Letting Go

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by Françoise Mathieu, M.Ed., CCC., RP

This is a post about transitions and making time for reflection.

And listening to podcasts.

Yes, it may seem like a strange combo, but stay with me for a sec.

I have been doing a lot of driving this summer: back and forth from my home to the cottage to deal with a septic tank (oh yes, my life is full of glamour), one trip to visit my sister and her gorgeous new baby, one to drop off my son and his buddies on their back-country camping adventure and then to bring them home four days later (the car slightly less fragrant on the way back) and two trips for memorial services and major events in our extended family.

For some of those trips, I wasn’t in a huge rush, and I decided to take some country roads to break it up and skip our major highway which seems to be full of construction and sleep-deprived truck drivers these days.

This is a big transition summer for my family as our youngest prepares to go away to university (in less than 30 days! But apparently, I’m the only one doing that countdown, and no, it’s not because I can’t wait for him to leave), and our oldest goes back to Nova Scotia to complete her final year and starts thinking about next steps.

 

Pic of my son and his friends canoeing towards a forest fire and thunderstorms. Symbolism aplenty.

So, in order to maximize time with my kids while they work summer jobs, I haven’t taken a holiday per se, but I have worked shorter hours so I can be home for a spontaneous BBQ with them and their friends, or a quick trip to the ice cream shop – or, quite frankly, just work from my little garden in the back of our house and grab a few minute to chat as they come and go. It’s precious and sweet, and I cherish my time with these two incredible young adults. Granted, they don’t do many dishes, lose their wallets and keys regularly, and text me “What’s for dinner?” or “Can I have the car?” almost daily.

It’s hectic, but it’s so fun.

One night, we all took the local ferry (20 minutes to cross, free!) to Wolfe Island and had a leisurely dinner with friends on a patio and watched the sun set and the blood moon emerge. It felt like a week-long vacation but we were minutes from our house. Amazing.

 

Kingston also has a gorgeous new urban beach which is just down the street from where I live. I love that everyone in our city finally has free access to a beautiful swimming spot. My friend Amber took this pic a few days ago, and it was likely early in the day as the beach is full to the rafters by midday:

 

When I drive alone, I love to listen to podcasts. Here are the ones I have been listening to:

 


Hidden Brain – NPR: A podcast about social psychology with Shankar Vedantam

Check out these two episodes:


Revisionist History (season 3) – Malcolm Gladwell: Gladwell is back with a third season of his fantastic RH podcast

From their website: “Each week for 10 weeks, Revisionist History will go back and reinterpret something from the past: an event, a person, an idea. Something overlooked. Something misunderstood.”

Two great episodes that focus on memory and recall (and throws in a great story about a spy and Ingrid Bergman):


Bodies – Allison Behringer: recently launched, Bodies starts each episode with a medical mystery and does a deep dive.

The first episode is called “Sex Hurts” where Behringer explores her own journey with pelvic pain with complete candor and presents some very interesting findings in the literature and expert interviews. She also discusses the ongoing lack of knowledge among medical professionals about women’s health. This is a powerful and important topic.

I am really looking forward to the next episodes in this series.


So anyway, this is all to say that I’ve deliberately carved out time this summer to process, reflect and mull over what this massive change means in my family’s life. 

And I have also decided that mini-breaks and staycations can be sweet and restorative.

I hope that you enjoy these podcast recommendations.

Disappoint Someone Today

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by Françoise Mathieu, M.Ed., CCC., RP

A few years ago, I was running late one morning and rushed out of the house to get to work. My teenage daughter called me a few hours later and told me on speakerphone, with all her friends in the car, “mom, you left the straightening iron on, it could have caused a fire. I’m not angry, I’m just disappointed.” And then she burst out laughing. Other than my dangerous oversight, this was a funny interaction because my daughter was using language that she clearly had heard several times in her life (from me, I might as well admit it right now) and she was enjoying the role reversal.

I don’t know if you’re like me, but there is very little I dislike more than knowing that I have disappointed someone. I think that a lot of us caregivers have this natural predisposition to please others and take care of everyone else’s needs. This makes us excellent friends, family members and professionals. There are also deeply fulfilling positives to feeling needed, helpful and caring. I would not trade that for the world.

However, there can also be a cost to being super-human caregivers, because, it turns out, the need will ALWAYS outweigh what we can provide. This is true professionally, as well as personally.

