Rev. Mia Baumgartner MDiv, MNPL, BCC
UWMC Spiritual Care Manager
Rev. Michelle Todd MDiv, BCC
SCCA Spiritual Health Clinician
Resilience and Self Compassion
Self-Compassion &
Resilience
Joy Purpose
Self- Compassion
Grief
STS & Moral Distress
Care Plan
Compassion Satisfaction
& Social Cohesion
What brings you joy and meaning at work?
• Resiliency Practice: Reconnect with purpose, mission
Resilience
“the capacity to prepare for, recover from and adapt in the face of stress, challenge or adversity” -HeartMath Institute
“giving ourselves the same kindness and care we’d give to a good friend” –Kristin Neff
Self Compassion & Resilience • Sustains self-care practices • Soothes the inner critic/negative bias • Decrease burnout and exhaustion • Decrease anxiousness and depression • Increase expression of compassion to others • Increase in the ability to forgive •Mediates symptom severity of PTSD* *Hirakoa et al, Self-Compassion as a Prospective Predictor of PTSD Symptom Severity Among Trauma-Exposed U.S. Iraq and Afghanistan War Veterans, J Trauma Stress. 2015 April; 28(2): 127–133 All other references are from published articles of Kristin Neff, PhD, self-compassion.org
yyytyyyty
Self Compassion Assessment take a look
Mindfulness Over-identification
Common Humanity Isolation
Self-Kindness Self Judgment
Kristin Neff, PhD, Self Compassion Scale www.self-compassion.org
Mindfulness
When something painful happens I try to take a balanced view of the situation. (3)
Over-identification When I’m feeling down I tend to obsess and fixate on everything that’s wrong.(9)
Common Humanity I try to see my failings as part of the human condition (5)
Isolation
When I fail at something that’s important to me, I tend to feel alone in my failure (8)
Self Kindness I try to be understanding and patient towards those aspects of my personality I don’t like. (2)
Self Judgment
I’m disapproving and judgmental about my own flaws and inadequacies. (11)
Influencing Our Inner Dialogue Exercise: Befriending our Self-Critical Talk
Befriending our Self-Critical Talk
• Recognize • Acknowledge • Investigate • Nourish yourself
• RAIN framework is from Tara Brach’s work. Speaking to one’s self-critical voice is from
Kristen Neff/Chris Germer. See more practices on her website www.self-compassion.org
• If I start to develop compassion for myself I will become dependent on it
• I will lose my self-criticism and my flaws will show • I will become someone I don’t want to be • I will become a weak person • Bad things will happen • My standards will drop if I become less self-critical. • If I start, I will feel overcome with loss/grief • When I try, I just feel kind of empty • I would not know where to begin. • Getting on in life is about being tough and not compassionate
• P. Gilbert, K. McEwan, M. Matos, A. Rivis. Psychology and Psychotherapy: Theory, Research and Practice (2011), 84, 239–255
Fear of self-compassion scale
“We burn out not because we don’t care
but because we don’t grieve.”
Rachel Naomi Remen, MD Kitchen Table Wisdom
Befriending our Grief • MORAL DISTRESS
Self Care
Diagnosis:
• Grief
• Secondary Traumatic Stress
• Empathic Fatigue
• Moral Distress
• Workplace Burnout
Symptoms: Practices:
• Grief
• Ongoing
• In the Moment
• Role Transition
Next Appt: (Ex: Check in monthly on the 30th?)
What are your Trauma/Grief Indicators?
Resiliency Skill: Awareness
Secondary Trauma Indicators • Feeling Helpless and Hopeless • A Sense that one Can Never Do Enough • Hypervigilance • Inability to Embrace Complexity •Minimizing • Chronic Exhaustion/Physical Ailments • Inability to Listen/Deliberate Avoidance
Trauma Stewardship: An Everyday Guide to Caring for Self While Caring for Others, Laura van Dernoot Lipsky with Connie Burk, Chapter 4 (2009)
Secondary Trauma Indicators • Dissociative Moments • Sense of Persecution • Guilt • Fear • Anger and Cynicism • Inability to Empathize/Numbing • Addictions • Grandiosity : An Inflated Sense of
Importance Related to One’s Work
Trauma Stewardship: An Everyday Guide to Caring for Self While Caring for Others, Laura van Dernoot Lipsky with Connie Burk, Chapter 4 (2009)
Self Care
Diagnosis:
• Grief
• Secondary Traumatic Stress
• Empathic Fatigue
• Moral Distress
• Workplace Burnout
Symptoms: Practices:
• Grief
• Ongoing
• In the Moment
• Role Transition
Next Appt: (Ex: Check in monthly on the 30th?)
Research Lack of Self Compassion (SC) • strongest personal resilience domain predictor of
burnout in Stanford Medicine Physicians. 2016 Physician Wellness Survey Final Report, Stanford Medicine, WellMD Center
Self Compassion Predicted Lower PTSD Severity • Self-Compassion as a Prospective Predictor of PTSD Symptom
Severity Among Trauma-Exposed U.S. Iraq and Afghanistan War Veterans Hirakoa et al, J Trauma Stress. 2015 April; 28(2): 127–133
SC 12 week course Decreased PTSD Symptoms in Vets: • Loving-Kindness Meditation for Posttraumatic Stress Disorder: A
Pilot Study, Kearney et al (2013), Journal of Traumatic Stress 26: 426-434. DOI:10.1002/jts.21832 (VA-Seattle)
cddicctoorr ooff ddicctoorr oofofff
Helplessness and Self-Compassion “Why Are We Doing This?: Clinician Helplessness in the Face of Suffering,” Back et al, Journal of Palliative Medicine, Vol 18:1, 2015 • The feeling of helplessness reframed as an indicator of our internal
state and our connection to the patient.
