Spring 2016 Vancouver Compassion Fatigue Workshop ...

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

 Dr Rachel Remen, MD

Hi Everyone!

 

The Caring On Empty: Creative Tools for Compassion Fatigue Resilience for Helping Professionals workshop will be held at the Granville Island Hotel on May 6th this year and we hope you can join us!

Compassion Fatigue, (the natural posttraumatic stress, "fatigued" compassion, diminished desire to be empathic and emotional disengagement from the very people we're trying to help), affects most helping professionals at various times in our careers. It develops as we hear and respond to more and more stories of others' trauma, loss and suffering.

Some warning signs that we may be at risk for developing Compassion Fatigue are the loss of our sense of humour, feed-back from our family and friends that we're not fun anymore, dreading going back to work no matter how much time we've had off, profound exhaustion, sleep difficulties, irritability, anger and cynicism, uncivil behaviour, anxiety, emotional numbness or over-reactivity, social isolation, self medicating, increased sick time and feelings of helplessness and hopelessness.   

This small (only 25 seats), discovery-based, multidisciplinary workshop will provide a safe and reflective space for:

*  Exploring the concept of Compassion Fatigue (CF) and how it differs from burnout,

*  Discovering your current CF risk and identifying personal early warning signs,

*  Assessing your current level of self care and learning to reduce trauma exposure,

*  Learning positive, practical strategies for reducing CF risk and building resilience and

*  Creating an ongoing personal resilience plan.

The workshop uses mini-lectures, film, self-reflection exercises and group interaction to help participants awaken to their current level of CF risk and create a personalized resilience plan. Others have loved the relaxed energy of this workshop and left asking for more!

So, if your work involves hearing stories of others' trauma and suffering - health care professionals and support staff, educators, therapists and counsellors, addiction workers, family court lawyers and judges, journalists, humanitarian workers, first responders, translators and interpreters, social service providers, clergy and pastoral care workers, and others -  this is the workshop for you. I hope to see you there! 

PLEASE NOTE:  The registration deadline is extended to April 22nd. 

You can email Jan at caregiverwellness@shaw.ca for a registration brochure.

Please share this information with colleagues and friends - Anti-Spam Legislation makes it more difficult to tell people about the workshop this year. Thank you!  Jan 

Softening A Hardened Heart ...

There is beauty to seeing stone 

turned to moist soil, broken open, receptive

to the seeds of love.

Omid Safi

Hi Everyone!

Last time, we spoke about how our hearts can become hardened through repeated exposure to our own and others' trauma. Today, I'd like to move on to how we can begin to soften our hearts, allowing us to receive more love, nurture and support.

We all have a wall around our hearts. According to Persian tradition, the heart is a walled garden, an inner garden protected by an outer wall. When we have experienced great pain, our own or others', that wall can become a hardened fortress, protecting us but also keeping out the very ones who could be a source of our healing and renewal.

Omid Safi, Director of the Islamic Studies Centre at Duke University, likens this hardened heart to dry land - hard, parched and cracked. To break it open, to till and water it so it is ready to receive a seed of love, (a kind glance, a touch, a word, a compassionate action), takes time, patience, effort and vulnerability.

As Professor Safi says:

The seed of love falls on the heart's soil. Is it a hardened earth, a rock-covered surface, one that will have the seed washed away with the first water? Or is it a soil that has been prepared, tilled, softened up, opened up again and again and again, ready to embrace the seed of love that would surely come?

When we suffer Compassion Fatigue, our hearts' soil hardens and we become less receptive to the seeds of love sown by our colleagues, family and friends. As we recognize and acknowledge that this is the case, we can consciously make an effort to till, water and soften that soil.

Three ways we can soften the soil of our hearts are to practice self compassion, learn heart-centered spiritual practices and consciously allow ourselves to open up and become more vulnerable in our daily relationships.

1.  Self-compassion researcher, Kristin Neff, describes self-compassion as, "acting the same way toward yourself when you are having a difficult time, fail, or notice something you don't like about yourself, as you would toward a friend." She says that instead of just ignoring your pain with a "stiff upper lip" mentality, you stop to tell yourself, "This is really difficult right now. How can I comfort and care for myself in this moment?" You can learn more about practicing self-compassion on her website. 

2.  Heart-centered spiritual practices can be found in most spiritual traditions. The point of these practices is not to resolve our emotions or to figure them out but to simply to allow them to have some space within us without pushing them away. Here is one (slightly abridged) practice written by Christine Valters Paintner, PhD, Benedictine Abbess of the virtual online monastery, Abbey of the Arts.  (It is a simple practice that should only take about 5 or 10 minutes to complete.)

