Compassion Fatigue Solutions

This will be my last blog entry until mid January as I will be taking two weeks off for Christmas. I will be heading to Quebec's Laurentian "mountains" to visit with family and friends. I put mountain in quotes as the Laurentians are very old and therefore quite eroded gentle little hills. (Friends from Western Canada, I hear you laugh!) But the Laurentians offer beautiful and serene forests, wonderful cross country skiing and even one half decent downhill slope.

We (my children and husband and I) are all very much looking forward to being somewhere that isn't wired to the tv, internet or voice mail. I have several new board games that I pretend I purchased for the kids but I'm dying to play them (although apparently I get a bit too competitive when I play Clue, I've been told. I am ashamed to admit that last year I got a little excited trying to beat the 6 year olds!)

Apparently there has been a huge spike in the mouse population however, so we may have to devise some clever new strategies to deal with our little friends. I have a rather embarrassing mouse phobia which once found me sitting on the kitchen counter, phoning my father in law for emergency assistance as one mouse had gotten into the huge bag of dog food and was bouncing around like mad in there...I guess I have something to work on in 2008! (that and learning how to drive standard and how to windsurf and play hockey in a women's league but that's for another day)

What I would like to share with you today before I sign off to go eat and drink and play Risk is a very exciting new venture that I am embarking on.

But first, an update you on WHP's work stuff

The Walking the Walk workbook is almost done. I received one permission to reprint a testing scale that I absolutely needed and so I can now forge ahead in January and finalise my 'camera-ready' text.

I am looking forward to visiting several different cities in January-March, including Winnipeg, Manitoba (last year the temperature in February dipped to -41.7 celsius one day!), Hamilton, Toronto and Montreal. I will be working with agencies such as: a school board, an acquired brain injury clinic, Children's Aid, Military hospital staff, helpers working with high risk infants and youth, a large group of hospital social workers, a burn unit, an oncology ward and possibly a group of staff working with spinal chord injured patients. I am really excited about the opportunity to spend some time with such a varied group of helpers and look forward to learning from them and sharing ideas and strategies.

New Projects - Going deeper with the CF Solutions work

In the New Year, I will be embarking on a new partnership that I would like to describe a little bit here. I greatly enjoy the work I do in the field of CF (in fact, I could easily spend three times as much energy on it every day as my interests far outweigh the time available) and I have been looking for material that goes beyond "day one" of my CF workshops. I have developed several presentations on the topic, but had not yet found some truly excellent organizational resources that addressed the very specialised needs of my helper clientele, until now.

A few months ago, I came across the work of Dr Pat Fisher, CEO of Fisher and Associates. Dr Fisher is a psychologist with a wealth of expertise in the areas of organizational health and wellness. She created an organizational health and wellness company that operates out of Victoria, B.C. and New York and has offered in depth training to staff in the fields of justice and corrections, children's aid and the civil service to name a few.

Dr Fisher and I connected and talked at length about our vision, our values and our programs and came to the conclusion that her work was very complementary to mine. I therefore decided to become an associate of Dr Fisher's which will allow me to retain my independence and also be in the position to offer Fisher and Associate's programs to any of my clients seeking more in depth organizational training and assessment strategies for their agency.

Fisher & Associates offers organizational health and wellness programs using thorough, empirically tested assessment tools that will benefit managers, staff and the organization as a whole. If your agency has already participated in WHP's one day or half day workshops on Compassion Fatigue and self care and wants to look at Stage Two tools for the organization as a whole, there are several different programs being offered by Fisher and Assoc. to meet those needs.

Pat Fisher has developed several workbooks and training courses for health care and human service workers. She co-wrote "When Working Hurts: Stress, burnout and trauma in human, emergency and health services" A workbook designed to accompany the 2 day workshop she offers to agencies; and "The Manager's Guide to Stress, burnout & trauma in human, emergency and health services" which is a companion workbook to a 2 day training program aimed at managers in health services.

If you would like to know more about Fisher, you can visit their website: www.fisherandassociates.org or feel free to email me: whp@cogeco.ca

Here is an excerpt from the company website:

"Fisher and Associates Solutions is an international company based in both Canada and the United States. We are a dedicated team of psychologists, social workers, executive coaches, and mental health professionals specializing in helping organizations, managers, and employees cope with workplace stress and job trauma, including vicarious trauma and compassion fatigue.

We are Organizational Health and Employee Wellness specialists who provide comprehensive, research-based training programs and services. We work with high stress workplaces and occupational groups who are exposed to traumatic stress due to the nature of their work.

Our programs work! Recent follow-up studies with two large organizations that completed our Core Workplace Wellness programs found measurable positive impacts including:

* decreased absenteeism
* improved productivity
* decreased job stress
* better physical and mental health

Wellness programs and educational services offer a significant return on your investment including cost savings in areas such as long and short term disabilities, absenteeism and staff retention! Research tells us that workplace stress and trauma are extremely costly to individuals and organizations. You can lower incidence of workplace stress, burnout and trauma through intervention and education. This can result in increased work performance, higher staff morale, greater employee engagement, less absenteeism and improved overall health of employees. Organizational health and employee wellness are paramount foundations to both high quality work and quality of life"

In the New Year, I will provide more concrete information on the way this training can be offered to your agency, should you be interested to know more about this.

On that note, I would like to wish you all a happy New Year and some time to rest and replenish yourselves.

Françoise

That is the title of a book written by Wayne Muller (1999). It was recently sent to me by Jan Spillman, a colleague based in British Columbia who works with caregivers experiencing compassion fatigue. Here's a quote that struck me:

"Charles is a gifted, thoughtful physician. One day were were discussing the effects of exhaustion on the quality of our work. Physicians are trained to work when they are exhausted, required from the moment they begin medical school to perform when they are sleep-deprived, hurried and overloaded. "I discovered in medical school," Charles told me, "that if I saw a patient when I was tired or overworked, I would order a lot of tests. I could see the symptoms, I could recognize the possible diagnoses, but I couldn't really hear how it all fit together. So I got into the habit of ordering a battery of tests, hoping they would tell me what I was missing. "But when I was rested - if I had an opportunity to get some sleep, or go for a quiet walk - when I saw the next patient, I could rely on my intuition and experience to give me a pretty accurate reading of what was happening. If there was any uncertainty about my diagnosis, I would order a single, specific test to confirm or deny it. But when I could take the time to listen and be present with them and their illness, I was almost always right." (p5-6)

I really resonated with this quote, as I know for a fact that I have been more directive with clients when I have felt overwhelmed with other work requirements (a full waiting room on a Friday afternoon for example vs an empty one on a slow day). That is not something I am proud of, but I can look back with compassion now and realise that I was not rested enough to be able to problem solve with creativity.

Wayne Muller's book adopts a multifaith perspective and encourages the reader to re-explore the concept of taking time out of our weekly schedule for rest and renewal.

I had to take a week off from my weekly posts as there was a death in my family (my aunt, who had been ill with cancer for the past two years). Although we knew she was ill, her death came more quickly than expected. I therefore had to do some last minute fancy footwork to get back to Montreal for the funeral and I am very glad I did. Connecting with loved ones is definitely a wonderful way to replenish ourselves when we are facing difficult life events. I enjoyed seeing relatives that I had not seen in many years.

