Empathy Fatigue: Healing Empathy Fatigue: Healing the Mind, Body, and Spirit the Mind, Body, and Spirit of Professional Counselorsof Professional Counselors

Mark A. Stebnicki, Ph.D., LPC, CRC, Mark A. Stebnicki, Ph.D., LPC, CRC, CCMCCM

Professor, Dept. of Rehab StudiesProfessor, Dept. of Rehab StudiesEast Carolina UniversityEast Carolina University

The More We Stress Together…The More We Stress Together… There are discrete, basic, and universal emotions that There are discrete, basic, and universal emotions that

persons react to on a Mind, Body, & Spiritual level.persons react to on a Mind, Body, & Spiritual level. Emotions involve different body systems which arouse Emotions involve different body systems which arouse

our parasympathetic and sympathetic system.our parasympathetic and sympathetic system. Chronic activation of the nervous system (stress Chronic activation of the nervous system (stress

response) has both a physiological and emotional cost.response) has both a physiological and emotional cost. Cumulative effects of multiple client problems lead to a Cumulative effects of multiple client problems lead to a

deterioration of the professional’s coping skills and deterioration of the professional’s coping skills and resiliency skills- esp. if symptoms go unrecognized.resiliency skills- esp. if symptoms go unrecognized.

A Paradigm Shift in Mental Health and A Paradigm Shift in Mental Health and the Allied Helping Professionsthe Allied Helping Professions

Horrific terrorist attack Sept. 11Horrific terrorist attack Sept. 11 thth (2,996 deaths) (2,996 deaths) War in Afghanistan & Iraq (3,860 Am; 84K Iraqi War in Afghanistan & Iraq (3,860 Am; 84K Iraqi

Civilian deaths +)Civilian deaths +) Tsunami December 26Tsunami December 26thth 2004 (275,000 deaths+) 2004 (275,000 deaths+) Hurricane Katrina 2005 (70 deaths +)Hurricane Katrina 2005 (70 deaths +) Child Deaths (intentional-unintentional) by gun Child Deaths (intentional-unintentional) by gun

violence (3,024 deaths/yr)violence (3,024 deaths/yr) School shooting deaths (171 deaths ‘92-’98)School shooting deaths (171 deaths ‘92-’98) Cumulative AIDS-related deaths in U.S (through 2002 Cumulative AIDS-related deaths in U.S (through 2002

501,669d); Ethiopia (1.8 mil predicted by ’08)501,669d); Ethiopia (1.8 mil predicted by ’08)

Types of DisasterTypes of Disaster

Fire Fire Flood Flood Hurricanes/Hurricanes/

TornadosTornados Ice stormsIce storms Plane crashesPlane crashes VolcanoesVolcanoes EarthquakesEarthquakes EpidemicsEpidemics

Workplace violenceWorkplace violence Traumatic injury in Traumatic injury in

the workplacethe workplace School shootingsSchool shootings BioterrorismBioterrorism Transportation Transportation

AccidentsAccidents Civil UnrestCivil Unrest

Different Models & Philosophy inDifferent Models & Philosophy inCrisis ResponseCrisis Response

American Red Cross (ARC)American Red Cross (ARC)

Critical Incident Stress Debriefing (CISD)Critical Incident Stress Debriefing (CISD)

Critical Incident Stress Management (CISM)Critical Incident Stress Management (CISM)

National Organization for Victim Assistance (NOVA)National Organization for Victim Assistance (NOVA)

Acute Traumatic Stress Mgt (ATSM)Acute Traumatic Stress Mgt (ATSM)

NC Disaster Task Force (eclectic model)NC Disaster Task Force (eclectic model)

In a Constant State of Disaster In a Constant State of Disaster Preparedness: Crisis Response TeamsPreparedness: Crisis Response Teams

ARCARC EMS/IC-EMEMS/IC-EM Law/FireLaw/Fire Public HealthPublic Health DSSDSS School CounselorsSchool Counselors CISM TeamsCISM Teams MH/LMEMH/LME EAPsEAPs

Baptist MenBaptist Men Salvation ArmySalvation Army United WayUnited Way FEMAFEMA National National

Guard/MilitaryGuard/Military Insurance AdjustorsInsurance Adjustors MediaMedia Airline IndustryAirline Industry Banks/Financial Banks/Financial

InstitutionsInstitutions

Hurricane KatrinaHurricane Katrina

FW Katrinia Slide Show.ppt FW Katrinia Slide Show.ppt

Who Takes Care of the Who Takes Care of the Healer’s Wounded Soul?Healer’s Wounded Soul?

““What kind of God could allow such pain, What kind of God could allow such pain, suffering, or horrific acts to take place …”suffering, or horrific acts to take place …”

The search for personal meaning in extraordinary The search for personal meaning in extraordinary stressful and traumatic events due to natural stressful and traumatic events due to natural

disasters, chronic mental/physical conditions, life-disasters, chronic mental/physical conditions, life-threatening disease, or addictions requires threatening disease, or addictions requires

constant attention to self-care practices.constant attention to self-care practices.

Purpose and Intent Purpose and Intent

A growing interest among educators, A growing interest among educators, practitioners, and clinical supervisors in the practitioners, and clinical supervisors in the identification of risk factors for professional identification of risk factors for professional impairment professional fatigue syndromes.impairment professional fatigue syndromes.

