Telling Our CF Stories ...

Journal-writing specialist, Christina Baldwin, says:

"Every person is born into life as a blank page - and every person leaves life as a full book. Our lives are our story, and our story is our life. Story is the narrative thread of our experience - not what literally happens, but what we make out of what happens, what we tell each other and what we remember."


This morning, I was thinking about how often we write and teach about the facts of compassion fatigue -  the definitions, trajectory, symptoms, resilience-building - and yet we rarely speak of or write about our stories, the felt experience of compassion fatigue. (Unless we're in our therapists' offices, writing in our journals, or bravely sharing in small groups at a CF workshop.)

However, this week I've come across four poignant stories of the lived experience of CF and I would like to share them with you today. The first is the blog post of a counselling student recognizing his compassion fatigue for the first time:

My brain was becoming more and more jumbled, and my short-term memory was getting worse and worse. I had lost all motivation to do anything non-passive. I wanted nothing more than to be by myself. The mere thought of people immediately drained my soul dry. The light of day hurt my head, and I was depressed when I was forced to go out into it.

In fact, I was depressed most of the time. The weird part was, I would wake up in the morning feeling okay, but as soon as something went wrong with ANOTHER one of my many needy friends, I would suddenly become void of energy and positivity for the next few days. This slowly morphed into not wanting to get out of bed at all, in anticipation of what complaints, suicide threats, nervous breakdowns, and any other traumatic events I'd be getting phone calls ... about that day.

That sounds cynical, but that's what I was turning into - a bitter cynic. I was so stressed out, but I couldn't quite pinpoint why. It got to the point where I couldn't even solve my own relatively simple life problems, and they began to add up and overwhelm me. Then I was dealing with my problems AND theirs.

After some thought and a little bit of research, I realized I had compassion fatigue. Severe compassion fatigue, I would say, that has been building up for about four years. I am going to seek counselling, because I can't go on like this. I can't.

The second is Behind the Mask, a 10-minute YouTube video by a paramedic recovering from CF, the third is the blog post of a church ** minister ** and writer who left public ministry a few years ago to recover from his CF, and the fourth is the story of a Compassion Fatigue Specialist who has not only recovered from CF, but has become weller than well and now helps others with their healing journeys.


I hope that these stories will help you to better understand how it feels to live with CF, (if you haven't had the experience, yourself) - or - that they will help you to see the similarities between your own  "narrative thread" and theirs, and thus to feel a little less alone.

** Note:  Gordon is in the midst of changing his website host so when you click on "minister" you will hit an error page. Click on "Select a month" under Archives, select February 2012, then scroll down to February 27th.

Friday Night, Heading Home ...

Hi everyone! It's 3:29 pm here in Vancouver and I've just come back from a beautiful walk at the Lake - my favourite transition ritual for closing out the day at work and opening up to life at home. (A bit of a tricky transition when your office is actually the back bedroom!)

When we're engaged in helping work and it's time to head home, it's important to have a formal way of delineating work-time and home-time. (Formal, in the sense that we need to create a particular ritual that marks the transition between work and home.) We all need a way to let our bodies know that it's time to let go and let down, time to ease out of our work-a-day arousal and into relaxation mode.

There are as many of these rituals as there are people and I always love to hear original "ritual" ideas that come up during the compassion fatigue workshops. Here are a few:

• Taking a walk in the park, really noticing the season
• Stopping at a church on the way home and sitting for a while in the quiet
• Taking a shower or washing your hands and consciously washing off the cares of the work day
• Changing into "play clothes" 
• Yoga or tai chi in the park on the way home
• Sitting by the bird feeder for 10 minutes before going into the house
• Going for a run  
• Debriefing the day with a workmate over coffee
• Meditation practice
• Singing along with your favourite songs all the way home
• Sitting with a cup of tea in a peaceful part of the house for 15 minutes before interacting with anyone 
• Speaking a second language when you get home
• Playing an instrument until your body relaxes 

If you have other rituals that work well for you, please do share them in the comments section as a way of inspiring others to make personal transition plans of their own.

ps  If you are a family caregiver whose "workplace" is at home and whose work never seems to end, try to carve out even 15 minutes for yourself at the end of the day and do one small thing that will mark "the end of work" and the beginning of your 15 minutes of "me-time". I think you might find it's worth the effort.