Then, work-wise, I had the pleasure of presenting to a team from a Montreal hospital and got to offer the workshops in Frenglish as the staff was bilingual and made up of some English speakers and some French speakers. To be honest, Frenglish is my preferred language of choice in spite of years of hard work on my mother's part to instill a clear discipline in sticking to one language at a time! I may have to go to French boot camp and then to English reform school to get the bad habits out of my system. But it was so much fun...

These are all asides, what I wish to tell you about relates to a book I was recently sent by a colleague. I'll write about that now in my official Sunday post for this week.

A little update on what WHP has been up to in the last week:

Serious stuff:
-I have been making sugar cookies with kids and went to see the new disney movie Enchanted (actually a fun movie and excellent self care. Patrick Dempsey is a nice addition to the movie for us adults who enjoy his...acting)

Fun stuff:
-I had a very interesting and stimulating dinner conversation with Dr Pat Fisher who is a clinical psychologist and workplace wellness consultant based in NYC and Vancouver. Pat Fisher is the CEO of Fisher and Associates. Her company specialises in helping agencies address the health of their organization from a systemic approach. Over the past 10 years, she and her team have developed solid, empirically tested tools and a manualised approach to helping individuals, teams, managers and the organization as a whole face the challenges of CF, burnout and other major organizational transitions and stresses. I found her work to be of the highest quality and it has real depth and substance (unlike, to be honest, much of the workplace wellness material I have come across so far). This is material developed by helping professionals who are able to go deep and make a real impact. I look forward to future conversations with Pat.

-I have been making steady progress on the Compassion Fatigue Workbook, which is nearing completion. The most time consuming part is obtaining permissions to reprint certain testing scales and tools from publishers of other works. One such conversation has already been going on for one year. A typical email goes like this:

Publisher: "how many copies of this manual will you be printing on your first round?"
Me: I email an answer
two months pass....
Publisher: "will you be selling this on your website or in bookstores?"
Me: I email an answer (even though I told them all of this in the initial email)
two months pass...
Publisher: "do you prefer apple pie with ice cream or with cheese?"
two months pass...

So, at this rate, I may have to leave out a few tools or invent new ones myself!

I am also finishing a booklet on "how to run a workshop in your community" and the train the trainer manual. However, since the TtheT manual hinges on the WtheW workbook, I will focus on WtheW first and then complete the rest.

I hope you are well and taking some time to bake cookies with children or whatever is your equivalent self care activity (maybe buying cookies and eating them without a child in sight, that might also be very relaxing).

This week, I would like to offer you an article I recently wrote for my professional association's newsletter. It is currently being considered for publication.

Compassion fatigue (CF) is characterized by deep emotional and physical exhaustion and by a shift in a helping professional’s sense of hope and optimism about the future and the value of their work. It has been called “a disorder that affects those who do their work well” (Figley 1995) The level of CF a helper experiences can ebb and flow from one day to the next, and even very healthy helpers with optimal life/work balance can experience a higher than normal level of compassion fatigue when they are overloaded, are working with a lot of traumatic content, or find their case load suddenly heavy with clients who are all chronically in crisis.

The best strategy to mitigate the impact of Compassion Fatigue is to develop excellent self care strategies, as well as an early warning system that lets the helper know that they are moving into the caution zone of CF.

If would you like to assess your current level of Compassion Fatigue, visit Dr Beth Stamm’s website and take the compassion fatigue self-test: www.isu.edu/~bhstamm/tests.htm. This test not only looks at CF, it also assesses helpers’ level of compassion satisfaction which is “the pleasure you derive from being able to do your work well.” (Stamm, 1999)

For the past 7 years, I have been working as a compassion fatigue specialist, offering training and counseling to helpers through workshops and individual counseling work. Here are some of the top strategies that workshop participants have identified as being most protective:

1.Take Stock: Check-in with yourself on a regular basis. I have my clients draw a dinner plate on a piece of paper and list every demand/commitment/concern they currently carry with them inside the plate. Then, I ask them to identify the demands that may be changeable, even by one percent. Participants often comment that they rarely take the time to take stock, let alone try to identify areas where improvement is possible. This can become an important and useful tool in monitoring your level of work and home stress.

2. Find time for yourself every day: Whether it’s 5 minutes or one hour, time for yourself allows you to regroup and refuel. Aim to rebalance your workload if you can, by spreading out your most challenging clients, or having short breaks between sessions to take a walk, do some paperwork, talk with colleagues or visit a fun, non-work related website.

3. Have a transition from work to home: Aim to leave work behind and start fresh at home. This can mean changing out of your work clothes when you get home, walking twice around the block before walking into your house or some other mindful ritual that allows you to transition and leave the work-related worries and difficult stories back at work, where they belong.

4. Learn to say no (or yes) more often: Many helpers tell me that they realize they now say no to friends and family all the time as they feel too tired or depleted to give any more. Others say that they are caregivers in all aspects of their lives, and walk in the door from work only to get phone calls from family members in need, or a pager from work or from the numerous committees they are on. Explore ways to set better limits at work or with demanding family members or friends or, conversely, try to say “yes” to something each week that is time-limited. Learning to set limits is a key tool in optimal self care.

5. Assess your Trauma Inputs: Do you read about, see photos of, and are generally exposed to difficult stories and images at your work? Take a trauma input survey of a typical day in your life. Starting with the moment you get up in the morning, note how many traumatic images and stories you absorb through the media, newspaper and/or radio. Now look at your work. Not counting direct client work, how many difficult stories do you hear, whether it be in a case conference, around the water cooler, debriefing a colleague, or reading files? Now look at your return trip home. Do you listen to the news on the radio? Do you watch TV at night? What do you watch? If you have a spouse who is also in the helping field, do you talk shop and debrief each other? There is a lot of extra trauma input that we do not need to absorb or to hear about. We can create a “trauma filter” to protect ourselves from this extraneous material. This requires mindfulness and an awareness of what is coming at us.

And a few more strategies…

-Attend Workshops/Professional Training Regularly: Further professional development has been identified as one of the top protective factors against CF by researchers in the field. It makes sense: the more competent and confident we feel doing our work, the less stressful the work is, and the less depleted we become.

-Consider Joining a Supervision/Peer Support Group: This can be very informal and involve only two or three colleagues or friends. Debriefing and connecting with others is a significant way to protect ourselves from burnout and compassion fatigue.

-Consider working part time (at this type of job): It has been found that the optimal number of days of doing direct client work is three days per week. If you would like to investigate ways to make this financially possible, there are some excellent books on this topic, such as Your money or your life by Joe Dominguez and Marsha Sinetar’s Do what you love and the money will follow. You can also explore the possibility of job sharing direct client work and taking on other duties that feel complementary and interesting to you on the other two days.

-Learn more about Compassion Fatigue and Vicarious Trauma: Read books (see below), visit websites and attend educational sessions on CF and VT. Workshops can be validating experiences where you meet other helpers and learn new strategies.

