SURVIVING COMPASSION FATIGUE AKA Secondary & Vicarious Traumatization HELP FOR THE HELPER Beverly...
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Transcript of SURVIVING COMPASSION FATIGUE AKA Secondary & Vicarious Traumatization HELP FOR THE HELPER Beverly...
SURVIVINGSURVIVINGCOMPASSION FATIGUECOMPASSION FATIGUE
AKAAKA Secondary & Vicarious Secondary & Vicarious TraumatizationTraumatization
HELP FOR THE HELPERHELP FOR THE HELPER
Beverly Kyer, MSW, ACSWBeverly Kyer, MSW, ACSWCOMPASSION FATIGUE SPECIALISTCOMPASSION FATIGUE SPECIALIST
20142014
Beverly Kyer ©TheKyerGroup2
Topics that will be coveredTopics that will be covered
• The Care Service Provider’s vulnerability to 2ndary The Care Service Provider’s vulnerability to 2ndary or vicarious trauma.or vicarious trauma.• Factors that cause CF/VT and burnoutFactors that cause CF/VT and burnout• How to become resilient in the face of overwhelming How to become resilient in the face of overwhelming
and emotionally intense demands.and emotionally intense demands.• New ways to care for ourselves.New ways to care for ourselves.• New ways to support co-workers and increase moraleNew ways to support co-workers and increase morale• Being accountable to someone who will support you Being accountable to someone who will support you
and help you say “no”and help you say “no”• Planned intentional strategies for “self care”.Planned intentional strategies for “self care”.
Beverly Kyer ©TheKyerGroup 3
What is Compassion Fatigue ?What is Compassion Fatigue ?AKA Vicarious or secondary TraumaAKA Vicarious or secondary Trauma • Compassion Fatigue is a syndrome which Compassion Fatigue is a syndrome which
consists of various symptoms that mirror Post consists of various symptoms that mirror Post Trauma Stress Disorder (PTSD).Trauma Stress Disorder (PTSD).
• PTSD is a disorder that affects people who PTSD is a disorder that affects people who have experienced extreme traumatic or violent have experienced extreme traumatic or violent events in their lives. People who have events in their lives. People who have experienced natural or man made disasters; experienced natural or man made disasters; victims of violent crimes, domestic violence, victims of violent crimes, domestic violence, child sexual or physical abuse.child sexual or physical abuse.
Beverly Kyer ©TheKyerGroup 4
What is Compassion Fatigue ?What is Compassion Fatigue ?AKA Vicarious or secondary TraumaAKA Vicarious or secondary Trauma
• People who develop the disorder similarly People who develop the disorder similarly report episodes of fear, depression, confusion, report episodes of fear, depression, confusion, helplessness, hopelessness, feeling out of helplessness, hopelessness, feeling out of control, extreme mood swings, avoidance control, extreme mood swings, avoidance behaviors, etc.behaviors, etc.
• People who develop Compassion Fatigue have People who develop Compassion Fatigue have not been direct victims of trauma, but have not been direct victims of trauma, but have intense involvement with people who have.intense involvement with people who have.
Beverly Kyer ©TheKyerGroup 5
Who can get Compassion Fatigue?Who can get Compassion Fatigue?
• People who provide care, assistance and support to People who provide care, assistance and support to others in pain, either physical or emotional, tend to be others in pain, either physical or emotional, tend to be empathetic and compassionate. These necessary empathetic and compassionate. These necessary qualities that help them to do their jobs, place them in qualities that help them to do their jobs, place them in the direct path of experiencing secondary and vicarious the direct path of experiencing secondary and vicarious trauma AKA compassion fatigue reactions. trauma AKA compassion fatigue reactions.
• Many helping professionals and caretakers as a result Many helping professionals and caretakers as a result of listening to stories or witnessing the aftermath of of listening to stories or witnessing the aftermath of traumatic events could develop many of the same traumatic events could develop many of the same symptoms associated with Post-Trauma Stress symptoms associated with Post-Trauma Stress Disorder including symptoms that are Disorder including symptoms that are more insidiousmore insidious..
