1. Michele M. Many, MSW, LCSW, BACS Department of Psychiatry
The Critical Importance of Self-care for Child Welfare Professionals and Volunteers
Michele M. Many, MSW, LCSW, BACS
November 8, 2017
LSU Health, New Orleans
Department of Psychiatry

2. Stress and its impact

3. Different Kinds of Stress
Demands
exceed
abilities
Chronic or
Excessive Stress
Low demands
(Boredom)
Challenge
(Optimal performance)

4. One way to think about stress

5. Physical Effects of Stress
Chronic/Excessive Stressors

6. Seeing is believing

7. Fight, Flight, and Freeze
Threat !!!
Adrenaline
Cortisol
Increased heart rate
Increased glucose
Rapid, shallow breathing
Hyper-focus on threat/escape
No complex thought is possible
Cannot weigh options, make moral judgments, think about consequences.

8. Basic brain development
3 primary sections of the brain - evolutionarily ordered
Brainstem/Cerebellum – body brain – “Freeze”
Limbic system – emotional brain – “Fight/flight”
Neocortex – thinking brain
Brain stem & Cerebellum
Limbic system
Neocortex

9. It works when facing a bear
But nowadays the “bear” is an angry parent or a driver who cuts you off…
Our brains/bodies don’t know the difference
Chronic activation of “alarm system”
“Free floating anxiety”, depression, cynicism, irritability
Cuts off/reduces access to our “thinking brain” or neocortex
Interferes with comprehension and problem solving
“Tunnel vision” and “blind with anger”

10. What Is Vicarious Trauma and Secondary Traumatic stress?

11. Stressors faced by Helpers
Vicarious Traumatization
“. . .the cumulative effect of working with survivors of traumatic life events. Anyone who engages empathically with victims or survivors is vulnerable.” (Pearlman & Saakvitne, 1995, p.31.)
Related to Secondary Traumatic Stress
STS is an acute response to traumatic material and mimics PTSD
Anyone exposed to others’ traumatic narrative is vulnerable

13. Risk Factors Engaging empathically
Measuring self-worth by how much you help others
Unrealistic expectations
Fear of showing “weakness”
Fear of being judged unable to do job
Discomfort with offers of emotional support

14. Risk Factors Repeated exposure to traumatic material
Inability to say “no.”
Letting work bleed over into your personal time
Exposure to the survivor’s anger
Perfectionism

15. Signs of Vicarious Trauma

16. “Red flags” for VT Problems with Emotion regulation Self worth
Making decisions
Managing boundaries
Relationships
Physical health (aches & pains, illnesses, accidents)
Emotional detachment

17. What Helps?

18. “Interpersonal neurobiology”
Specific to mammals – prolonged caregiving period
Brain/NS development related to our social supports/caregiving experiences
Ghosts and Angels in the Nursery
Allows us to expand our survival response to our community
Helps us to feel and be safer

19. Good news! Caring for others is a protective factor!
Oxytocin protects the
heart
Triggers use of social
supports to deal with
stress.
Belief that stress is
harmful increases
harmful effects
Belief that it is not neutralizes that effect and allows coping skills applied to be more effective

20. Prevention strategies

21. Prevention (personal)
Prioritize your social supports
Improve eating, sleep and exercise habits
Maintain adequate self-care
Identify nourishing activities and prioritize them
Reduce depleting relationships and activities.
Know & honor your own limitations
Self-compassion
Say “no” when you can

22. Prevention at work Venting can make you feel worse Assume the best
Maintain appropriate boundaries with clients
Ask yourself: “Whose needs am I meeting?”
Leave work at work! - Unwind on the way home
Take breaks
Humor (to reduce tension, not increase it)

23. Changing how you feel

24. Meditate/Mindfulness 10 minutes a day

25. Most important: agency level strategies

26. Administrators should
Ensure a culture of support and respect
Model
appropriate self-care practices
accepting emotional support from others
appropriate use of vacation/sick leave
Monitor conflicts and promote positive staff relations
Buddy systems
“2 is 1 and 1 is none”
Regularly debrief after stressful incidents
Manage workloads

27. Agency-level interventions
Provide professional supervision
“Reflective Supervision” is a powerful tool
Supervision for those who are exposed to others’ traumas as part of their work
Originally developed for home-visiting early childhood workers
Training and resources at Zero to Three: (Shamoon-Shanok & Gilkerson)

28. Resources
Secondary Traumatic Stress: A fact sheet for child-serving professionals
Professional Quality of Life screener – self score
Essential Elements of a Trauma Informed Juvenile Justice System
Desk Stretches – Mayo Clinic video collection
Van der Kolk, B. (2014). The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma, Viking, NY NY.

29. Contact info