-Start small: You may not notice it right away, but making one small change to your daily routine can have tremendous results in the long term. Imagine if you started walking up two flights a stairs per day instead of using the elevator, what might happen after three months?

Recommended books on Compassion Fatigue and Vicarious Trauma:

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

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.

Stamm, B.H. (Ed.). (1999). Secondary traumatic stress: Self-care issues for clinicians, researchers, and educators, 2nd Edition. Lutherville, MD: Sidran Press.

Self-Care books for Helpers:

Borysenko, J. (2003) Inner peace for busy people: 52 simple strategies for transforming your life.

Fanning, P. & Mitchener, H. (2001) The 50 best ways to simplify your life

O’Hanlon, B. (1999) Do one thing different: 10 simple ways to change your life.

Posen, D. (2003) Little book of stress relief.

Richardson, C. (1998) Take time for your life.

SARK, (2004) Making your creative dreams real: a plan for procrastinators, perfectionists, busy people, avoiders, and people who would rather sleep all day.

Weiss , L. (2004) Therapist’s Guide to Self-care.

Not as in art restoration, but as in refueling the self.

I had a very busy October, and now I am chilling out a bit, taking some time to listen to music, run, think, and do some yoga (while of course still driving kids to soccer, hockey, doing laundry and cooking meals, I am, after all, still the mother of two active youths but I've decided to let myself off the hook in terms of nonessential chores. My messy basement can remain messy for another month (or year) non? Do I really need to start Christmas shopping? I went to bed at 9pm last night which to me is incredibly decadent and restorative. I really think that there are lots of ways to carve out some restoration time even if you are buried in family demands. You have to start small. As a workshop participant said a few weeks ago: "My goal is to drink an entire cup of coffee from start to finish without being interrupted by family demands!"

I have also decided to book a day off a week from my private practice to finish several writing projects related to Compassion Fatigue Solutions. I will post some more on this in the coming weeks.

Music to accompany restoration: anything by Ben Harper or Jack Johnson will do the job. Amos Lee has a beautiful touching song called "long line of pain" that brought tears to my eyes when I first heard it: "I come from a long line of pain, my family suffered greatly for my gain. (you can buy it from itunes for 99 cents). One would think this would not be a song that takes me away from thoughts related to CF, but for some reason I love the music in that song and his smoky, sultry voice.

Web: Visiting a non-work related site such as "A photo a day from Planet Earth" planetearthdailyphoto.blogspot.com

What do you do to refuel?

Widely published author and internationally respected researcher, Dr. Greenberg is one of the primary developers of emotion focused therapy (EFT) for individuals and couples. This workshop will teach clinicians practical and specific interventions to help clients resolve feelings of anger and hurt in their relationships with others.

Using a combination of lecture, videotape demonstration and focused Q&A periods, Dr Greenberg will present three major resolution processes with an emphasis on the importance of accessing and working through emotions related to the injury: Holding the other accountable, Letting Go, and Forgiving. Dr Greenberg will also explore the differences in the process of resolving injuries in individual and couples therapy.

Dr. Greenberg’s workshops are designed to provide participants with techniques they can readily integrate into their everyday practices. His workshops are highly praised and are renowned for their atmosphere of authenticity and warmth.

Topics covered will include: Steps of an empirically supported set of interventions for facilitating the process of resolution; The therapeutic tasks of exploring the impact of the injury; Processing the pain; Changing representations of self and other in adaptive ways; Accessing compassion and empathy for self and injurer.

About the Presenter:
Leslie Greenberg, Ph.D. is Professor of Psychology at York University in Toronto, Ontario. He is the Director of the York University Psychotherapy Research Clinic and is the developer of an Emotion-Focused approach to therapy (EFT). He was awarded the 2004 Distinguished Research Career award of the International Society of Psychotherapy Research.

He has authored all the major texts on emotion-focused approaches to treatment. These include Emotion in Psychotherapy (1986), Emotionally Focused Therapy for Couples (1988), Facilitating Emotional Change (1993). Working with Emotions in Psychotherapy (1997), Emotion-focused therapy: Coaching clients to work through emotions (2002), and most recently, Emotion-focused Therapy of Depression. He was recently funded by the Campaign for Forgiveness Research to study the process of forgiveness in couples and individuals.

Dr. Greenberg is a founding member of the Society of the Exploration of Psychotherapy Integration (SEPI) and a past President of the Society for Psychotherapy Research (SPR). He has been on the editorial board of many psychotherapy journals, including currently the Journal of Psychotherapy Integration, Journal of Constructivist Psychology, the Journal of Marital and Family Therapy.

Dr. Greenberg’s workshops are renowned for their atmosphere of authenticity and warmth. His workshops have brought him critical acclaim throughout Canada and the United States, and in the United Kingdom, France, Germany, Austria, Italy, Spain, Portugal, Finland, Norway, Sweden, Argentina, Brazil, Chile, South Africa and Australia.

Feedback from reviewers of Dr Greenberg’s publications:

“There is no doubt that Les Greenberg is both a pioneer and the field's premier investigator in the important work of applying the basic research on emotions to the process of psychotherapy. The focus on primary emotions and their change is what distinguishes this book. It is a fabulous compendium of strategies for working with emotions and draws from both behavioral and experiential therapies.”

Marsha M. Linehan, PhD, University of Washington

"In a refreshing blend of clinical sensitivity and compelling research findings, the authors have done a masterful job of explaining why an emotion-focused intervention is central to therapeutic change, and describing how this may be implemented clinically. Their lucid, jargon-free exposition of conceptual and therapeutic issues proves an invaluable resource for practicing therapists of any orientation. This indeed is a landmark contribution to the field."

Marvin Goldfried, PhD, Professor of Psychology and Psychiatry, SUNY, Stony Brook

“... at the frontier of contemporary marital and family therapy”

Alan S. Gurman, Ph.D., Professor of Psychology, University of Wisconsin Medical School


Workshop Fees (lunch on your own):
$155 before December 1, 2007: $169 after December 1, 2007
Students: $120 if registered before December 1, 2007; $145 after December 1, 2007

To Register:
By phone: (613) 547-3247 (leave message for Françoise Mathieu)
By Fax: (613) 547-0655
By email: whp@cogeco.ca
By mail: 837 Princess St., Suite 300, Kingston, On., K7L 1G8
To Download registration form: www.compassionfatigue.ca

Method of payment - Please note: full registration fee is due prior to start of workshop.
Payment must be made by cheque only, payable to
Workshops for the Helping Professions.

**Cancellation Policy: An administrative fee of $30 will be charged for all cancellations 15 days or more prior to the workshop. After this cancellation deadline, no refunds will be available. If you cannot attend, you may send a substitute but must notify us ahead of time.

