Compassion Fatigue Recovery...

Recovering from Compassion Fatigue can be a slow and difficult process, particularly when there is a significant amount of personal loss and trauma, (primary traumatic stress), to work through. At the same time, it is a journey that can yield true joy and wellness if we're willing to do the work of becoming self aware and self caring.

Yesterday was one of those days of joy and wellness in my own recovery process.

Since sunny childhood mornings spent weeding with my mother, gardening has been a great source of peace, creativity and comfort in my life. But after the experience of maintaining a trauma therapy practice while caring for my husband and then for my mother during her brief terminal illness three months after his death, I didn't want to take even one step through the garden gate. The thought of caring for anything or anyone in any way was overwhelming. I couldn't even care for myself very well.

That was almost five years ago and so much has changed since then. With intention, effort and patience I made space for my body, mind and spirit to heal. I found a good grief counsellor to be a companion and "emotional container" as I grieved and, later, I did body work to release the traumatic stress stored in my muscles and sinews. I walked every day by the Lake, allowing Nature to do her healing work. I meditated and prayed and I waited in the stillness until I was able, finally, to store enough energy to interact with others again. Then I began to spend time with selected loved ones who gently led me back to life. I journalled, I listened to Mozart and Abba and I read my favourite authors and poets. Gradually, I remembered the things that authentically refresh and sustain me.

But, still, I didn't want to garden. The very thought of it made my chest tight and and my limbs heavy  with inertia. As I sat with these feelings, I came to believe that the return of my desire to garden would announce my emergence from this last severe episode of Compassion Fatigue.

So, imagine my delight when I woke at 4:20 yesterday morning with plans for springtime plantings swirling about in my head. New roses to replace those damaged by the winter's cold. More container vegetables this year. Sweetpeas for the trellises. I was up and perusing gardening books by 5:00 and at the garden center when it opened at 9. This morning, there are three new bushes in the rose garden and a row of sweetpeas along the fence. This afternoon, the tomatoes and swiss chard will be bedded and the first batch of mesclun sown.

But, best of all, is the knowledge that in waiting and trusting my own process, I have allowed my energy to accumulate to a point of abundance again. I have healed and filled myself up and now that energy can overflow into healthy caregiving - of both plants and people. It has been more than worth the effort and the wait and now I have my garden as both a source of joy and beauty and as an early warning system for encroaching compassion fatigue in the future.

  

 

  

  

Personal Boundaries....

When we grow up in families of trauma, we may lack the opportunity to develop healthy personal boundaries. (A personal boundary is an imaginary line of demarkation between me and not me.). When our boundaries are poorly differentiated, we run the risk of overextending ourselves in our helping roles.

As James Miller expresses so clearly in The Caregiver's Book -

To be close, you must establish boundaries.

When the needs of someone you care for are great, 

or when you have become part of the other's life in so many ways,

you may desire to draw as close as possible.

You may be inclined to keep that person always at the forefront of your thoughts.

You may try to keep yourself always within easy reach of their grasp.

You may find yourself almost merging with the other person,

so whatever happens to them happens to you.

Whatever they feel, you feel.

Whatever upsets them, upsets you.

Whatever their pain, you take it on as your own.

Identifying so completely with another

is an ideal some caregivers have sought

But it is less than ideal.

We all need healthy personal boundaries.  We need to be able to maintain a separate self with our own experiences, limits, sense of privacy, supportive relationships, and times of reprieve and refreshment.  When we create a separate space for ourselves, we allow the people we care for to have their own space as well.  As Miller says, -

They need it as much as you - perhaps even more. For they may not have the 

strength or clarity to create that space on their own.

And as Rainer Maria Rilke has said, -

Love consists in this:  That two solitudes protect and border and salute each other.

Are there ways that you can create your own space today? Define your own limits? Take some time out? Nurture supportive relationships? It will make a healthy difference to you and to all those for whom you care.

    

Letting Go...

Sometimes it feels as though letting go, surrendering control, will allow the world to fall apart. What if something goes wrong? What if someone makes a mistake? What if there's a mix-up?

And yet, carrying the burden of responsibility for everything turning out right is exhausting. We become drained, anxious and irritable when we try to hold life together by sheer force of will. I spoke with a woman this week who is a helping professional who is also caring for her mother, a woman living with cancer. She told me that although she speaks about "letting go"  all the time in her work, she'd never realized to what depths and repeatedness this act was required of family caregivers.

So, what would happen if we didn't try so hard to control things in advance? Could we lighten up, just a little, and respond to circumstances as they arise instead? Kate, the beloved adolescent character of Jean Little's writings, understood about the need to let go, at least occasionally:

Today

Today I will not live up to my potential.

Today I will not relate well to my peer group.

Today I will not contribute in class.

I will not volunteer one thing.

Today I will not strive to do better.

Today I will not achieve or adjust or grow enriched

or get involved.

I will not put up my hand even if the teacher is wrong

and I can prove it.

Today I might eat the eraser off my pencil.

I'll look at clouds.

I'll be late.

I don't think I'll wash.

I need a rest.

Perhaps we could all let go, just a little, in our own ways, today, and have a rest...?

I will be doing just that on Friday when I travel to southern California for a week. And after that comes Easter weekend so you will not be seeing a blog post here for the next two weeks. Until then - Happy Easter!

Jan 

 

   

The Promise of Spring...

I encountered these crocuses under a tree by the lake yesterday, a reminder of the hope and the promise of Spring.