1.  Begin by becoming aware of your body. Notice how your body is feeling simply by being present to sensations you are experiencing, welcoming in both the body's delight and discomfort. 

2.  Connect to your breath, deepening it gently. As you inhale, imagine Love breathing life into you. As you exhale, allow yourself to experience a moment of release and surrender into this time and place, becoming fully present. Take a couple of cycles of breath to simply notice this life-sustaining rhythm which continues moment by moment even when you are unaware of it.

 3.  In your imagination, gently allow your breath to carry your awareness from your head (which is your thinking, analyzing, judging center) down to your heart center (where you experience life from a place of greater integration, feeling, and intuition). Consider placing your hand on your heart to experience a physical connection with your heart center and draw your awareness to this place.

 4.  Breathe into your heart center and begin to notice what you are feeling right now in this moment without judging or trying to change it. Take a few moments to simply be present to whatever you are feeling and making some room within yourself to experience this without pushing it away (this alone can be revolutionary for many of us - to just allow ourselves to have the experience we are having without judgment.)

 5.  Call to mind the spark of Love which the ancient monks and mystics tell us dwells in your heart. Bring the compassion of Love to however you are feeling right now, not trying to change anything, but just gently holding yourself in this space.

 6.  As you experience yourself filling with compassion for your own experience, imagine breathing that compassion out into the world and connecting with other hearts beating across the world in a rhythm of love.

 7.  Gently allow your breath to bring your awareness back to the room and take a moment to name or write what you noticed in this experience.

3.  Becoming more vulnerable to others, the third way we can soften the soil of our hearts, may seem like a risky weakness in our toughness-saturated workplaces. But, as shame and vulnerability researcher, Brene Brown, writes, "Vulnerability sounds like truth and feels like courage. Truth and courage aren't always comfortable, but they're never weakness."

It takes honesty and courage to open ourselves to speak from our tender places and to receive the healing love of others. While it is important to choose wisely those with whom you will be vulnerable, it is also important to have people in your life with whom you can really be yourself, "warts and all", knowing that you will be accepted and respected. To learn more about intentional  vulnerability, try listening to Brene's TED Talk on The Power of Vulnerability .

There are many more wonderful ways to soften the soil of our hearts but these three are a good start. Let me  leave you, once again, with the words of Omid Safi - There is beauty in stone being turned to moist soil, broken open, receptive to the seeds of love.

May this Valentine's Day bring each of you an opportunity to soften your heart and receive some much needed seeds of love.

  

The Hard Heart of Compassion Fatigue ...

We seem to value "strength". We want "hard" bodies, "strong" minds, "tough" wills, "hard-as-nails" determination,"rugged" personalities, "sturdy" character and so on. ...  But let us praise softness. ... Let us seek a heart that is not hard, but soft.

Omid Safi

Hi Everyone!

This is a story about hard and soft hearts written by life coach, Darren Poke, in 2011, in Melbourne, Australia. I'd like to share it with you today as we approach Valentine's Day:

There was a young man named Tom who lived in a small village.

He was an angry young man, overreacting to every offense and keeping others at a distance.

 In desperation, his parents asked Tom to go and see the eccentric old priest who lived in the village.

The priest was renowned for his unorthodox methods that somehow worked.

When Tom saw the priest, the older man told the youth to go away and come back with two lumps of clay.

He returned a few hours later and then was told to make a vase out of one of the lumps.

The young man thought that this must have been part of the therapy, so he threw himself into the task with enthusiasm, believing that the opportunity to create art would help him with his temper.

He made the vase, decorated it and put it in the kiln to harden.

Upon completion, Tom presented the beautiful vase to the priest. He was proud of his accomplishment and believed that he was now cured of his anger issues. 

The priest smiled approvingly and gave the young man a hammer.

"Now hit the vase with this hammer," the priest commanded.

"But it will break my beautiful creation!" Tom protested.

"Hit the vase with this hammer," the priest insisted.

"Don't you like it? Isn't it good enough for you?

"Hit the vase with this hammer," the priest continued.

Annoyed, the young man snatched the hammer from the priest and tapped the vase firmly.

The vase immediately smashed into pieces.

"Now look what you've done," Tom said angrily. "You've wasted all of my hard work."

The priest ignored the outburst and left the room for a moment.

He returned with the second lump of clay and placed it on the floor next to the young man.

"I suppose you want me to waste my time by making another vase? Well you can forget about it!" Tom said rudely.