Workshop Outline:
Emotional injuries
• Emotion and self-organization
• Emotional change processes
Video Demonstrations
• Letting go & Forgiving
• Emotion-focused treatment of emotional injury
• Working with Injury as Unfinished business using empty chair dialogue
Resolving Emotional Injury
• Acknowledging the impact of the injury
• Working through painful emotions
• The emotional process
• Letting go of anger and hurt
• Accessing and restructuring emotional memories
Video Tape Demonstrations

Lunch: (on your own)

The Change process in working with injury in individuals
• Imagining the other
• Empathy
• The role of self-affirmation and self-forgiveness
• Change in view of the other
• Letting go and forgiveness
• Reconciliation
Video demonstration
The process of resolution of emotional injuries in couples
• Key steps
Video demonstrations
Comparing individual and couples work for resolving emotional injuries
• Common elements
• Differences
Discussion

This workshop is designed to help you:

1. Understand the phenomenon of emotional injury and forgiveness
2. Discriminate different emotions
3. Learn steps to promote forgiveness or letting go
4. Understand different emotional change processes

I just finished co-presenting a three day crisis intervention workshop (www.crisisinstitute.com) with my colleague Dr Mike Condra. This is a workshop we offer every October in Kingston and we meet dozens of crisis intervention workers from across the country who come to retool and hone their skills.

During this workshop, I am often asked questions related to working with clients who are chronically in crisis.

Most helpers say that they find clients in chronic crisis to be the most draining clients to work with: their seemingly endless demands, high needs, difficulty self-soothing and sometimes poor problem solving skills. The fact that we will work incredibly hard to set up a referral link for them and then the clients will sometimes sabotage the help they are being offered. The self-destructiveness, the splitting...

I have spent a lot of time pondering this challenge and seeking training on working with high need clients, and have the following suggestions for anyone wishing to continue helping such clients and retaining a respectful, helpful stance while not burning out.

1) Let's reframe success: I think that we need to re-evaluate what we consider to be progress or success in therapy with high needs clients. I call this "working with the toenail of the elephant". If, in the middle of a session, you find yourself feeling frustrated and stuck, re-assess your goals. Are you trying to fix the whole elephant at once? Clients in high emotional distress often see many issues as equally urgent and we can get swept away in the energy of this emotional disorganization. Focus the session on the smallest toe of the elephant and work from there.

2) Labeling - Rethinking the use of damaging diagnoses such as Borderline. Are we using the term borderline to refer to the high level of emotional disorganization a client is experiencing, or are we saying borderline to morse code "manipulative, frequent crisis, difficult, treatment resistant" to colleagues? What does it mean for a client to receive that diagnosis when they seek help in the future? Why are men almost never given the borderline diagnosis?

I recall when I was studying at Columbia University my instructor, Dr Farber, told us that borderline personality disorder (bpd) should really be renamed ptsd as the stats on the number of clients with bpd who have experienced childhood abuse and neglect was in the 90%. If this is true, and bpd clients are nearly all trauma survivors, doesn't it then make sense that they use poor self-soothing techniques at times?

3) Do some reading/attend workshops. There are some good books on this topic, as well as some excellent workshops working with clients in chronic crisis.

John Briere, trauma expert and gifted researcher and presenter offers a deconstruction and reconceptualisation of the concept of BPD. He will be presenting in Toronto in November (see sidebar for information) and I highly recommend attending his training for tools and new ideas on this topic and on trauma therapy in general.

Any presentation by the school of Narrative Therapy (Michael White and others) offers a truly refreshing look at "treatment resistance".

If you have other suggestions, feel free to post a comment at the end of this blog entry.

Books:
James Masterson has written a very powerful book called "THE SEARCH FOR THE REAL SELF: Unmasking the Personality Disorders of our Age" (1988). Interestingly, in a personal communication with John Briere, where I asked him how he felt about Masterson's book, he replied that he felt Masterson wasn't compassionate enough towards clients with personality disorders and he found him too labelling. I have to agree with Briere, but Masterson still provides a very helpful angle that focuses on empathy and compassion and uses attachment theory to better understand why some clients are so emotionally disorganised. So, caveats aside, the Search for the Real Self still remains #1 on my book shelf.

Here is a description of the book, excerpted from Masterson's own website:

"Some are outwardly charming, confident, and apparently successful; others are obviously struggling with feelings of inadequacy; while still others lead lonely, isolated lives. All of these individuals suffer from today's characteristic personality disorders - borderline, narcissistic, or schizoid - caught in a knot of self-destructive behavior that eventually sabotages their lives.
Many compensate for their inability to know themselves or establish meaningful relationships with others by forming superficial friendships and pursuing empty life-styles focused on competition for status rather than personal satisfaction, or resorting to alcohol, drugs, and impersonal sexual encounters. Their inner torment has long confounded themselves as well as their colleagues, family, lovers, friends, and even the professionals to whom they turn for help.

Now, in this long-awaited book, renowned psychotherapist James F. Masterson provides the keys to understanding these previously untreatable disorders which have become the classic psychological disturbances of our age, afflicting thousands of modern Americans.

The volume begins by explaining how the healthy real self develops and how it functions to enable the individual to adapt successfully to life's challenges and opportunities, express deepest needs and desires, and find true fulfillment in love and work.

Masterson then describes how the impairment of the real self early in life leads to a personality disorder: when the child's self-expression is not adequately supported, he or she may experience powerful feelings of rejection and fear of the "abandonment depression," precipitating the creation of a protective yet ultimately harmful "false self" whose function is to suppress these painful feelings at the expense of true self-fulfillment, intimacy, or even a clear perception of reality.

Drawing on vivid case histories from his practice, the author examines how this false self behaves at work and in relationships. The narcissist is often intensely competitive and domineering, demanding constant adulation from others to support his inflated false self. The borderline can be clinging and manipulative and frequently pursues an unfulfilling "instant intimacy" with a distant or unavailable partner. The schizoid remains cold and aloof, often immersing himself in work or in a wholly imaginative alternative world rather than engaging in any relationship which would threaten to engulf his fragile sense of himself.

Offering practical guidance and real hope for therapeutic success, Masterson delineates the most effective treatment approaches to help borderline, narcissistic, or schizoid personalities overcome their trauma, reconstruct their psyches, and rejoin the mainstream of life. He exposes the common pitfalls and explains how to develop the necessary and appropriate therapeutic alliance to treat each personality disorder.

While therapy offers hope of overcoming the impairment of the real self, it is not the only area in which the real self can emerge. Individual creativity also offers a valuable avenue for self-expression. In analyzing the behavior of artists with personality disorders, Masterson offers surprising insight into the lives and works of Jean-Paul Sartre, Edvard Munch, and Thomas Wolfe, whom the author respectively refers to as the philosopher, painter, and novelist of the abandonment depression. However, it is not only the creativity of artistic genius that expresses the real self. Masterson argues that the real self is reflected in everyday innovation and creative problem solving which enable us to experiment in work and in love, to find and achieve the sense of a personal meaning essential for a fulfilling life."
(From www.mastersoninstitute.org)

Another excellent resource is Scott Miller. Miller is a clinical psychologist, workshop presenter extraordinaire, co-director of the Institute for Therapeutic Change (www.talkingcure.com) and co-author of "The Heroic Client" a book that looks at empirically valid therapeutic approaches and "what works" in therapy. If you have a few minutes to spare, go visit his website and see for yourself.

