Compassion Fatigue

“Le syndrome d’épuisement professionnel n’est cependant ni un prix à payer inévitable, ni un cauchemar redoutable qui devrait tous nous démobiliser. Véritable leçon d’humilitée, il est là aussi pour nous rappeler nos limites, nous faire prendre conscience que nous aussi (et pas uniquement les malades) pouvons craquer, souffrir, baisser les bras, et du coup nous rassembler dans une même “humanité” avec ceux que nous soignons.”

Consoli dans “Le burnout du soignant” (2003)

Standards of Self Care Guidelines

Green Cross Academy of Traumatology – to view the standards of self care guidelines, please click here.

OSSTF/FEESO Questions and Answers

Here is the Q&A from the two November workshops offered to the OSSTF. I have added some resources on anxiety and depression and other mental health links at the end of the document.

Mindfulness meditation resources: I was also sent this wonderful free resource from one of your colleagues:

http://www.insightmeditationcenter.org/programs/for-beginners/

Ressources en Francais

Voici une liste de ressources en français sur l’usure de compassion et le traumatisme vicariant. J’offre ici la pdf de l’excellent article de Jan Richardson “Guide sur le Traumatisme Vicariant” dans son intégralité car il est très difficile à obtenir en ligne (et n’est plus disponible par le biais du centre national d’information de violence dans la famille, pour une raison que j’ignore, car c’est un document exceptionnel). J’inclus également le dossier 2007 de la CSST sur le traumatisme vicariant.

Si vous avez de bonnes ressources en francais, n’hésitez-pas à me les envoyer et je les rajouterai à la liste Read more ›

Books for your toolbox: Some great reads to navigate Compassion Fatigue

I have been doing a lot of training this Fall, offering the introductory course on compassion fatigue and vicarious trauma, the Part Two compassion fatigue workshop (a brand new presentation), a series of workshops on mental health, crisis intervention and the compassion fatigue train the trainer. I love doing these presentations as they are always different:  each group has different needs and reactions, and each group has resources that are best suited to them.

I will soon be winding down for the season and taking the month of December off to retool and…read lots of books! I grew up in a book-loving family and the best part of Christmas was always settling down with our new book haul and settling in for hours of pleasure and escapism. We used to go to this wonderful second hand bookstore in Montreal called the Book Nook (sadly, long gone) and do most of our gift shopping there.

In the spirit of the holidays,  here are the books/CDs I would recommend you put on your wish list:

Read more ›

Compassion Fatigue: How do we lay the foundation for wellness?

[...] by developing the deep sense of awareness needed to care for ourselves while caring for others and the world around us, we can greatly enhance our potential to work for change, ethically and with integrity, for generations to come.

Lipsky, 2009

Last week, I had the honour of co-presenting with Dr Gabor Maté at a workshop organised by Gluckstein Law of Toronto – Dr Maté was doing the bulk of the day, and I was closing the event. It was wonderful to have the opportunity to hear the presentation based on his book “When the Body Says No” a second time – I always find that I get something different out of each time I reread a great book, or hear a thoughtful, inspiring speaker present. In fact, the second iteration is often the one where I learn the most. I can’t wait to have Dr Maté present at the Compassion Fatigue Conference in June.

One of the key messages in Dr Maté’s work is on the importance of self awareness – Read more ›

It was high time for a new photo…

I haven’t updated my profile photo in about 7 years, so I thought it was time. (I was getting worried that I would one day get the: “you don’t look a thing like your photo!” – ageing rapidly moving us in one direction only…) But a new photo never seemed to be a priority until last weekend, when my daughter and her close friend decided to do a makeover on me. They were appalled to hear that my normal makeup ritual only involves a 5 year old eyeliner pencil. Apparently that is not considered hygienic (or a beauty routine)! Who knew!

So, hi there! Welcome to my blog (or welcome again if you have been a regular reader). I am in the middle of a busy Fall training season and several projects have been on the go since I came back to work after a nice long summer break. Here’s a sampling: Read more ›

Greater awareness of physician burnout and depression needed, experts say

An international conference co-hosted by the AMA aims to remove stigma and foster a healthier emotional climate for doctors.
By CAROLYNE KRUPA, amednews staff. Posted Oct. 21, 2010. To read more click here.

Upcoming events of interest

Summer is here and I am done with workshops for the season. Phew! Although I thoroughly enjoyed meeting wonderful folks all across the country, I am in need of a little R&R after a rather punishing pace since the Fall. I will only be blogging intermittently during the next couple of months as I am taking part of July and the entire month of August off. Being self-employed is not always all it’s cracked up to be (no job security, no pension, no sick pay), but one real bonus is having control over your schedule.

