Trauma Recovery: Trauma Recovery: Wellness for Wellness for

Counselors and Counselors and TeachersTeachers

Dr. Vaughn MillnerDr. Vaughn Millner

ObjectivesObjectives

As a result of this viewing this As a result of this viewing this presentation, participants will be able to:presentation, participants will be able to:

Identify personal signs of compassion Identify personal signs of compassion satisfaction and fatiguesatisfaction and fatigue

Examine various components of mental Examine various components of mental healthhealth

Begin an individual wellness planBegin an individual wellness plan

Helpers Also Cope with Helpers Also Cope with Disaster and TraumaDisaster and Trauma

It is essential that as you care for others during It is essential that as you care for others during disaster recovery, you take care of yourself.disaster recovery, you take care of yourself.

How are you How are you Mentally?Mentally? Physically?Physically? Emotionally?Emotionally? Spiritually?Spiritually?

BalanceBalance

MindMind BodyBody SpiritSpirit

Stress at Work Stress at Work (2005 Wellness Councils of America)(2005 Wellness Councils of America)

40% of individuals say that job is “very” 40% of individuals say that job is “very” or “extremely” stressfulor “extremely” stressful

43% of adults suffer health problems due 43% of adults suffer health problems due to stress – about 90 million peopleto stress – about 90 million people

75% to 90% of all visits to primary care 75% to 90% of all visits to primary care physicians are stress-relatedphysicians are stress-related

GENERAL ADAPTATION SYNDROMEGENERAL ADAPTATION SYNDROME(Hans Selye)(Hans Selye)

When stress strikes, the following occurs:When stress strikes, the following occurs: Alarm ReactionAlarm Reaction. Prepares the body . Prepares the body

for flight or fight.for flight or fight. ResistanceResistance.. Your body releases stress Your body releases stress

hormones. Blood pressure, heart rate, hormones. Blood pressure, heart rate, respiration, and body temperature respiration, and body temperature increase.increase.

ExhaustionExhaustion.. Body’s ability to adapt runs Body’s ability to adapt runs out. out.

BurnoutBurnout

Condition of feeling “wasted physically, Condition of feeling “wasted physically, emotionally, spiritually, interpersonally, emotionally, spiritually, interpersonally, and behaviorally (MacClusky and and behaviorally (MacClusky and Ingersoll)Ingersoll)

Stages of BurnoutStages of Burnout

Three Stages of BurnoutThree Stages of Burnout(Texas Medical Association)(Texas Medical Association)

Stress ArousalStress Arousal (persistent irritability, anxiety; high (persistent irritability, anxiety; high blood pressure; bruxism; insomnia; forgetfulness; heart blood pressure; bruxism; insomnia; forgetfulness; heart palpitations; unusual heart rhythm; inability to concentrate; palpitations; unusual heart rhythm; inability to concentrate; headaches)headaches)

Energy ConservationEnergy Conservation (lateness for work, (lateness for work, procrastination; need 3 day weekends; decreased sexual procrastination; need 3 day weekends; decreased sexual desire; tiredness in mornings; turning work in late; social desire; tiredness in mornings; turning work in late; social withdrawal; cynical attitudes; resentfulness; increased withdrawal; cynical attitudes; resentfulness; increased caffeine consumption; increased alcohol consumption; caffeine consumption; increased alcohol consumption; apathy)apathy)

Exhaustion Exhaustion (chronic sadness or depression; stomach or (chronic sadness or depression; stomach or bowel problems; mental fatigue; headaches; desire to “drop bowel problems; mental fatigue; headaches; desire to “drop out”out”

Burnout results in:Burnout results in:

ExhaustionExhaustion CynicismCynicism Tense exchanges with others including Tense exchanges with others including

students Particularly impacts those in students Particularly impacts those in caring professionscaring professions

Low level, chronic fuzziness of caring for Low level, chronic fuzziness of caring for others to feeling emotionally “numb”others to feeling emotionally “numb”

Compassionate CaringCompassionate Caring

Compassionately caring for others Compassionately caring for others without taking time for self is a recipe for without taking time for self is a recipe for burn-out.burn-out.