I would also suggest reading or re-reading Judith Herman's pioneering book: Trauma and Recovery and Pearlman and Saakvitne's hefty tome Trauma and the Therapist: Countertransference and Vicarious trauma in psychotherapy with incest survivors.

If you live near Ottawa and are ever looking for a great locale for a meeting or retreat, I would highly recommend Strathmere (www.strathmere.com). Strathmere is a country retreat, with barns that were converted into beautiful meeting rooms and it has excellent food and outstanding service. I have been looking for the ideal setting for our CF retreats and I think this is it. The also offer overnight accommodation which would make the possibility of an overnight retreat very appealing. Something to think about down the road.

This week was the Fall offering of WHP's Walking the Walk workshop, and I had the pleasure of meeting a highly varied group of helpers. For those of you who participated in this workshop, I have enclosed below the self care strategies that you produced during the "bowl game." My only regret is not taking a photo of peewee the pumpkin, but she's standing guard at Strathmere, full of the rewards of the work that we gave her during our circle.

The best part of these workshops is the privilege of having a group of helpers spend a day together, sharing common experiences and offering validation and support to one another. We spend so much time working in isolation during our day to day work. In fact, in their ARP training program for compassion fatigue therapy, Baranowsky and Gentry list the following key elements as being key to keeping compassion fatigue at bay:

1) Resiliency Skills: “rebounding from life and work difficulties” - “strengthening areas of our lives to cushion the fall when the going gets rough”

2) Skills acquisition: "What symptoms are being caused by areas of work where I do not have adequate training?"

3) Self Care: “What symptoms are caused by the professional overextending themselves in their work or personal lives?” Strategies involve developing or improving soothing skills, boundaries.

4) Internal Conflicts: Unresolved personal issues, knowing what we need to do yet being unable to do it (eg physical exercise, proper eating etc)

5) Connection with others: “Developing a personal “therapeutic community” is mandatory in preventing CF." (Excerpted from Baranowsky and Gentry, ARP training manual (1999))

Here they are, in no particular order. Can you pick three you can commit to in the next month?

-Pedicure
-Walk in nature
-Play hooky for a day
-"Chill out dude!"
-Time with kids/pets
-Cooking/baking
-Short road trips
-Soak in bathtub with candle light
-Connecting with friends (call them, go to movies)
-Play dress-up with child
-Try something new (new place, new food...)
-Book a massage
-Gardening
-Listen to music/dance
-Play a musical instrument
-Enjoy loud music to unwind without worrying about others
-Share food with friends/co-workers
-Laugh/have fun
-Lighten up/get silly
-Take a nap
-Have a cup of tea
-Creative endeavour: knitting, painting
-Dancing (ballroom, belly)
-Take flying lessons (or not!)
-Learn something new (hobby)
-Connect with friends over lunch
-Take time off
-Exercise, try a new sport
-Enjoy a glass of wine
-Reflexology/pedicure
-Go to the beach
-Have a party
-Read a fun book
-Start recreational swimming at the Y
-Humour in the workplace
-Develop your spirituality
-Walk/cardio
-Nature-related activities
-Take birthday off
-Go to a spa
-Book a weekend getaway
-Get your hair done
-Spend time with nature
-Photograph new things
-Go to movies, museums, art gallery
-Try something new

Before introducing my posts, I must share with you this photo that was taken at my latest workshop presentation. The agency rented a gorgeous bowling alley (totally redone retro-style) and although I had to compete with the pinball machine noises once in a while, it was good fun. I couldn't resist asking to have my photo taken inside the Airstream trailer that has been converted into a bar. I assure you, I do not have a boring job!

This week, I am posting two different articles. The first, which will follow this intro speaks for itself. The second needs a bit of an introduction and context. It was written by my friend and colleague Dr Deb Thompson, who is a clinical psychologist in private practice and who is also in the process of certifying as a coach through a very intensive and fascinating program called Integral Coaching (based in Ottawa: www.integralcoachingcanada.com). Deb recently completed her first full marathon and sent her friends and supporters the following piece. I asked whether she would be willing to share it with the Compassion Fatigue Solutions Blog as I feel she touched very eloquently on so many issues we all face as helpers: the inner critic, the drive to push and achieve, the competing demands, balancing, self care, insight. See below for Deb's entry.

Today, I would like to share some thoughts on parenting and self care.
Yesterday, I was sitting on the bleachers at my son's hockey game, and was overhearing (yes, I am a shameless people watcher and even more scandalous eavesdropper. You will recall the journalism aspirations from my childhood - or perhaps I would have made a good anthropologist if you could actually make a living being one. Some of my favourite books when I was young was anything written by the ethologist Desmond Morris). Anyhow, I was listening to parents around me talk about their Saturday routine:

Woman in brown turtleneck: "We were at the arena at 7am today for middle child's game, then raced back home to pick up older child and take her to dance lesson, then raced back home again to get youngest child to his basketball practice, then two of them had birthday parties in two different parts of town and we are going out tonight so I'm not sure when I'll have a chance to even get changed!".

To which Man with crew cut (we live in a military area) replied: "I hear you, junior had to be at soccer at 8am AND we had the builders coming to fix our driveway while my older child had to be at his hockey practice. It's crazy isn't it?"

I had two reactions to this (and I hear these stories every week as I sit on the bleachers doing my people watching). My first thought came from the Critic (do you have one? Everyone has one, non?).

Critic said: "tsk tsk, these overcommitted people who enroll their kids in more than one activity, probably feeding them junk food in the car on the way from karate to swimming lessons. When will people learn to scale down? This is insane. When do they have time for themselves, do they even get any physical exercise or is it just always about sitting on your bacon watching your kid play sports. Do they all think their kids are going to the olympics! Tsk tsk..."

Then, suddenly, I was visited by a totally different voice, the Compassionate Voice who said "You know, those crazy years of driving children to hockey and soccer are very brief. Maybe these parents are having a wonderful time taking a few hours out of their day to sit (perhaps mindfully) and relax and watch their kids play games and have a lovely time. Maybe these parents are really enjoying the sense of community of meeting the same parents every week and sharing stories and common experiences. Gosh, maybe some of these parents waited years to have children and went through tons of fertility treatment and maybe even adoption for the joy of watching their kids play hockey.

Compassionate Voice continued, "Look around you, how many parents look harried and stressed out?" (my unempirical unscientific answer would be about 25%) and what about the rest? Well, to be honest the rest of them seem to be having fun! No, really, I looked around on the bleachers and I saw parents talking to one another, getting involved in the management/coaching aspects of the children's sports, taking part in the sports themselves. I also saw parents enjoying their children's youth and energy and having fun watching them play sports. The Dad with crew cut had a huge smile the whole time he was at the game, and he seemed to be having a wonderful time.

What is the take home message here? I guess it's twofold, first, that my inner critic is alive and well and ready to pass judgment on how people manage their time (and pass judgment on my own actions), without taking the extra step to assess the full picture and secondly, that sometimes, Compassionate Voice doesn't get much air time.