I recently went to a grocery store to pick up several favourite food items for my family and it wasn’t until I got back to the car and drove away that I realised that I had not for a second thought about getting what I myself needed or wanted. I parked the car on a side road, and took a few minutes to breathe. What was I trying to prove? To whom? That I am invincible, without needs? That I can always take care of everyone else, no matter what?

We learn these patterns early, and they become embedded in our identity.

I come from a long line of caregivers, and maybe you do too. My mother told me about caring for her depressed mother, cooking meals for the family, taking care of household chores at age five (yes, five years old, not even in primary school yet). My brother and I took on adult responsibilities at ages nine and twelve when our parents got divorced and things were tough in our house. We are still both known for our solid, dependable, reliable character. We pride ourselves on it. It has brought us professional rewards and tremendous satisfaction. My mother too, as a matter of fact. She was a shining star in her field, and was highly recognised for her incredible work ethic, fairness and trustworthiness.

And then, one day, we start to realise that we are running on empty. Or maybe we drop the ball, forget something, let someone down inadvertently. Or we get sick, or start feeling low. Or we completely max out our bandwidth and we simply cannot do it all because the demand is completely exceeding our capacity.

The wonderful author Cheryl Richardson has written about “Extreme Self Care” in several of her books. She invites us to reassess life’s true priorities, apart from the basics of safety, shelter, food and love. I return to Richardson’s books time and again and always find a quote to support what I know to be what I truly need.  

Here is one from her book “The Art of Extreme Self-Care”: “if you want to live an authentic, meaningful life, you need to master the art of disappointing and upsetting others, hurting feelings, and living with the reality that some people just won’t like you. It may not be easy, but it’s essential if you want your life to reflect your deepest desires, values and needs.”

So, taking a page out of Cheryl’s work, I would like to invite us all to look at what’s on our plate at the moment, perhaps in the coming two months. Is there something that you have already agreed to do (personally and/or professionally) that you could say no to? What would the consequences be, of saying no? Will someone be disappointed? Is that the fear? And then what? What if, in fact, we DO need to disappoint sometimes? Are we afraid of losing love, respect, friendships? Do we exist if we are not the “go-to” at all times?

These are profound questions. I will admit. Things that I grapple with almost daily.

I had to disappoint people that I deeply care about recently. At first, I resisted. I felt so guilty, I was going to upset them, without a doubt. But something had to give. I was completely stretched at work and at home and I was totally overwhelmed. So, I did what I always do when I feel like my head is going to burst: first, I went for a long walk. Then, the next time I had an hour to myself, I went to yoga. Then I got a full night’s sleep. Finally, I went to talk to a trusted advisor.

A trusted advisor can be a dear friend, a coach, therapist or a spiritual counsellor. In my case, I am very lucky to have several wise women in my life who know me well and aren’t afraid to challenge me. They know my patterns and can also call me on my bullshit. I went to see one of them and I probably talked for 45 minutes uninterrupted, unloading my dilemmas and multitude items on my to do list. Finally my friend said “it just can’t all be done. You are going to have to disappoint some people, but also recognise that you have set a pattern over years of always saying yes and, therefore, their reaction will likely not be very good. So be prepared for that. But also, be honest, tell them what’s going on, and why you are saying no.”

So I did. I went off and disappointed a whole bunch of people.

And although I felt badly about it, I also felt tremendous relief. I carved out some space to breathe, and the need for me to reassess how much capacity I claim to have, to take on more than I can handle. To be the fixer, the reliable one at all times.

I truly believe that in order to maintain integrity and compassion in the very challenging work that we do, we must be honest about our limits, and to above all else, to be able to show ourselves compassion first before we can truly care for others.

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Recommended Readings:

Resilience, Balance and Meaning Workbook by Dr. Patricia Fisher, R.Psych., L.Psych.

Take Time for Your Life: A 7-Step Program for Creating the Life You Want  by Cheryl Richardson

Self-Compassion: The Proven Power of Being Kind to Yourself  by Kristin Neff, Ph.D.

Compassion Fatigue Workbook by Françoise Mathieu, M.Ed., CCC., RP

Excerpts from “The San Diego International Conference on Child and Family Maltreatment, 2015”

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Françoise presented her “Beyond Kale and Pedicures” keynote at the Chadwick Center’s annual San Diego Conference on Child and Family Maltreatment conference in January, 2015, during which she reviews the history of compassion fatigue research, as well as suggests new directions for the field.

Below are highlights from the keynote: (Warning: Strong Language)

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The San Diego Conference focuses on multi-disciplinary best-practice efforts to prevent, investigate, treat, and prosecute child and family maltreatment. The objective of this annual conference is to develop and enhance professional skills and knowledge in the prevention, recognition, assessment and treatment of all forms of maltreatment. Learn more about the conference here.

