Addressing Compassion Fatigue – An Ethical Mandate

 

 Addressing Compassion Fatigue – An Ethical Mandate

Webinar Roundtable – American Bar Association, aired September 30, 2015


Working with clients in trauma can impact lawyers who represent children in the child welfare system, both personally and professionally.  Prolonged or repeated exposure to the abuse and neglect suffered by child victims can result in an acute form of burnout called compassion fatigue.

However, child lawyers, unlike other helping professionals, rarely have language for this loss of capacity nor support systems in place to combat it.  Large caseloads, inadequate resources and systems that sometimes re-victimize instead of rehabilitate, leave practitioners feeling ineffective, incompetent and lacking compassion. These conditions compromise the child lawyer’s ethical duty to provide competent representation.

Speakers focus on preventative and responsive strategies for solo practitioners, agency lawyers and leaders who manage child lawyers, as well as the ethical implications of compassion fatigue on child representation.

Speakers:
Trenny Stovall, Esq., DeKalb County Child Advocacy Center, Decatur, GA (moderator)
Alexandra Dolan, MSS, LSW, Support Center for Child Advocates, Philadelphia, PA
Josh Spitalnick, PhD, ABPP, Adjunct Asst. Professor in Psychiatry and Behavioral Sciences, Emory University SOM, Atlanta, GA
Françoise Mathieu, M.Ed., CCC., Co-Executive Director, TEND, Kingston, Ontario, Canada
Danielle Lynch, Esq.,  Supervising Attorney. DeKalb Child Advocacy Center, Decatur, GA

Source

Breathe, Reset, Refuel. Rinse, Repeat.

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I have been thinking a lot about energy and pacing lately.

More specifically, I have been reflecting on the fuel that we put in our tanks with the aim to do our best at work, to care for our loved ones and to get a few (or many) of the grown-up things off our list.

I don’t know about you, but I think that, although being an adult has many perks  – like eating what we want, when we want (toast for dinner! Popcorn for breakfast!) and going to bed early or staying up too late to watch our favourite shows (ok, maybe I watched Pippi Longstocking too many times. My goodness, I loved her so…) –  sometimes being a responsible grown-up can feel really overwhelming.

At this very moment, I can hear my washing machine rattling like an airplane taking off. The repair person told me it’s finished, and we need a new one. Well, ok, he told me that in August and that if I didn’t do anything, one day it would leak all over the place. But I got busy, and so it’s on the List.

My furnace too, apparently needs replacing  – on the List.

I have 93 unread emails that all say “TIME SENSITIVE!” – on the List.

Today, my son lost his dorm keys and is asking me to find them in his bedroom at home and ship them to him urgently. My daughter just called. She needs me to call our insurance company about something ASAP. On the List!

A friend just had very upsetting news, and I deeply care about him, so he’s on my mind right now, too.

That’s probably only 1% of my list, but it all rattles around in my head, trying to prioritize and make sure I don’t drop too many balls.

Can you relate to this?

(Note that there is nothing on that list about self-care, it just gets pushed to the bottom, because, you know, it can wait, right?)

 

Are you “the General” in your life?

 

I recently pinched something in my arm which caused this weird impingement all the way from my shoulder, into my elbow and into my hand. It wasn’t horrible, but it was very uncomfortable. I wasn’t able to use my arm to drive or do yoga or carry things or sleep properly.

“Poor posture” was the physio’s diagnosis. (Wow. Thanks!) When that didn’t help, I went to see a great massage therapist and he hummed and hawed and tapped and poked and prodded. After a solid hour of this, he said to me: “Are you the General in your life? At work and at home?”

I paused.

Well, yes, as a matter of fact I am.

I think of myself as an ultra-responsible, reliable, loving, caring person (read “Disappoint Someone Today” for more on this, if you want). I have two members of my family who live with ADHD which can lead to some very interesting and sometimes intense situations for them and for the rest of our family. I think of them as neuro-exceptional as they are super bright, passionate, high energy people – but they also struggle with lost items, low frustration tolerance, intense irritability and a need for order to manage the chaos that frequently enters their brain.

We openly talk about this in my home, and we have developed many strategies over the years to help reduce stress for all of us. But sometimes, it’s a lot.

At the end of our session, the massage therapist gave me this advice: “Less planning, less thinking, more rest, more quiet, long walks, and more expressive arts – use the part of your brain that doesn’t require thinking and being in charge all the time.”

He was basically saying “Slow down! Quiet that mind a bit!”

 

How much is enough?

 

We were training a wonderful group recently, and one participant asked us: “How much self-care is the recommended amount?” This is a surprisingly tough question to answer.