• Reflects on two common responses when clinicians are faced with helplessness: hyper (over-identifying) and hypo (detaching) engagement.
• RENEW Model: Prompts self-nurture and return to constructive patient engagement after becoming aware of how we embody helplessness in ourselves.
From Empathic Distress to Compassion Satisfaction
Kelly McGonigal, CCARE, Cultivation Compassion Training-CCT
1.) Awareness of suffering
2.) Feeling of concern for the one who is suffering
3.) Desire to relieve that suffering
4.) Belief that you can make a difference
5.) Willingness to respond or take action
6.) Sense of satisfaction warm glow
Empathic Distress
(pain response)
Compassion Satisfaction (reward/caregiver response)
PROTECTIVE FACTOR FOR : Secondary Traumatic Stress Burnout Compassion Fatigue POSITIVE PREDICTOR of Compassion Satisfaction Journal of Professional Nursing Jan-Feb;30(1):89-99. doi: 10.1016/j.profnurs.2013.04.004
Social Cohesion
Self-Compassion Resilience
Joy Purpose
Self- Compassion
Grief
STS Moral Distress
Care Plan
Compassion Satisfaction
Social Cohesion
J.Bryan Sexton, PhD - Duke University
Take aways….
“A moment of self-compassion
can change your entire day.
A string
of such moments can change the course
of your life.”
Chris Germer
Helpful Apps & Gadgets
Insight Timer: Meditation timer bell. Wide Variety of crowd sourced guided meditations. Android/iPhone and online access insighttimer.com/ Free
Lotus Bud Mindfulness Bell: Sends gentle bell reminders randomly throughout the day. Take the opportunity to breath, reset or activate any practice.
10% Happier-Meditation for Fidgety Skeptics (Podcast, App and website) Dan Harris and Joseph Goldstein 10percenthappier.com
Books and related Websites Trauma Stewardship: An Everyday Guide to Caring for Self While Caring for Others Laura Van Dernoot Lipsky with Connie Burk (2009) www.traumastewardship.com
Self-Compassion: The Proven Power of Being Kind to Yourself Kristen Neff (2011) www.self-compassion.org
Book and Online Grief Ritual
Gratefulness.org/light a candle Create a mindful grief ritual right from your desk. Light a candle. Candle will burn down in 48 hours. Can be “shared” so others can visit it and share in the Vigil. www.gratefulness.org/light-a-candle/
Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain and Illness. Jon Kabat-Zinn, PhD. (1990, 2013) He Created Mindfulness-Based Stress Reduction (MBSR) Trainings. 6-12 weeks.
Research Loving-kindness Meditation (LKM) • Reduced the severity of PTSD symptoms
• Loving-Kindness Meditation for Posttraumatic Stress Disorder: A Pilot Study, Kearney et al (2013), Journal of Traumatic Stress 26: 426-434. DOI:10.1002/jts.21832
• Improved well-being, sense of connection to others, self and other-focused affect • Loving-kindness meditation: a tool to improve healthcare provider compassion,
resilience and patient care, Seppala et al. (2014) Journal of Compassionate Health Care 1:5 DOI:10.1186/s40639-014-0005-9
Social Cohesion • Protective factor for STS, Burnout, Compassion
Fatigue, Compassion Satisfaction • Group Cohesion and Organizational Commitment: Protective Factors for Nurse
Residents' Job Satisfaction, Compassion Fatigue, Compassion Satisfaction, and Burnout, Li et al (2014), Journal of Professional Nursing Jan-Feb;30(1):89-99. doi: 10.1016/j.profnurs.2013.04.004
References 1. Self-Compassion assessment, research and interventions: See the work of Kristen
Neff, PhD. Her book, website and research: Self-Compassion (2011) www.selfcompassion.org Neff, K. D. (2003). “Development and validation of a scale to measure self-compassion. Self and Identity,” 2, 223-250.
2. Secondary Traumatic Stress/Compassion Fatigue Trauma Stewardship by Laura van Dernoot Lipsky with Connie Burk (2009), www.traumastewardship.com
3. “Self-care of Physicians Caring for patients at the End of Life: Being Connected… A Key to My Survival.” Kearney et al. JAMA, March 18, 2009—Vol 301, No. 11 Themes include: compassion fatigue, exquisite empathy, self care
4. Parasympathetic Nervous System- HeartMath (www.heartmath.org) has evidenced based research, the tested QUICK COHEHERENCE practice and a biofeedback hardware and apps that measure Heart Rate Value (HRV) and train people to access their PNS.
5. Accelerated Recovery Program for Compassion Fatigue - Baranowsky, Gentry & Dunning
6. Mindfulness Based Stress Reduction (MBSR) John Kabat-Zinn, Full Catastrophe Living and many other volumes on mindfulness. Look for courses in your area.
7. “Why Are We Doing This?: Clinician Helplessness in the Face of Suffering,” Back et al, Journal of Palliative Medicine, Vol 18:1, 2015
8. Resiliency/Self Care Plan Outline: Green Cross Academy of Traumatology Self Care Guidelines/Inventory. http://compassionfatigue.dreamhosters.com/wp-content/uploads/2010/11/academy-ethical.pdf
Self Compassion • Sustains self-care practices • Soothes the inner critic/negative bias • Decrease burnout and exhaustion • Decrease anxiousness and depression • Increase expression of compassion to others • Increase in the ability to forgive • Mediates symptom severity of PTSD* All other references are from published articles of Kristin Neff, PhD, self-compassion.org