A critical need among the helping professions A critical need among the helping professions to address early intervention for coping with to address early intervention for coping with the mental, emotional, spiritual, and the mental, emotional, spiritual, and occupational exhaustion that occurs as a occupational exhaustion that occurs as a natural artifact of providing services to others.natural artifact of providing services to others.

Cultivate healthy coping and resiliency Cultivate healthy coping and resiliency strategies.strategies.

Top Ten Signs You Had a Bad Top Ten Signs You Had a Bad ThanksgivingThanksgiving

10. You ran out of booze by 11am.10. You ran out of booze by 11am.

9.9. Most frequently used phrase at dinner: “Excuse Most frequently used phrase at dinner: “Excuse me, I need to use the bathroom.”me, I need to use the bathroom.”

8.8. Your meal was frozen left-overs from Your meal was frozen left-overs from Thanksgiving 2006.Thanksgiving 2006.

7. 7. Severed your thumb on the new electric knife Severed your thumb on the new electric knife because the cousins were fighting over the because the cousins were fighting over the turkey wishbone.turkey wishbone.

6. 6. Only thing on TV:Miami (0-9) at NY Jets (1-7).Only thing on TV:Miami (0-9) at NY Jets (1-7).

5. 5. Your turkey is wearing a dog collar.Your turkey is wearing a dog collar.

4. 4. When your dinner came out, so did your When your dinner came out, so did your Aunt Ginny. Aunt Ginny.

3. 3. You woke up from a tryptophan-induced You woke up from a tryptophan-induced sleep and found yourself naked in the sleep and found yourself naked in the neighbors backyard.neighbors backyard.

2. 2. Your turkey dinner came from a box Your turkey dinner came from a box labeled “Bojangles.”labeled “Bojangles.”

1. 1. You had to show-up to work Monday and You had to show-up to work Monday and you still had relatives at your house you still had relatives at your house

Empathy Fatigue: A Concern for the Empathy Fatigue: A Concern for the Helping ProfessionsHelping Professions

APAAPA - Advisory Committee on Colleague Assistance Impaired - Advisory Committee on Colleague Assistance Impaired Professionals.Professionals.

AMAAMA- Physician Impairment: “physical, mental, and behavioral - Physician Impairment: “physical, mental, and behavioral disorder that hinders the physician’s ability to safely treat disorder that hinders the physician’s ability to safely treat patients safely.”patients safely.”

American Nurses Association- “Compassion Fatigue”.American Nurses Association- “Compassion Fatigue”. ACA Task Force on Counselor Wellness and Impairment:ACA Task Force on Counselor Wellness and Impairment:- Educate counselors on prevention strategiesEducate counselors on prevention strategies- ID resources counselorsID resources counselors- Intervention and treatment recommendationsIntervention and treatment recommendations- Advocate for professional counseling associations to establish Advocate for professional counseling associations to establish

programs on counselor impairmentprograms on counselor impairment

Empathy Fatigue: A Combination of Empathy Fatigue: A Combination of other Professional Fatigue Syndromesother Professional Fatigue Syndromes

Countertransference: Countertransference: the unconscious absorption of the patient’s the unconscious absorption of the patient’s issues, involves a type of symbolic or parallel experience of emotional issues, involves a type of symbolic or parallel experience of emotional button-pushing. It results in a sense of anxiety, stress, sense of loss, button-pushing. It results in a sense of anxiety, stress, sense of loss, grief, and over-identification w/pt. (Jung et al.)grief, and over-identification w/pt. (Jung et al.)

Burnout: Burnout: a negative shift in the way professionals view people they a negative shift in the way professionals view people they serve. A cumulative emotional exhaustion, depersonalizaiton, feelings serve. A cumulative emotional exhaustion, depersonalizaiton, feelings of a lack of personal accomplishment resulting in a loss of of a lack of personal accomplishment resulting in a loss of compassion, genuineness, and concern for the patient. (Maslach; compassion, genuineness, and concern for the patient. (Maslach; MBI)MBI)

Compassion Fatigue: Compassion Fatigue: An acute stress reaction unhealthy form of An acute stress reaction unhealthy form of countertransference results from emotional, mental, and physical countertransference results from emotional, mental, and physical exhaustion. (Figley; Stamm, et al.)exhaustion. (Figley; Stamm, et al.)

Empathy Fatigue (EF)Empathy Fatigue (EF)

“ “ A dynamic state of psychological, A dynamic state of psychological, emotional, social, physical, emotional, social, physical, occupational, and spiritual exhaustion occupational, and spiritual exhaustion that occurs on a continuum, resulting that occurs on a continuum, resulting from the helpers’ own wounds that from the helpers’ own wounds that are continually revisited by their are continually revisited by their client’s life-stories of stress, chronic client’s life-stories of stress, chronic illness, mental/physical disability, illness, mental/physical disability, trauma, grief, and loss.”trauma, grief, and loss.”

Theory of Empathy FatigueTheory of Empathy Fatigue

Persons who work in “high touch” professions are more Persons who work in “high touch” professions are more vulnerable than those that don’t…vulnerable than those that don’t…

A natural artifact of working with patients that have A natural artifact of working with patients that have intense acute and chronic physical conditions, mental intense acute and chronic physical conditions, mental health conditions, and behavioral health issues.health conditions, and behavioral health issues.

Many times an unconscious process where the Many times an unconscious process where the professional and those around them may not recognize.professional and those around them may not recognize.