My amazing co-facilitator replied something like this: “I don’t think that the aim is to race through our days at rocket speed and then collapse in a heap at the end of the day on our couch or yoga mat and call that “self-care”. I think that self-care needs to be a moment by moment process, where we notice, we pause, we breathe, and then we keep on doing what we’re doing, if we have to, or we take some time out to refuel and reset.”

I don’t think that the aim is to race through our days at rocket speed and then collapse in a heap at the end of the day on our couch or yoga mat and call that “self-care”. I think that self-care needs to be a moment by moment process Click To Tweet

 

I drove my son back to university yesterday. It’s a stressful 3-hour drive on a major highway. Lots of trucks, freezing rain, bad drivers … you know the kind of drive I’m talking about.

After dropping him off, I drove another 45 minutes through even worse conditions and went to my favourite airport hotel on my way to a gig out-of-province. And, get this – that hotel has a wicker swing in the lobby! You know those big egg-shaped swings from the 70s? I swear, if they get rid of that swing I’m never going to that hotel again.

Anyhow, I sat cross legged in that swing for three hours, answering emails, reading a book and just rocking gently and resting. I could feel my nervous system calming right down and after this lovely pause, I felt completely refreshed. I texted a friend and said “I don’t need a week long trip to the beach, I just need three hours in a swing!”

So, for all of us, what are micro-moments that we can integrate in our days so that we can reset, refuel and take pause when we don’t have a three-hour blissful break from everything?

And yes, I’m going to work on my posture too 😉

I wish you a happy, restful and refueling start to 2019!


Recommended Resources:

[Online course] WTF – Strategies to keep helping professionals grounded and centered by Diana Tikasz, MSW, RSW

[Book] Busy: How to Thrive in a World of Too Much by Tony Crabbe

[Website] calm.com


 

Three Simple Guidelines for Healthy Living

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We were recently visiting beloved old friends for a rare weekend away. Sitting together over a leisurely breakfast, we could see the warm Fall sunshine pouring into the dining room through the windows  – fresh fruit, yogurt and croissants offered on a beautiful table made of reclaimed wood. Delicious coffee, warm hearts. Real talk.

One them said: “Now that I am almost 60, I have high blood pressure, some other health concerns and I am worried. I know that I need to make changes to my lifestyle, but I don’t know where to start! How do I introduce more plant foods in my diet? I hate veggies. My mom used to boil the life out of veg and I have never liked them. I feel stuck.”

Another friend said to me, just last week: “We are bombarded by information about what we need to do to stay healthy, 50 ways to lose weight, 75 ways to sleep better… and a great deal of the information actually contradicts the previous studies. I feel overwhelmed – Should we fast? Should we eat only protein? No protein? Bubbly water? Flat water? It’s too much!”

They are right – it’s confusing out there.

So many research papers, reports and books on healthy living, weight loss, anti-ageing, debt reduction, decluttering… it’s a multi-million dollar industry for a reason. Nothing sticks and some of the fads are so extreme that very few people can adhere to them for more than a few weeks.

However, there is a way to simplify the body of research to a few essential guidelines. I recently attended a very interesting training on the connection between gut health, the brain and the body. They explored the most recent science on chronic inflammation and its toxic impact on our entire body and soul and how it can have a powerful influence on our immune system, mental health and increase vulnerability to disease.

Here’s a cheat sheet for my two friends (and for you if you are feeling the same way). 

 

 Guideline #1 – Eat more plants. Every day

Try to gradually increase your fresh vegetable consumption – add chopped peppers, cherry tomatoes, carrots, cucumbers or whatever raw veg you enjoy to your lunches and snacks. Bring a small tub of hummus or tzatziki to dip them in if that helps. Add a fresh green salad or lightly steamed vegetables to your dinner. Make a simple dressing from oil and vinegar, not the stuff in the bottles.

Focus on colourful vegetables: beautiful squash, rainbow chard, sweet potatoes, fresh peas, and eat lots of leafy greens, the darker the green the better. If you’re not a fan of plain cooked vegetables, steam them briefly and lightly saute them in a small amount of olive oil and garlic. Start with a small serving and increase over time. Go to the farmer’s markets and try a new vegetable each week.

My family became huge fans of spiralized zucchini this summer (a spiralizer is a little hand-cranked machine that grates vegetables into spaghetti strands). We throw the “zoodles” into a bit of garlic and olive oil in a pan, toss around for about 5 minutes and serve with fresh tomato sauce or pesto I made from the garden with whatever I had around: fresh basil, spinach, arugula, or a mixture, walnuts, almonds or cashews, (doesn’t matter), garlic and nutritional yeast instead of parmesan for my dairy-free daughter, oil, salt and pepper and you’re off to the races. Add some shrimp for the meat eaters or pork tenderloin on the side or tofu for the vegetarians and vegans.

