1. www.cambridgesupervisiontraining.com Anthea Millar
What is Trauma? DSM 5 (2013)
Direct exposure to actual or threatened death, serious injury and abuse
Witnessing traumatic events happening to those close to us.
Repeated extreme exposure to aversive details of traumatic events.
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2. What is Second Hand Shock? (ref: Izzo & Carpel Miller 2010)
Vicarious Trauma
Secondary Traumatic Stress
Compassion Fatigue, Burnout
Vicarious Trauma
Secondary Traumatic Stress
Compassion Fatigue Burnout
Izzo and Carpel Miller identify 3 modes of SHS -
The terms Vicarious Trauma, Secondary Traumatic Stress and Compassion Fatigue/Burnout have often been used synonymously – but key experts in this field (eg Figley, Pesrlman and Saakvitne, Izzo and Carpel Miller) have identified differences – They are all related and overlap to some degree –and mirror symptoms associated with PTSD
Compassion fatigue: Some re-experiencing of events or traumatised person / numbing off Long term exhaustion and diminished interest in one’s work – a lessening of compassion over time as a result of the taxing nature of extending compassion to those in need - apathy
Burnout: different extreme circumstance – major impact on physical/and or mental well being due to impact or overload of work.
Secondary Traumatic Stress: The natural consequent behaviours and emotions that result from knowledge of another’s traumatic experience. (Figley) experience intrusive thoughts, bad dreams, anxiety, insomnia, unexplained illnesses – echo of PTSD
Vicarious Traumatisation: a permanent transformation in the helper’s inner experience resulting from empathic engagement with a client’s traumatic material….or simply: a set of cognitive, emotional, physical and spiritual disturbances - this workshop will focus particularly on vicarious trauma as this is more subtle and covert – creeping up slowly –
Summary
If feeing less compassionate /apathetic about your work PLUS GENERAL RUN DOWN: Compassion fatigue /Burnout : crisis point – running on empty
If intrusive thoughts bad dreams, insomnia, PTSD type symptoms: Secondary traumatic stress -
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3. Secondary Traumatic Stress
Secondary exposure to a traumatic event – happens rapidly and associated with a particular event
Traumatic stress symptoms paralleling PTSD
A natural rather than ‘pathological’ response.
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4. www.cambridgesupervisiontraining.com Anthea Millar
Vicarious Trauma
Cumulative effect of being compassionate to others when listening to the trauma experiences of others……
…..whilst ALSO controlling natural empathic responses OR being unconscious of impact of empathy
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5. Compassion Fatigue and Burnout
Long term exhaustion and diminished interest in one’s work.
Lessening of compassion over time as a result of the continual challenge of extending compassion to those in need
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6. www.cambridgesupervisiontraining.com Anthea Millar
16 Warning signs of Trauma exposure response Laura van Dernoot Lipsky (2009) ‘Trauma Stewardship’
1. Feeling helpless and hopeless
2. A sense that one can never do enough
3. Hypervigilance
4. Diminished creativity
5. Inability to embrace complexity
6. Minimizing
7. Chronic exhaustion/physical ailments
8. Inability to listen/deliberate avoidance
9. Dissociative moments
10. Sense of persecution
11. Guilt
12. Fear
13. Anger and Cynicism
14. Inability to empathize/numbing
15. Addictions
16. Grandiosity: an inflated sense of the importance of one’s work
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7. The Challenge of Empathy Empathic Strain Wilson and Lindy (1994), Etherington 2009
Empathic Withdrawal
Empathic Repression
Empathic Enmeshment
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8. Facial mimicry and the Botox challenge
Sensory feedback from the movement of facial muscles is essential to help us:
Recognise our own emotions
Recognise emotions in others
Botox impairs this recognition (Neal and Chartrand 2011)
Without facial mimicry it’s easy to misinterpret the emotional content of s and texts
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9. Mirror Neurons (Rizzolatti and Gallese 1996)
Our brains are social organs primed to tune into other’s moods and experiences
When exposed indirectly to trauma our brain activates mirror neurons in the pre frontal cortex
The process forms a neurological loop which creates in the listener similar body sensations as if they are actually experiencing the event
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10. Counter-Transference: The Wounded Healer and the Double Whammy
Reaction TO the client in relation to our own ‘stuff’
‘Double whammy’ when our ‘stuff’ links with the clients’. May result in stuckness and boundary difficulties
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11. www.cambridgesupervisiontraining.com Anthea Millar
Boundaries
Ethical issues
Physical distance comfort zone
Body awareness
Controlled imagery exercises
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12. Body /Mind /Energy exercises
‘Un-mirroring’
Strong Back – Soft Front
Zip Up
Mindfulness – breathing space
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13. Organisational stress
The approach of the organisation is central to prevention and reduction of vicarious and secondary trauma.
Bober and Regehr (2006):
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14. www.cambridgesupervisiontraining.com Anthea Millar
Books and Articles
Izzo, E., and Carpel Miller, V . (2010) Second Hand Shock: Surviving and Overcoming Vicarious Trauma. Arizona:HCI Press
Mathieu, F. (2012) Compassion Fatigue Workbook: Creative tools for transforming Compassion Fatigue and Vicarious Traumatisation
Rothschild, B. (2006) Help for the Helper: Self-Care Strategies for Managing Burnout and Stress. New York: Norton
Saakvitne, K. W., Pearlman, L. A., (1996). Transforming the pain: A workbook on Vicarious Traumatization. New York: W.W. Norton.
Lipsky, Laura van Dernoot.(2009) Trauma Stewardship: An everyday guide to caring for self while caring for others. San Francisco: Berrett-Koehler.
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15. www.cambridgesupervisiontraining.com Anthea Millar
Online Resources
Vicarious Trauma Institute; Izzo & Carpel Miller
TEND Academy
Vicarious Trauma. Headington Institute institute.org
Compassion Fatigue: Charles Figley
Professional Quality of Life: Version 5 (ProQOL).
Carl Marci: Neurobiology and Physiology of Empathy
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16. Cambridge Supervision Training cst
CST Diploma in Supervision Sept March 2018
An Integrative Approach | Accredited by ASIIP. Two places left
Next Full Diploma Sept 2018 to June 2019
All enquiries: Contact Jim Holloway on
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