If you were able to relate to the story above, whether it be with your kids or with your own extracurricular pursuits, do you know how your Critic and your Compassionate Voice react? I know that I value Critic's input and it has helped me enroll my children in one, count it, one sporting activity at a time. Critic is also helpful in figuring out my self care situation. But sometimes, Compassionate Voice needs to have input as well.

Do you have something going on in your life right now that needs to be filtered through your compassionate voice?

Hey sportsfans

Well here I type with rather tender legs, finally getting to write my first race report...

Toronto Waterfront Marathon September 30, 2007

Leading up to this race, my first marathon, I spent a lot of time fantasizing about what it would be like, especially during all those hours running out on Highway 2. I looked forward to the happy buzzy atmosphere I have loved at shorter races, and feared an attack of the legs o'lead in the last miles. I worried if injury or illness would prevent me from participating or finishing. I started noting endorphin-induced epiphanies for this race report or the See Jane Tri retreat weekend about life lessons from sport.

What I had not anticipated was how recently re-entering training to become fully certified as an Integral Coach would plunge me into questioning many of my choices in life, including whether or not to go to the marathon. In the three weeks prior to the race, being coached had brought me face to face with my propensity to over-cram my life, and called me to examine my many choices that have brought me once again to this point of burn out. My probing extended to all corners of my life, into the role of my hobbies and habits, including long distance running and racing. Was this just another addiction, under the guise of 'health'? Was running a restorative relaxing practice I loved? Was I escaping my life and its demands through running? Did running bring certain blessings? Did running so much close out other good things? Was it a fab way for me to stay fit and well (and get to eat cinnamon rolls and stay thin)? Was doing a marathon my "go big or go home" way again? Did running bring some great relationships to my life? Was I unwise to go ahead with the marathon given my exhaustion and overwhelmedness? Could I drive myself bonkers trying to figure this out?

The answers seemed to be "yes" to all of the above. It was and, and, and... not either/or.

So I was confused and uncertain. I tried to let myself be open to going and not going, not forcing a decision. Over the last week or so, my desire to experience the race I had readied myself for surfaced in my somewhat disheartened heart with a palpable shape, albeit less solid than I would have liked. I wondered if this somewhat sober and wobbly decision was in keeping with my desire to accept the unfoldings of the race (my life) with less insistence on certainty/control, and even a useful dampener to my over-excitability that had led to me not pacing well in several half marathons (my life). I can find a silver lining in just about anything evidently.

Off I went to Toronto alone on the train, my family staying home with our new young pup. I was eager to hear John "The Penguin" Bingham, the comedic champion of the ordinary runner, speak at the Expo. I have loved his credo, "The miracle isn't that I finished. The miracle is that I had the courage to start" since my early days, 4 years ago, of starting to walk, weighed down by about 90 lbs. of extra weight, 15 years of a busy but so sedentary life, and the ego of a former high school athlete. I remember walking out 15 minutes, and turning around to hobble home in a variety of gaits to vary the pain. It took much courage and faith to keep on walking, and eventually walk-jogging in an unwieldy body, more than running for hours does now. Listening to Bingham encourage people to enjoy moving their bodies, however 'waddly' their steps may be, was golden. He spoke about running/racing with a sense of wonder, not expectation, which seemed so appropos it was eerie! I spoke to him briefly, thanking him for his motto, and was struck by his gracious and warm presence. I felt renewed in my tender intention to stay loose and light in my head, with some room for hoped for finishing times, but moreso being in the marathon as a celebration, an experience, an opportunity, a blessing, a challenge... the 'full catastrophe'. The totally unwelcome but undeniable fact that one day, maybe sooner than later, I won't be able to run any more was on my mind, with my desire to revel in my regained mobility while I still have it. I thought of all the people I know who would love to run or move their bodies freely, but cannot, and felt what Sue calls the "attitude of gratitude".

In the blink of an eye, it was morning, and I was up up at 4:45 a.m. to eat, drink, go to the can, rub silicone on the bits that get chafed, get dressed, go to the can, write the words "celebrate" and "wonder" on the back of my hand, and go to the can. Time to head out and find a coffee, which was pretty funny, since all the other patrons at Fran's Diner had evidently been out all night, and would be crashing in bed while I was out hammering out the miles. Off to the race start! What a throng (about 11,400 runners in the half and full marathons, from 44 countries, up to age 80)! The air was electric with excitement, nerves, anticipation. I decided to use a "pace bunny" to try to run more steadily, and to aim for a finishing time that seemed in sync with my training runs (4:00 hrs). This was good until about 16 or 17 kms, when I began to get an inkling of my classic race problem with quadricep pain, which had clearly set in by the half way mark (21 km)... I let the bunny and her group go, and settled in to just run my best. On two loops of the course we got to see the top runners on their way back... amazingly sinewy athletes... indeed, the record for a marathon in Canada ended up being broken by the winner (2:09:30). I cannot run one km as fast as they run 42.2 ... mind boggling! Well, it was an unseasonably warm and very sunny day, and I tried to stay hydrated and use energy gels as planned, but by about 30 km, some nausea had set in, and my quads were very sore, and I needed to take some walk breaks. I shifted my goal again, this time to finishing. Bingham had described the 'brain melt' of the last miles rather humorously in his talk the day before... and I smiled a little when I got hopelessly confused between '35 km, 7 to go' and '37 km, 5 to go'. I started to set very small goals: run to that post... good... run to that hydrant... good. I felt massively fatigued, even sleepy, and thought of how Kyla had described people in the Ironman lying down in the gravel at the side of the road. The last few km were very foggy... I kept trying to listen to the words on the music on my iPod, and just keep moving ahead. The last song that came on was a fabulous one I recently got from my coaching course: Every Little Day by Greg Greenway: "I felt terrible, I felt lucky, at the ways things are, like a glad accident, like a bright shooting star, like a brave little ripple in an ocean so large"... with a mercifully lively tune/beat. I thought I would cry crossing the finish line (chip time: 4:20), but instead I felt a little stunned ("can I really stop now?")... the tears came when the medal for finishing was put around my neck, the magnitude of this accomplishment overflowing me. Then it was time to drink, drink, drink... which had my brain back in gear in an hour or so. The legs were pretty bad, so I sucked it up for my first trembly ice bath to try to reduce inflammation and suffer less later. And then home on the train to my lovelies, and a much more pleasant warm bath, and to bed for 8 p.m.

On the train there and back, I did some journaling, reflecting on what I had learned in these past 5 months and culminating 4.33 hours. One big one has been paradox, something I really wrestle with, always seeming to prefer the seeming solidity of uncontradictory conclusions even as I might know it is illusory. The rigorous training was about and for the race day -- while I would have been running regardless, the structure and duration of my runs was definitely in preparation for a one day event. All this hard work, which was necessary but entirely insufficient for the race to transpire as desired. How to hold the marathon as a focal motivator yet be open to it being kyboshed by injury, illness, life's unwelcome droppings was such a difficult tension to try to stay with, rather than slipping to "well I can't fully control the result through my efforts, so I can't risk fully wanting or commiting", or "I prepared and worked hard, and now the outcome should follow accordingly". To do what I could do to ready myself, and yet be open to the final day's surprises. To let go of my expectations or hopes during the race, over and over. I am beginning to realize that this will an ongoing opportunity for me, and maybe for most of us; to stay with the sweet and gnarly challenges of the serenity prayer -- God grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.