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Ask the Expert: Q&A Webinar with Françoise Mathieu

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Last week, Françoise had the honour of being invited to participate in an “Ask the Expert” webinar by CIR – the Centre for Innovation and Resources Inc. The CIR serves those who are working to protect and heal children and families. They work to optimize established services so that children, families, and communities are served in a holistic way based on best practices and current research.

During this webinar, Françoise answers questions from healthcare professionals surrounding the issues of vicarious trauma and compassion fatigue, as well as offers suggestions on how to combat its effects in our work and personal life.

Some of the questions include:

“I like to watch the news to keep informed, however I’m aware it affects me due to vicarious trauma. I’ve tried not watching or reading any news at all, but that doesn’t work. What do you suggest?”

“What are some tools that I can use to help me with the stories that haunt me?”

“What are some strategies for recharging when we realize that compassion fatigue or vicarious trauma is affecting our ability to connect with the work we do, and our personal lives?”

Find the answers to these questions and many more in the full “Ask the Expert” webinar:

 


Resources mentioned in the video:

TEND Blog posts – Becoming Trauma-Informed, Bridges out of Poverty

TEND Articles – Low Impact Debriefing , Beyond Kale and Pedicures, The Business Case

TEND Training – Window of Tolerance Framework by Diana Tikasz

Online Resource – SHIFT wellness

Book Recommendation – Bouncing Back, by Linda Graham.

 

Reducing Unnecessary Trauma Exposure in Service Providers

by Françoise Mathieu, M.Ed., CCC., RP

Many years ago, when my dear friend Robin Cameron and I developed our very first compassion fatigue workshop, we came across the term “limited disclosure” in Laurie Anne Pearlman and Karen Saakvitne’s book Trauma and the Therapist.

The authors, who were well ahead of the curve on all matters related to VT and Compassion fatigue solutions, suggested that we, as professionals, should consider taking a careful look at “how much detail about the violence or abuse [we] want to share [with one another].” (Pearlman, personal communication)

This concept of “limited disclosure” rang so true to us that we immediately integrated it in our training. We called it Low-Impact Debriefing in a cheeky nod to the aerobics craze of the 80s and also because it formed the acronym L.I.D. The idea of low impact debriefing is twofold: to be able to share the information that we need to, while at the same time not having a highly negative impact on the listener. We were not suggesting that we should keep a lid on difficult things but wanted to suggest that we should all perhaps take a careful inventory of how much graphic information we need to be sharing when debriefing difficult stories or consulting on cases with colleagues. Perhaps a better analogy is that of a pressure cooker that lets the steam out little by little rather than in one giant burst with potentially negative consequences.

Over the past decade, my team has received many invitations to present at trauma trainings: child abuse symposia, conferences for parents of murdered children, workshops for sex crimes investigators, courses on the Dark Net and cybercrime, and many similar other conferences. We are often struck by the extremely graphic details that are almost invariably shared during these events: gruesome photos shown on a giant screen during a lunch time keynote, detailed descriptions of a murder or assault on a child, minute details about the smells, sounds and sights of a crime scene and even, at times, graphic audio and video footage. Some of these scenes can be very difficult to forget.

When is Trauma Exposure Gratuitous and When it is Necessary?

I think that we can all agree that many media outlets share an excessive amount of potentially disturbing images in their coverage (and in fictional shows, but that’s for another post). I remember listening to CBC news radio on my headset a few years ago while I was out for a run, and suddenly, without warning, the host played an actual audio of a child being victimized. I remember tearing the earpieces away from me and thinking “WTF just happened? Why was this necessary during a midday radio show? And I that instance, I don’t think that the now overused customary warning “content may be disturbing to some” was enough to justify airing that footage.

I am also well aware that at times, graphic details are essential to a trauma training – if you are a forensic examiner or an investigator of any sort, you must be able to recognise and differentiate between an accidental injury and one that has been deliberately caused by another person, or you may need to learn how to assess a crime scene and the related details that are present. You may need to learn how to interview a criminal in order to develop better investigative or clinical skills. Sometimes, we need videos, photos and details in order to do our job properly.

But here is my question to you: how much detail is too much? Even at a trauma conference, are all details required at all times? Is it enough to give people a warning at the start of our talks “this may disturb you” or do we all have a responsibility to reassess what we are sharing and how much detail is enough?