Voila.

By the end of summer, my kids were eating one of those baseball bat-sized zucchinis each. Yes, each. That’s a lot of zucchini, but when the markets are full of them, it’s a cheap and quick source of vegetables.

 

Guideline #2 – Reduce sugar, go for simpler foods

Refined carbs are one of the main sources of inflammation-causing foods. Eating foods in their least transformed states will help you avoid refined carbohydrates, which are often full of sugar, trans-fats and excess salt (breakfast cereal, most store-bought breads, white pasta, crackers, for example) and avoid white sugar in drinks such as pop and anything sweetened with high fructose corn syrup (HFC). If you don’t eat stuff out of a package, can or a box, you don’t need to worry about this so much.

If you crave something sweet and transformed and full of refined carbs and other goo, go for it! Have a small serving of it. Just don’t do it at every meal.

 

Guideline #3 – Move at least 45 minutes a day

I have a friend who doesn’t seem to age. It’s weird. I know that she is in her fifties, but in the decade that I have known her, she has not changed at all. And, no, it’s not what you think – no weird injections and creepy fillers.

Her answer: she walks. A lot.

(Ok, and she most likely has great genes, probably avoided the sun and didn’t smoke).

But she makes a point of walking every single day, rain or shine. If she is somewhere where she can’t walk outside – like a hotel in the middle of an overpass (don’t laugh, that’s my weekly lot in life when I am on the road), she will do a few sessions up and down the stairs. If she’s in an airport, she takes the stairs instead of the escalators. During breaks, she walks through the hospital where she works.

How much walking? The recommended daily minimum is 45 minutes of walking each day – it doesn’t have to be all at once. You could do two or three shorter walking sessions a day if that works better for you. But you need to walk vigorously enough to be a bit out of breath and not able to carry out a conversation comfortably while you are doing it. So that’s pretty active walking for most of us.

My friend also has another trick: She always wears comfortable shoes that she can walk in. So, no stiletto excuses. Personally, I carry super comfortable little shoes in my briefcase at all times. So then I can switch out of my fancy shoes any time I want to walk.

 

How to stick to it

So that’s it. Three things: more plants, less refined carbs and sugar, more walking. 

But please if you are new to this, don’t go all New Year’s resolution on yourself, just take a look at your daily habits and make one small change each day.

A study by Woolley and Fishbach (2016) explored why many resolutions – which they call “Long Term Goals” – don’t seem to work. They concluded that most of us mere mortals need immediate rewards to stay motivated. An immediate reward, the study explained, could be simply feeling a sense of enjoyment during or immediately after the activity.

An example of this could be listening to your favourite music while doing your power-walk or your favourite book on tape. I like to listen to a great podcast series while I prepare my veggies and healthy lunches for the week ahead. It has become a Sunday ritual and I look forward to it. When I am trying to solve a problem at work and I feel stuck, I make myself leave my desk and go for a walk down to the lake close to where I live. I always come back refreshed and ready to crack the problem that was stumping me.

So that’s it – to riff on Michael Pollan’s famous recommendations:

“Eat real foods, mostly plants and not too much, walk briskly at least 45 minutes per day, not necessarily all at once, and reduce/avoid refined carbs, white sugar and HFC from your diet as much as possible. Do these things while doing something else that you enjoy.”

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Good Reads:

Blackburn, Elizabeth & Epel, Elissa (2017) The Telomere Effect

Hamshaw, Gena (2015) Food 52 Vegan: 60 vegetable-driven recipes from any kitchen

Liddon, Angela (2014) Oh She Glows Cookbook: Over 100 Vegan recipes to Glow from the Inside out  – (try the lentil sloppy joes, amazing).

Pollan, Michael (2008) In Defense of Food: An Eater’s Manifesto

 

Websites for more plant-based cooking:

Oh She Glows  – This Canadian author wrote her first cookbook to introduce her meat eating partner to vegan cooking. Therefore the recipes are highly accessible for omnivores as well as vegans and anyone in between.

The Full Helping – Gena Hamshaw is my favourite vegan food blogger but her recipes are a little more “intermediate” level than Liddon’s. Gena does a lot of batch cooking on Sundays for the week ahead. Her sweet potato hummus is fantastic.

 

 

A Fresh Start for Fall

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Autumn is always a welcome reset time for me. I know that not everyone feels that way about the Fall, and I have some friends who openly talk about it being a rather melancholy time for them, with the weather shifting and the lighter schedule of summer ending, but I love it all.

