Compassion Fatigue Solutions

January to April are very busy months for people who, like me, are in the business of offering professional development to agencies and government-funded services.

The key operative words are "unallocated funds" which basically means that if you are an agency who gets to March 31st and you haven't spent your whole professional development budget, you won't get as much funding the following year and you lose the leftover money you had, no carryover allowed. So, all of a sudden, around January/February, agencies are scrambling to find high quality workshops to bring to their staff asap.

So this, combined with the fact that caring managers are very concerned about burnout and compassion fatigue means that I am often very busy on the workshop circuit in the winter and early spring and therefore have to be even more aware of self care and life work balance during these hectic times. Of course, talk to me from June to September, and that's a whole other story. So my "ideal schedule" in the winter months is not the same as what works the other 6 months of the year. Shift workers and aid workers who get deployed for months at a time will likely relate to this reality.

The quest for the ideal schedule is an ongoing one, something that we constantly need to tweak and experiment with. When my kids were very young, and just about to start school, I remember grilling my friend whose children were older: "and what do you make them for lunch? how do you deal with homework? what is the best way to structure the time after school?" this was part curiosity and partly my seeking to nagivate this new regime in a way that was successful and allowed me, a full time crisis counsellor at the time, a way to stay sane and healthy.

Through the EAP(employee assistance)work that I do, I have the opportunity to meet workers from all walks of life: from truck drivers to insurance adjustors, nurses to senior ranking officers in the military, donut shop workers and police officers. I am absolutely fascinated to hear how they juggle and what works best for them. Am I alone in being obsessed with this????

Why Nuts and Bolts? Well, first of all, N&B is my favourite insanely oversalted snack, but the real reason is that I feel I have several unrelated matters to mention today (or are they unrelated? they likely are very connected in some part of my brain...)


Bolt #1
During my morning run, I listen to CBC radio (normally in French and sometimes in English) and I often end up racing home to jot down ideas/interesting guests/book titles that I have heard on the morning shows before I forget about them, which will, sadly, happen rather quickly. This week, I heard a fascinating interview with philosopher Ramin Jahanbegloo.

From the CBC The Current Show, January 17th 2008:
"On April 27, 2006, Ramin Jahanbegloo was getting ready to board a plane from Tehran to Brussels when Iranian authorities pulled him aside. The Iranian-born Canadian citizen and political philosopher was blindfolded and sent to the notorious Evin prison -- the same prison where Canadian photographer Zahra Kazemi was tortured and killed. He was locked in solitary confinement and subjected to interrogations for the next 125 days. He didn't understand why he was being held. He had no idea if or when he would be released. And as a philosopher, he faced the daunting task of trying to come up with a constructive way of thinking about his situation just to maintain his sanity. Ramin Jahanbegloo is now back in Canada and teaching at the University of Toronto where he's a research fellow at the Centre for Ethics and a Massey College Scholar-at-Risk. He is the author of more than 20 books including Conversations with Isaiah Berlin and Iran: Between Tradition and Modernity.

From http://www.eurozine.com/authors/jahanbegloo.html:
"Ramin Jahanbegloo was born in Tehran, Iran, and received his PhD in philosophy from the Sorbonne. He is the author of 20 books, including Conversations with Isaiah Berlin (1991), Gandhi: aux sources de la non-violence (1998), and Iran: Between Tradition and Modernity (ed.) (2004). Also a citizen of Canada, Jahanbegloo taught in Toronto, Delhi, and Tehran; he has been responsible for bringing scores of prominent Western intellectuals to Iran, including Jürgen Habermas, Richard Rorty, Noam Chomsky, Toni Negri, and Edward Said."