Here are some upcoming events that may interest you:

The next Compassion Fatigue Train the Trainer sessions will be held in Ottawa November 4-5th and in Kingston November 16-17th. The pre-requisite course, Walking the Walk, will be offered on October 15th in Ottawa and November 15th in Kingston. For more information on the Ottawa course, please visit Safeguards. For more information on the Kingston event, please visit www.compassionfatigue.ca

Back by popular demand – a workshop just for Managers with Dr Pat Fisher: June 13-14th, 2011 in Kingston. This manager’s workshop received rave reviews last May. Please visit my website for more information.

Save the date! The first annual Compassion Fatigue Conference will be held on June 15-16th 2011 in Kingston with Dr Gabor Maté and Laura van Dernoot Lipsky as keynote speakers. Please visit the conference website for more information.

Toronto’s Leading Edge Seminars has just published their Fall schedule, and wow, what a great lineup! In particular, I draw your attention to John Briere’s workshop on “Deconstructing Trauma: Memory Exposure, Mindfulness and Existential Awareness in Psychotherapy”. As many of you know, John Briere has had a great influence on my clinical work and I heartily recommend you go hear him if you have not already done so.

Moving out of the red zone of compassion fatigue: getting feeling back in our toes

Last week I was at the drugstore with my 10 year old son. I was paying for my things when an elderly man approached the counter. He appeared to be in his late eighties and had deep red bags under his eyes. He looked, in a word, absolutely terrible. With a shaking hand, he took a photo out of his pocket and showed it to us and to the women behind the cash. “This is my wife” he said “She died two days ago, we were married for 58 years. She was the love of my life. Now I can’t sleep and the doctor wants me to take these pills” We all fell silent for a minute and then I had a little chat with him. He told me his children all lived out of town, and that he was completely alone. When I left the store with my son in tow, I felt regret that I did not do more. My head was already buzzing with all the community resources I know about, how to link him with the right ones, how we should have taken him out for tea, etc. I was dying to case manage this man into getting support right on the spot but I also had to go home and cook dinner and take care of my family.

This is the constant challenge we face as helpers. Pain and suffering is all around us, it’s not just at work. Where do you draw the line? Do you take every elderly widower out for tea? Do you tell every person with a funny-looking mole to go get checked out? Do you rescue every kitty you see? So what we do is we try our best to figure out boundaries. Sometimes we over-correct and we become like Fort Knox, not letting a single person inside our walls. Sometimes we go too far in the other direction and become ambulance-chasers, rescuing every stray dog and baking for every little old lady on our street.

In my workshops, I am always advocating that we need to gain a better understanding of our own warning signs along the continuum of compassion fatigue. Using traffic lights as an analogy, the green zone is where you are when you are at your very best (I sometimes joke that you are only in the green zone when you’ve been in the field for two weeks or when you have just returned from a 5 month yoga retreat in Tahiti). The yellow zone is where most of us live most of the time. We have warning signs emerging but we often ignore them. The red zone is the danger zone. The extreme end of the red zone finds us on stress leave, clinically depressed or totally withdrawn from others and wracked with anxiety.

We will all visit the less extreme end of the red zone several times in our career – it is a normal consequence of doing a good job.

What suffers first is our emotional and physical health, our family and friends, our colleagues and eventually our clients do pay the price as we become less compassionate, irritable and may make clinical errors.

But back to my story. The reason I am telling you this little anecdote is that I would not have always had this warm compassionate reaction to this man. In fact, my reaction is actually a sign for me that I am well out of the red zone of compassion fatigue (for the time being!). You see, there have been times where I have felt so depleted by all my work demands and difficult stories that I would have hardened myself to this old man’s story and not talked to him at all. Not nice, eh? Have you ever noticed that in yourself or am I the only hard crusty person out there? Conversely, for some of you, being in the red zone would mean you would have jumped into rescuing this man and neglected your family’s needs for the evening.

Research shows that compassion fatigue hits hardest among those of us who are the most caring. As helpers, we have a homing device for need and pain in others and we have this from childhood onwards (for many reasons: family of origin issues, birth order, heredity, etc.) So often for helping professionals the main challenge in their personal life is setting limits and not being a helper/rescuer to everyone around. But eventually, compassion fatigue makes us detach from others: often our colleagues, family and friends suffer far before our clients and patients. Although I am not proud of it, I know that I always seem to save the best for work and give the remaining crumbs to my loved ones. In my clinical work, I feel present, warm and loving towards my clients, even the most challenging soldier who has never wanted to come to counselling and hates being there. But when I am in the red zone I avoid my neighbours, ducking into my house as quickly as possible to avoid a chat, feeling slightly guilty and irritated at the same time. I avoid the phone: “why is my lovely dad calling me to say hi? grrr”

Each of us will have different warning signs. The key to developing an early intervention plan is getting better acquainted with your own. (If you want more resources on this, consider reading my Compassion Fatigue Workbook).

The fact that I feel ready to give again is a great sign of “green zonedom.” Now the trick is keeping it in check and not overcorrecting and becoming depleted again. Keeping the balance, my friends, is a lifetime’s work. I’m ok with that.