We were recently asked to create a brand-new course called “The Things We Can’t Unsee: Reducing the Impact of Secondary Trauma Exposure” which we have had the privilege of offering to legal professionals, child abuse investigators and victim service providers across North America this year. The response has been extremely positive and has led to some powerful discussions and reflection among participants. A good place start addressing this issue is to perform a personal “trauma audit” for ourselves and see how much extraneous trauma stories we are sharing with one another. To go further, please read The four steps to Low Impact Debriefing as discussed in my book (Click here).

“I’m not bothered by these stories”

Now, I have been in the field long enough to know that some of you will say “I have been exposed to thousands of stories, they don’t bother me anymore” and perhaps this is true. We all have a different level of sensitivity to difficult images and traumatic details based on a whole host of personal factors. But it would be interesting to be able to measure our stress hormones and see whether that is actually true, or to be able to perform a brain scan and see how our limbic system responds to repeated exposure. As psychiatrist Dr. John Bradford so eloquently explained in his testimonials a few years ago, after 30 years of exposure to gruesome images, he also thought that he was immune, until, one day, he was not: http://www.ottawacitizen.com/health/Tough+forensic+John+Bradford+opens+about+PTSD/9152171/story.html

To Learn More:

 

Sources:

Mathieu, F. (2012) The Compassion Fatigue Workbook: Creative Tools for Transforming Compassion Fatigue and Vicarious Trauma. New York: Routledge.

Pearlman, L. A., & Saakvitne, K.W. (1995). Trauma and the therapist: Countertransference and vicarious traumatization in psychotherapy with incest survivors. New York: W.W. Norton. pp. 383-384.

 

The Edge of Compassion – Françoise Mathieu giving a TEDTalk for TEDxQueensU

For the past 15 years, Secondary Trauma specialist and compassion fatigue educator Françoise Mathieu has been exploring tools to help all of us navigate the challenges of sustaining compassion and empathy towards others – both as individuals and professionals.

This talk explores ways to find the right balance between caring for others while staying healthy and empathic. Françoise is a Registered Psychotherapist and a compassion fatigue specialist. Her experience stems from over 20+ years as a mental health professional, working as a crisis counsellor and trauma specialist in university counselling, military, law enforcement and other community mental health environments.

Françoise is co-executive director of TEND, whose aim is to offer consulting and training to helpers on topics related to secondary trauma, compassion fatigue, burnout, self-care, wellness and organizational health. Since 2001, Françoise has given hundreds of seminars on compassion fatigue and secondary trauma across North America to thousands of helping professionals in the fields of health care, child welfare, the criminal justice system and other similar high stress, trauma exposed professions.

Françoise is the author of “The Compassion Fatigue Workbook” which was published by Routledge in 2012 as well as several articles and publications.

This talk was given at a TEDx event using the TED conference format but independently organized by a local community.


 

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“Françoise Mathieu’s writing is wonderful: she speaks from the heart, practitioner to practitioner, about the stressors and strains of human service work, particularly those that come from prolonged regular work with traumatized patients and clients. This is a book you help write by yourself and about yourself. That’s why it is the workbook for trauma work.” – Charles R. Figley, Tulane University, Louisiana, USA, and author of Treating Compassion Fatigue

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Balancing our Work and Life while Staying Well – Five Essential Tools

By Françoise Mathieu

This post was initially published on the Oregon OEA Choice Trust website: http://oeachoice.com/5-essential-tools-for-balancing-your-work-and-life-while-staying-well/

I grew up in a family of educators. My parents moved from Montreal to the high arctic in the early 1960s and worked in a variety of schools in very remote Inuit communities for the following decades. Over the years, my father was a teacher and then became school principal, then superintendent and eventually director general of an entire region. He travelled extensively for work, visiting numerous villages for a third of each year, dealing with labour disputes, financial cutbacks and the complex societal challenges facing First Nations communities. My mother co-developed one of the very first teacher training program for Inuit women in Canada.

Needless to say, my parents were very dedicated and hard-working. Education reform and the challenges of the work was daily conversation in our household. Working as educators in small communities presented many challenges and rewards: our house was often the informal hotel, food bank and shelter, and villagers would frequently knock on our door for advice or support.

Are you living in the community that you serve?

If you live and work in the same community, you may have experienced something similar: you go to the grocery store on a Saturday in your sweatpants, and a parent accosts you for advice on their child’s problematic learning difficulties. You go to a party and are immediately grilled on your thoughts about educational policies or the best ways to beat the SATS.

How do you find balance between work and your private life?