EF is cumulative and ranges on a continuum of low, EF is cumulative and ranges on a continuum of low, moderate, and high levels of physical-emotional-mental moderate, and high levels of physical-emotional-mental spiritual, and occupational exhaustion.spiritual, and occupational exhaustion.

The Nature of the Helping ProfessionThe Nature of the Helping Profession

Requires facilitating empathic approaches, cultivating client Requires facilitating empathic approaches, cultivating client connections and relationships where we must attend, listen, act connections and relationships where we must attend, listen, act empathically to help our clients unfold the multiple layers of empathically to help our clients unfold the multiple layers of their stress, grief, loss, or traumatic experiences by searching their stress, grief, loss, or traumatic experiences by searching through their emotional scrapbook. through their emotional scrapbook.

The search for personal meaning and purpose of our client’s pain The search for personal meaning and purpose of our client’s pain and suffering may contribute to the helper’s spiritual fatigue and suffering may contribute to the helper’s spiritual fatigue experience. experience.

If professional helpers are mindful of this experience, and view If professional helpers are mindful of this experience, and view this as an opportunity for nurturing personal growth and this as an opportunity for nurturing personal growth and development, then they will learn resiliency strategies that can development, then they will learn resiliency strategies that can help to replenish their wounded spirit.help to replenish their wounded spirit.

The Wounded Healer Experience: The Wounded Healer Experience: Healing the SpiritHealing the Spirit

Traditional Native American teachings Traditional Native American teachings “each time you heal someone you give “each time you heal someone you give away a piece of yourself until at some away a piece of yourself until at some point you require healing.”point you require healing.”

The phenomenon that takes place between client The phenomenon that takes place between client and therapist when the therapists own and therapist when the therapists own psychological and emotional wounds are opened psychological and emotional wounds are opened by listening to their client’s story. (Jung)by listening to their client’s story. (Jung)

Healing the SpiritHealing the Spirit

Wounded healer experience (Nouwen, 1972) “When Wounded healer experience (Nouwen, 1972) “When our souls are restless, driven by other conflicting stimuli our souls are restless, driven by other conflicting stimuli and worries…withdrawn into ourselves…how can we and worries…withdrawn into ourselves…how can we possibly create the room and space where someone else possibly create the room and space where someone else can enter freely without feeling himself an unlawful can enter freely without feeling himself an unlawful intruder?”intruder?”

(Miller, 2003) suggests client stories of addictions, (Miller, 2003) suggests client stories of addictions, physical or sexual abuse and psychological trauma can physical or sexual abuse and psychological trauma can adversely affect the mind, body, & spirit of the healer. adversely affect the mind, body, & spirit of the healer. Wounded therapists have vulnerabilities too- we have Wounded therapists have vulnerabilities too- we have responsibility for disclosing our wounds along side our responsibility for disclosing our wounds along side our clients…clients…

The Nature of Empathy FatigueThe Nature of Empathy Fatigue

Dalai Lama (1999) suggests counselors can Dalai Lama (1999) suggests counselors can become exhausted by their duties because become exhausted by their duties because of the constant exposure to the suffering of of the constant exposure to the suffering of others and can induce feelings of others and can induce feelings of helplessness and despair. helplessness and despair.

““Empathy is really what we are describing Empathy is really what we are describing when we talk about compassion fatigue and when we talk about compassion fatigue and that it is the simple compassion a person that it is the simple compassion a person experiences when they want to see another experiences when they want to see another person free from suffering.”person free from suffering.”

Share Your Experiences as a Share Your Experiences as a Professional HelperProfessional Helper

1.1. II chose the profession/career I am in because…chose the profession/career I am in because…

2.2. I am encouraged by my clients’/patients’ success when I I am encouraged by my clients’/patients’ success when I see that they…see that they…

3.3. My mind, body, and spirit is most affected by My mind, body, and spirit is most affected by clients’/patients’ who are…clients’/patients’ who are…

4.4. I work best and my needs are met when I have…I work best and my needs are met when I have…

5.5. I do not work well under conditions that involve…I do not work well under conditions that involve…

6.6. If I could make any change(s) in my career/job I would If I could make any change(s) in my career/job I would like to…like to…

EF Risk Factor Functional EF Risk Factor Functional AssessmentAssessment

Personality TraitsPersonality Traits History of MH ProblemsHistory of MH Problems Maladaptive Coping Behaviors Maladaptive Coping Behaviors Age and Experience-Related FactorsAge and Experience-Related Factors Organizational FactorsOrganizational Factors Job Duties within the OrganizationJob Duties within the Organization Socio-Cultural FactorsSocio-Cultural Factors Person’s Response to Past EventsPerson’s Response to Past Events Level of SupportLevel of Support

Empathy Fatigue: Critical Empathy Fatigue: Critical PathwaysPathways

Impairment in professional helpers who uses empathy-Impairment in professional helpers who uses empathy-focus therapeutic interactions.focus therapeutic interactions.

Communication (verbal/non-verbal) between clients Communication (verbal/non-verbal) between clients and professionals during therapeutic interactions that and professionals during therapeutic interactions that are integrated in the professional’s thoughts and are integrated in the professional’s thoughts and feelings and becomes associated as a physical-feelings and becomes associated as a physical-emotional reaction.emotional reaction.

Multiple interaction of personality traits, coping Multiple interaction of personality traits, coping resources, developmental level of helper, and resources, developmental level of helper, and opportunity (or lack of) to build resiliency opportunity (or lack of) to build resiliency organizational-environmental supports.organizational-environmental supports.