Beverly Kyer ©TheKyerGroup 6
Burn outBurn out
• Stems from overwhelming demands of tasks.Stems from overwhelming demands of tasks.• Does not come close to the impact of vicarious Does not come close to the impact of vicarious
traumatrauma• The distinction is the sympathy/empathy The distinction is the sympathy/empathy
caregivers experience from the suffering of caregivers experience from the suffering of others.others.
• Where children are concerned, this is often Where children are concerned, this is often outside of the realm of what we expect as caring outside of the realm of what we expect as caring human beingshuman beings
• Burnout has a better prognosis for recovery.Burnout has a better prognosis for recovery.• Beware the combination of both CF and Burn outBeware the combination of both CF and Burn out.
Beverly Kyer ©TheKyerGroup 7
Causes and Triggers of Causes and Triggers of Compassion FatigueCompassion Fatigue
• Working with adults and particularly children who are Working with adults and particularly children who are victims of trauma or violence.victims of trauma or violence.
• Lack of training in dealing with issues of trauma or Lack of training in dealing with issues of trauma or violence and it‘s subsequent outcomes.violence and it‘s subsequent outcomes.
• High ideals of making a difference in the lives of children High ideals of making a difference in the lives of children and adults. and adults.
• Personality traits of compassion and empathy.Personality traits of compassion and empathy.• Past histories of trauma or victimization in the worker.Past histories of trauma or victimization in the worker.• Lack of consistent self-care behaviors and habits.Lack of consistent self-care behaviors and habits.• Working with large numbers of traumatized and/or Working with large numbers of traumatized and/or
victimized peoplevictimized people
Beverly Kyer ©TheKyerGroup 8
Stop and reflect on thisStop 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
Beverly Kyer ©TheKyerGroup 9
Critical Brain SystemsCritical Brain Systems
Neural Circuitry
Pituitary Gland Amygdala
Orbitofrontal Cortex(Social/Emotional Control Center)
Adrenal Glands
Brainstem(Lower Limbic/Reptilian)
Hippocampus
Spinal Cord(Lower
Limbic/Reptilian)
Beverly Kyer ©TheKyerGroup 10
The Professional Impact of The Professional Impact of Compassion Fatigue.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
Beverly Kyer ©TheKyerGroup 11
Personal Impact of Compassion FatiguePersonal Impact of Compassion Fatigue
COGNITIVE EMOTIONAL BEHAVIORAL SPIRITUAL INTER- PERSONAL
PHYSICAL
-Confusion -Spaciness
-Anxiety -Emotional rollercoaster
-Clingy -Moody -Nightmares
-Loss of purpose
-withdrawn -Over protective
-Aches/pains -Shock -Dizziness
-Trauma imagery
-Anger/rage -Numbness -Overwhelmed
-Impatient -Appetite changes
-Anger at God
-Mistrust -Decrease in intimacy/sex
-Breathing difficulties
-Rigidity -Apathy -Self-doubt minimization
-Fear -Depression -Depleted -Sadness
-Hypervigilance -Elevated startle response -Use of negative coping
-Questions -Prior religious beliefs
-Isolation -Projection of anger/blame
-Somatic complaints -Impaired immune system
-Thoughts of self-harm or harm to others
-Survivor’s guilt
-Sleep disturbances
-Pervasive hopelessness
-Intolerance -Loneliness
-Rapid heartbeat
-Disorientation
Beverly Kyer ©TheKyerGroup 12
A POTENTIAL CONSEQUENCE OF A POTENTIAL CONSEQUENCE OF WORKING WITH TRAUMATIZED WORKING WITH TRAUMATIZED
PEOPLEPEOPLE
Let’s take the testLet’s take the test
Beverly Kyer ©TheKyerGroup 13
Seek/Ask for help when you:Seek/Ask for help when you:
• Have difficulty separating work from your Have difficulty separating work from your personal life. [VT?]personal life. [VT?]
• Dread working with certain individuals.Dread working with certain individuals.• See the world in terms of victims and See the world in terms of victims and
perpetrators.perpetrators.• Experience increased transference and counter Experience increased transference and counter
transference issues with certain individuals.transference issues with certain individuals.• Struggle with acute or chronic sadness.Struggle with acute or chronic sadness.
Beverly Kyer ©TheKyerGroup 14
The body keeps score of the The body keeps score of the small things too.small things too.