Veriditas - The Greening of Spring ...

Hi everyone! It's finally Spring - the time of greening.

11th century German Abbess Hildegard of Bingen, one of the most respected ecologists of her time, called the greening of spring, veriditas, (or, viriditas), which translates from the original Latin as a partnering of green and truth.


Other writers have defined veriditas as spiritual and physical health, freshness, vitality, fertility, fecundity, fruitfulness, growth, and the healing greening power of Nature or God. Science fiction writer, Kim Stanley Robinson, uses the term to mean "the green force of life, expanding into the Universe".  And yet another definition is, "the divine freshness that makes human creativity and fruitfulness possible".

Regardless the later definitions or descriptions, Hildegard of Bingen felt that we humans are each fertile "earth" with our own "moistness, verdancy and germination power". She believed that we are all co-creators, containing the juice of creation within our souls. Her primary message to us all was to stay juicy, wet, green and moist so we can blossom and flourish, fight injustice, heal the earth, help others, and save the cosmos.

So, what can Hildegard's wise words say to us today? And how can we apply them to our own lives this Spring? After a long, cold, hibernation-brown period of winter, (or a time of unbalanced living or a period of compassion fatigue, itself), we all need some of the veriditas of Spring. We need to be brought back to life, to make ourselves "juicy, wet, green and moist" again so our work and our lives can blossom.

The first step toward reclaiming our aliveness is to make an assessment of the parts of our lives that are tired, brown and dessicated. Where do you need a little greening - in your physical life, your emotional life, your spiritual life, your relational life, your financial life, your work life, your creative life, your artistic life, your social life, your parenting life, your recreational life, your life in your home? Once we have determined where the dry places are, there are millions of individual options for encouraging our sap to rise. Here are a few greening possibilities that others have shared - if you have some more, please add your own.

1.  Go outside in the newly longer days. Do whatever you can out of doors. Soak in the longer hours of light. Move your exercise outside again. Feel the March winds on your face. Walk in the grass with your bare feet.

2.  B-r-e-a-t-h-e deeply of the spring air, noticing the scents of daffodils, cherry blossoms, rain, freshly mown grass and laundry airing on the line.

3.  Open your windows and listen to the birdsong - a sign of new life!

4.  Revamp your diet to include more locally-grown fresh fruit and vegetables. Try a green smoothie to boost your energy and stabilize your blood sugar.

5.  Spring clean - yourself and your environment. Out with the old and in with the new. Get a pedicure or a massage. Try a new haircut or make-up. Cull your wardrobe. Buy a new T-shirt. Wash the windows. Sew some fresh and simple cushion covers. De-clutter the shed or garage.

6.  Plant a garden that will feed your soul but not overwhelm you with weeds and work.

7.  Get up with the sun and spend your first half hour in quiet stillness - meditate, pray, be.

8.   Sit outside with a cup of tea and your journal. Write about your needs, your feelings, your dreams, self care, self intimacy, self nourishment. Create a gratitude or memory journal.

9.  Think of the things that make you happy and practice taking in the good several times a day.

10.  Do something creative every day. Write. Paint. Do woodwork. Quilt. Sing. Play an instrument. Dance. Film a video. Make pickles or bread. Arrange flowers.

11. Read something inspirational every morning and every night.

12. Laugh out loud - a big, belly-shaking, tear-stirring kind of laugh - at least once a day.

13. Spend time with people you love and tell them you love them.

14. Learn to live within your means and see a financial consultant to plan for your financial security.

15. Get sufficient sleep at night. 

16. Have regular, deep, thoughtful, transparent conversations about the things that matter.

17. Move your body whenever you can. Don't just sit - get up and move around. Stand up to do activities you might normally do sitting down. Exercise during TV commercials. Turn off the TV and go for a walk.

18. Make appointments for your medical and dental checkups and for a mental health tune up. 

19. Take a parenting class even if you've been a parent for a long time. There's so much great new information to learn.

20. Take a spring vacation with your partner to rejuvenate your relationship.

  

Taking In the Good! ...