I would say, in hindsight, that my parents were frequently completely exhausted at night, and did not know a thing about work-life balance. Being from the War Generation, born in the 1940s, their cohort had not learned about the importance of balance and self-care. For them, you worked until you fell down, and then you got up again and worked some more. They had very little time for themselves. This was the norm among the educators that I knew.

Burnout Research

So how can we find balance working in the education field? How do we learn to set limits so that we can bring our best selves to work and yet not burn out? How do we juggle the competing demands of our home lives and careers?

Notions of self-care are fairly new to the education field. In fact, it wasn’t until the late 1980s that researchers started investigating the concept of work-related burnout among mental health professionals and nurses.  Compassion fatigue, the emotional and physical exhaustion that can lead to a shift in our ability to experience empathy for others is a concept that emerged in the 1990s and lead to the growth of an entirely new field exploring provider wellness.

Here’s what we now know: we cannot expect to work in highly demanding and frequently under-resourced environments without taking some active steps to maintain our emotional and physical health. Some workplaces have implemented some very successful workplace wellness initiatives and we have featured them in our article “Beyond Kale and pedicures” (http://www.tendacademy.ca/wp-content/uploads/2016/01/BEYOND-KALE-AND-PEDICURES-Article.pdf)

The good news is that we now have over 25 years of research that map out what works and steps that we can each take to stay well. I have written extensively on this topic in my book The Compassion Fatigue Workbook and related articles.

Here are my top five favourites:

What works? 5 Key steps

Step one: Take stock

Cheryl Richardson wrote an outstanding book called Take Time for your Life in 1990 which provides a great self-assessment checklist called “What’s draining you?”. Richardson invites readers to identify the main drains on their energy: relationships, environment, body mind and spirit, work and money. Completing this checklist allows you to decide where to begin. Which of these areas is causing you the most stress at the moment? Which area shows the most possibility of improvement?

Step two: Identify your warning signs

How do you know you’re headed for trouble? What are your most recurrent physical warning signs? What about emotional reactions? Have you noticed some predictable behavioural patterns that show up when you’re overloaded? Learning to recognise your top three warning signs can help you catch things early before you become too depleted.

Step three: Pick your battles at work

The field of education is complex, and frequently under-resourced. Some of us deal with these realities more successfully than others. If you work with a colleague or a team that is frequently negative or engage in constant office gossip or naysaying, consider making more strategic alliances in the workplace. Venting once in a while is fine, daily gripe sessions bring nothing constructive to the workplace.

Step four: develop a community of support

Research has shown that social support is one of the best strategies to address compassion fatigue and burnout. Who are your accountability partners? Who do you spend time with at work and at home? Can they be there to help you stay on target with your self-care goals?

Step five: Reassess where you are at regularly

I recently wrote a new year’s resolution blog post on my website: www.tendacademy.ca where I discuss my lack of enthusiasm for new year’s resolutions. Rather than making big commitments once a year, I prefer to have weekly tweaks and adjustments. On Sundays, each week, I take gentle stock: how am I doing? What needs more attention? What needs tweaking?

Conclusion

My parents excelled in their careers, but it took a significant toll on their health and their personal lives. I look back on their work with admiration but also see a cautionary tale of working without balance. We know better now. Where will you start?

Warning signs of Vicarious Trauma/Secondary Traumatic Stress and Compassion Fatigue

 

 Adapted from “The Compassion Fatigue Workbook

Downloadable PDF to share

If you would like more resources after reading this article, please have a look at our online training resources and books.

We also have a more detailed example of Signs and Symptoms here.

Learning to recognise one’s own warning signs of compassion fatigue (CF) and vicarious/secondary trauma (VT/STS) serves a two-fold purpose:

First, it can serve as an important check-in process for someone who has been feeling unhappy and dissatisfied, but did not have the words to explain what was happening to them. Secondly, developing a warning system allows you to track your levels of emotional and physical depletion. It also offers you tools and strategies that you can implement right away.

Let me give you an example of what a warning system may look like:

Say, for example, that you were to learn to identify your CF/STS symptoms on a scale of 1 to 10 (10 being the worst you have ever felt about your work/compassion/energy, and 1 being the best that you have ever felt).

Then, you learn to identify what an 8 or a 9 looks like for you i.e. “when I’m getting up to an 8, I notice it because I don’t return phone calls, think about calling in sick a lot and can’t watch any violence on TV” or “I know that I’m moving towards a 7 when I turn down my best friend’s invitation to go out for dinner because I’m too drained to talk to someone else, and when I stop exercising.”