One gift from the training was on the "changing what I can" side: the development of more faith in the adaptive powers of my body and mind. What looked so very daunting at the start of my training program, especially three 20 mile runs, became manageable by the time those days arrived... because I had done the 12 and 14 and 16 and 18 mile runs by then. I think about how often I freak myself out at the beginning of a process in thinking about how I am not yet prepared for the culmination. I smile at the silly arrogance under this self-doubt... somehow expecting to be ready without preparation. This lesson is front and center as I begin a 9 month certification program in Integral Coaching, and worry if I will be fit for the final exam. My teachers tell us: trust the process, do the work, and you will be ready. One of our practices is a 20 minute sitting meditation 6 days a week; to choose to take our seats, to be open to the sitting as it is that day, to gradually build our capacity to be with "what is". And so it has been for me with my running this year: not so much a "just do it" in a harsh or driven way, but in the way of an abiding commitment to a proven process that sometimes shifted in the details, but did not actually waver overall because of holidays, heatwaves, headwinds, and most of all, not feeling like it. And there has been something really valuable in having known this steady dedication to 'taking my seat', and having my capabilities shift over time.

However, to date, my faith in transformation through practice is pretty limited to active ones. Running shines another light for me on how hooked I am on going forward, action, doing, the yang side of life. Tapering for a race, running less and less, and eventually not at all, makes me so anxious that I will lose all my fitness, all my ability... and while intellectually I know this is ridiculous, I cannot seem to hang on to the substantiveness of my strength without very recent concrete evidence of it. Or yet fully believe in the development of power through times of rest, nondoing, yin... for muscles or me in general. Such fear... fear I am trying to both be gentle with, but not necessarily as fully driven by. A recent run on a suddenly cold day in my customary tank top let me squirm in how very loathe I was to turn back, catching in my deep groove of "onward", scratched over decades. I was inspired to return home for a long sleeve shirt as a drop-of-wood-filler move in honour of self-care, flexibility, and being able to turn 'back' more readily in my life... in coaching conversations that are not landing as planned, through to reconsidering where we will live, and shifting how I make a living, and how I would even define "a living". Cool.

Something else that is getting more clear for me is how much I like familiarity and sameness, and struggle with the discomforts of newness, even when it brings goodness. Breaking in new shoes, that I know I need for the fresh cushioning, always makes my feet go numb against the stiffness of the soles. And so it is with new practices and concepts... oh so shiny and appealing at first, but then they feel tight and stiff and make me cry for my old scuffed squishy ones back, even though they don't really support me anymore! The cycles of excitement, disenchantment, and re-engagement that I am spinning through in these early days of being coached, and see in my clients in their ongoing processes of development too, spiraling towards steadiness and embodiment. This shoe metaphor reminds me to lace on the new stuff a little loosely at first, to not panic when it feels stiff and foreign, to allow for alternating between old and new while new is so unfamiliar, to trust in gradually feeling my foot soften and imprint new into a better fit, and to relax a little into the never-ending-ness as new becomes compressed and unsupportive someday...

Finally, the marathon reminded me of how readily I can get stuck in my own pain, imagining myself to be alone, and my suffering to be somehow unique. I come back to what Joanne G. told me of how she had complained of leg pains to her companion late in her first marathon, and of his rather sharp reply: "look around you, everyone's hurting now"... I thought of this many times in my last grueling miles, and I would like to stay awake to this maxim more and more in everyday life too. Seeing others rejoice and cry at the finish line, as in my coaching class, my office, my home, has been a very poignant opening this past year to connect more fully, deeply and compassionately
with them and myself... an opening which lets me once again call upon the miracle of the courage to start, and to stay and to settle, and to start...

All my best, Deb

email: drdeb@bellnet.ca

First, I would like to thank those of you who have visited the blog and emailed me with comments and feedback. Community, sharing ideas and supporting one another is really the number one compassion fatigue solution. I invite you all to post a comment with a self care idea, if there is one that you would like to share with our community.

The best test of all these self care ideas is when you are really having to "walk the walk" and "talk the talk" and this week is one of those for me: I had a wonderful weekend away with my family, went up to the Laurentian mountains (or hills for those of you out West, I'm sure you would fall over laughing at the size of these little bumps but they are aged mountains to us Quebeckers, used to be huge but are really old and worn down and we love them!). The Fall colours were wonderful and we could hear the Canada Geese flying overhead. But a weekend away means that there is no time for preparing the week, and all the grocery stores were closed when we got home! Hence, a rather hectic start to a very busy week.

I will be in London, Ont. later this week, presenting to a large organisation that offers assistance to homeless men and women in crisis, individuals who often face addiction, mental illness and have very few places to turn. I am very much looking forward to meeting this team.

So, tips for planning a busy work week will follow.

I will label this post "Tips for Busy Times" and will archive it accordingly, and will add tips for busy times at a later date.

Tip #1: Make sleep and exercise your top priorities
If you have a lot on your plate for the coming work week, is it realistic/a good idea to clean out your messy kitchen drawers/make the world's coolest children's lunches/put away your summer clothes? I find that when I have a lot going on, I am not always the best judge of what take priority. So, contrary to logic, what I did yesterday when we got home from our long drive was go for a run. Yes, I went for a run, I didn't unpack the bags, clean the fridge or vacuum the house (although it sorely needed it). I went for a run to go over in my mind the week ahead and best ways to take care of myself. Second thing I did was go to bed early (after watching my favourite TV show, Intelligence. It's a CBC show about the undercover world of the Canadian mafia and police that is wonderful as it's full of intrigue but very little violence or trauma content. A rare thing.)

Feel free to send tips for busy times, and have a good week.

Today, I would like to talk to you about food and how I see it as a key compassion fatigue solution. (Sceptics, please read on - really, just a few more lines...).

Those of you who know me personally will already know that food is a very big part of my life: I own an embarrassingly large cookbook collection, I love to talk about, read about and plan meals. I carry peanut butter and jelly sandwiches in my briefcase "just in case" I need food asap (ok that's partly because I'm hypoglycemic and I get very weird when my sugar levels crash but it's also because I always need to know where my next meal is going to be).

My favourite thing to plan and think about in the food realm are simple everyday meals, not dinner parties (in fact, I cook the same thing every time I host a dinner, just so I don't have to worry about things not turning out. I jokingly call it my "kraft dinner" meal although it's actually quite a delicious meal of salmon with coriander and caper sauce, mushroom risotto and asparagus).

No, the meals I love to plan don't have to be very complicated, in fact I tend to favour the simple and rustic vs the rich and fussy: homemade bread and soup, tomatoes and basil, fresh from the garden, tossed with extra virgin olive oil, balsamic vinegar and baby mozzarella, grilled chicken rubbed with rosemary & garlic ... plain fare with the best ingredients.