Negative images, stories and experiences can permeate the lives of those of us who care for the suffering or traumatized, often leading to pessimism, low mood, irritability, anxiety, learned helplessness, relational difficulties and other signs of compassion fatigue.

And, to make matters worse, we humans have evolved a "negativity bias" in order to ensure our species survival. That is to say, in order to survive as a species, we have developed the tendency to pay more attention to negative experiences than to positive ones. (ie It is better to attend to the tiger stalking in the bushes than to the delicious meat roasting on the fire if we want our genes to carry on to another generation.)

This protective negative focus of attention, and the negative thoughts and feelings that flow from it, can, through a process called neuroplasticity, cause actual changes in brain structure - which then perpetuate the negative focus, thoughts and feelings. (It's a vicious circle.)

Dr Rick Hansen, PhD, author, neuropsychologist and founder of the Wellspring Institute for Neuroscience and Contemplative Wisdom, has studied neuroplasticity in depth and describes the negativity bias this way:

The negativity bias makes the brain like Velcro for negative experiences and like Teflon for positive ones.

Now, the good news in all this negativity is that we can use the same neuroplastic process to build our stress resilience and to bring more joy into our lives! We can do this by engaging consciously in a 3 step process that Dr Hansen calls, taking in the good. As Dr Hansen says:

Taking in the good (TIG) is not a Pollyanna-ish notion of endless positivity. (There are benefits to negative experiences - anger can fuel positive change, loss can make our hearts more compassionate, remorse can teach us higher values.) Rather, taking in the good is a focused psycho-spiritual practice of becoming aware of, and intentionally taking in, the positive experiences in our lives so as to re-sculpt our brains and thus our outlooks.

So, taking in the good is not a matter of denying the negative, but of weaving positive emotions, optimism, and resilience into our brains and our selves along side the negative. But how do we take in the good, exactly?

Dr Hansen's premise is that just having positive experiences is not enough.  Positive experiences tend to pass through the brain like water, while negative experiences get caught. We need to engage positive experiences actively to weave them into our brains:


Three Steps to Taking in The Good:


1.  Help a good fact to become a good experience.  

• Look at positive facts and let them become positive experiences. Pay attention to the good things in your world and inside yourself - the sun going down over an open field, the taste of a good meal, reading a great book, finishing the laundry, receiving a loving hug from your child, a kindness done, controlling your anger, lovely spring flowers, getting to the gym - and allow them to feel good, thus producing positive experiences.

2.  Savour the positive experience.

• Sustain the good feeling for 10-20-30 seconds without getting distracted. 
• Feel and intensify the experience in as many ways as you can. Do this at least 6 times a day.
• Notice any reluctance to feel good - thinking that you don't deserve it, that its selfish, vain or   shameful or that if you relax into it, something bad will happen.
• Acknowledge the reluctance then turn your mind back to feeling good.

3.  Sense and intend a soaking in.

• Sense and intend that the positive experience is soaking into your brain and body - registering deeply in emotional memory. You might want to visualize it flooding your chest with golden light or you might want to just think about it, conceptually, as a positive experience held in awareness.

Over time, your attention to positive experiences, using these three steps, will begin to change your brain structure and your outlook will alter as well. Why not give it a try? It could just change your life!

If you would like to learn more about taking in the good, try reading Rick Hansen's book, The Buddha Brain, or watching his videos on YouTube. 

Book Review: The Comfort Garden - Tales From the Trauma Unit ...

I'm late posting this week after spending two days on the livingroom floor, resting and exercising a wayward lumbar disc back into place. While the view from the floor was not exactly exciting, the opportunity to read Laurie Barkin's award-winning new book, The Comfort Garden, was.

Laurie was a psychiatric nurse consultant on the surgical trauma service at San Francisco General Hospital for five years before leaving to heal her own vicarious trauma. Her book is a memoir of her work with traumatized patients; her relationships with her coworkers and family; her interactions with a healthcare system losing its way due, in part, to managed care and compassion fatigue; her own journey through the pain of secondary traumatic stress; and the healing and sustenance she finds in SFGH's Comfort Garden.

