Secondary Trauma for Caregivers and professionals Presenter Courtney Smith, M.Ed Blue Spiral Consulting

Contents History of Caregiver Stress and Secondary Trauma Trauma Exposure Response Trauma Stewardship Risk factors Prevention

History

Trauma Exposure Response Caregiver Stress Empathic Strain Compassion Fatigue Vicarious Traumatization Secondary Traumatic Stress Disorder First noted in the early 1990s in reference to Vietnam vets and Holocaust survivors. In 2007, CNN published an article about caring for aging parents and called it “Caregiver Stress” This report referenced a study indicated one out of every four families was caring for a relative over 50 and linking that caring to increased medical and health risks including higher blood pressure, diabetes, compromised immune systems and other illness linked to prolonged elevated stress hormones. Charles Figley used the term “Compassion Fatigue” and “Secondary Traumatic Stress Disorder.” Laurie Anne Pearlman, Karen Saakvitne and IL McCann refer to the process as “Vicarious Traumatization.” Jon Conte uses the word, “Empathic Strain”

Trauma Exposure Response Defined as the transformation that takes place within us as a result of exposure to the suffering of other people, living beings or the planet. Ways in which the world looks and feels like a different place to you as a result of the work that you do or the field that you are in.

What Does Trauma Exposure Response Look Like? Exhaustion Emotional numbing Removal of authentic self for protection Health concerns Ignoring needs of self and family Cynicism Suffering for the cause Martyrdom A culture of suck-it-up Keep going no matter what Over work Not stopping to process Participant page – 16 warning signs

http://www.youtube.com/watch?v=tAKPgNZi_as

What is Trauma Stewardship? Trauma Stewardship refers to the process of: How we come to do this work How we are affected by it How we make sense of and learn from our experiences How we manage our trauma exposure How we shift our practice over time What is Trauma Stewardship? Stewardship: the careful and responsible management of something entrusted to one’s care.

LaUra Van DerNoot Lipsky

Trauma Stewardship is: Remembering that what we do is a privilege and that answering the call to help is a sacred process. It means maintaining our highest ethics, integrity and responsibility to ourselves, to those we help, and to the systems in which we are helpers. In many ways, this work is spiritual in nature and so requires a daily practice.

Trauma Stewardship includes: Daily practice through which individuals, organizations and societies tend to the hardship, pain or trauma experienced by humans, other living beings, or the planet itself. The understanding that both joy and deep pain are realities of life and that suffering can be transformed into meaningful growth. Knowing that self care is the only solution to caregiver fatigue and secondary trauma Modeling SELF CARE Teaching self care strategies that work

Risk factors

16 Warning Signs of Trauma Exposure Response Feeling Helpless and Hopeless A Sense that One Can Never Do Enough Hyper vigilance Diminished Creativity Inability to Embrace Complexity Minimizing Chronic Exhaustion or Physical Ailments Inability to Listen – Deliberate Avoidance Participant page – 16 warning signs

16 Warning Signs of Trauma Exposure Response Dissociative Moments Sense of Persecution Guilt Fear Anger and Cynicism Inability to Empathize/Numbing Addictions Grandiosity – An Inflated Sense of Importance Related to One’s Work

Notion of scarcity and “not enough-ness” comes from a larger framework of systematic oppression. Internalized oppression happens when victims believe in the notion of scarcity. The oppressor creates a climate in which people feel there is not enough – so they conform to the oppressor’s ideals to survive. p. 60 Will we ever be Black enough? Man enough? Gay enough? NY City’s Administration for Children’s Services (ACS) has actually used this “enough” concept to recruit social workers p. 62 Culture of pushing yourself to your limits at the expense of your health and your family for the good of the cause and not taking care of yourself and your own family’s needs. Never Enoughness

Hyper Vigilance Difficulty staying fully present in the moment Hyper vigilance to the work to the exclusion of everything else. Feelings that everything around is exaggerated, significant and dangerous or a safety concern. Feeling like we are always “on” even when there is nothing to do Trauma First Aid p. 65 Arousal response Examples: No spending the night with ‘pedofiles’ GAP shopping trip causes trauma exposure response to clothing and human trafficking

Diminished Creativity Bored with what you’re doing Stagnant practice that looks the same with everyone Inability to have periods of rest that fuel creativity Workplaces that create environments where creativity isn’t valued or encouraged

Chronic Exhaustion/Illness There is a difference between feeling tired because you have put in a hard day’s work and feeling exhausted in every cell of your being. Trauma exposure is tiring. As exposure accrues, our bodies and minds require extra attention to be fully rested and refreshed.

Inability to Listen- Deliberate Avoidance When avoidance is a regular habit in your life, the highlight of your workweek is when you don’t have to do your job. Often shows up in our personal lives – Don’t answer the phone Only hang out with people who “get it” Superficial engagements with people

“I feel guilty because I can leave at the end of the day” “I went shopping last week for a pair of shoes, and I thought to myself, “What kind of a persons would go shopping for a pair of shoes right now?” – Katrina worker Thich Nhat Hanh Should we work to enjoy and appreciate the beauty in life? No, whould should not ever have to work to tak in what is beautiful, sacred, precious. Minimizing your own family, hobbies, sense of self, feelings of hopefulness and optimism in contrast to what and who you are working for.

Prevention Look in the slide notes below for topics to consider talking about Consider talking about: Personal self-care Social self-care

Mindfulness or Meditation Practice Daily Practice 1 Mindfulness or Meditation Practice 2 Gratitude Journaling 3 Physical Exercise 4 Concrete plans for self care and relief

Shawn Achor – The Happy Secret to Better Work https://www.ted.com/talks/shawn_achor_the_happy_secret_to_better_work

Metta Meditation May I be happy May I be peaceful May I be well in body and mind May I be free from suffering May I experience lovingkindness Levels of Metta Loving-kindness Myself “May I. . . .” Beloved “May he, she. . .” Neutral “May he, she. . .” Difficult “May he, she. . .” Humanity “May we all. . . “

For More information: Courtney@bluespiralconsulting.com