Experienced by helpers as an acute, chronic, delayed Experienced by helpers as an acute, chronic, delayed onset reaction ranges on a continuum.onset reaction ranges on a continuum.

Experienced by helpers dealing with a variety of Experienced by helpers dealing with a variety of issues- daily hassles to addictions, trauma...issues- daily hassles to addictions, trauma...

Cumulative effects that lead to deterioration of Cumulative effects that lead to deterioration of counselor’s coping abilities and resiliency.counselor’s coping abilities and resiliency.

Case Illustration of Nurse RatchetteCase Illustration of Nurse Ratchette

While we were in nurses training, we were always told to While we were in nurses training, we were always told to “be professional.” No one ever said exactly what that “be professional.” No one ever said exactly what that meant, or how to be a professional. I guess we thought meant, or how to be a professional. I guess we thought it meant being cool and calm under pressure, objective it meant being cool and calm under pressure, objective with our patients, and not to get easily rattled by things. with our patients, and not to get easily rattled by things. But I did get rattled and upset at times- like the first But I did get rattled and upset at times- like the first time a patient died. I would be feeling panicky, angry, time a patient died. I would be feeling panicky, angry, and sad but I would be fighting any expression of those and sad but I would be fighting any expression of those feelings because I knew they were not “professional.”feelings because I knew they were not “professional.”

Nurse Ratchette Nurse Ratchette {continued} {continued}

Everyone else seemed to be handling things okay, Everyone else seemed to be handling things okay, which made me feel even worse- like a real which made me feel even worse- like a real failure- like someone who wasn’t cut-out for this failure- like someone who wasn’t cut-out for this kind of work. I didn’t dare say anything for fear kind of work. I didn’t dare say anything for fear people would find out how weak I really was. It people would find out how weak I really was. It wasn’t until much later in my career that I wasn’t until much later in my career that I discovered that most everyone else was just as discovered that most everyone else was just as scared and lonely as I was when it came to scared and lonely as I was when it came to death and dealing with trauma cases.death and dealing with trauma cases.

Summative Philosophy of EFSummative Philosophy of EF

It is not necessarily the nature of the client’s/patient’s It is not necessarily the nature of the client’s/patient’s stress, trauma, loss, grief, daily hassles, coping, or stress, trauma, loss, grief, daily hassles, coping, or disability adjustment issues that creates a sense of EF; disability adjustment issues that creates a sense of EF; rather it is the professional’s perception towards that rather it is the professional’s perception towards that particular patient’s personality traits/states and particular patient’s personality traits/states and behavioral characteristics that determines the behavioral characteristics that determines the professional’s response to it; and it is determined by professional’s response to it; and it is determined by multiple factors that lead to a diminished capacity to multiple factors that lead to a diminished capacity to listen, respond empathically, provide competent listen, respond empathically, provide competent professional services…professional services…

Empathy Fatigue: The Mind-Body Empathy Fatigue: The Mind-Body Connection within the Emotional Connection within the Emotional

BrainBrain* * Neuro-scientist, Dr. Joseph LeDoux’s revolutionized Neuro-scientist, Dr. Joseph LeDoux’s revolutionized our understanding of the neural pathways of the brain.our understanding of the neural pathways of the brain.* Pre-determined chemical and electrical impulses * Pre-determined chemical and electrical impulses {Amygdale} are triggered when we perceive emotions {Amygdale} are triggered when we perceive emotions {fear, stress, and anxiety}.{fear, stress, and anxiety}.*Amygdala {our home security system} and *Amygdala {our home security system} and hippocampus {seat of emotions} sends out an hippocampus {seat of emotions} sends out an emergency call to our sympathetic nervous system and emergency call to our sympathetic nervous system and involves an all-out body system response. involves an all-out body system response. * A fight-flight response triggers increase blood flow to * A fight-flight response triggers increase blood flow to muscles, activates our cardiovascular system, and muscles, activates our cardiovascular system, and secretes stress hormones-epinephrine and secretes stress hormones-epinephrine and norephinephrine heightens reactivity to stress.norephinephrine heightens reactivity to stress.* End result – hypothalamus region of the brain, acting * End result – hypothalamus region of the brain, acting through the pituitary gland stimulates the neuro stress through the pituitary gland stimulates the neuro stress hormone Cortisol, which depresses overall brain hormone Cortisol, which depresses overall brain functioning, can be toxic to tissue at high levels, functioning, can be toxic to tissue at high levels, depresses memory, learning, and are markers for depresses memory, learning, and are markers for depression and anxiety.depression and anxiety.

Peripheral/ANS: Sympathetic-Peripheral/ANS: Sympathetic-Parasympathetic NervousParasympathetic Nervous

The Neuroscience of Empathy Fatigue: The Neuroscience of Empathy Fatigue: Our Emotional BrainOur Emotional Brain

There are discrete, basic, and universal emotions There are discrete, basic, and universal emotions that persons react to on a M-B-S level;that persons react to on a M-B-S level;

Emotions involve different body systems which Emotions involve different body systems which arouse our parasympathetic and sympathetic arouse our parasympathetic and sympathetic system;system;

Chronic activation of the nervous system (stress Chronic activation of the nervous system (stress response) has both a physiological and emotional response) has both a physiological and emotional cost;cost;