The higher your level of The higher your level of conscientiousness, the higher the danger conscientiousness, the higher the danger of burnout of burnout (American Academic of Family Physicians, 1997).(American Academic of Family Physicians, 1997).

Secondary Traumatic Stress (STS) Secondary Traumatic Stress (STS) (sometimes called compassion (sometimes called compassion fatigue or vicarious fatigue or vicarious traumatization)traumatization) Risk related to empathy with another’s Risk related to empathy with another’s

traumatic informationtraumatic information

Can result from hearing emotionally shocking Can result from hearing emotionally shocking material from others over timematerial from others over time

Can result in depression, insomnia, loss of Can result in depression, insomnia, loss of intimacy; “numbing” of feelingsintimacy; “numbing” of feelings

Watch for these signs:Watch for these signs:

BEHAVIORALBEHAVIORAL Clock watchingClock watching Postponing contact with children Postponing contact with children Postponing returning phone callsPostponing returning phone calls Generalizing others (Example: When faced Generalizing others (Example: When faced

with a few children misbehaving in the with a few children misbehaving in the classroom, thinking “They’re all the same”)classroom, thinking “They’re all the same”)

Increased use of drugs to control mood/sleepIncreased use of drugs to control mood/sleep Marital conflictMarital conflict AbsenteeismAbsenteeism

Watch for these signs:Watch for these signs:PSYCHOLOGICALPSYCHOLOGICAL Resistance to going to work every Resistance to going to work every

dayday Sense of failureSense of failure Feelings of resentmentFeelings of resentment Feelings of discouragement or Feelings of discouragement or

indifferenceindifference NegativismNegativism Self-preoccupationSelf-preoccupation Feelings of powerlessnessFeelings of powerlessness Rigidity in thinking and resistance to Rigidity in thinking and resistance to

changechange Anxiety Anxiety DepressionDepression Feelings of guilt and blameFeelings of guilt and blame

Suppressing emotionSuppressing emotion Suppressing problemsSuppressing problems Refusing to handle Refusing to handle

stress effectivelystress effectively Difficulty in saying “no”Difficulty in saying “no” Assuming additional Assuming additional

responsibilityresponsibility Sacrificing personal life Sacrificing personal life

for workfor work

Watch for these signs:Watch for these signs:

PHYSICALPHYSICAL Tired during workdayTired during workday General fatigueGeneral fatigue ExhaustionExhaustion Sleep problemsSleep problems Frequents colds and/or fluFrequents colds and/or flu Frequent headachesFrequent headaches Frequent gastro-intestinal problemsFrequent gastro-intestinal problems Frequent aches and painsFrequent aches and pains Long time to rebound in enthusiasm and energy about Long time to rebound in enthusiasm and energy about

workwork

Helper Traits and Helper Traits and BurnoutBurnout

Fragile self-esteemFragile self-esteem Lacking intimacy in personal lifeLacking intimacy in personal life IsolationIsolation Need to rescue othersNeed to rescue others Need for reassurance about self worthNeed for reassurance about self worth Substance abuseSubstance abuse

Avoiding Compassion Avoiding Compassion Fatigue & Burnout Fatigue & Burnout

Increase personal capabilitiesIncrease personal capabilities Enhance support systemsEnhance support systems

Meeting your needsMeeting your needs

After trauma, the school system will attempt to After trauma, the school system will attempt to meet students’ basic needs, such as providing meet students’ basic needs, such as providing physiological support and a sense of safety. physiological support and a sense of safety. The school and you also help to provide a The school and you also help to provide a sense of belonginess to students. Remember: sense of belonginess to students. Remember: you have these needs, as well.you have these needs, as well.

Getting your needs met results in you:Getting your needs met results in you:a. Feeling self-determineda. Feeling self-determinedb. Interpersonally connectedb. Interpersonally connectedc. Feeling competentc. Feeling competent

Assume Personal Assume Personal ResponsibilityResponsibility

Compassion fatigue can be avoided. Compassion fatigue can be avoided.

