SURVIVING COMPASSION FATIGUE AKA Secondary & Vicarious Traumatization HELP FOR THE HELPER Beverly Kyer, MSW, ACSW Compassion Fatigue Specialist 2015

Learning Objectives Learn the Service Provider’s vulnerability Learn factors that cause CF and burnout How to become resilient in the face of overwhelming and emotionally intense demands. Learn new ways to care for ourselves. New ways to support co-workers and increase morale To be accountable to someone who will support you and help you say “no” Learn planned intentional strategies for “self care”

What is Compassion Fatigue ? AKA Vicarious or Secondary Trauma Compassion Fatigue is a syndrome which consists of various symptoms that mirror Post Traumatic Stress Disorder (PTSD) PTSD is a disorder that affects people who have experienced extreme traumatic or violent events in their lives such as natural or man made disasters; being victims of violent crimes, domestic violence, child sexual or physical abuse

What is Compassion Fatigue ? AKA Vicarious or Secondary Trauma People who develop the disorder similarly report episodes of fear, depression, confusion, helplessness, hopelessness, feeling out of control, extreme mood swings, avoidance behaviors, etc. People who develop Compassion Fatigue have not been direct victims of trauma, but have intense involvement with people who have

Who Can Get Compassion Fatigue? People who provide care, assistance and support to others in pain, either physical or emotional, tend to be empathetic and compassionate. These necessary qualities that help them to do their jobs, place them in the direct path of experiencing secondary and vicarious trauma AKA compassion fatigue symptoms. Many helping professionals and caretakers as a result of listening to stories or witnessing the aftermath of traumatic events could develop many of the same symptoms associated with Post-Trauma Stress Disorder including symptoms that are more insidious.

Burn out Stems from overwhelming demands of tasks. Does not come close to the impact of CF The distinction is the sympathy/empathy caregivers experience from the suffering of others. Where children are concerned, this is often outside of the realm of what we expect as caring human beings Burnout has a better prognosis for recovery. Beware the combination of both CF and Burn out.

Some Causes and Triggers Working with adults and particularly children who are victims of trauma Lack of training in dealing with issues of trauma and it‘s subsequent outcomes High ideals of making a difference in the lives of children and adults Personality traits of compassion and empathy Past histories of trauma or victimization in the worker Lack of consistent self-care behaviors and habits Working with large numbers of traumatized and/or victimized people

Stop and reflect on this If trauma is not quickly “integrated “ and the changes in the anatomy, biology and neurology become chronic, it makes people more vulnerable to such events in the future. The body loses its natural rhythms for regulating arousal and relaxation; entering a seesaw between hyper arousal and hypo arousal; moving the person from explosive emotions to numbness fatigue, detachment and isolation……. Let’s share in a discussion to anchor your understanding

Critical Brain Systems Hippocampus Orbitofrontal Cortex (Social/Emotional Control Center) Pituitary Gland Brainstem (Lower Limbic/Reptilian) Amygdala Spinal Cord (Lower Limbic/Reptilian) Neural Circuitry Adrenal Glands

The Professional Impact of Compassion Fatigue Low morale Low motivation Avoiding task Obsession about details Apathy Negativity Lack of appreciation Detachment Poor work commitments Staff conflicts Absenteeism Exhaustion Irritability Withdrawal from colleagues Loss of confidence

Personal Impact of Compassion Fatigue

A POTENTIAL CONSEQUENCE OF UNMANAGED TRAUMATIC STRESS Let’s take the test A POTENTIAL CONSEQUENCE OF WORKING WITH TRAUMATIZED PEOPLE

Seek/Ask for help when you: Have difficulty separating work from your personal life [vicarious?] Dread working with certain individuals See the world in terms of victims and perpetrators Experience increased transference and counter transference issues with certain individuals Struggle with acute or chronic sadness

The body keeps score of the small things too. Examine stressful scenarios Exercise on personal examples _________________________________________________________________________________________________________________________________________________________________________________________________

Our Challenge Care professionals Care providers Care givers are often trapped in this role and personal over identification which leaves us bereft of asking for help What you do is not who you are ! Never confuse having a career with having a life

TEAM STRESS FEUD Identify the Impact-Symptom Poor concentration __________________ Preoccupation with trauma __________________ Overly sensitive __________________ Accident proneness __________________ Questioning the meaning of life _______________ Increased interpersonal conflicts ______________ Sweating _______________ Chronic and intensifying physical illness ________ Perfectionism _________________ Losing things _________________ Mistrust _________________ Loss of faith _________________

Narrative The Road to Wellness The power of story and the restorative quality of personal self awareness clearly aids in rebuilding life quality. The story becomes a component of the journey back to wellness. Herman,1992; Dietrich et al, 2000 Tell the story of why…………….