80% of all physical illness is cause by stress (Kabit-80% of all physical illness is cause by stress (Kabit-Zinn, 1990; Sapolsky, 1998; Selye, 1976; Weil, Zinn, 1990; Sapolsky, 1998; Selye, 1976; Weil, 1995)1995)

Why Zebras Don’t Get UlcersWhy Zebras Don’t Get UlcersA Video Presentation of Stress A Video Presentation of Stress

ZebrasZebras

Cortisol

Adrenaline

Pituitary

Hypothalamus

Q. Why Zebras Don’t Get Q. Why Zebras Don’t Get UlcersUlcers

Answer: Zebras don’t have cumulative stressAnswer: Zebras don’t have cumulative stress

““If you constantly mobilize energy, If you constantly mobilize energy, You never store it; Your muscles You never store it; Your muscles waste away; Your vascular system waste away; Your vascular system is under constant pressure; and is under constant pressure; and constant Cortisol production constant Cortisol production turns off growth factors and can turns off growth factors and can harm every system in the body…”harm every system in the body…”

The Problem with Too Many The Problem with Too Many Unhealthy Thoughts, Unhealthy Thoughts,

Perception & Feelings: Perception & Feelings: Stress !!!Stress !!!

Excessive, recurrent, and intense Excessive, recurrent, and intense emotional arousal; emotional arousal;

Repeated reactivation of our Repeated reactivation of our perceptual-cognitive-affective response;perceptual-cognitive-affective response;

Stored unhealthy thoughts, perceptions, Stored unhealthy thoughts, perceptions, and emotions, become a worn neural and emotions, become a worn neural pathway which leaves an imprint on our pathway which leaves an imprint on our cognitive unconscious and causes a cognitive unconscious and causes a mind-body interaction.mind-body interaction.

The Critical Stress Factor in Disease: The Critical Stress Factor in Disease: Optimizing the Healing System Optimizing the Healing System {Dr. Weil}{Dr. Weil}

Lack of EnergyLack of Energy

Poor CirculationPoor Circulation

Restricted BreathingRestricted Breathing

Impaired DefensesImpaired Defenses

Toxic OverloadToxic Overload

AgeAge

Thoughts, Perceptions, CognitionsThoughts, Perceptions, Cognitions

Spiritual ProblemsSpiritual Problems

Solution-Focus PreventionSolution-Focus Prevention What would this problem situation look like if you were What would this problem situation look like if you were

managing it better?managing it better? What changes in your present situation/life would make What changes in your present situation/life would make

sense right now?sense right now? What would you be doing differently with your problem What would you be doing differently with your problem

situation if you were to make the changes you wanted to situation if you were to make the changes you wanted to make?make?

What things have you thought about that would make life What things have you thought about that would make life better for you right now?better for you right now?

What things/feelings in your life would you like to What things/feelings in your life would you like to eliminate right now?eliminate right now?

If you eliminated certain things in your life what would If you eliminated certain things in your life what would that feel like?that feel like?

When do you plan on making these changes?When do you plan on making these changes?

Changing the Stress Response: Changing the Stress Response: Protective Factors & ResiliencyProtective Factors & Resiliency

Feeling some degree of internal control;Feeling some degree of internal control; Exerting some control over your environment;Exerting some control over your environment; Increasing your level of information and Increasing your level of information and

awareness;awareness; Changing your thoughts and perceptions;Changing your thoughts and perceptions; Shifting from mindless (unconscious) reaction to Shifting from mindless (unconscious) reaction to

mindful recognition;mindful recognition; Creative solution-focused problem-solving;Creative solution-focused problem-solving; Support from others in our socio-familial Support from others in our socio-familial

environment;environment; High-ranking Baboon; Not living alone !!High-ranking Baboon; Not living alone !!

Locus of ControlLocus of Control

http://www.dushkin.com/connectext/psy/ch11/http://www.dushkin.com/connectext/psy/ch11/survey11.mhtmlsurvey11.mhtml

Empathy Fatigue Resiliency QuizEmpathy Fatigue Resiliency Quiz1= not true of me….5=exceptionally true of me1= not true of me….5=exceptionally true of me

As a professional counselor I perceive myself to be…As a professional counselor I perceive myself to be…

1.1. Resilient, adapt quickly to new client issues as they arise, Resilient, adapt quickly to new client issues as they arise, and good at bouncing back after listening, attending, and and good at bouncing back after listening, attending, and responding empathically to my clients’ stories all day.responding empathically to my clients’ stories all day.

2.2. Optimistic, perceive that my client can increase their Optimistic, perceive that my client can increase their level of adaptive functioning regardless of how difficult level of adaptive functioning regardless of how difficult their issues are, and I anticipate that things will turn out their issues are, and I anticipate that things will turn out well for them.well for them.

3.3. Calm and focused while my client’s life is in crisis.Calm and focused while my client’s life is in crisis.4.4. A good problem-solver by facilitating appropriate A good problem-solver by facilitating appropriate

interventions by empowering my client with good interventions by empowering my client with good resources. resources.

5.5. Able to trust my clinical intuition and facilitate creative Able to trust my clinical intuition and facilitate creative solutions to my client’s stressful life-challenges.solutions to my client’s stressful life-challenges.

Resiliency Quiz Resiliency Quiz (continued)(continued)

6.Self-confident, optimistic, enjoy healthy self-esteem, and 6.Self-confident, optimistic, enjoy healthy self-esteem, and have an attitude of professionalism about my work.have an attitude of professionalism about my work.

