
above the oxymoron of its noisy hush
we, in folding chairs on the bank,
wait to slow down, to let the mind wander,
to to turn primitive. Simplicity
is what we say we want - the current's
single-mindedness, even its monotony.

A week goes by. It would be so good
to be aimless. To be content to be aimless.

But we are mothers, keepers of homes.
At the campsite we work to keep the firewood dry,
the butter cool, the food secure from bears.
the tent zipped against mosquitoes,
the water heating for coffee.

We are caught - neither civilized or wild.
Even in the deep forest the houses in town call us,
the families, the phone messages, the bills to be paid,
the laundry; our guilt is alive and waiting.

Out in the centre of the riverbed a single boulder,
embedded in a pebble shoal, sun-washed, gleams.


The message I took from the busy mom's comment, and the poem that followed, is that trying to maintain a normal life for families while caring for an ill or disabled loved one is hard work, even - or especially - during vacation and holiday times.

The picture above was taken of my goddaughter and her mom while we were camping at Porteau Cove many years ago. Her mom, a carepartner extraordinaire, managed to do everything mentioned in the poem and more, but I'm sure that, given half a chance, she would have hired a caregiver's caregiver to come along and allow her some time to taste the simplicity and monotony she was creating so generously for us.

So, if you're camping with a family caregiver this weekend, perhaps you could offer to cook a meal or cut some firewood or do a round of dishes so she can rest awhile in one of those folding chairs ...? She (or he) certainly deserves it!