Main OptimismMain Optimism Take control over personal well-being. Take control over personal well-being.

No one will do this for you. No one will do this for you. Make wise choices through each day. Make wise choices through each day. Take personal action. Do not put off Take personal action. Do not put off

taking care of self.taking care of self.

Wellness FocusWellness Focus

Recognize the signs and symptomsRecognize the signs and symptoms Correct thoughts and attitudes that are hurting Correct thoughts and attitudes that are hurting

you. (Example: Change “I can’t keep doing you. (Example: Change “I can’t keep doing this” to “I can do most things over a brief period this” to “I can do most things over a brief period of time. I really do care about others.”)of time. I really do care about others.”)

Talk to responsive and responsible colleaguesTalk to responsive and responsible colleagues Be assertive; set limits; learn to say “no”Be assertive; set limits; learn to say “no”

RecoveryRecovery

Listen to your body.Listen to your body. Reassess your values.Reassess your values. Pace yourself.Pace yourself. Take care of your body.Take care of your body. Maintain your sense of humor.Maintain your sense of humor.

Living with our ValuesLiving with our Values

““Better to fail at doing the right thing than Better to fail at doing the right thing than to succeed at doing the wrong thing”to succeed at doing the wrong thing”

~ Guy Kawasaki~ Guy Kawasaki

““The key is not to prioritize what’s on your The key is not to prioritize what’s on your schedule, but to schedule your priorities.”schedule, but to schedule your priorities.”

~ Stephen Covey~ Stephen Covey

Take a Moment Now: Take a Moment Now: Contract With SelfContract With Self

What will I do by the end of this week that What will I do by the end of this week that will help me take better care of myself?will help me take better care of myself?

____________________________________________________________________________________________________________________________________________________________________________________________________________

Signature __________________________Signature __________________________

Intention and PersistenceIntention and Persistence

Do not let what you cannot do interfere Do not let what you cannot do interfere with what you can do.with what you can do.

~John Wooden~John Wooden

Cognitive RestructuringCognitive Restructuring

Experience is not what happens to you - Experience is not what happens to you - it’s how you interpret what happens to it’s how you interpret what happens to you.you.

~Aldous Huxley~Aldous Huxley

Develop a Wellness Develop a Wellness PhilosophyPhilosophy

I suggest you express these thoughts to yourselfI suggest you express these thoughts to yourself I have all the time I need to accomplish my I have all the time I need to accomplish my

work.work. I give myself personal time.I give myself personal time. I provide myself with good nutrition.I provide myself with good nutrition. I exercise myself (body, mind, spirit).I exercise myself (body, mind, spirit). I have fun.I have fun. I spend time with friends and family.I spend time with friends and family. I connect with a higher being.I connect with a higher being. My life has purpose.My life has purpose.

Self-ReflectionSelf-Reflection

The biggest change we can make is to The biggest change we can make is to make a change within ourselves.make a change within ourselves.

PersistencePersistence

Success is the ability to go from failure to Success is the ability to go from failure to failure without losing your enthusiasm.failure without losing your enthusiasm.

~Winston Churchill~Winston Churchill

Leisure: Take Time for Leisure: Take Time for YourselfYourself

““As I must repeat once again, the first principle As I must repeat once again, the first principle of all action is leisure.” (of all action is leisure.” (AristotleAristotle, Po., Bk VII,3), Po., Bk VII,3)

Time is “of the essence”Time is “of the essence”

Now is the time of your life.Now is the time of your life.

You are free to choose your thoughts and free You are free to choose your thoughts and free to be. Play during free time.to be. Play during free time.

Investing in Life Investing in Life

Click below for a reminder to take time for Click below for a reminder to take time for yourself (from www.workyourlife.com):yourself (from www.workyourlife.com):

http://www.scottstratten.com/movie.htmlhttp://www.scottstratten.com/movie.html    

Thank you.Thank you.