7. Playful, humorous, have the ability to laugh at myself.7. Playful, humorous, have the ability to laugh at myself.

8. Curious, facilitate good interviewing skills, have a 8. Curious, facilitate good interviewing skills, have a desire to understand how things work in my client’s life, desire to understand how things work in my client’s life, and consult with others when I need help.and consult with others when I need help.

9. Constantly learning from my past mistakes during 9. Constantly learning from my past mistakes during therapy and from the mistakes that I see other therapy and from the mistakes that I see other therapists make.therapists make.

10. Flexible, and feel comfortable with things that are 10. Flexible, and feel comfortable with things that are somewhat complex in my client’s life, and can adapt to somewhat complex in my client’s life, and can adapt to various client behaviors and personalities in my various client behaviors and personalities in my counseling practice.counseling practice.

Resiliency Quiz Resiliency Quiz (continued)(continued)

11. Able to anticipate when my client will develop 11. Able to anticipate when my client will develop specific problems and I have confidence that I specific problems and I have confidence that I will know how to deal with the unexpected.will know how to deal with the unexpected.

12. Able to personally deal with my client’s 12. Able to personally deal with my client’s negative or dysfunction life patterns and the negative or dysfunction life patterns and the ambiguity or challenge this presents in my own ambiguity or challenge this presents in my own life.life.

13. Non-judgmental, a good listener, possess good 13. Non-judgmental, a good listener, possess good empathy with my clients, express my feelings empathy with my clients, express my feelings and be able to “read” other people well.and be able to “read” other people well.

14. Able to recover emotionally from my client’s 14. Able to recover emotionally from my client’s losses and setbacks, and let-go of negative losses and setbacks, and let-go of negative feelings that I may have and how to ask others feelings that I may have and how to ask others for help.for help.

Resiliency Quiz Resiliency Quiz (continued)(continued)

15. Durable, keep on ticking after tough 15. Durable, keep on ticking after tough client sessions and possess an client sessions and possess an balanced and healthy fighting spirit.balanced and healthy fighting spirit.

16. Stronger and better after 16. Stronger and better after facilitating interventions with difficult facilitating interventions with difficult clients issues.clients issues.

17. Able to discover some meaning in 17. Able to discover some meaning in my own life at the end of the day, my own life at the end of the day, even after hearing multiple client even after hearing multiple client stories of stress, trauma, addiction, stories of stress, trauma, addiction, anxiety, and depression.anxiety, and depression.

Empathy Fatigue Resiliency Quiz ScoringEmpathy Fatigue Resiliency Quiz Scoring

75 + = Very Resilient!!75 + = Very Resilient!!

65-75 = Resilient more than most counselors.65-75 = Resilient more than most counselors.

55-65 = Slow to rebound- but adequate.55-65 = Slow to rebound- but adequate.

45-55 = Whoa- I’m struggling as a counselor.45-55 = Whoa- I’m struggling as a counselor.

45 or less = I should leave now and seek help!45 or less = I should leave now and seek help!

Resilient ProfessionalsResilient Professionals Convey a sense of genuine commitment and confidence to help Convey a sense of genuine commitment and confidence to help

with their client’s stress levels and critical issues; with their client’s stress levels and critical issues;

Communicate competence and have a good sense of mastery Communicate competence and have a good sense of mastery with handling challenging and difficult clients;with handling challenging and difficult clients;

Feel optimistic, positive, and energetic about the good work they Feel optimistic, positive, and energetic about the good work they do and have good coping resources;do and have good coping resources;

Have a purpose-driven life, find meaning with their profession Have a purpose-driven life, find meaning with their profession and practice good self-care techniques;and practice good self-care techniques;

Maintain excellent interpersonal insight and still have the Maintain excellent interpersonal insight and still have the capacity for warmth, caring, and empathy.capacity for warmth, caring, and empathy.

The Resiliency AdvantageThe Resiliency AdvantageDr. Al SiebertDr. Al Siebert

1. Making conscious choices in life.1. Making conscious choices in life.2. Power of Positive Thinking.2. Power of Positive Thinking.3. Take responsibility.3. Take responsibility.4. Internal locus of control.4. Internal locus of control.5. Self motivate yourself.5. Self motivate yourself.6. Don’t fear trying-out new things.6. Don’t fear trying-out new things.7. Take control of your life.7. Take control of your life.8. Practice positive approaches to life.8. Practice positive approaches to life.

A Paradigm Shift in A Paradigm Shift in Conventional - Traditional Self-Conventional - Traditional Self-

Care PracticesCare PracticesHistorically: Historically:

1960s: Human Potential and Personal Growth Movements 1960s: Human Potential and Personal Growth Movements began in Big Sur CA- Eslen- strategies for empowerment, began in Big Sur CA- Eslen- strategies for empowerment, creative problem solving, happiness, self-actualizing. creative problem solving, happiness, self-actualizing.

1970s: Birth of New Age movement & the Self-help book.1970s: Birth of New Age movement & the Self-help book. New Age movement both Western paradigm cognitive-New Age movement both Western paradigm cognitive-

behavioral and humanistic based, and Eastern philosophies – behavioral and humanistic based, and Eastern philosophies – Goal of achieving M-B wellness- but criticized as a Goal of achieving M-B wellness- but criticized as a pseudoscience, overuse of psychobabble, and too New Aggie pseudoscience, overuse of psychobabble, and too New Aggie

During 1970s: collaborative interdisciplinary approach with During 1970s: collaborative interdisciplinary approach with psychology, neuro- biological, immunology psychology, neuro- biological, immunology (psychoneuroimmunology) gave-way to biopsychosocial (psychoneuroimmunology) gave-way to biopsychosocial models of health and healing - CAM/IM (600+ healing txs).models of health and healing - CAM/IM (600+ healing txs).

