Three Simple Guidelines for Health 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.”

—–

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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September 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

From the TEND resource page – A chat with Deb Thompson from Your Nourished Life – “the Elephant in the room — how so many of us use food for comfort against the general wear and tear of life.” 

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 September?

Stop. Pause. Play – Using Music for Self-Care

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by Amanda Williams, MTA, MT-BC, NMT

“Music, uniquely among the arts, is both completely abstract and profoundly emotional. It has no power to represent anything particular or external, but it has a unique power to express inner states or feelings. Music can pierce the heart directly; it needs no mediation.” 

-Oliver Sacks, Musicophilia: Tales of Music and the Brain


It’s Monday morning.

Your car makes the slow crawl down the congested and crowded 401 highway. You’re running late. Even though you know that the clock on your car dashboard is five minutes fast, the visual reminder heightens your anxiety. You have a meeting in 20 minutes.

And to top it all off, you didn’t have time to get a coffee. 

Talk about stressful.

However, this scenario is becoming more and more common in our fast and frenetic lives. We’ve found ourselves with too much to do, too many places to be, and too many people to please. We try to clear our mind, invoke our breathing practice, channel positive thinking – all to no avail. Today it isn’t working. Today is just too awful.

So, when time is short and our tempers even shorter, what’s a person to do? How can we care for ourselves? 

My advice to you – stop, pause, and press play.

Music. 

Music is part of being human

We respond to music on a deep and fundamental level – even below our level of consciousness.  It can affect our bodies and brains in profound ways without us needing to do much more than sit and listen. 

We all have the ability and capacity to respond to music (despite what your crusty, old music teacher might have implied in grade school). This is because music is a human invention – made by humans, for humans – and has been around for many, many moons. There are even some who suggest that humans may have been singing before they ever spoke a word. To quote Oliver Sacks from his fascinating book Musicophillia: Tales of Music and the Brain  – “music is part of being human.” 

And that isn’t just a nice, poetic thought.

In this book Human Universals, Donald Brown includes music as one of the cultural universals – meaning that, although the sounds, instruments and melodies may change across the world, music has been independently developed in every known human culture

 

Music affects the Brain

The study of music and the brain is a growing area of research. Here are just a few of the cool things researchers are discovering about music:

  • Music increases our dopamine levels  – the “feel good” hormone.
  • Music is intimately tied to our emotional memory. Ever have that feeling of being transported back in time when you hear a particular song?
  • Music affects our breathing rate and heart rate. We listen to lullabies to sleep, and upbeat tunes to push us through that last set of squats and burpees. 

As a music therapist, I have the unique and wonderful experience of bringing music to my clients, many of whom face extreme challenges to their physical, cognitive and emotional well-being. I’ve experienced first-hand the benefits of using music as an intentional tool for health and wellness. 

Below are some suggestions to incorporate music into your repertoire of self-care strategies.

Five Tips for using Music for Self-Care

1. Get out of that funk by keeping an SOS playlist

Music is a powerful memory stimulant and can evoke strong emotions – you can use this nifty fact to give yourself a boost when you feel bogged down. Create a playlist of songs that have a significant and positive association for you. Maybe it includes the biggest hit when you were in high school rocking that mohawk. Or maybe its a lullaby your grandma used to sing to you. My top song is “You Make My Dreams Come True” by Hall and Oates (I walked up and down the aisle to this one). 

2. Calm your nerves by listening to music with a slow tempo

Create a playlist of songs with a slower tempo. Try to find songs with a bpm (beats per minute) between 60-80 – the average resting heart rate. There are websites, such as this one, which can help you find the bpm of a song. 

3. Use music to process difficult emotions

Sometimes in our lives and work, we encounter some heavy stuff: whether that be through working with clients facing extreme challenges; hearing a second-hand account of a traumatic event through a colleague; or even seeing something that deeply affects us on the news (which seems to be happening more and more these days). 

I used music for self-care often when I was working on a palliative care unit. This was wonderfully rewarding work. It also left my tank empty. At the end of the day, I was often left with unresolved questions and emotions that needed processing. “Bring Him Home” from Les Misérables (the anniversary version only. Sorry, Hugh Jackman) was, undoubtedly, my top played song during this time. It kind of felt like I was talking with someone who completely understood everything I was feeling. It helped me avoid “sliming” my partner with all my difficult stories (to use Françoise’s amazing phrase), as well as tide me over until my next supervision meeting. 

“Low Impact Debriefing – How to Stop Sliming Each Other” by Francoise Mathieu 

4. Have a transition anthem

We all need to be mindful of how we move from our busy time to our down time – else, we run the risk of never having any down time! Music can be a useful tool to help us navigate the transition from work to life by giving us an aural cue that work is done (reminiscent of the school bell), and also help us shift our frame of mind. 

Being from the East Coast (and having an admittedly dry sense of humour) one of my favourite songs for this purpose is “The Idiot” by Stan Rogers. If I feel as though I’m heading home with a heavy load on my shoulders, I’ll reserve the last few minutes of my commute to mindfully listen, and mentally pack up my troubles for the day.

5. Get involved and make some music!

….

Hear me out.

If you’re the kind of person who has sung the “I couldn’t carry a tune in a bucket” refrain your whole life, I am here to tell you – you don’t need to be a musician to play music. Don’t let our crazy, elitist, money-obsessed society convince you that music is the domain of the talented (my lest favourite word, by the way). 

Music is a skill which can be learned – just like learning to tying your shoe. 

And it is well documented that participating in music has positive impacts on our mood, self-esteem, cognitive functioning, memory, focus – so much so that musicians even have bigger brains.

“But wait!” you cry. “I’m too old to learn music! You can’t teach an old dog new tricks!’