Being able to recognize that your level of CF/STS is creeping up to the red zone is the most effective way to implement strategies immediately before things get worse.

But look back to what also emerges in this process: you are starting to identify the solutions to your depletion.

If I know that I am getting close to an 8, I may not take on new clients with a trauma history, I may take a day off a week, or I may return to see my own therapist.

In order for you to develop your warning scale, you need to develop an understanding and an increased awareness of your own symptoms of compassion fatigue and vicarious trauma/STS.

For a more complete list of Warning Signs, have a look at the Compassion Fatigue Workbook or Compassion Fatigue 101 Course.

In their book Transforming the Pain, Saakvitne and Pearlman (1996) have suggested that we look at symptoms on three levels: physical, behavioural and psychological/emotional. As you will see, there is often overlap between these categories.

Please take a look at the list below and notice which ones are your most frequent warning signs:

Physical Warning Signs (More detail available in extra information post)

  • Exhaustion
  • Insomnia
  • Headaches
  • Increased susceptibility to illness
  • Sore back and neck
  • Irritable bowel, GI distress
  • Rashes, breakouts
  • Grinding your teeth at night
  • Heart palpitations
  • Hypochondria

Behavioural Signs (More detail available in extra information post)

            Increased use of alcohol and drugs

  • Anger and Irritability at home and/or at work
  • Avoidance of clients/patients
  • Watching excessive amounts of TV/Netflix at night
  • Consuming high trauma media as entertainment
  • Not returning phone calls at work and/or at home
  • Avoiding colleagues and staff gatherings
  • Avoiding social events
  • Impaired ability to make decisions
  • Feeling helpless when hearing a difficult client story
  • Impostor syndrome – feeling unskilled in your job
  • Problems in personal relationships
  • Difficulty with sex and intimacy due to trauma exposure at work
  • Thinking about quitting your job (not always a bad idea by the way!)
  • Compromised care for clients/patients
  • Engaging in frequent negative gossip/venting at work
  • Impaired appetite or binge eating

Emotional/Psychological Signs (More detail available in extra information post)

  • Emotional exhaustion
    Negative self-image
    Depression
  • Increased anxiety
    •Difficulty sleeping
  • Impaired appetite or binge eating
  • Feelings of hopelessness
  • Guilt
  • Suicidal thoughts*
  • Reduced ability to feel sympathy and empathy towards clients or family/friends
    •Cynicism at work
  • Anger at work
    •Resentment of demands being put on you at work and/or at home
    •Dread of working with certain clients/patients/certain case files
    •Diminished sense of enjoyment/career(i.e., low compassion satisfaction)
  • Depersonalization – spacing out during work or the drive home
  • Disruption of world view/heightened anxiety or irrational fears
    •Intrusive imagery (You can read an excellent description of this in Eric Gentry’s Crucible of Transformation article).
  • Hypersensitivity to emotionally charged stimuli
    Insensitivity to emotional material/numbing
    Difficulty separating personal and professional lives
    Failure to nurture and develop non-work related aspects of life

Take Stock:

Once you have read through and circled your most frequent warning signs, try and identify your top three most frequent warning signs. I call them the “big three”. Are they all physical, emotional or behavioural or do you see a mixture of signs from each category? Would you say that you are currently in the Green (healthy), Yellow (warning sign) or Red zone with your overall functioning?

Now, ask a loved one or close colleague to share with you what they think your “Big Three” warning signs are, at home and at work.

Next Steps:  

Each warning sign has specific tools that can help reduce your levels of stress. For example, if you are experiencing a lot of secondary exposure-related symptoms, you may wish to examine your caseload, the availability of debriefing and grounding strategies and you may need to assess the level of extraneous trauma images and stories that you are exposing yourself to in your personal life. If you have a lot of emotional symptoms, you may want to consider a consultation with a well-trained mental health professional who is familiar with vicarious trauma and the nature of the work that you do.

In our post on Tools and Resources (link here) we will provide some more suggestions.

*Suicidal or hopeless thoughts? Get Help Now Please remember that no matter how stressful/traumatic our work is, it is not a normal consequence of VT/STS to experience suicidal thoughts or prolonged bouts of depression or hopelessness. Please seek help as soon as you notice these symptoms in yourself. If you are worried about confidentiality, or unsure where to turn, please consult online sources of support. There are urgent suicide support hotlines available 24/7 which you can find with a click of the web. Don’t suffer alone. Get help. You deserve it and so do the people who love you.

 

Sources:

Figley, C.R. (Ed). (1995) Compassion Fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. New York: Brunner/Mazel.