 The priest looked at him with kindness and said,"Hit the clay with the hammer."

"With pleasure!" the young man responded.

He swung the hammer with all of his might and it hit the clay with a thud, leaving a large mark.

"Happy now? What was the point of that?"

The priest picked up the broken pieces of the vase and held them in his hands before the young man.

"See this vase? This is like your heart. You think that you need to be hard to cope with the inevitable disappointments that happen in life. You respond with anger, bitterness and violence, keeping people at a distance, but it doesn't work. Your hardness makes you more fragile. Adversity breaks your spirit too easily."

The priest then picked up the lump of clay, it had a mark where the hammer had hit it, but it was still in one piece.

"You need to soften your heart and be more like this clay. It is still impacted by what happens to it, but it can be restored more easily. A soft heart forgives, loves and uses soft words. It understands that pain and suffering is a part of life and instead of fiercely resisting, it absorbs the blow. It still feels the pain, but isn't broken by it."

The protective hardening of our hearts is a common way of dealing with over-exposure to others' trauma and suffering. Some people make a conscious decision to create a wall of coldness, withdrawal, anger or prickly behaviour, (I know someone who calls this her "force field"), in order to save themselves from further pain. Others don't even notice that their hearts are becoming stony. It happens so slowly and insidiously that they are shocked when others point out that they no longer seem to care.  However it occurs, this hardening eventually takes its toll and we pay the price in the irritability,  brittleness, reactivity, cynicism and emotional fragility that are hallmarks of Compassion Fatigue.

So, how is it with you right now? Is your heart so hard that, instead of feeling protected, you are shattered by any bad call, hard session or emotionally intense event? Are you wondering where the caring person inside you has gone? Are you wishing you could soften your heart and become the person you used to be? Are you afraid to try for fear of being shamed in a workplace culture that only seems to value strength and toughness?

In the next post we will look at some useful practices for beginning to soften our hearts ( - just in time for Valentines Day!).

 

Celebrate! ...

Life should not only be lived,

it should be celebrated!

Osho

Hi Everyone!

So this week I reached one of those BIG birthdays and I've be feted, gifted and feasted all week. There's a bouquet of cards on the mantle piece, one of spring flowers on the kitchen table and a small grouping of gifts, waiting for new homes, sitting on a chair in the dining room. And it's not over yet. Tomorrow, my middle sister will host a Scottish Afternoon Tea for me and sixteen of my closest friends. My heart overflows with happiness and gratitude in the face of all this celebration. I feel loved and supported and energized for the next decade.

The Oxford English dictionary defines celebration as publicly acknowledging a significant or happy day or event with a social gathering or social activity. So it's not just a matter of feeling happy and grateful in your own heart, it's a matter of sharing that happiness with others in some public way. (Or, perhaps, sharing a more complex emotional experience like grief or hope.)

Throughout history, we've created gatherings, ceremonies and rituals to celebrate any number of situations  - births, deaths, survival, defining our identities and acknowledging to whom we belong, changing seasons, planting and harvest, anniversaries, welcomes and leave-takings, establishing relationships and ending them, and marking developmental milestones and life transitions.

In times past, more formal celebrations have centered around our religious institutions. Today, as these institutions are less central to life in neighbourhoods and communities, people known as celebrants can help us to plan individualized celebrations.

Why should we go to all the trouble of celebrating ? Because it's good for us. It allows us to connect with our emotions and with our fellow human beings. It builds our strength. It reinforces positive aspects of our culture and spirituality. It roots us in the rhythms of Nature and of Life itself. 

I think it is important for those of us who care for others, at home or at work, to intentionally find things to celebrate. Celebrating builds energy. It binds teams and communities together. It builds hope and motivates us to keep moving forward. Sometimes, when we face obstacles or when progress is achingly, frustratingly slow or when, in fact, the situation is actually deteriorating, it can seem as though there's little or nothing to celebrate and we become saddened and discouraged. 

These are the times when we most need to find something to celebrate or commemorate with others. These are the times when we can look to the ordinary stuff of life - having learned a new skill, feeling healthy, getting through a rough week, having a time of respite, acknowledging acts of synchronicity or unexpected blessing, the love and support of family or friends  - for something to celebrate. One of my favourite celebrations for helpers is the Blessing of Hands , often held during Nurses Week in this country. There is something uplifting and sustaining about having such (extra)ordinary things as one's hands blessed so they can continue to be a blessing for others.