This is a book worth reading by anyone who works with traumatized people and their families. Between Laurie's compelling stories lie many insightful observations and pearls of wisdom:

There's a word for people like Rochelle: counter-dependent; people so phobic of being weak and dependent on others that they deny their own normal needs. Lots of nurses are counter-dependent, caring for others but unable to care for themselves or to allow others to take care of them. I should know. I'm one of them.

Too many of us nurses are bad about self-care. We're overweight; we smoke; we overwork; we slip into addiction. We're so used to being the helpers that we can't see when we ourselves need help.

I had begun to wonder if I was in danger of losing my grip; if the random trauma and human cruelty I've witnessed every day at work for the past four years has been affecting me because of some defect in my character. Now I know that it may have something to do with the dose of trauma I'm exposed to every week in the absence of enough support to ameliorate it.

Our director ... created a buoyant work environment and hired energetic and idealistic staff... he taught us to exaggerate and celebrate miniscule moments of success with our patients. I have applied that lesson to my work with all patients ever since...

I walk in The Comfort Garden when I need to clear my mind (of the trauma stories).

According to the most recent journal articles, people who dissociate in response to trauma are the most likely ones to develop PTSD. However, a good social support system can protect a person from developing PTSD. 

Resonance between people - the warm and responsive embrace between two souls - protects and heals us from the world's ills and makes possible its greatest bounties. 

From the point of view of style, I found The Comfort Garden an easy read but from a content standpoint, I was introduced to people and situations so authentic and well-drawn that I had to pause from time to time to pace my emotional response. That is not to say that Laurie uses gratuitous descriptions in her story-telling. Quite the opposite, in fact. There are few "gory details". Rather, it is her accurate depiction of unrelenting trauma exposure that took me back to my work in hospital settings and triggered familiar emotions.

The feelings I felt most strongly, though, as I finished this book, were those of gratitude for fine nurses like Laurie Barkin and hopefulness for a future that acknowledges the impact of secondary traumatic stress and strives to provide support and build resilience for all trauma workers.

This touching and inspiring story received the American Journal of Nursing Book of the Year Award for 2011 and it is deserving of the honour.

If you are interested in ordering a copy of The Comfort Garden, you can go to the online store at Moss Communications Publishing.

Baby Steps Toward a Healthy Heart ...

February is Heart Month and as a former coronary care nurse, a former cardiac spouse, and a woman-of-a-certain-age, I take a particular interest in heart health.

I've always rather prided myself on not having any of the risk factors for heart disease but over the past few years, since stopping running and power-walking due to running injuries in both feet, I've noticed my weight beginning to creep up and my waist circumference increasing. This week, while doing the Canadian Heart & Stroke Foundation Risk Assessment, I had quite a rude awakening - one that has motivated me to clean up my dietary habits and to find an alternate way of getting The Montreal Heart Institute's recommended minimum of 30 minutes  exercise a day.

I have decided to reduce my sugar intake (my Achilles heel - I'm the original cookie monster!) and to ride my stationary bike at intervals throughout the day when its too cold and wet to want to take my usual walk around the lake. These two changes seem small enough to be manageable, (we so often sabotage ourselves by taking on too much at once), and yet large enough to make a difference. I will report back to you on my progress in making these changes over the next month. (And, if anyone wants to join me in making some "babystep changes" toward a healthier heart, you're more than welcome to post your intention here.)

While perusing the Heart & Stroke Foundation website, I found a number of great resources including 10 healthy eating guidelines and some delicious heart-healthy recipes. On their February calendar there are different dinner recipes for each day of the the month, including a particularly good one for Hearty Tuscan Soup.

There are also many fantastic, flavourful recipes in two of my favourite heart-healthy cookbooks  -

1.  Lighthearted at Home: The Very Best of Anne Lindsay by Anne Lindsay

2.  The Best of HeartSmart Cooking by Bonnie Stern.

Whatever your current state of heart health, I hope you will join me in taking the Heart and Stroke Foundation's Risk Assessment and then in deciding, with your own health professional, how you want to optimize your cardiac health. (Another gentle reminder that those of us who care for others do better when we care for ourselves first!)