The farmers’ markets are filled with beautiful late summer produce, which motivates me to start cooking more; the light is changing, which makes for better photos; and I have more energy when the temperature cools. I like getting organised and back to a bit more of a sensible daily routine.

This is the first September without my lovely son at home as he has just gone off to university. There it is – the proverbial and much-discussed “empty nest”.  I coped with this wrenching loss (and excitement for him, of course) by doing a massive declutter of the house. Anyone else out there manage sadness, anger, irritation, lack of control etc. by cleaning? I find it very therapeutic.

When I was driving him to drop-off last week, I told my son that I wasn’t sure if I was more upset about him leaving or more excited about finally getting into his room to give it a deep clean. (I found about 50 single socks under his bed. Impressive).

I was only half-kidding of course.

These are profound life transitions and anyone who has been through it likely knows what I mean. A complex roller-coaster of melancholy, happiness about more free time, worry about my kids being safe and well, missing them, happiness about more free time, (wait I said that already right?) a much tidier house, and the need to make some major adjustments or just sit with this gigantic life event and maybe not change anything at all.

But even if you’re not going through such a profound life transition this Fall, we all need a reset once in a while. I have written a lot about self-care on this blog about the importance of regular good quality sleep, exercise, healthy eating, meaningful social connections and restorative time.

Here are a few things that I am doing this September to reset and get in a healthy place before my busy travel schedule starts.

 

Going on a digital mini-diet

I deleted my Facebook a few months ago (no judgement if you love FB, it was just a time-wasting vortex for me). Instead, I have committed to reading a book before bed rather than watch “just one more episode” of whatever on Netflix. I fall asleep faster and sleep better. (Of course, the truth is that I watched 33 episodes of Inspector Morse this summer, so I sound more virtuous than I really am.)

I’m probably just between shows right now, but I find it a better routine for me. I have been enjoying Tina Brown’s Vanity Fair Diaries, a book which was given to me a bit sheepishly by a lovely senior physician at our local hospital as a thank-you for a talk that I gave. He said “sometimes, we just need something decadent and completely superficial” and he was so right. I am almost through the entire brick and love tucking into it once my day is done.

 

Clean up my finances

I have enjoyed several personal finance/frugality blogs in the past. If you haven’t had the pleasure of reading financial guru Gail Vaz-Oxlade in the past, I highly recommend her book Debt-Free Forever:

Here is a link to Gail’s website which is full of resources.

Here are a couple of financial blogs I have been reading recently. You don’t need to aspire to their extreme money-saving beliefs to enjoy these. “Our Next Life” has a great blog post about being a road warrior if you fly a lot for work.

Frugalwoods (and they also have a book): 

Our Next Life 

Eat more vegetables

My partner switched to a primarily plant-based diet several years ago for health reasons and became a fantastic cook. Although I am not vegetarian, I have enjoyed lightening my diet (and having a happier gut) by adding more gorgeous fresh vegetables to our meals. Here are some of the cookbooks and foods blogs we like to check out regularly:

Cookbooks

Food 52 vegan: 60 Vegetable-Driven Recipes for Any Kitchen by Gena Hamshaw

A Modern Way to Eat by Anna Jones

Whitewater Cooks Pure, Simple and Real Creations from the Fresh Tracks Cafe by Shelley Adams

Food Blogs

The Full Helping 

Smitten Kitchen

Food52

Exercise

I had hip surgery several years ago to repair a torn ligament and had to completely stop my beloved long-distance running. It took time to find a replacement for this stress-relieving and creative protected time in my day. I now do a combination of cross-training 2-3 times a week and yoga 1-2 times a week when I’m feeling really dedicated. I try to fit in a long walk at least twice a week.

My dear colleague Diana, who is far more disciplined than I am, ensures that she walks 45 minutes each and every single day, rain or shine. My challenge is that when I’m on the road (which is a lot), I get more sedentary and I don’t do as much as I should. I am going to try to add some walking to my schedule. We know it’s good for us and it requires no equipment.

Books

The Telomere Effect: A Revolutionary Approach to Living Younger, Healthier, Longer by Elizabeth Blackburn & Elissa Epel

Video

23 and 1/2 hours: What is the single best thing we can do for our health? by Dr. Mike Evans

 

Improve my Sleep

Some people seem to be able to drink coffee right up until bedtime and are totally unaffected. I started feeling “revved-up” when I got to work this summer and was having difficulty falling asleep or would wake up at 3am unable to fall asleep again.

I realised that I had started increasing my caffeine consumption and needed to take it down a notch. Therefore, I have cut back on coffee by using a really good quality decaf coffee bean. I feel much better overall.

That’s it! Those are my Fall commitments to myself. What are you going to do to reset and take good care this Fall? 

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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