Cognitive Restructuring 1st line of defense: stress inoculation; a process to build up positive thoughts when negative events are encountered. The aim is to modify the internal dialog Focus on yourselves: Ask. Where am I in the moment? Label your feelings and link to physiological response Regulate self with positive spin; block toxic thinking (examples) Look beyond the immediate and move to general themes and patterns

Cognitive Restructuring Phase 1: INPUT (sight or sound) Phase 2: PROCESSING INPUT conscious interpretation reasoning analyzing memory Phase 3: OUTPUT (action or behavior) You are making a conscious appraisal of the stimuli while blocking toxic thoughts Meichenbaum

Cognitive Restructuring What we say to ourselves creates an internal environment in which we either flourish of flounder. We must challenge our internal dialog to create a peaceful inner world. “Call those things that be not as if they were”

Develop Your Therapeutic Community Reaching out to others who will: Lift us and validate our self care habits Hold us accountable for our self care Support our sense of resilience Not allow us to isolate Nurture us Delightfully immerse us in humor

Stress Reduction Creating Your Own Sanctuary Stress Relief Funny Stress Management EXERCISE Creating Your Own Private Sanctuary to Heal Everyday Through Structured Self Care Plan & design your time and space

Everyday Strategies for Self Care Boundaries: 40-60 to 30-70 Realize the mind-body connection Talk it out/process with someone Discharge and Recharge Self-sooth and pamper (sanctuary time) Breathing techniques (3 – 6 technique) Spiritual feeding and lifting Being accountable to someone who cares

Every Day Release, Refuel and Recharge Techniques Emotional Freedom Technique Muscle release/Tense to relax Thought blocking Humor Meditate/quiet your mind Brisk Walk Dance

Structured Self Care Professional Quality of Life Scale (ProQOL) www.proqol.org Plan and develop a “Self Awareness and Action” template to keep on hand Body scan Self Management Plan /Anxiety Reduction Dual awareness The Callahan Techniques/tapping Recovery and resilience blue print

Plan and develop a template to keep Structured Self Care Plan and develop a template to keep List things you will pay attention to during each session List what you need when you are with the client List things you will do between sessions List things you will do at the end of each day or evening List things you will do each week; bi-monthly; monthly Now discuss these plans with someone(s) you will be accountable to

TOOLS FOR THE ROAD Cognitive Negative Awareness Relaxation/pamper Meditation Mindfulness Journaling Creating Narratives Exercise/Asian Massage Dance Therapy Baroque Music The Arts Reading Feeding your Spirit Thera-play Nutrition Aroma therapy Art creation

What are your plans for self care ? Psychosomatic Wellness Conclusion What are your plans for self care ? _______________________________________________________________________________________________________________________________________________________________ A gift of refreshing Psychosomatic Wellness

Beverly Kyer, MSW,ACSW CEO & Founder, The Kyer Group Corporation We Help The Helper Survive Compassion Fatigue ORGANIZATIONS * GROUPS INDIVIDUALS* COUPLES* FAMILIES   WE ARE A TEAM OF TRAUMA INFORMED SPECIALIST WHO PROVIDE TRAININGS * CONSULTING * COACHING * RETREATS HIGH QUALITY SERVICES ARE DELIVIERED AT YOUR CONVENIENCE IN PERSON * PHONE CONFERENCE * SKYPE SESSIONS TO SCHEDULE A FREE PHONE CONSULTATION WITH MS. KYER AND BE ASSIGNED THE BEST TEAM MEMBER FOR YOUR NEEDS, CONTACT E-mail: kyergroupcorp@gmail.com www.beverlykyer.com