What so moved me about this interview (and the podcast of the show would render it far more justice than I can) was Dr Jahanbegloo's description of how he decided to deal with his 125 days of captivity, isolation and daily interrogations by recalling his past readings of nonviolence literature (Ghandi, the Dalai Lama, Martin Luther King):

“I was in a very small cell for a very long period of time […] It was very difficult to tell the time […] It was quite tough. That’s why the first thing that I thought was that I had to fight for my mental sanity, more than my physical sanity. To take somehow my mind out of the cells. […] I wrote some aphorisms on life, death, violence, everything which came to my mind. […] There was a lot of reflection [… ] on the fact that human beings seem to need to humiliate each other to show their greatness. So there was a lot of reflection on that […] there are two reactions when you face the evil: you can become very bitter about it […] and the second is where you want to resist it. So I had this bitterness but at the same time I was thinking of an ethical resistance towards the inhuman and the evil I was living. So I got back to the idea of non violence, truth and the idea of whether there should be compassion and I went back to all my readings of the dalai lama, ghandi, martin luther king and all the nonviolent thinkers I had worked on. […] These are lessons which I learned from reading on Ghandi, meeting Dalai lama, and he always talks about compassion. […] I was trying to find my own nature and I was trying to redefine my own nature vs feeling only anger, fear and bitterness. I tried to spend most of the moments of my day not having bitterness and feelings of revenge.”

Bolt #2
I guess that interview does, in some way, connect with the other topic I have been reflecting on, which has to do with war, combat stress and the military as I am preparing a one day compassion fatigue/vicarious trauma workshop for a military base hospital.

A very large portion of my private practice involves working with military personnel and/or their spouses. Many of these clients have been to "hot zones" in the world in the recent past for 6, 9 and sometimes 18 months. Some of them have been on 5 or more tours of duty in the past 15 years. We often discuss the challenge of reintegrating into daily life, relationship challenges, parenting vs giving out orders. We also, of course, discuss the things they have seen in the hot zones.

For the non military partner, we discuss having to accept the return of your spouse when you have been running the house alone for 6 months, the nightmares and odd reactions he/she may have at times and many other challenges.

In addition, I am also one of the employee assistance counsellors that military helpers can turn to for support, debriefing and counselling. So I also get to meet with the nurses, social workers, doctors, chaplains, clerks etc. who assist these clients in reintegrating their Canadian lives.

If you enter the Canadian Forces' operational stress injury peer support organisation (OSISS) website: www.osiss.ca, you will see a stunning photograph of a soldier crouching down, holding his head in his hands. His wire-rimmed glasses are on the ground by his side. The photograph, on its own, is incredibly powerful and evocative. Then you read, when you search the net a bit, that this photograph was taken in Rwanda in 1994 by a lieutenant colonel who himself developed PTSD and turned his struggles into greater good and created the peer assistance program. If you wish, go have a look at the photograph and see what it evokes for you.

When I look at the photograph, wearing my helper hat, I feel deeply moved and concerned for this individual. As a compassion fatigue specialist, I also think "who will he tell his story to? and what will they do to cope with the story he must tell?"

That, in a nutshell, is the challenge of the work that we do as helpers.
I should also add that working with military personnel has been and continues to be some of the most rewarding clinical work I have ever done. The helper's conundrum is there, in a nutshell: the challenge is to take truly excellent care of ourselves in order to be able to continue providing the help that is needed with compassion and an open heart.

Bolt #3
If you are a little bit web-savvy, and would like to see Dr Figley present a one hour talk on CF (in Toronto in 2006) follow this link: www.glucksteinlaw.com
I particularly like the part where he discusses the survivor/victim concept. See what you think. We don't have nearly enough video material on Compassion Fatigue that is easily accessible and free. (although i haven't been on you-tube, maybe it's full of great stuff, I just don't really dare!)

Ok, that's my last salty shreddie/cheerio/pretzel for this week.

Bonne semaine à tous et toutes.

Happy New Year to you all and greetings to new readers!

There is a lot coming up in 2008 and here's a sampling, in no particular order:

-For those of you who live near Kingston, there are still spots available to attend Dr Greenberg's January 25th workshop "Letting Go of Anger and Hurt". Visit website: www.compassionfatigue.ca to learn more.

