SURVIVING COMPASSION FATIGUE AKA Secondary & Vicarious Traumatization HELP FOR THE HELPER Beverly...

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SURVIVING SURVIVING COMPASSION FATIGUE COMPASSION FATIGUE AKA AKA Secondary & Secondary & Vicarious Vicarious Traumatization Traumatization HELP FOR THE HELPER HELP FOR THE HELPER Beverly Kyer, MSW, ACSW Beverly Kyer, MSW, ACSW COMPASSION FATIGUE SPECIALIST COMPASSION FATIGUE SPECIALIST 2014 2014

Transcript of SURVIVING COMPASSION FATIGUE AKA Secondary & Vicarious Traumatization HELP FOR THE HELPER Beverly...

Page 1: SURVIVING COMPASSION FATIGUE AKA Secondary & Vicarious Traumatization HELP FOR THE HELPER Beverly Kyer, MSW, ACSW COMPASSION FATIGUE SPECIALIST 2014 2014.

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

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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”.

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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.

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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.

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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..

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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.

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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

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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

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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)

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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

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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

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A POTENTIAL CONSEQUENCE OF A POTENTIAL CONSEQUENCE OF WORKING WITH TRAUMATIZED WORKING WITH TRAUMATIZED

PEOPLEPEOPLE

Let’s take the testLet’s take the test

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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.

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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

_________________________________________________________________________________________________________________________________________________________________

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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

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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 ______________________

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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…………….

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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:

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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

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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”

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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

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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

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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

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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

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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.

Page 26: SURVIVING COMPASSION FATIGUE AKA Secondary & Vicarious Traumatization HELP FOR THE HELPER Beverly Kyer, MSW, ACSW COMPASSION FATIGUE SPECIALIST 2014 2014.

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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

Page 27: SURVIVING COMPASSION FATIGUE AKA Secondary & Vicarious Traumatization HELP FOR THE HELPER Beverly Kyer, MSW, ACSW COMPASSION FATIGUE SPECIALIST 2014 2014.

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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

Page 28: SURVIVING COMPASSION FATIGUE AKA Secondary & Vicarious Traumatization HELP FOR THE HELPER Beverly Kyer, MSW, ACSW COMPASSION FATIGUE SPECIALIST 2014 2014.

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ConclusionConclusion

What are your plans for self care ?______________________________________

____________________________________________________________________________________________________________

_______________

A gift of refreshingPsychosomatic Wellness

Page 29: SURVIVING COMPASSION FATIGUE AKA Secondary & Vicarious Traumatization HELP FOR THE HELPER Beverly Kyer, MSW, ACSW COMPASSION FATIGUE SPECIALIST 2014 2014.

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

INDIVIDUALS* COUPLES* FAMILIES

 

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TRAININGS * CONSULTING * COACHING * RETREATS

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TO SCHEDULE A FREE PHONE CONSULTATION WITH MS. KYER AND BE ASSIGNED THE BEST TEAM MEMBER FOR YOUR NEEDS, CONTACT

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