You have been given a tremendous task. You have been given a tremendous task. You have children and adolescents in You have children and adolescents in your care who particularly need to feel your care who particularly need to feel safe and wanted. They may not know safe and wanted. They may not know how to express this. Of all the lessons how to express this. Of all the lessons they learn throughout life, the lessons they learn throughout life, the lessons they learn now will be among those not they learn now will be among those not soon forgotten. soon forgotten.

Thank you so much for being there. Thank you so much for being there.

ReferencesReferences

American Academy of Family Physicians (1997). American Academy of Family Physicians (1997). Balancing act: Are you Balancing act: Are you stressed out?stressed out? Retrieved February 17, 2005. Available at Retrieved February 17, 2005. Available at

http://www.aafp.org/fpm/970300fm/balance.htmlhttp://www.aafp.org/fpm/970300fm/balance.html Aronson, E., Pines, A. M. (1988). Aronson, E., Pines, A. M. (1988). Career burnout: Causes & curesCareer burnout: Causes & cures. New. New

York, NY: The Free Press.York, NY: The Free Press. Arthur, N. M. (1990). The assessment of burnout: A review of threeArthur, N. M. (1990). The assessment of burnout: A review of three

inventories useful for research and counseling. inventories useful for research and counseling. Journal ofJournal of Counseling and Development, 69Counseling and Development, 69, 186-189., 186-189.

Canfield, J., & Miller, J. (1998). Canfield, J., & Miller, J. (1998). Heart at work: Stories and strategies forHeart at work: Stories and strategies for building self-esteembuilding self-esteem a and re-awakening the soul at worknd re-awakening the soul at work. New York:. New York: McGraw Hill.McGraw Hill.

Chandler, C., Bodenhamer-Davis, E., Holden, J. M., Everson, T., &Chandler, C., Bodenhamer-Davis, E., Holden, J. M., Everson, T., & Bratton, S. (2001). Enhancing personal wellness in counselorBratton, S. (2001). Enhancing personal wellness in counselor trainees using biofeedback: An exploratory study. trainees using biofeedback: An exploratory study. AppliedApplied Psychophysiological Biofeedback, 26Psychophysiological Biofeedback, 26(1), 1-7.(1), 1-7.

ReferencesReferences

Corey, G., Corey, M. S., & Callanan, P. (2003). Corey, G., Corey, M. S., & Callanan, P. (2003). Issues and ethics in the Issues and ethics in the counseling professions counseling professions (6th ed.). Pacific Grove, California: Brooks/Cole.(6th ed.). Pacific Grove, California: Brooks/Cole.

Davis, M., Eshelman, E. R., & McKay, M. (1999). Davis, M., Eshelman, E. R., & McKay, M. (1999). The relaxation and stressThe relaxation and stress reduction workbookreduction workbook (4th. ed.). Oakland, CA: New Harbinger. (4th. ed.). Oakland, CA: New Harbinger.

Figley, C. R. (1995). Compassion fatigue: Toward a new understanding of theFigley, C. R. (1995). Compassion fatigue: Toward a new understanding of the costs of caring. In B. H. Stamm (Ed), costs of caring. In B. H. Stamm (Ed), Secondary traumatic stress: Self-Secondary traumatic stress: Self-

carecare issues for clinicians, researchers issues for clinicians, researchers, , and educatorsand educators (pp. 3-28). Lutherville, (pp. 3-28). Lutherville, MD:MD:

Sidran Press.Sidran Press. Gladding, S. T. (2000). Gladding, S. T. (2000). Counseling: A comprehensive professionCounseling: A comprehensive profession (4th ed.). Saddle (4th ed.). Saddle

River, NJ: Prentice-Hall.River, NJ: Prentice-Hall. Kleinke, C. (1998). Kleinke, C. (1998). Coping with life’s challengesCoping with life’s challenges (2nd. ed.). Pacific Grove, CA: (2nd. ed.). Pacific Grove, CA:

Brooks/Cole.Brooks/Cole. LiPuma, R. (2004). LiPuma, R. (2004). A four-step wellness model for self-understanding and totalA four-step wellness model for self-understanding and total

health-1992 health-1992

ReferencesReferences MacCluskie, K. C., & Ingersoll, R. E. (2001). MacCluskie, K. C., & Ingersoll, R. E. (2001). Becoming a 21st centuryBecoming a 21st century

agency counselor: Personal and professional explorationsagency counselor: Personal and professional explorations .. Belmont, CA: Wadsworth/Thompson.Belmont, CA: Wadsworth/Thompson.