Celtic poet and philosopher, John O'Donohue, has written a blessing to remind us of the importance of celebration. You'll find it in his well-loved book, To Bless the Space Between Us: A Book of Blessings:

Now is the time to free the heart,

Let all intentions and worries stop,

Free the joy inside the self,

Awaken to the wonder of your life.

Open your eyes and see the friends

Whose hearts recognize your face as kin,

Those whose kindness watchful and near,

Encourages you to live everything here. 

See the gifts the years have given,

Things your effort could never earn,

The health to enjoy who you want to be

And the mind to mirror mystery.

May each of you find something, small or large, to celebrate this week!

Paramedic and Family Caregiver "First Responder" Stories

Many of our first responders will be diagnosed with PTSD during their careers, and will battle mood disorders, substance abuse, and suicidal thoughts as a result.

These are kids who live on borrowed time and would test anybody's resilience.

                                                     

Hi Everyone!

While making my monthly stop at CBC Radio's, White Coat, Black Art, I've just come across two programs that are well worth your listening time. The quotes above are from the series host, Dr Brian Goldman, MD.

1.  The first program, Sock Drawer Stories: Portraits of Hope and Healing, describes the posttraumatic stress of emergency paramedics, one in particular who learned to deal with her PTS symptoms through painting. Teresa Coulter paints powerful portraits of colleagues with PTS, "opening their hearts and her's to healing". 

Teresa uses the analogy of a sock drawer (similar to the "file folder in your chest" you've heard me speak about in workshops) to describe what happens when we take the memory and emotion of each "bad call" or medical emergency or other trauma and stuff it in the back of our sock drawer. This works pretty well in the short term, allowing us to "forget" the trauma and present an "I'm fine!" face to the world. However, as time passes and the drawer fills up, opening it to add one more memory can cause all the old memories and feelings to fly out onto the floor.  This is what happens when we find ourselves "over-reacting" to a situation. It makes our PTS warning signs come out on full display.

In this piece, Teresa and her colleagues are interviewed by Brian Goldman about their PTS experiences and their individual paths to healing. 

2.  The second program, One More Thing Moms' Club, describes the experiences of another group of "first responders", a passionately articulate group of family caregivers in the Ottawa area faced every day with the frontline primary care and advocacy for a child with complex illness. While these Moms discuss the realities of life as they care for their children, much of what they say also applies to those caring for adults with similar conditions.

When I first saw the name of this support group, it occurred to me that it could have more than one meaning. Not only are these parents people who always have "one more thing to do" but they also have " one more thing to ask" of helping professionals exiting the room  because there's always another question, arrangement or issue to stress. I can't think of a more apt name for this group!

The unabridged interview with this amazing group of caregivers is well worth hearing in its longer-than-usual format.  

I hope you can take the time to settle into a big chair with a cuppa and really listen to both of these excellent programs. You'll come away inspired.

   

Compassion Fatigue: Who's At Risk?...

A case manager is supposed to do just referrals and that's it, but many times ... you're the first one that they're telling ... everything to. ... You end up hearing everything as if you were their psychologist and (it is hard to know) how to deal with those emotions when sometimes we don't have training aside from whatever we review.

Case Manager, Los Angeles Children's Hospital

Hello, everyone,

It's the beginning of a new year, so I thought we could go back to the basics today and take a fresh look at who is at risk for Compassion Fatigue (CF).

The primary criterion for determining CF risk is exposure to the trauma stories of the people we serve.  (Other vulnerability and protective factors also come into play but this is the primary contributor.) The greater and more graphic the accumulated trauma exposure, the more likely we are to develop CF.

These days, we are quite used to thinking of moderate CF as a natural consequence of working as first responders (paramedics, physicians, nurse practitioners, fire and police professionals, and humanitarian and victim assistance volunteers) or other helping professionals like nurses, teachers, social workers, lawyers, prison workers, mental health professionals and clergy. On the other hand, there are helpers at risk of CF who don't come to mind so readily.

In one of the best written articles on CF I've read in a while, Sophie de Figueiredo and her colleagues at Children's Hospital, Los Angeles and USC describe the cross-diciplinary experience of CF among service providers for highly traumatized children and adolescents, focusing much of their attention on case managers. 

