Compassion Fatigue Solutions

(Photo: Late June in Umea, Sweden)

I have just finished a busy past two weeks. I offered a full day training in Toronto, a shorter presentation at a PTSD conference and at a conference for community social services and finally the two day Compassion Fatigue Train the Trainer. I also had the opportunity to hear Babette Rothschild present grounding techniques from her very useful book "Help for the Helper". I have also been processing orders for the new Compassion Fatigue Workbook which I am very happy to now have available for helpers who are looking for more resources to work through CF strategies on their own or as a team.

Now, thankfully, there is a bit of time to process and digest it all, (and weed the garden a bit.)

I had a widely varied group of participants at the train the trainer workshop: veterinarians, managers from homeless and women's shelters, hospital social workers, addictions counsellors, to name a few. In our discussions, we discovered that the challenges we face are far more similar than they are different - whether you are working with pet owners or with humanoid patients, there is a strong human factor in the work: people are grieving, people are angry (often at us, for a flawed system, for a lack of resources, maybe for errors we make or errors they perceive we made). Dealing with loss, grief and anger takes its toll on us, and so does having to turn people away when we simply do not have the resources to help them.

Having a two day retreat with a small group of helping professionals is a rare opportunity to talk and reflect (in a very lovely environment - the centre where I hold these workshops is beautiful) and that alone is worth its weight in gold, in giving us all the opportunity to replenish ourselves.

I think that we need to look at small ways to create retreats for ourselves even if we do not have the time or money to go to a train the trainer workshop or an actual retreat. Here are some suggested steps:

A Retreat plan for yourself

1) Get your daytimer and book a day off (two is even better). Make sure that the entire day is free. If you have more financial resources, consider booking yourself into a local B&B and make this retreat an overnight event. You can also buddy up and plan the retreat with a colleague or two, but make sure they are committed to making this a replenishing experience and not talk shop.

2) Plan your day, making sure that you will include three key components: Stress Reduction, Relaxation and Resilience. What does this mean?

(The following text is excerpted from The Compassion Fatigue Workbook. If you would like to receive an excerpt of the book, please send me an email: whp at cogeco.ca or visit my website and click on Resources and Links.)

Eric Gentry, compassion fatigue scholar and co-developer of the Accelerated Recovery Program (ARP) for helpers with compassion fatigue, wrote a powerful article in 2002 called The Crucible of Transformation. I highly recommend that you read it. To obtain a pdf of the article, simply Google: Gentry crucible of transformation and then download the article from his website: www.compassionunlimited.com. (Make sure you do not download the one from the website Gift from Within as it is incomplete. For some reason, visiting his website directly does not work but googling does.)

In this article, Gentry offers two important principles that are critical to remaining healthy in the face of the challenges of our work:

“These two important principles, which have become the underlying goals for our work in the area of compassion fatigue, are: (1) the development and maintenance of intentionality, through a non-anxious presence, in both personal and professional spheres of life, and (2) the development and maintenance of self-validation, especially self-validated caregiving. We have found, in our own practices and with the caregivers that we have treated, that when these principles are followed not only do negative symptoms diminish, but also quality of life is significantly enhanced and refreshed as new perspectives and horizons begin to open.” (Gentry, 2002)

Let us highlight the two key concepts from that paragraph:

“(1) the development and maintenance of intentionality, through a non-anxious presence, in both personal and professional spheres of life, and

(2) the development and maintenance of self-validation, especially self-validated
caregiving.”

What does this mean exactly?

A non-anxious presence refers to the ability of being in the room with the client’s pain and suffering and being able to express empathy and compassion without taking on the other person’s suffering. In both the personal and the professional realm, it is about mindfulness, the ability to notice and control your physical symptoms of stress and anxiety, and your breathing. It is a concept that is explored in depth by Babette Rothschild, author of Help for the Helper: the psychophysiology of compassion fatigue and vicarious trauma (2006).

“Self-validated caregiving” refers to self-care that is guilt-free, self-care that is prioritised as a means of remaining healthy in this line of work.

So, reflect on this for yourself:

What stress relief strategies do you enjoy? Examples of stress relief are taking a bath, sleeping well or going for a massage.

What stress reduction strategies work for you? Stress reduction means cutting back on things in our lives that are stressful (switching to part time work, changing jobs, rejigging your caseload, etc.)

What stress resiliency strategies can you use? Resiliency strategies are relaxation methods that we develop and practice regularly, such as meditation, yoga or breathing exercises.

Ok, now let's return to our Retreat plan:

Step one (a discussed above): Carve out some protected time for yourself, either on your own or with a good friend/colleague.

Step two: Make sure that your day has the five following elements:

1- Plenty of unstructured time to rest, nap, read (something unrelated to work), sit, swing in a hammock, lie on your bed...

2- A physical component: sign up for a fitness class, go swimming, stretch, run, go for a long walk around your neighbourhood or if you need a change of scenery, take public transit or drive to a completely different part of your community. If you can afford it, book a massage for your retreat day.

3- A relaxation component: Consider downloading a relaxation tape from itunes, or purchase a relaxation cd from your local bookstore (I recommend Mark Berber's Creating Inner Calm, which is available at Chapters/Indigo) and trying out one or two relaxation or deep breathing activities.

4 -A stress resiliency activity: Consider taking a yoga class or trying out a brief meditation tape from itunes.

5-During this day, eat healthy, simple food, try to avoid caffeine and any other stimulants. If not drinking caffeine is a problem for you in terms of withdrawal, try and have just one cup in the morning and reduce the rest of your day's caffeine intake.

What may happen during this day: You may feel wonderful at the end of your mini retreat, or you may find that it was a very dificult day for you. This is important information. First of all, slowing down and letting go of our daily concerns takes time and practice. Secondly, working in this field, and having to live with compassion fatigue and vicarious trauma within us, sometimes stopping and slowing down means that we are letting our guard down. This guardedness is actually something we use as a protection mechanism during our daily working lives. So you may find that your day off is filled with images, thoughts about work or about certain clients etc..

If you find that this is very strong, and difficult to deal wtih, I strongly recommend that you consider seeking the support of a trained counsellor or psychotherapist who understands compassion fatigue.

You may also find that you need to practice being in a retreat mode and that it takes a few times to get it right. I recall the first time I ever tried mindfulness meditation was at an all day mindfulness retreat (no half measures for this gal...) and it was a very uncomfortable day for me. I felt twitchy, bored, restless and eager for the day to end. As we were walking out of the retreat day, my colleague who had come with me looked totally relaxed and blissed out. I said "so, how was it for you?" She replied "oh, wonderful, refreshing, so relaxing. I feel fabulous." I was lucky enough to experience the replenishing qualities of mindfulness meditation a few years later, but I learned that meditation takes practice and a lot of kindness towards ourselves: we can't necessarily speed our way through it.

Your retreat will be whatever it is - easy, hard, challenging, replenishing - set the bar low. The main step is to actually carve out time away from work and other family and life commitments. From there on, it's all gravy.

Let me know how it goes.