Late 1970s significant growth in transpersonal psychology-Late 1970s significant growth in transpersonal psychology-the esoteric, developing psychic-intuitive abilities, secular the esoteric, developing psychic-intuitive abilities, secular mysticism, Native American traditions.mysticism, Native American traditions.

Native American TeachingNative American Teaching

““Every time you heal someone, you give a Every time you heal someone, you give a piece of yourself away, until at one point piece of yourself away, until at one point

you will need healing yourself”you will need healing yourself”* Shaman or Medicine Man/Woman in many * Shaman or Medicine Man/Woman in many

indigenous cultures understood that in healing indigenous cultures understood that in healing practices the healer sometimes must takes-on practices the healer sometimes must takes-on the pain and suffering of others while planting the pain and suffering of others while planting the seeds for transformation.the seeds for transformation.

* Each personal transformation should bring * Each personal transformation should bring about the necessary experiences for handling about the necessary experiences for handling the next crisis so the mind, body, and spirit the next crisis so the mind, body, and spirit can be transformed.can be transformed.

Old World vs. New World Old World vs. New World ShamanShaman

Old world shaman live in a world different from Old world shaman live in a world different from their people, so they may have a clear vision of their people, so they may have a clear vision of what to do – what direction to take with their what to do – what direction to take with their people.people.

All activities are spent in developing faith, All activities are spent in developing faith, spiritual awareness, rituals to protect and heal spiritual awareness, rituals to protect and heal M-B-S.M-B-S.

Shaman carry-on traditional teachings: Shaman carry-on traditional teachings: storytelling, talk circles, pipe ceremonies, storytelling, talk circles, pipe ceremonies, prayers, dancing, singing.prayers, dancing, singing.

Shaman specialize in finding meaning and Shaman specialize in finding meaning and purpose for tribal members.purpose for tribal members.

Post-modern Self-HelpPost-modern Self-Help

New (Old) Age has ignored or neglected the New (Old) Age has ignored or neglected the ancient and collective wisdom of indigenous ancient and collective wisdom of indigenous cultures.cultures.

A Calling for getting back to the roots of A Calling for getting back to the roots of community, family, ext family, connections.community, family, ext family, connections.

Professional helpers live in a much more Professional helpers live in a much more intense world today post- Sept. 11intense world today post- Sept. 11thth

More is required in preparing for handling More is required in preparing for handling critical incidents (natural person-made critical incidents (natural person-made disaster response) disaster response)

Show-upShow-up

Pay AttentionPay Attention

Be Open to the OutcomesBe Open to the Outcomes

Wellness AssessmentWellness Assessment

BreathingBreathing

MeditationMeditation

VisualizationVisualization

Adaptive Coping & Healing Adaptive Coping & Healing Strategies: OrganizationalStrategies: Organizational

• Skilled & Competent clinical supervisionSkilled & Competent clinical supervision• Mentoring approachesMentoring approaches• Peer-supervisionPeer-supervision• Shift focus of treatment team meetingsShift focus of treatment team meetings• Re-structure organizational philosophy Re-structure organizational philosophy

to a healthy person-centered {M-B-S}to a healthy person-centered {M-B-S}

The Human Energy Field and EmotionsThe Human Energy Field and Emotions

There is a relationship between the energy There is a relationship between the energy field of the heart and emotional states.field of the heart and emotional states.

The expression of love, compassion, fear, The expression of love, compassion, fear, anger, and anxiety produces a particular anger, and anxiety produces a particular harmonic frequency within cells of the body.harmonic frequency within cells of the body.

Emotions in general can be communicated Emotions in general can be communicated (or projected) by others (empathy & (or projected) by others (empathy & compassion).compassion).

Laying on of hands create frequencies that Laying on of hands create frequencies that stimulate immune functioning, CNS, stimulate immune functioning, CNS, neurotransmitters (give me a hug).neurotransmitters (give me a hug).

Body Energy Work and the Body Energy Work and the Human Energy FieldHuman Energy Field

A fundamental law in physics, A fundamental law in physics, Ampere’s Law, states when currents Ampere’s Law, states when currents flow through conductors (wires or flow through conductors (wires or

living tissues), then magnetic fields living tissues), then magnetic fields are produced in the surrounding are produced in the surrounding

space.space.

Electro-Chemical impulses occur Electro-Chemical impulses occur naturally in the brain, peripheral naturally in the brain, peripheral nervous system, heart, and in all nervous system, heart, and in all

muscles of the body.muscles of the body.

Quantum Healing, Energy Medicine, Quantum Healing, Energy Medicine, Body Energy Work- and the Physics of Body Energy Work- and the Physics of

ReikiReiki Pulsing Electromagnetic Field Therapy Pulsing Electromagnetic Field Therapy

(PEMF) for healing muscular skeletal (PEMF) for healing muscular skeletal conditions (TENS Unit), cardiovascular conditions (TENS Unit), cardiovascular disease (Pacemakers) have been disease (Pacemakers) have been established in mainstream medicine.established in mainstream medicine.