Figley, C.R. (Ed.). (2002) Treating Compassion Fatigue, New York: Brunner/Routledge.

Gentry, E. J., (2002) Compassion Fatigue: A Crucible of Transformation in Journal of Trauma Practice, Vol 1. No. 3/4. pp.37-61.

Killian, K. (2008). Helping till it hurts? A multimethod study of compassion fatigue, burnout, and self care in clinicians working with trauma survivors in Traumatology, (14, 2) 32-44.

Mathieu, F (2012) The Compassion Fatigue Workbook – New Revised and Expanded Edition

Van Dernoot Lipsky, L. (2009) Trauma Stewardship: A guide to caring for self while caring for others. BK Publishers.

Saakvitne, K.W.; Pearlman, L. A., & the Staff of the Traumatic Stress Institute (1996): Transforming the pain: A workbook on vicarious traumatization. New York: W.W. Norton.

 

© Françoise Mathieu 2017

 

Tools to Reduce Vicarious Trauma/ Secondary Trauma and Compassion Fatigue

 

Downloadable PDF

If you would like more resources after reading this article, please have a look at our online training resources and books.

In a previous post (links here) we discussed some of the warning signs of VT/STS and Compassion Fatigue. We are often asked “what can I do personally and professionally to reduce the negative stress-related effects of my work?” We have many resources to recommend.

First, please have a look at the extensive list of TEND resources further down in the post, or also the wealth of articles we have posted in our resources section from other authors who are specialists in the field. If you are struggling with significant frustration with your workplace and feel that you do not have much control over the system or your job, and don’t feel that you can move to a better employment situation, please start by reading this article:  Beyond Kale and Pedicures

Where to start?

For starters, hopefully you will have read through our other posts to assist you in identifying the main challenges that you are facing: Is it related to too much exposure to difficult stories or a lack of referral resources? Is it work overload or an unsupportive supervisor/toxic team? Are you struggling with difficult personal circumstances that are affecting your ability to manage your stress? Do you feel overwhelmed with your complex case load and feel that you lack training in managing the most difficult and challenging situations? The answers will likely be as varied as there are professions and individuals reading these lines. So where can we start?

I will be honest, we often disappoint people who come to us for sound bites and “quick fixes” to these complex issues because, well, the solutions are complicated, just like the work that we do is multi-faceted and challenging. But here are some places to start:

Recent research in the field of STS and Compassion fatigue suggests that there are particular vulnerability factors that can increase your likelihood of being negatively impacted by the work. Take a look at this Venn Diagram 

Which of these factors are true for you?

Prior Trauma history/vulnerability factors

Do you have your own history of trauma? Are you currently struggling with a difficult family/personal circumstance? Do you have a history of mental illness or addiction that is currently re-emerging? All of these factors can contribute to increased vulnerability when doing high-stress, trauma-exposed work

Traumatic grief/loss in the workplace

Have you experienced losses at work? The death(s) of clients or patients, someone that you worked with who disappeared and never returned, providing you with no closure? A beloved colleague who died unexpectedly or retired or was laid off? The loss of a well-respected supportive supervisor or mentor? Significant changes to your workplace?

Direct exposure

Are you exposed to dangerous situations in your work? Have you ever been threatened, assaulted physically or verbally on the job? Is your work high-risk?

Secondary/Vicarious Trauma

Are you regularly exposed to indirect trauma at work? Hearing/viewing difficult case files, traumatic images and stories?

Compassion Fatigue

Have you experienced a shift in your ability to feel empathy for individuals you work with and/or colleagues or loved ones? Some situations can be very depleting – chronically desperate clients who don’t follow through on your recommendations and keep coming back in distress, a very large homogenous case load where all of the stories start sounding the same, years of exposure to traumatic stories that no longer generate any reaction in you.

Systems Failure

Many professionals describe experiencing moral distress around failures of the system: rules, laws and policies that you disagree with but are still mandated to comply with and that you feel are causing further harm, lack of referral resources and other injustices. All of these can lead to a pervasive feeling of anger and contribute to burnout and workplace toxicity and a decrease in the quality of care provided.

Burnout

Burnout can result from a negative overall workplace experience: your hours, your salary, your workload, the health of your work climate, rewards and recognition, who you immediately report to, the quality of your work relationships with colleagues and a perception of fairness and adequate support to do your job in the best way possible. A negative combination of these factors can lead to burnout.

 What works?