Keeping the Love Alive ...

While some people seem to regard Valentine's Day as a commercial venture best avoided, I tend to think of it as a yearly opportunity to be intentional about expressing your love and appreciation in your most significant relationships.

It is easy, when caring for others all day long, to arrive at the evening hours exhausted, depleted and less than interested in conversation, let alone the amorous expressions of your significant other. The observance of Valentine's Day (or week), can offer a focused opportunity to begin to renew your connection with your loved one.

Research over the years has taught us that the work of physicians, nurses, psychotherapists, police, lawyers, clergy, and other professional helpers can have a profound impact on primary relationships. And a survey of 300 + family caregivers, published today at caring.com, revealed that although some believed that caregiving had enhanced and strengthened their relationships, 80% of respondents felt that caregiving had strained their relationship, 89% said that caregiving had kept them away from their spouse, 48% said that caregiving was causing them to drift apart, 46% felt that it was having a negative impact on their romantic relationship and 34% thought it had taken a toll on their sexual relationship. Harsh numbers, indeed.

So, how can we begin to re-pair our heart connection with our partners? It can be surprisingly simple, though not necessarily easy.

1.  Take care of yourself so you have the energy to nurture your relationship. Think back over the past year and acknowledge the times when you have really cared for yourself. (Don't be critical if there aren't too many. Just see today as a starting point for improving your self care.)

2.  Talk and listen to each other. Make space and time to reconnect with each other every day - even if it's only for a few moments. Protect that space and time. Reach out to each other, vent, and talk about your feelings, problems, expectations, frustrations and appreciations.

3. If possible, create a regular pattern of getting away together so you can connect at a deeper level - being geographically away from the sources of your stress can do wonders for your perspective. If you can't get away, create a vacation at home (or at a friend's home while they're away). Unplug from the electronics, don't answer the phone, eat delivery meals or cook together, watch a DVD, nest. (Remember to tell your family and friends that you're taking a break so they don't go into a in a state of panic when they can't reach you.)

4.  Get help with the responsibilities that drain energy from your relationship. Together, identify the top three or four drains on your relationship energy and brainstorm out-of-the-box ways of getting help. I spoke with a young woman recently who said her hectic life as the young mom, dancer and choreographer, and family caregiver had eased considerably when she and her husband decided to get a bookkeeper to handle their business books, to ask a local nursing student to babysit one evening a week for date night, and to share the housekeeping and baby care more evenly.

5.  Pamper each other. Do one small thing to pamper each other every day whether a neck rub, drawing a bath, buying coffee or a glass of wine to share in the garden, putting a love note in a bag lunch, breakfast in bed, making or going out for a special meal, offering to do one of your partner's chores, getting a massage together, going for a walk without the kids. If your partner is ill, he or she can recruit a friend to bring a selection of cards or gifts to your home to choose something for you on special days. Or try online shopping.

6. Remember that there's more to sexuality than intercourse. Even if you're seriously depleted or your partner is ill, you can still express your love physically. Spoon, hold, cuddle, stroke, touch each other tenderly without the expectation of intercourse, allowing loving closeness to be the goal.

7.  Take time to reflect upon your lives together. Remember the hurdles you've overcome and the pleasures you've shared. Visualize all the threads of memory that tie the two of you together. Early in my husband's illness we recognized that, in all the stress and grief, we might lose track of some of these stories, so we bought a beautiful "memory book" and wrote down, in detail, all the happy memories we could think of in our years together. It's now a wonderful gift to look back on on Valentine's Day.

8. If the loss of your loved one's cognitive abilities or the loss of the love in your relationship or the lack of a romantic relationship altogether makes you hate the very thought of Valentine's Day, tell someone you trust about your feelings or write about them in your journal or burn them out in some physical activity. Expressing them will usually bring some relief. Consider giving yourself a gift of flowers or chocolate or a spa certificate. Start a tradition of sharing time, cards, or small gifts with a friend or family. (My sister is taking me out to Barbara-Jo's Books to Cooks, tonight, for dinner and a lesson on cooking for one!)

Valentine's Day will mean something different to each of us but I wish each one the opportunities to make it a happy day.