Electromagnetic signals are emitted from Electromagnetic signals are emitted from the hands of trained healers; biomagnetic the hands of trained healers; biomagnetic energy field produced by a practitioner’s energy field produced by a practitioner’s hand can induce current flow into tissue and hand can induce current flow into tissue and can be measured; “The Electricity of can be measured; “The Electricity of Touch.”Touch.”

A Very Brief History of REIKIA Very Brief History of REIKI Dr. Mikao Usui Dr. Chujiro Hayashi Mrs. HawayoDr. Mikao Usui Dr. Chujiro Hayashi Mrs. Hawayo TakataTakata

(1865-1926)(1865-1926) (1870-1941)(1870-1941) (1900-1980) (1900-1980)

Intention of REIKI:Intention of REIKI:

To:To: Balance and harmonize Balance and harmonize the body’s own natural the body’s own natural healing energies.healing energies. Release ones’ emotional Release ones’ emotional energy blocks.energy blocks. Facilitate and increase the Facilitate and increase the body’s ability to achieve calm body’s ability to achieve calm and meditative states of and meditative states of

consciousness.consciousness.

NIH- National Center for NIH- National Center for Complementary and Alternative Complementary and Alternative

Medicine (NCCAM)Medicine (NCCAM)

Biofield TherapiesBiofield Therapies: Those therapies : Those therapies intended to affect energy fields that intended to affect energy fields that purportedly surround and interpenetrate purportedly surround and interpenetrate the human body (Reiki, Qigong, T.T.)the human body (Reiki, Qigong, T.T.)

Bioelectromagnetic-based TherapiesBioelectromagnetic-based Therapies: : Manipulation of electromagnetic fields, Manipulation of electromagnetic fields, invisible lines of electrical force or invisible lines of electrical force or currents (magnetic therapies)currents (magnetic therapies)

REIKIREIKI

““Reiki is God’s love in its purest form. Reiki is God’s love in its purest form. It is completely unconditional. It demands It is completely unconditional. It demands nothing of the giver nor of the receiver. It nothing of the giver nor of the receiver. It professes no creed or dogma. It requires no professes no creed or dogma. It requires no specific belief in the supreme being or in specific belief in the supreme being or in Reiki itself. Used in its traditional form, as Reiki itself. Used in its traditional form, as developed by Dr. Usui in the Usui System of developed by Dr. Usui in the Usui System of Natural Healing, Reiki heals the body and Natural Healing, Reiki heals the body and emotions, bringing them into balance and emotions, bringing them into balance and promoting health, happiness, prosperity, promoting health, happiness, prosperity, and long life”and long life”

How Does the REIKI How Does the REIKI Practitioner Work?Practitioner Work?

Practitioner gently places hands on or Practitioner gently places hands on or just above the body to channel REIKI just above the body to channel REIKI or Universal Life Energy to the or Universal Life Energy to the different Chakras or parts of the body different Chakras or parts of the body that function as a focal point for that function as a focal point for spiritual energy.spiritual energy.

Practitioner acts primarily as a Practitioner acts primarily as a conduit or vessel to channel REIKI in conduit or vessel to channel REIKI in a powerful concentrated form.a powerful concentrated form.

Touch Research InstituteTouch Research InstituteUniversity of MiamiUniversity of Miami

Physical contact prompts the Physical contact prompts the relaxation response endorphin releaserelaxation response endorphin release

Physiologically the person releases Physiologically the person releases serotonin and dopamine to slow down serotonin and dopamine to slow down the secretion of the stress hormones the secretion of the stress hormones norepinephrine, epinephrine, and norepinephrine, epinephrine, and cortisol cortisol

Dr. Harry Harlow’s MonkeysDr. Harry Harlow’s Monkeys

Attachment as the Foundation of Attachment as the Foundation of Hardiness and ResiliencyHardiness and Resiliency

Poorly attached children exhibit Poorly attached children exhibit higher levels of agitationhigher levels of agitation

low impulse controllow impulse control poor at social and interpersonal poor at social and interpersonal

relationshipsrelationships have higher rates of illness and have higher rates of illness and

mental health problemsmental health problems

REIKI ResearchREIKI Research

http://www.reikimedresearch.com/http://www.reikimedresearch.com/

International Center for Reiki International Center for Reiki TrainingTraining

http://www.reiki.orghttp://www.reiki.org

Body ChakrasBody Chakras

Each of the seven (7) body chakras Each of the seven (7) body chakras represents a vital life force “Ki” that represents a vital life force “Ki” that relates to different body systems.relates to different body systems.

Blocked chakras lead to emotional, Blocked chakras lead to emotional, mental, physical, and spiritual mental, physical, and spiritual imbalances.imbalances.

Too much energy, too little energy, or Too much energy, too little energy, or blocked energy within the body chakra blocked energy within the body chakra requires a harmonizing or re-balancing requires a harmonizing or re-balancing

77th-th- Crown Crown {Consciousness, {Consciousness,

Spiritual awareness}Spiritual awareness}

66thth- Third Eye - Third Eye {Intuitive/Inner vision}{Intuitive/Inner vision}

55thth- Throat - Throat {Self-expression}{Self-expression}

44thth- Heart - Heart {Love of self/others}{Love of self/others}

33rdrd- Solar Plexus - Solar Plexus {Power, Strength}{Power, Strength}

22ndnd- Sacral - Sacral {Self-esteem, Relationships}{Self-esteem, Relationships}

11stst- Root - Root {Survival, fertility}{Survival, fertility}