Miller, L. (1998). Our own medicine: Traumatized psychotherapistsMiller, L. (1998). Our own medicine: Traumatized psychotherapists and the stresses of doing therapy. and the stresses of doing therapy. Psychotherapy, 35Psychotherapy, 35, 137-, 137-146 146

Moore, T. (1992). Moore, T. (1992). Care of the soul: A guide for cultivating depth andCare of the soul: A guide for cultivating depth and sacredness in everyday lifesacredness in everyday life. New York: Harper Collins.. New York: Harper Collins.

O’Halloran, T. M., & Linton, J. M. (2000). Stress on the job: Self-care O’Halloran, T. M., & Linton, J. M. (2000). Stress on the job: Self-care resources for counselors. resources for counselors. Journal of Mental Health Counseling,Journal of Mental Health Counseling, 2222(4), 354-364.(4), 354-364.

Pearlman, S. D. (1995). Self-care for trauma therapists: AmelioratingPearlman, S. D. (1995). Self-care for trauma therapists: Ameliorating vicarious traumatization. In B. H. Stamm (Ed.), vicarious traumatization. In B. H. Stamm (Ed.), SecondarySecondary traumatic stress: Self-care issues for clinicians, researchers, andtraumatic stress: Self-care issues for clinicians, researchers, and educatorseducators (pp. 51-64). Lutherville, MD: Sidran Press. (pp. 51-64). Lutherville, MD: Sidran Press.

ReferencesReferences

Powers, A. S., Myers, J. E., Tingle, L. R., & Power, J. C. (2004). Powers, A. S., Myers, J. E., Tingle, L. R., & Power, J. C. (2004). Wellness, perceived stress, mattering, and marital satisfactionWellness, perceived stress, mattering, and marital satisfaction

among medical residents and their spouses: Implications foramong medical residents and their spouses: Implications foreducation and counseling. education and counseling. The Family Journal, 12The Family Journal, 12(1), 26-36.(1), 26-36.

Sherman, M. D. (1996). Distress and professional impairment due toSherman, M. D. (1996). Distress and professional impairment due to mental health problems among psychotherapists. mental health problems among psychotherapists. ClinicalClinical Psychology Review, 16Psychology Review, 16, 299-315., 299-315.

Thompson, R. A. (1996). Thompson, R. A. (1996). Counseling techniques: Improving relationships Counseling techniques: Improving relationships with others, ourselves, our families, and our environmentwith others, ourselves, our families, and our environment. Philadelphia, PA:. Philadelphia, PA: Accelerated Development.Accelerated Development.

Walsh, R. (2000). Asian psychotherapies. In Corsini, R. J. & Wedding, E. Walsh, R. (2000). Asian psychotherapies. In Corsini, R. J. & Wedding, E. (Eds.). (Eds.). Current psychotherapies ,Current psychotherapies , pp. 407-444. Itasca, IL: Peacock. pp. 407-444. Itasca, IL: Peacock.

Watkins, C. E. (1983). Burnout in counseling practice: Some potential Watkins, C. E. (1983). Burnout in counseling practice: Some potential professional and personal hazards of becoming a counselor. professional and personal hazards of becoming a counselor. Personnel Personnel and Guidance Journal, 61and Guidance Journal, 61, 304-308., 304-308.

ReferencesReferences

Well, A. (1998). Well, A. (1998). Health and healingHealth and healing. Boston: Houghton Mifflin.. Boston: Houghton Mifflin. Wellness Council of America (2005). Wellness Council of America (2005). Stress management at workStress management at work. Retrieved . Retrieved

February 28, 2005 from www.welcoa.org.February 28, 2005 from www.welcoa.org.