Compassion Fatigue Solutions

Whether or not we have children returning to school, many of us make resolutions in September. They often have to do with our lifestyle: to eat more fruit and vegetables, to sign up for a class, to go to the gym more often, to make menus and plan for the week ahead, etc.

Some of these resolutions become incorporated in our lifestyle, and others quickly fall by the wayside because they were either unrealistic, too ambitious or we got caught up in the busyness of life again and ran out of time. (Or, the therapist in me would suggest, we have not yet done the necessary emotional prep work to make this change possible.)

Suggested Activity:
Before the Fall gets too hectic, I would like to invite you to take a few minutes today to take stock of one of the following areas of your life:

Physical health
Physical exercise
Clutter
Finances

There are many other good categories we could explore, but this will do for today.

Take a blank sheet of paper and a pen (or your laptop) and select the first category that jumps out at you. Write this category down at the top of your sheet. Now, write down whatever thoughts or words come to your mind in reaction to this category. For most of us, these initial jots will likely be negative or "shoulds" e.g.: Physical health - haven't been to doctor in three years, back is sore, worried about mole on back, etc.

Write as many items down as can fill a sheet. Now turn the sheet over and write down all the positives about that category - your strengths or things that you have improved on.

Once you have written as many things as you can, have a think about one micro-movement you could make towards improving that area of your life. Micro-movements are a concept put forth by SARK in her book Make your Creative Dreams Real. It can be as small as you want. Examples would be: "I will book a doctor's appointment by the end of the month", "I will eat one more fruit per day starting tomorrow", "I will clean out one drawer in my messy office on Friday".

Once you have this mini resolution, write it down in your daytimer, agenda or calendar. To make this resolution even more solid, ask a friend of yours to be your accountability buddy or, if you want, you can post your commitment on this blog (it can be anonymous) in the comments section.

I am quite pleased with my own Fall resolution: I decided to delegate lunch making in my home. My children now make their own lunches - I still make the sandwich and they do everything else. I'm not sure how I ended up winning the easiest job but they both seemed really pleased with themselves when I said "ok, I'll do the sandwich and you do the three peanut-free, garbage free snacks which includes having to rummage through the plastic container cupboard in a futile search for the corresponding lid. Ok?" So I have now gained a full thirty minutes each morning (yes, that is how long it was taking me, don't ask, I don't know why, but it was).

Have fun with the resolution and make it realistic and achievable.

I've always liked the French term for the start of the school year. It's called La Rentrée. For me, it evokes shiny red apples, plaid skirts and brand new, rather stiff black patent leather shoes. Of course, I'd always end up wilting in the heat of the school yard during the first weeks of September, but it felt important to start the year with Fall stuff.

Actually, I am not going back to school, but the whole world around me seems to be heading back next week. I am back at work however, and so this is my own little Rentrée. I took a long break this summer, working part-time, doing a lot of reading and spending time with my family. Every summer, my kids and I endeavour to make some new food product from scratch (my own little contribution to "Where Things Come From"). Last year we made butter and ice cream and this summer we tried our hand at yogurt, sprouts and mozzarella. My husband laughed himself silly when he found out that a small ball of mozzarella required 8 litres of milk but the kids enjoyed the process and the degustation. Now I need my own dairy cow I guess...

I am looking forward to this coming year and wanted to begin by telling you about upcoming events.

Upcoming workshops

This Fall, I will be offering the two day Compassion Fatigue Train the Trainer retreat in Kingston November 24-25th. This workshop is designed for individuals who have not yet attended a full day or half day Walking the Walk workshop. If you are interested in the Train the trainer but already have Walking the Walk under your belt, please consider the March 3-4th session which has been designed for those with past Walking the Walk experience (there is also the option to attend Walking the Walk the day prior to this training, on March 2nd, 2010). For more information on these workshops click here.

I am also co-teaching the three day Crisis Intervention Institute from October 26-28th 2009 in Kingston. The emphasis of this course is on developing a thorough understanding of crisis-intervention and crisis management and the development of effective, concrete crisis-intervention skills. It is suitable for professionals in the field of mental health (psychologists, social workers, nurses, counsellors, physicians, crisis workers), and students in these disciplines. Dr Mike Condra and I have been offering this workshop for the past 6 years every Fall.

Invited lectures/workshops

I will be travelling all over the country this Fall, from Yellowknife to Prince Edward Island. In fact, I am nearly fully booked until December. If you are interested in booking an event, please email me and I can either offer you a Winter/Spring date or one of my associates can come to your agency in the Autumn: I am now working with three highly talented compassion fatigue educators who work in the field and have received rave reviews during past workshops.

What's in the works?
I am currently working on the following projects:

The Compassion Fatigue Workbook: I am currently in discussion with a public agency and we are exploring turning this program into a web-based course. As some of you know, the Compassion Fatigue Workbook is now available for sale at our online bookstore.

I am also working on the Stories from the Frontlines book, based on interviews with helping professionals.

This Blog: I will be posting strategies and book recommendations every Monday starting next week. If you want to receive notification of new posts, consider registering as a follower of this blog (you will see a sign up box in the upper left corner of the page called "Subscribe to Blog").