It’s never too late to learn. Here’s a quote from a great study that was featured in an article from National Geographic:

Jennifer Bugos, an assistant professor of music education at the University of South Florida, Tampa, studied the impact of individual piano instruction on adults between the ages of 60 and 85. After six months, those who had received piano lessons showed more robust gains in memory, verbal fluency, the speed at which they processed information, planning ability, and other cognitive functions, compared with those who had not received lessons.

Even at 85 years old, people are  benefiting from learning and playing music.

So, you now have full permission to join that community choir, dust off those piano keys, or even just belt it out in the shower. 


Suggested Readings:

Musicophilia: Tales of Music and the Brain, by Oliver Sacks

Tune In: Use Music Intentionally to Curb Stress, Boost Morale, and Restore Health. A Music Therapy Approach to Life, by Jennifer Buchanan

The Singing Neanderthals: The Origins of Music, Language, Mind, and Body by Steven Mithen


Do you have a song that “brings you back?” What is your transition anthem? Share your thoughts with us below!

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)

__________________________________________________________________________

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.

__________________________________________________________________________

“My kid got into college! Now what?” – a chat with Dr. Mike Condra

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What is this podcast about?

The transition from high-school to college or university can be a very stressful time for students and their parents/guardians. Leaving home, challenging courses, meeting new people – it can all feel daunting and hard. Sometimes these compounding pressures can feel like too much. If that happens, what should a student do? Who do they turn to?  What are the best options?  For parents/guardians, what are the warning signs that your child is in need of some extra support?

Dr. Mike Condra, a veteran mental health expert with 20+ years of experience working at one of Canada’s top universities has advice to help prepare parents and students understand how to navigate and address the mental health needs of students at post-secondary school. Click here for Dr. Condra’s full biography.

Listen to the full podcast here:


Transition Resources from Dr. Mike Condra:

Beginning Post-secondary Education: Tips for Parents/Guardians PDF

Mental Health Student Handbook (English, French and Accessible versions available)

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.

 

Good Reads for Helpers

If you’ve met me before, you will know that I am a huge believer in bibliotherapy, the transformative power of books – at least for those who enjoy reading. (I will have other suggestions in a future post for the rest of you.)

I was once told, at the end of a two-day compassion fatigue training that I had “recommended too many books” – Impossible, I say!

When I had a private practice, I had a shelf full of my top ten reads which I would lend to clients until I realised that the return rate was, ahem, random at best. So, instead, I started compiling lists of recommended readings which I continue to share in my workshops and trainings.

On these cold winter days, snuggling up with a good read and learning new strategies to combat compassion fatigue and general stress sounds like a healthy way to beat the winter blues.

My favourite books to help professionals stay healthy and compassionate:

 

Compassion Fatigue/Vicarious Trauma

Trauma Stewardship by Laura Van Dernoot Lipsky (2009) 

The Compassion Fatigue Workbook by Françoise Mathieu (2012) (available here)

 

Organizational Health

Is work Killing You? A Doctor’s Prescription for Treating Workplace Stress (2013) by David Posen 

Building Resilient Teams by Patricia Fisher (2016) (available here)

 

Trauma and the Body 

Bouncing back: rewiring your brain for maximum happiness by Linda Graham (2013)

 Childhood Disrupted: How your Biography Becomes your Biology by Donna Jackson Nakazawa, (2015).

 The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma by Bessel Van Der Kolk, (2014).

The Body Bears the Burden: Trauma, Dissociation and Disease by Robert Scaer, (2014).

 

Stress/Immune System

When the Body Says No by Gabor Maté

Resilience, Balance & Meaning Workbook by Patricia Fisher (available at here)

 

Work/Life Balance

Take Time for Your Life: a 7 Step Program for Creating the Life you Want by Cheryl Richardson (1999)

 Self Care/Stress Reduction

 Little book of stress relief by David Posen

 Simplify Your Life: 100 Ways to Slow Down and Enjoy the Things That Really Matter by Elaine St James

 

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

Taking Its Toll…Paying The Price: Vicarious Trauma in Law Enforcement

Law enforcement; a much maligned field but everyday these wonderful individuals knowingly put themselves in to positions of physical danger so that the rest of us can feel safe. While the potential harm to themselves physically is better documented, what are the long term risks of taking a bullet as a police officer, the mental health aspect of their work and who is more likely to end up traumatized by this work is just beginning to be understood. Enjoy this fantastic article by Dr.Fisher below!

By Patricia M. Fisher. Ph.D., & Mark LaLonde
Blue Line Magazine September Issue, 2001

THE SCOPE OF THE PROBLEM

As Tom’s example demonstrates, law enforcement professionals are exposed to two very different sources of stress – organizational (or systemic) job stress, and traumatic stress. Longterm exposure to systemic job stress results in a wide range of negative effects on individuals and the workplace. Exposure to traumatic stress also results in a characteristic set of distressing responses and symptoms. While both systemic stress and traumatic stress are each serious problems in their own right, when combined they greatly increase the risk for negative effects.

It is now clear that the effects of workplace stress and trauma are critical issues in lawenforcement. We know that the problem affects members, their families, the workplace, and the employer. We also know that the problem is increasing and that the personal and financial costs are escalating.

Consequences to the individual member may include a wide range of physical health problems including cardiovascular disease, gastrointestinal problems, increased risk for cancer, and immune system problems. Depression, anxiety, posttraumatic stress disorder, substance abuse and addictions are all outcomes of long-term high-level workplace stress. Unfortunately, longterm stress symptoms such as poor communication, withdrawal, aggression, mistrust and defensiveness often contribute to family breakdown and loss of the member’s support network.
In terms of the organization, effects include decreased productivity, poor morale, increased staff conflict, absenteeism, increased overwork and overtime. Stressed members are also at risk to “cut corners” and engage in more hazardous practices.

Read More Here