Examine stressful scenariosExamine stressful scenarios Exercise on personal examples
_________________________________________________________________________________________________________________________________________________________________
Beverly Kyer ©TheKyerGroup 15
Our challengeOur challenge
Care professionals
Care providers
Care givers
are often trapped in this role and personal identification which leaves us bereft of
asking for help
Never confuse having a career with having a lifeNever confuse having a career with having a life
Beverly Kyer ©TheKyerGroup 16
TEAM STRESS FEUDTEAM STRESS FEUDIdentify the Impact-Symptom Identify the Impact-Symptom
1. Poor concentration ______________________ 2. Preoccupation with trauma ______________________3. Overly sensitive ______________________ 4. Accident proneness ______________________ 5. Questioning the meaning of life ____________________6. Increased interpersonal conflicts ___________________7. Sweating ____________________
8. Chronic and intensifying physical illness _____________9. Perfectionism _____________________10.Losing things ______________________11.Mistrust ______________________12.Loss of faith ______________________
Beverly Kyer ©TheKyerGroup 17
NarrativeNarrative
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…………….
Beverly Kyer ©TheKyerGroup 18
Cognitive RestructuringCognitive 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: 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:
Beverly Kyer ©TheKyerGroup 19
Cognitive RestructuringCognitive 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
Beverly Kyer ©TheKyerGroup 20
Cognitive RestructuringCognitive 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”
Beverly Kyer ©TheKyerGroup 21
Developing a Therapeutic CommunityDeveloping a 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
• Who nurture us
• Who delightfully immerse us in humor
Beverly Kyer ©TheKyerGroup 22
Stress Reduction, Creating Your Stress Reduction, Creating Your Own SanctuaryOwn Sanctuary
Stress relief:
Funny Stress ManagementEXERCISE
Creating Your Own Private Sanctuary to Heal Everyday
Through Structured Self Care
Design your spaceDesign your space
Beverly Kyer ©TheKyerGroup 23
Everyday Strategies for Self CareEveryday Strategies for Self Care
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
Structured Self CareStructured 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
Beverly Kyer ©TheKyerGroup 24
Beverly Kyer ©TheKyerGroup 25
Structured Self CareStructured Self Care
Plan and develop a template to keepList 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 sessionsList things you will do at the end of each day or the end of
each evening.List things you will do each week; bi-monthly; monthlyNow discuss these plans with someone(s) you will be
accountable to.
Beverly Kyer ©TheKyerGroup 26
TOOLS FOR THE ROADTOOLS FOR THE ROAD
• Cognitive Negative Cognitive Negative AwarenessAwareness
• Relaxation/pamper• MeditationMeditation• Mindfulness• Journaling• Creating Narratives• Exercise/AsianExercise/Asian• MassageMassage
• Dance TherapyDance Therapy• Baroque MusicBaroque Music• The ArtsThe Arts• Reading• Feeding your SpiritFeeding your Spirit• Thera-playplay• Nutrition• Essential oils• Art creationArt creation
Beverly Kyer ©TheKyerGroup 27
Preventing Secondary Traumatic Stress Disorder
Individual
Personal Professional
Balance Boundaries/Limit Setting Getting Support/Help Plans for Coping Professional Training Evaluation of Own Healing Job Commitment Replenishment
Social Social Support Getting Help Activism
Physical Body Work Sleep Nutrition
Psychological Life Balance Relaxation Contact with Nature Creative Expression Skill Development Meditation/Spiritual Practice Self-awareness Humor
Environmental
Societal Education Strategies Coalition Building Legislative reform Social Action
Work Setting Physical Setting Value system Job Tasks & Personnel Guidelines Supervisory / Management Support Collegiality
Beverly Kyer ©TheKyerGroup 28
ConclusionConclusion
What are your plans for self care ?______________________________________
____________________________________________________________________________________________________________
_______________
A gift of refreshingPsychosomatic Wellness
Beverly KyerBeverly Kyer, , MSW,ACSWMSW,ACSW
CEO & Founder, The Kyer GroupCEO & Founder, The Kyer GroupWe Help The Helper We Help The Helper
Survive Compassion Fatigue Survive Compassion Fatigue ORGANIZATIONS * GROUPS
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TRAININGS * CONSULTING * COACHING * RETREATS
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Beverly Kyer ©TheKyerGroup 29