We rarely think of medical receptionists, medical office assistants or case managers as being at risk and yet, of course, they are. Not only are they often the first to hear peoples' trauma stories and crises, they can be obliged to write or re-tell these stories again and again as they communicate information to other helpers, thus increasing their exposure exponentially. Hear some of the case manager risk factors de Figueiredo reports in her 2014 article in Traumatology:

Descriptive findings provide evidence to suggest that case managers may be more susceptible to CF than other providers. Their caseloads were significantly larger than those of other provider groups. They were less likely to report having access to reflective and individualized supervision and reported higher dissatisfaction with the amount of supervision they received. Generally, they were younger and reported fewer years of education. Case managers were also less likely to receive trauma-specific training in traumatic stress or on the effects on providers of working with traumatized populations... Unfortunately, these providers received the least amount of support to address and combat the development of (CF and burnout).   (p 293)

Also at risk are middle managers and administrators who may hear the most difficult of the trauma stories and situations, ones that can't be dealt with lower in the hierarchy, and yet have no primary "hands-on" contact with the trauma survivors and thus are left holding painful stories without an outlet of direct action to alleviate suffering (the survivors' or their own).

This fall, I've also been surprised to speak with a number of 5th Step volunteers in 12 Step Programs who have developed CF over years of hearing others' 5th Step stories. (The 5th Step = "We admitted to God, ourselves and to another human being the exact nature of our wrongs.") Hearing "the exact nature" of others' behaviours while in the throes of addictive behaviour can be more than a little traumatizing, though I have to admit I hadn't thought to include these folk within the fold of CF risk.

Others who might be at risk but not necessarily cross our minds as needing education and support are the translators/interpreters and community volunteers who are making significant time, energy and emotional commitments to the Syrian refugees coming to Canada over the next few months. These helpers may have little or no understanding of the potential impact of refugees' trauma stories on their lives. It will be crucial to provide these caring folk with CF information before they become overwhelmed by trauma stories of the people they seek to help.

Not-for-profit workers in food banks, meal programs, community outreach programs and disease-specific support organizations may also be at risk and unprepared.

Even librarians can suffer CF in some circumstances. Librarians and library techs in home library programs form strong, long-lasting bonds with homebound patrons who can experience the abuses and/or traumas and losses of chronic ill health and disability. During harsh weather and harsher economic times, the homeless and displaced may also seek shelter in community libraries and spend time sharing their stories with kind but untrained and unprepared helpers.

These are just a few of the under acknowledged at-risk populations that come to mind this morning. I'd be interested to hear of any others you believe to be poorly recognized.

A Word for 2016 ...

What is your word for the year ahead? 

A word which contains within it a seed of invitation to cross a new threshold in your life?

Christine Valters Paintner

Hello everyone!

Here we stand on the edge of 2016, a new year full of promise and possibility. Thresholds such as these are times when we can consciously choose to relinquish the old, the tired and the overly familiar to step into a new space with arms and eyes wide open, ready to receive whatever gifts await us in the months ahead.

Thresholds are in-between places where the old is gone and the new has not yet arrived. In many spiritual traditions, these thresholds are seen as sacred places where the veil between earth and heaven is particularly thin. They are places where we can pause to reflect upon the past, deciding what wisdom and experiences we want to take forward with us into the new year. They are also places where we can look ahead with intentional openness to all that is to come. The ancient Celts, who honoured such thresholds, believed that there were unseen presences in these liminal spaces waiting to support us as we step onto new paths.

A more concrete support for the journey, one about which I've written in the past, is the process of allowing a word to "choose you" and act as a guide through the new year.  (You can click on the link to see the steps in this process and "receive" your own intuitive word for 2016.) 

As I look back over the past few years, I can see the positive effect wrought in my life by receiving and reflecting upon each guiding word. There is a clear (to me) connection among the four words I've "received" since learning about this enlivening tradition and I can see, in retrospect, how each has built on the one before. The words I've received thus far are act, veriditas, suppleness and alive.  I will be excited to see what my unconscious will produce for 2016.

As we each wait for our word to come clear, let me leave you with one of Jan Richardson's lovely blessings (you know how I love the notion of blessing!) along with every good wish for this new and beckoning year.

Blessing the Threshold

This blessing 

has been waiting for you

for a long time.

While you have been 

making your way here

this blessing has been 

gathering itself

making ready

biding its time

praying.

This blessing has been

polishing the door

oiling the hinges

sweeping the steps

lighting candles

in the windows.

This blessing has been

setting the table

as it hums a tune

from an old song

it knows,

something about

a spiralling road

and bread

and grace.

All this time

it has kept an eye

on the horizon,

watching,

keeping vigil,

hardly aware of how 

it was leaning itself

in your direction.

And now that

you are here

this blessing

can hardly believe

its good fortune

that you have finally arrived

that it can drop everything

at last

to fling its arms wide

to you, crying

welcome

welcome

welcome.

Welcome to 2016, dear friends!