Compassion Fatigue

When Helping Hurts

Jessica HeskinCalifornia State University, Sacramento

heskin@csus.edu

Christine WardCrime Victims Assistance Network (iCAN)

Foundationcward@ican-foundation.org

Your Facilitators

Ground Rules Please raise your hand when you have a

question What is shared in this room stays in this room All of us are important and special, please treat

each other as such No side conversations while the facilitators are

talking - please Let yourself go! Have fun – learn a little Please feel free to leave the room when needed

Compassion

compassion

noun Definition: sympathy: sympathy for the suffering of others, often including a desire to help

Fatigue fa·tigue (noun) Definition: 

1. mental or physical exhaustion: extreme tiredness or weariness resulting from physical or mental activity weak with fatigue after the long march

2. inability to respond to situation: the temporary inability of somebody to respond to a situation as a result of overexposure or excessive activity ( often used in combination ) compassion fatigue

3. physiology inability to respond to stimulus: the temporary inability of an organ or body part such as a muscle or nerve cell to respond to a stimulus and function normally after continuous activity or stimulation

Compassion Fatigue

com·pas·sion fa·tigue

Definition: loss of sympathy: (noun) a loss of sympathy for the suffering of others experienced by donors or caregivers as a result of the demands made of them

What causes compassion fatigue?

Indirect chronic repeated exposure to traumatic events

Stress responses due to repeated exposure

Burnout

Noun1. Physical or emotional exhaustion, especially

as a result of long-term stress or dissipation. 2. One who is worn out physically or

emotionally, as from long-term stress.

Compassion Fatigue vs Burnout

Compassion Fatigue is NOT "burnout". Burnout is associated with stress and hassles involved in your work;

it is very cumulative, is relatively predictable and frequently a vacation or change of job helps a great deal.

Compassion Fatigue is very different.

Compassion Fatigue is a state of tension and preoccupation with the individual or cumulative trauma of clients as manifested in one or more ways including re-experiencing the traumatic event, avoidance/numbing of reminders of the event, and persistent arousal. Although similar to critical incident stress (being traumatized by something you actually experience or see),with CF you are absorbing the trauma through the eyes and ears of your clients. It can be thought of as secondary post-traumatic stress.

(Ace Network www.ace-network.com)

Symptoms of Compassion FatigueExamples of Compassion Fatigue – Figley (Ed.) 1995;97

Cognitive• Perfectionism• Preoccupation with trauma• Spacing out• Loss of meaning• Self-doubt• MinimizationEmotional• Powerlessness• Anxiety• Guilt• Anger/rage• Survivor guilt• Hypersensitivity• Emotional roller coaster• Overwhelmed• Depleted energy

Behavioral•Impatient•Withdrawn•Irritable•Sleep disturbances•Hypervigilance•Accident prone•Losing thingsSpiritual•Questioning the meaning of life•Loss of purpose•Lack of self-satisfaction•Question religious beliefs

Personal Relationships•Withdrawal•Mistrust•Overprotective as a spouse or parent•LonelinessPhysical•Shock•Rapid heartbeat•Joint and muscle pains•Dizziness and disorientation•Impaired immune system

Impact of Compassion Fatigue

Reduction in job performance Decrease in moral Deterioration of personal relationships Increase in psychological issues Increase in health problems

How Do We Get There?It’s Hard Work Darn It!

(in the beginning) I am here to help, to make things right – to save the world! I am responsible for the outcomes of those I help In order to really care and be committed to the cause, those I help must

come first The victim will appreciate everything I do for them If I am with a victim/client, my friends, doctors, personal trainers, teachers,

etc. will understand if I call last minute to cancel or just don’t show up Working in this field you have to be strong – I can handle anything that

comes my way I need to please everyone I need to be liked and respected by everyone I cannot make a mistake, I must be perfect I can do everything Success to me is …..

Compassion Fatigue Phases

The Zealot Phase The Irritability Phase The Withdrawal Phase The Zombie Phase Pathology vs. Renewal/Maturation

Adopted from J. Baker, M.D. and J. Kane, M.D.

Zealot Phase

Committed, involved, available Solving problems/making a difference Willingly go the “extra mile” High enthusiasm Volunteers without being asked

Adopted from J. Baker, M.D. and J. Kane, M.D.