I think that early recovery from Compassion Fatigue is a little like the coming of spring. The signs of early recovery are subtle at first - being wakened one morning by a whisper of optimism, hearing yourself laughing for the first time in a very long while, feeling a longed-for gathering of energy and interest. Gradually the bud inside you begins to swell and grow, creating the new weller-than-well person you are becoming.

The process of recovery is not a direct line from A to B though, rather, a meandering route of two steps forward and one step back. As James E. Miller says of Spring in Winter Grief, Summer Grace:

This season cannot be all brightness and glow, however. You still feel sad sometimes.

You get caught off guard by sudden rushes of painful emotions.  That's the nature of 

Spring - The gradual warming punctuated by brief stabs of chill. Yet as you  let your 

feelings evolve in ways most fitting to you, you promote the natural unfolding of your 

grief, the natural unfolding of your life.

He goes on to describe this natural unfolding in more detail:

You can begin to direct more and more what is happening around you.

You can decide about those things you want to start doing again.

You can experiment with things you've never tried before, realizing that something

within you now is eager to try.

You can begin to turn your attention more to others,

offering what you have to give, welcoming what is there to receive.

You have every reason to do both,

and every right.

In fact, James Miller is speaking about the process of recovery from bereavement but I believe he's got it right for those of us recovering from compassion fatigue as well. There is a seasonal flow to both experiences and the season of Spring brings the warmth, showers, budding and blossoming that equate to the Springtime of our recovery.

Most of you who have heard me speak more than once, know that I use a beautiful haiku by Jean Little, as a closing for all my workshops.  Over the years it has become my "signature", a blessing for those courageous enough to be beginning their own recovery. It goes like this:

Surprise

I feel like the ground in winter,

Hard, cold, dark, dead, unyielding,

Then hope pokes through me like a crocus.

So, bouquets of crocuses to each of you as you take the next step toward recovering from the

"gift" of compassion fatigue.

* Both books I've quoted today would make beautiful gifts for yourself or for someone you

love. Winter Grief, Summer Grace has wonderful photographs and poignant prose with

unintrusive Christian overtones and Hey World, Here I Am! by Jean Little makes a

great gift for an adolescent or pre-adolescent girl - or anyone who ever was one!

 

 

 

 

 

Getting Enough Sleep...?

This past week has certainly been one of diminished sleep for me!

Between the advent of this year's Daylight Savings Time, an out-of-town workshop with a time zone change, an overnight visit with an old friend, and seeing my goddaughter off on Spring Break at the airport at 4:15 this morning, my sleep debt, (the difference between the amount of sleep we need and the amount of sleep we get), is pretty high. The bad news is that this sleep debt is cumulative. The good news is that a few consecutive nights of full, uninterrupted sleep will usually return us to full functioning.

How do we know when we're sleep deprived? Sleep researchers say that our sleep latency tells the tale. In other words, if we are well rested, we will make the transition to sleep within 15 - 20 minutes but if we're sleep deprived, we will fall asleep in less than 5 or 10 minutes. (Or as soon as our heads hit the pillow, as the saying goes.) Other ways of taking stock include asking ourselves if it is hard to wake up in the morning, if we wake refreshed or tired, if we run out of energy by late afternoon or how long we sleep if we don't have to wake up.

Most adults need 8-9 hours sleep each night but many of us average around 7 hours with the result that we have more accidents, we're more prone to infection, we make more mistakes at work, we lose concentration, short term memory and IQ points and we are less resilient to stress. 

When we add to this the effects of long term professional shift work or 24/7 family

caregiving, we have the potential for serious physical and mental health problems and a diminished ability to care for others safely.

In,  The Little Book of Stress Relief,  Dr. David Posen, MD, suggests that we:

*  Assess how much sleep we're getting currently & how much we need to function well.

*  Go to bed half an hour early for a few nights and see what happens.

*  Then add another half hour for a few nights.

*  Keep adding to your sleep until you wake naturally, feeling refreshed.

*  Sleep in an hour or two on weekends if you run a deficit during the week.

If you are working extra long shifts because there are not enough staff or if, as a family caregiver, the idea of getting more than a few consecutive hours sleep any night makes you laugh, (or cry), things might not be so easy. You might need to summon help or actually get away regularly in order to meet this most basic of needs.

Can you ask a friend to take your children after school so you can sleep til dinner time when you're working night shift? Can you renegociate your care aide allotment? (During the last year of my husband's illness, I traded 120 hours of daytime care aide help for 2 or 3 nights of RN coverage a week and that saved my sleep and my sanity.) Can you ask a family member to watch things at your house while you go to theirs' for a nap? Can you arrange to go away for a weekend for the sole purpose of catching up on your sleep? Brainstorm with others in similiar situations to find outside-the-box ways of catching an extra 40 winks. It will make all the difference to your mood, your energy and your perspective.

   

      

Before I Leave...

I'm on my way to Banff very early tomorrow morning to teach a Compassion Fatigue workshop for transplant professionals. I am greatly looking forward to working with this dedicated group of people, and also, to seeing a nursing friend from the old days in CCU and to meeting my new great granddaughter for the first time! It promises to be a busy, happy - and cold! - weekend.

Before I leave, though, I would like to tell you about an online learning opportunity with the Compassion Fatigue Specialist and Accelerated Recovery Program (ARP) developer, Eric Gentry. He will be offering a teleseminar, Compassion Fatigue Prevention & Resiliency:  Fitness for the Frontline, through PESI Continuing Education Seminars on Friday March 13, at 2:00 - 3:30 pm (Eastern Standard Time).  The price is very reasonable and the outline looks comprehensive  and well integrated with the latest research.  You can  find seminar information and registration at www.pesi.com.  

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.