Download - compassion fatigue
What you don’t know CAN hurt you!
Compassion Fatigue
Definitions
What do you think it means?
I dunno. What do YOU think it means? Beats me!!
Vocabulary
• Compassion Satisfaction–Positive aspects of working as a helper
Compassion Satisfaction
• The positive aspects of helpingProviding careThe systemWork with colleaguesBeliefs about selfAltruism
Vocabulary
• Compassion Fatigue–Negative aspects of working as a
helper
Compassion FatigueAka as secondary traumatic stress disorder evidenced by:• hopelessness• a decrease in experiences of
pleasure, constant stress and anxiety • and a pervasive negative attitude
Compassion FatigueCF describes the emotional, physical, social and spiritual exhaustion that overtakes a person and causes a pervasive decline in his/her desire, ability and energy to feel and care for others.
CF results from the combined effects of primary trauma, secondary trauma, and burnout to produce painful symptoms in caregivers.
CF is the gradual loss of empathy for others over time due to emotional and physical overload.
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CF refers to the emotional and physical exhaustion that helpers (nurses, doctors, social workers, police officers, chaplains, caregivers, the list goes on and on) experience over time when working in these challenging and rewarding fields.
CF is a state experienced by those helping people in distress; it is an extreme state of tension and preoccupation with the suffering of those being helped to the degree that it is traumatizing for the helper.
Vocabulary• Burnout–Inefficacy and feeling overwhelmed
Burnout• Occupational burnout, characterized by
exhaustion, cynicism, and reduced professional efficacy within the workplace
• Frustration and exhaustion stemming from a highly stressful workload and/or a non-supportive work environment
• Stress that is cumulative, relatively predictable, and frequently can be helped through a respite or habit/life change.
Burnout and STS- Co Travelers
• Burnout–Work-related hopelessness and
feelings of inefficacy• Secondary Trauma Stress (STS)–Work-related secondary exposure to
extremely or traumatically stressful events
Vocabulary• Work-related traumatic stress–Secondary traumatic exposure to event
due to a relationship with the primary person (Vicarious trauma)
Secondary Trauma Stress
Secondary trauma stress is work-related, indirect exposure to extremely stressful events such as working with child abuse victims, treating war-related causalities and responding to disasters.
It often begins soon after exposure to another person’s specific traumatic event but it can also be cumulative with repeated exposure to others’ traumatic situation.
Karen Dickason, LCSW, CFAP
People Bring Themselves• Victim assistance workers include people
with all types of education, training and income• Some workers bring with them histories
of difficult lives that may include trauma• Some people have difficult family,
economic, or other personal situations
People Bring ThemselvesPeople bring a past and a present to anything they do– Their schemas and beliefs– Their social support systems• Positive support• Negative reactions
– Their history of trauma and illness– Their families and close others– Their economic situation
Stages and Symptoms
Compassion FatigueTrajectory
• The Zealot Phase• The Irritability Phase• The Withdrawal Phase• The Zombie Phase
Zealot Phase• Committed, involved, available• Solving problems/making a
difference• Willingly go the “extra mile”• High enthusiasm• Volunteers without being asked
The Irritability Phase• Begin to cut corners• Begin to avoid clients/patients• Begin to mock co-workers and
clients• Begin to denigrate the people we
serve
• Use of humor is inappropriate• Oversights, mistakes and lapses of
concentration• Start distancing ourselves from
friends and coworkers
The Withdrawal Phase
• Enthusiasm turns sour• Clients become irritants,
instead of persons• We make complaints about
our work life and our personal life
• Tired all the time, don’t want to talk about what we do• We start to neglect our family,
clients, coworkers and ourselves• We try to avoid our pain and sadness
The Zombie Phase
• Our hopelessness turns to rage• We begin to hate people…
any/all people• Others appear incompetent
or ignorant to us
• We develop a real distain for our clients• We have…no patience…no
sense of humor…no time for fun
Where are you?
•What phase do you think you are in right now?
Not me. I’m a trained
professional..Nope, not me
Me, either. I’m too mentally tough.
There must be something wrong with me. I think
I’m developing it.
WHO IS AT RISK?
EVERYONE
Symptoms• Can’t rid oneself of thoughts and images
of a client’s situation and pain• Compulsive desire to work with certain
clients• Client time leaches over into private time• You see the clients as fragile individuals
who “need” you
Symptoms• Avoidance behaviour especially of
certain clients or types of clients• Sleep disturbances which may
contribute to forgetting and loss of concentration• Feelings of inadequacy (you can
never do enough, be good enough)
Signs of CF
• Emotional Signs• Social• Physical• Intellectual• Spiritual• Professional
EMOTIONAL
• Feel depressed – may want to quit job
• Sudden outbursts of anger• Feel sad, tears just below the
surface• Feel cynical, numb, or hardened• Nightmares or flashbacks• High volatility of feelings
SOCIAL
Loss of interest in previously enjoyed activitiesAvoidance of certain patients / clientsHyper vigilant response to certain casesDiminished sense of purpose / enjoyment
• Difficulty separating work life from personal life• Diminished functioning in non-
professional circumstances• Increases in in-effective or self
destructive self soothing behaviours
PhysicalIntrusive thoughts / imagesHeadachesGI symptomsInsomnia / nightmares / sleep disruptionsDecreased immune responseLethargyBecoming more accident prone
Spiritual
• Questioning the meaning of life
• Questioning prior religious beliefs
• Increased scepticism • Loss of hope
PROFESSIONAL
• Difficulty separating work life from personal life
• Withdrawal from colleagues• Feelings of therapeutic
impotence• Diminished functioning in non-
professional circumstances
Solutions
PersonalOrganizational
Professional
Three Areas to Consider
ORGANIZATIONAL
Indications of Organizational Compassion Fatigue
• Increased absenteeism• Constant changes in co-worker
relationships• Staff sniping at one another• Negativity toward management and
clients
• Inability of staff to complete assignments and tasks; or to respect/meet deadlines• Lack of flexibility among staff• Inability for staff to believe change is
possible – “why bother?”
Organizational Strategies• Have established roles, clear policies
and protocols, supervision sessions, reasonable expectations
• Recognize the “banking analogy” – no withdrawal without a deposit
• Quality more important than quantity, or how fast you complete treatment
• Encourage team work rather than competition• Discourage over-time, excessive
client load
• Educate staff about what they might expect to experience• Hold in-service activities• Have managers be aware of changes
in behaviour of staff
PROFESSIONAL
Professional Strategies• Supervision – ask for it and use it• Be clear and aware of potential
Boundary violations• Self-awareness
Professional Strategies• Processing of events and emotions• Realize that not all cases are
treatable and you are not inadequate because you did not seem to be able to help.
PERSONAL
Personal Strategies• Be aware – know the symptoms of CF• Health Promotion- Take care of yourself first. You can’t feed the hungry from an empty soup kettle•Learn to “Roll with the punches” – not everything is equally important•Talk to yourself in a positive way
Personal StrategiesComplete this sentence five times, in five different ways: “I sometimes find it difficult to balance______ with ______.” (Hint, think about demands, responsibilities, and desires acrossdifferent people, roles, and situations in your life).
More Healthy Strategies
• Take some time to decompress after difficult sessions• Don’t think about work away from
work• Personal journals• Good nutrition
More Healthy Strategies• Breathing (deep)• Take vacations – don’t be a
martyr• Engage in exercise,
recreation and hobbies• Develop a strong support
system
REMEMBER
• You can only do what you can do• You are not God• There will always be more need than
resources• Their pain is not your pain
QUESTIONS????