 First, take a look at which elements of the Venn Diagram are most salient for you and begin by addressing those that feel most manageable. As the saying goes “Dig where the ground is soft”. Seek support, formally with a good mental health practitioner or a coach, informally with colleagues and friends, look at ways to reduce trauma exposure in your personal/leisure time. Learn some stress-reduction techniques; get more training in trauma-informed practices which can be highly protective in retaining compassion when working with difficult cases and finally, please be open to the possibility of changing jobs if things are just too challenging where you are now. As Cheryl Richardson says in her book “Take time for your life” (1999) “Do not confuse difficult choices with no choice.” There is too much at stake to ignore compassion fatigue and secondary trauma.


WANT MORE? Here are some TEND resources to explore:

Live Training – bring one of our TEND associates to your organization for specialized training in resilience, compassion fatigue, etc.

Join us for our annual Care4You Conference, in 2018 we will be Halifax on June.18th


Books – we carry 3 wonderful books (and e-books of each) written by our wonderful co-executives Françoise Mathieu and Dr.Patricia Fisher

Building Resilient Teams – a workbook designed as a practical, realistic and effective approach to building team resiliency and cohesion through a sequence of safe and respectful guided discussions.

Resilience Balance and Meaning Workbook – designed to provide you with practical help in addressing the effects of workplace stress, burnout and trauma. You will see that it is designed as a highly interactive tool and you are encouraged to make the book your own by responding to the frequent questions, reflections and self-assessments.

The Compassion Fatigue Workbook – a lifeline for any helping professional facing the physical and emotional exhaustion that can shadow work in the helping professions


Online Courses – TEND also offers online courses at a very affordable price, we do bulk discounts as well for larger groups. These courses are led by Dr.Patricia Fisher and Françoise Mathieu

Organizational Health in Trauma-Exposed Environments: Essentials – an intensive online course designed for managers and supervisors of teams working in high stress, trauma-exposed environments such as healthcare, the criminal justice sector, social and human services, emergency response, armed forces, education, child welfare, community mental health, non-profit organizations and related services

Compassion Fatigue 101 Online Course -Three-part webinar series that aims to help participants identify compassion fatigue, vicarious trauma and burnout, and participants will develop self-care strategies.

Resilience in Trauma-Exposed Work – This workshop will provide a solid framework to understand the mechanisms of stress and resilience within trauma-exposed environments, and will introduce practical, best-practices approaches to increasing resilience and enhancing individual wellness and organizational health.


Other Suggested Resources:

Compassion Fatigue/Vicarious Trauma/STS:

The Compassion Fatigue Workbook by Françoise Mathieu 

Trauma Stewardship by Laura Van Dernoot Lipsky

Organizational Stress:

Building Resilient Teams by Dr. Patricia Fisher, R.Psych., L.Psych.

Is work Killing You? A Doctor’s Prescription for Treating Workplace Stress by David Posen

Stress Reduction

Resilience, Balance & Meaning Workbook by Dr. Patricia Fisher, R.Psych., L.Psych.

Grounding Skills

 Graham, L. (2013) Bouncing back: rewiring your brain for maximum happiness. New World Library.

Tools for Managing Trauma:

NakazawaD.J. (2015) Childhood DisruptedHow your Biography Becomes your Biology. Atria.

 Van Der KolkB. (2014) The Body Keeps the ScoreBrainMind and Body in the Healingof TraumaPenguin Books.

ScaerR. (2014) The Body Bears the BurdenTraumaDissociation and Disease. Routledge.

MatéG. (2003When the Body Says No: Exploring the Stress/Disease Connection. Wiley & Sons.

Work/Life Balance:

Richardson, C. (1999) Take Time for Your Lifea 7 Step Program for Creating the Lifeyou Want. Broadway books.

Mindfulness & Selfcompassion websites

www.franticworld.com/free-meditations-from-mindfulness

www.self-compassion.org

www.mindfulselfcompassion.org

Beyond Kale and Pedicures

Beyond Kale and Pedicures: Can We Beat Burnout and Compassion Fatigue?

Françoise Mathieu, M.Ed., CCC.

“I have been locked out of the seminar room. Peering through the glazing, I can see two dozen operating room nurses in scrubs, milling about inside the auditorium. The space is nearly full, and they are chatting and eating lunch. The session on compassion fatigue and self-care is about to begin, but the door is locked and I can’t get in. I knock once, and then again a little bit louder. They can see me, but no one comes to unlock the door. Problem is, I am the presenter, and this isn’t starting out particularly well…”

Read the full article here: BEYOND KALE AND PEDICURES Article