The Irritability Phase

Begin to cut corners Begin to avoid clients/patients Begin to mock co-workers and clients Begin to denigrate the people we serve Use of humor is inappropriate Oversights, mistakes and lapses of concentration Start distancing ourselves from friends and

coworkersAdopted from J. Baker, M.D. and J. Kane, M.D.

The Withdrawal Phase

Enthusiasm turns sour Clients become irritants, instead of persons We make complaints about our work life and our

personal life Tired all the time, don’t want to talk about what we

do We start to neglect our family, clients, coworkers

and ourselves We try to avoid our pain and sadness

Adopted from J. Baker, M.D. and J. Kane, M.D.

The Zombie Phase

Our hopelessness turns to rage We begin to hate people…any/all people Others appear incompetent or ignorant to

us We develop a real distain for our clients We have…no patience…no sense of

humor…no time for funAdopted from J. Baker, M.D. and J. Kane, M.D.

Even Mother Theresa

…understood the need for self care.

Mother Theresa wrote in her plan to superiors that it was mandatory for her nuns to take an entire year off from their duties every 4-5 years to allow them to heal from the effects of their care-giving work.

How do we prevent this?

Organizational – Have a clear purpose or goal– Clearly defined roles– Effective management structure and

leadership– Team support– Stress management plan

ABC

A=AwarenessB=BalanceC= Connections

Awareness

Issues and Contributing Factors

What in your work contributes to your stress level increasing your vulnerability to compassion fatigue?

B=Balancekeeping your life in balance

And BOUNDRIES Self care Your “me” calendar Transform the negative impact of your

work (find meaning, practice gratitude, avoid negativity)

B=Balance

We are human and it’s ok to ask for help– Get professional help if needed

C=Connections

Talk it out– Trusted friends/co-workers/clergy/therapist– Build a strong support network that supports

your health, not fuels your stress– Hang out with your pet– Connect with yourself

What you can do Sleep as much as needed to feel refreshed and healthy during the following

day, but not more. Limiting the time in bed seems to solidify sleep, while spending excessively long times in bed seems related to fragmented and shallow sleep.

Wake up at a regular and consistent time in the morning. This strengthens sleep cycles and can help you fall asleep at similar times each night.

A steady, daily amount of exercise may deepen sleep, but occasional exercise does not necessarily improve sleep the following night. Also, do not exercise right before bedtime.

Occasional loud noises, such as traffic and airplanes, disturb sleep even in people who are not awakened by noises and cannot remember them in the morning. Playing white noise, using earplugs or sound-proofing bedrooms may help those who must sleep close to noise.

Although excessively warm rooms disturb sleep, there is no evidence that an excessively cold room promotes sleep.

Things you can do continued Hunger may disturb sleep. Therefore a light snack may help you sleep. Some good

snacks include milk and cereal or a turkey sandwich, both of which have tryptophan, an ingredient that helps you sleep.

An occasional sleeping pill may be of some benefit, but the chronic use of sleeping pills is ineffective for most insomniacs.

Caffeine in the evening disturbs sleep, even in those who feel it does not. Therefore, it is a good idea to avoid drinking caffeinated beverages in the evening.

Alcohol helps tense people fall asleep more easily, but the resulting sleep is more fragmented. We recommend avoiding alcohol before going to sleep.

If you feel angry and frustrated because you can't sleep, you should not stay in bed. Instead, get up, turn on the light and do something different, such as reading, watching television or doing simple crafts. Once you are sleepy again, go back to bed.

Pajamas at bedtime only The chronic use of tobacco disturbs sleep. Promoting good sleep habits is another

reason to stop smoking.

Self Care

To stay healthy– Exercise– Relax– Sleep– Eat well/hydrate– See your doctor regularly

How to take care of me….

How to take care of my colleagues……

Get up and Move

ResourcesMindfulness meditation apps for phone:

BuddhifyHeadspace—this one charges money but has progressive meditation sequences Insight timer Calm Chill Mindshift

Website for guided meditations:http://marc.ucla.edu/body.cfm?id=22

 Sleep Hygiene Website:http://www.cdc.gov/sleep/about_sleep/sleep_hygiene.htm

Resources

Energy Medicinehttp://innersource.net

Qi Gonghttp://www.sacramentoqigong.com/