-In the coming months, I will be interviewing wellness professionals of various types on this blog. We will be speaking with a health and nutrition specialist, a life coach and several other experts in their field. Stay tuned for these monthly posts.

-I will be reviewing new books in the field and interviewing their authors for the blog as well. Please email me if you have a favourite author/book you would like to see featured. I will try my best to get in touch with them and getting an interview.

Here's my post this week:

What is the picture above about? Well, it's my 7 year old completing the 1000 piece puzzle that he and I did (with some help from visitors) during our 2 week xmas holiday. Why is this worthy of mention? It's worthy of mention because it was a deliberate, mindful process to do a puzzle. Let me explain.

Like many of you, I'm sure, I tend to be a fairly driven, A-type person in many areas of my life. Now, I feel that I have made great progress in setting limits, improving self care, exercising regularly etc. but one thing that is a constant challenge is to sit down and not be doing chores all the time. When I'm at home this involves laundry, lunches, cleaning out the fridge, battling the basement mess, the list is endless. At the cottage, I could be chasing mice, sorting through the battered, broken handled pots and pans someone "donated" (ie dumped) to us while we were away. (This happens quite a bit. Friends and family who borrow the cottage enjoy giving us their used treasures -could be useful at the cottage! - actually this is a little message to any of them: please do not donate any more aluminum pots and pans, fondue pots in the shape of a bunch of bananas (we have one of those already), fiesta ware pottery, lead is bad for us just like anyone else and bright orange bedsheets from the 70s. We do NOT need any more of any of these things!)

But I digress...Let me return to the puzzle.

When I pulled out the puzzle at the cottage, my dad, who was visiting us for a few days, said "Wow, 1000 pieces. You are patient! Are you going to have time to finish it in two weeks?" and I replied "Don't know. Don't care really, I just enjoy the process of finding a piece that fits. It's so rewarding." Quizzical look on his face. He walks away, only to ask me, every single morning when he got up "So! Finished the puzzle already?" Laughter. It was cute on day 1 and 2, a bit annoying on days 3 and 4...

Anyhow, I did exactly what I told him, I got up each day, made some coffee and sat down to look for a piece that fit. I did this every day for two weeks. I didn't read edifying psychology books, I didn't read cookbooks, women's magazines, trashy magazines or anything else. I listened to Jack Johnson and Ben Harper on my cd player and worked on my puzzle.

A few days before the end of the holidays, several guests started getting worried that the puzzle wouldn't be finished in time. I really didn't care. But, people being people, it got finished by a team, including my seven year old who had the privilege of popping in the final piece (hence the photo).

So there you go. A rather lengthy explanation of a very mindful process. Not all of you will agree that doing a puzzle is a mindful thing, but I would like to suggest that there are many ways to fit in a mindful ritual/process in your daily life.

One of my favourite self-help books is by Patrick Fanning, entitled "50 best ways to simplify your life: Proven techniques for achieving lasting balance." It contains 50 very creative (and a few rather bold) strategies. The book is simply written - 2 pages per solution and easy to read. The one I enjoyed reading about this week was the following: It suggested picking a daily activity that you already do (his example was brewing coffee in the morning) and using that time to practice a mindful activity. How long does coffee take to brew? 4, 5 minutes? Fanning suggested taking that time to sit on a cushion and meditate.

Patti, a relative of mine, said that she had a similar thought after reading the wonderful book Eat Pray Love by Elizabeth Gilbert. She decided that her mindfulness ritual would be the following: whenever she was stuck in a traffic jam, she would tell herself "Ahead of the traffic jam is a miscommunication. When the miscommunication is resolved, we will start moving again. Until then, I need to breathe and focus on something within me."

What do you think? Do you have a mindfulness ritual of some kind? Could you practice a three minute meditation while lining up for groceries?

I hope you have a lovely week.