In fact, as a teenager, after letting go of the dream of becoming a journalist (as it didn't turn out to be the idealistic job I had imagined...), I toyed with the idea of becoming a Chef. In hindsight, I am very glad that I did not in fact become a chef now that I know more about the gruelling pace they keep (read Anthony Bourdain's Kitchen Confidential if you're curious). I did work briefly in a restaurant as a teen, which is a story that I tell in its entirety during my CF workshops as it caused my very first case of work-related burnout.

Before having kids, a typical Sunday in my household looked like this: Get up around 8:30am, read entire newspaper (which, when we lived in NYC and subscribed to the Sunday New York Times took about 6 hours! thank goodness we moved - think of the hours I've gained). Then I would make bread and soup and while soup was cooking and bread was rising, I would go for a long run. Then, I would come back from my run, bake the bread, read or nap while bread was baking, then eat soup and bread and feel completely blissed out.

Needless to say, having kids threw a rather major wrench in this idyllic routine, but I'm starting to get a few more hours back to myself on weekends, since children grow and time passes and all good things eventually return (I'm an optimist which is another great CF tool).

Ok, what is my point? My point is several-fold:

-One: food is important to self care. Good quality food, made either by yourself or by someone you trust and care (that could be your mom, your husband/wife/life partner, your local caterer or whoever else, I just happen to like cooking). Good quality food is essential to fueling your body as you work in this incredibly demanding field. I don't know about you, but if I have a really challenging morning clinic, where I'm working with people who are really struggling with difficult painful stories, knowing that midway through my day there is an amazing sandwich made with foccacia bread from our local Italian deli makes a difference to me.

And when I sit down to eat that great sandwich I am doing several things:
1) I actually am taking lunch - how many helpers skip lunch altogether?
2) I am eating something healthy and nutritious
3) I am mindfully eating the sandwich, taking a few minutes to put everything aside and making it a meditative, quiet little buddhist sandwich.

The point being that I think that as helpers, we need to take stock of the ways in which we fuel ourselves and food is the first obvious area to investigate.

The second point is that eating well does not necessarily have to mean that you are letting go of health considerations. You have seen the soaring obesity rates in our society: It comes from eating on the run, skipping breakfast, grabbing a donut for lunch, pizza for dinner, eating without really processing that we are eating. Many helpers who attend my workshops confess that they often eat in the car, while driving, on their way from one client to another. If you would like to make some changes but aren't sure where to start, take a look at Chatelaine magazine and Canadian Living's websites. They both have a large collection of quick and healthy online recipes that can be done in 30 minutes or less. Have a look at the slow food movement (www.slowfood.com) for more information on eating well and staying healthy.

Thirdly, (hey this is my blog I can make as many points as I want, let's see how many I end up with!), thirdly, eating well does not have to mean spending tons of time on food preparation. It does require some planning ahead however. This can be a quick affair: you surf the web sites I mention above, decide on four meals you and your family will have next week and make your grocery list. You can even double up and eat the same supper every other day. This can be done in 10 minutes or less.

Fourthly, eating well saves money!

By the way, if you're curious, my favourite cookbooks are:
-Anything at all by Nigel Lawson (a male British chef - not the gorgeous, voluptuous Nigella of the same name although her cookbooks are pretty good too, and she's not hard on the eyes) - Nigel Lawson's recipes are great and the food photography is out of this world
-Bonnie Stern's Heart Smart cookbooks, I don't know how she did it, but she manages to offer low fat recipes that taste phenomenal
-Delia Smith's Summer Recipes for simple and easy meals when you are entertaining

Two interesting time saving cookbooks are:
1) Cook once a week, eat well every day: make-ahead meals that transform your suppertime circus into relaxing family time by Theresa Albert
2) "Frankly I'd rather be with the kids" from www.moretimemoms.com

The concept of Self care is a funny thing, particularly for people such as us Westerners who live in such an achievement-oriented society. I don't believe that you can take a diploma in self care, post the certificate on your wall and voila, you're done, onward and forward...

You see, in my opinion, we are never "done" with self care, it's not like painting our living room or some other chore on our to-do list, in fact, I would say it's more akin to making sure you eat more vegetables every day. Gobbling down three pounds of broccoli on Monday does not mean you have met your needs for folacin and all the other lovely nutritional requirements for the week does it now? (Alas)

No, self care, in my mind, is something that we continually have to check in with, have conversations with and tweak. Hence, the lovely image I carry with me about self care is a teeny tiny wrench. I tinker with self care as lovingly as the guy who works on his 1983 Fiat Spider (that's a car for those of you who aren't fans) and who never really wants it to be fixed. In fact, that's not really his goal at all. He just loves the process.

The Ideal Schedule
I think of my work schedule that way. Every week on Sundays, I sit at my laptop with a nice big latte and take a look at the upcoming week. My first question is: where can I fit in physical exercise? (I'll write more on this later), and so I take my daytimer and write in exercise time everywhere that I possibly can (the goal is to get out for a run/fitness class at least three times during the work week). The second thing that I do is look at scheduling something fun and restorative. Something to look forward to. This can be a small as "rent such and such movie on Thursday night" or "plan dinner party" or going to book club, scrapbooking club or curling. It has to be something restorative that you self-define as fun. For some of us, working as helpers mean that we need to be "off" duty to unwind and the most appealing fun and restorative activity is to watch a seinfeld rerun in our pjs with the phone off the hook. That's ok.

The second process with my work schedule is to look at the coming few weeks or even the next couple of months and pre-book some down time, plan ahead that if I'm going to be travelling or presenting a workshop on a Thursday, I need to have blocked off the Wednesday to prepare the workshop, get photocopies made, review my material, pre-cook a few meals for the kids, etc. This may seem totally obvious to some of you, but I know some people who are continually surprised and overwhelmed by the weeks they face. I have a friend who often says "I have a week to week planner, so I often say yes to something without looking at the following week and then when I do peek at the coming week, I realise I've booked myself to go out of town three times in 7 days and then I feel unbelievably stressed and overwhelmed."

Collect Ideas from others
A friend just emailed me to say that she has finally figured out how to fit in a run in her schedule every other day. My immediate reply back to her was "good for you! How did you manage to fit that in? What is your best time or what strategy did you use to make that happen?" When I was young, I dreamed of becoming a journalist, (or so I thought until I found out what it's really about). What I really loved was researching and collecting information (hence my first Degree in history). When my first born was about to begin school, you would have found me in the playground, interviewing friends with older children about their best strategies for making lunches, homework, best times for swimming lessons etc. This was not driven by anxiety or apprehension on my part, but rather a total curiosity about what others do to make things run more efficiently (the quest being, let's remember, optimal self care, which is never truly attainable).

Now that I have had the privilege of working with hundreds of helping professionals in my consulting and counselling work, I have a veritable treasure trove of ideas for the ideal schedule. I hope to share these with you as the weeks pass. Feel free to share yours as well either by replying to this blog or emailing me: whp@cogeco.ca

This blog was born today September 25th and is still waking up. Come back in a few days for weekly postings on self care, burnout, compassion fatigue, books, links, workshops and ideas on related topics.