Please do not hesitate to drop me a line via email or through this blog. I wish you a great Rentrée.

(photo courtesy of www.freedigitalphotos.net)

As I wrote in a prior post on preventive medicine, Dr Béliveau has carried out a great deal of reseach on the link between cancer and the foods we eat.

Dr Béliveau is a biochemist who works as a research scientist at two Montreal Universities. He is an expert in cancer prevention and is also a gifted communicator who aims to bring his lab findings to our dinner tables. He has written three books on cancer prevention and nutrition: Foods to Fight Cancer, Cooking with Foods that Fight Cancer and his most recently released Eating Well, Living Well: Everyday Preventive Medicine which will be available in English in the Fall of 2009.

He was interviewed by Yannick Villedieu on Radio Canada in February 2009. I had the opportunity to hear it rebroadcast last Sunday. If you speak French, I recommend you follow the links to hear this highly informative interview.

If you don't speak French and you missed my original post, I invite you to return to read it. You will find the same take-home message in the post.

(free photo from Pediant, wikicommons)

I am going to be posting off and on this summer. I will not be posting every Sunday as I have been doing for the past year and a half but rather going to "summer hours". To receive information about new posts, I invite you to subscribe (see left column of the blog). You will then receive an email notification once I post again.

I am spending most of July working half time. I am able to do this thanks to an "x over y" plan that teachers are familiar with: you save part of your monthly salary each month in order to be able to take time off later. Being self employed offers no benefits, no unemployment insurance and no job security whatsoever, but it does offer the flexibility of being able to work or not work as you decide.

So I am spending the month dealing with home improvement projects that have been lingering for years (that darned basement..., the leaky taps, the paint jobs that have been waiting, many trips to the local charity dropoff and Habitat for Humanity to get rid of all the clutter that we have accumulated, god knows how.)

I am also simply taking time to enjoy the all too brief summer we have in this part of the world. One of the things I most enjoy is to bike down to the shores of lake Ontario and go watch the windsurfers on Richardson beach. This is nearly olympic-level surfing - a very wild patch of the lake, and I love watching them fly in the air and flip themselves around. I like to pretend to myself that I too, have the upper body strength and the skill to be there with them (I don't doubt my abilities to do other things, such as run a half marathon, but I seriously doubt my capacity to windsurf on this crazy lake! But it's fun to dream...)

I hope you have some time to breathe this month, and are able to carve out a bit of time for you.

peonies from my garden. A brief burst of colour to start the summer.

Walking the Walk: Creative Tools for Transforming Compassion Fatigue
March 2nd, 2010 Donald Gordon Centre, Kingston, On., 8:30am-4:00pm

Instructor: Françoise Mathieu, M.Ed. CCC. Compassion Fatigue Specialist

Workshop Description: Compassion fatigue is a normal consequence of working in the helping field. The best strategy to address 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 Compassion Fatigue. This is a highly interactive one day workshop, incorporating a combination of solo, small group and whole group activities.

Topics covered will include: Understanding compassion fatigue and vicarious trauma. Symptom checklist, targeting areas for strategic planning; Evaluating self-care, identifying triggers; Developing a personalised strategic plan for identifying and treating compassion fatigue.

*This workshop is also a prerequisite for the two day CF Train the Trainer workshop which will be offered immediately following the March 2nd training.

Who should attend? Helping professionals in the fields of mental health, health care, education, emergency services, corrections and law enforcement, volunteers and caregivers.

Cost: $165.00 (incl gst) includes lunch, breaks and handouts.


Compassion Fatigue Train the Trainer Retreat
March 3 & 4th 2010. Donald Gordon Centre, Kingston

Instructor: Françoise Mathieu, M.Ed. CCC. Compassion Fatigue Specialist

Workshop Description: This workshop offers tools, handouts, training material, strategies and marketing tips to adapt the one day Compassion Fatigue Workshop Walking the Walk to your community's specific needs (and to your own presentation style).

**Prerequisite: This workshop is aimed at helping professionals and educators in the helping fields. Prior attendance to full day or half day Walking the Walk is highly recommended. Walking the Walk will be offered on March 2, 2010. Please email whp at cogeco.ca for more information.

Cost: $598.00 (incl gst) which includes lunch, breaks, training manuals, power point presentation and handout templates. **Space is limited to 20 participants for this retreat.

More information and registration forms will be posted on the website next week

I came across this speech on the blogosphere. It was written by the Jeremy Adam Smith, senior editor of the Magazine Great Good, an online publication whose mission is described as follows on their site: "Greater Good highlights ground breaking scientific research into the roots of compassion and altruism. It fuses this science with inspiring stories of compassion in action, providing a bridge between social scientists and parents, educators, community leaders, and policy makers."

This speech was given as a talk to nurses of UC Berkeley Health Services on surviving compassion fatigue.

Low impact disclosure: Just a warning before you read it: the first portion of the speech describes a brief but violent attack (the author was mugged which is the beginning of the story) and some of you may not want to read it for that reason.

(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.