Compassion fatigue

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  • 1. Compassion Fatigue Secondary Trauma What is it?

2. History 1982: Charles Figley defines SecondaryTraumatic Stress as a phenomenon associated with the cost of caring 1992: Nurse Joinson used term in Nursing Magazine to describe feeling of worn down 1992: Jeffrey Kottler writes CompassionateTherapy to emphasize importance of compassion when dealing with difficult / resistant clients 1995: Figley redefines SecondaryTraumatic Stress to a more friendly term - Compassion Fatigue 3. CF defined: Those who work with the suffering suffer themselves because of the work We absorb the traumatic stress of those we help (Beaton & Murphy, 1995) 4. AKA Secondary Trauma or Secondary Post-Traumatic Stress or Secondary Exposure or SecondaryVictimization orVicariousTraumatization or Emotional Contagion or Secondary Survivor Phenomenon associated with the cost of caring for others in emotional pain (Figley, 1982) 5. Compassion Fatigue Secondary Trauma Do I have it? 6. CF Possible Solution 7. Compassion Fatigue Secondary Trauma How did I get it? 8. The CF Process Figley, 2001 9. The CF Process 1. Exposure to Suffering 2. Empathic Concern motivation to respond to those in need 3. Empathic Ability aptitude for noticing the pain of others 4. Empathic Response helper makes an effort to reduce the suffering of the sufferer 10. The CF Process 5. Compassion stress compulsive demand for action to relieve the suffering of others 6. Prolonged Exposure on-going sense of responsibility for the care of the suffering 7. Traumatic recollections memories that trigger the symptoms of PTSD 8. Demands of Life unexpected changes in schedule, routine, & managing lifes responsibilities that demand attention 11. The CF Process 9. Compassion Fatigue state of tension and preoccupation with the traumatized by: a. Re-experiencing the traumatic events b. Avoidance/numbing reminders c. Persistent arousal 9. CompassionTrap inability to let go of the thoughts, feelings and emotions useful in helping another, long after they are useful 12. A Codependen t Co- worker with Compassion Fatigue 13. Compassion Fatigue Secondary Trauma How bad is it? 14. Contributing Factors Intensity Frequency Severity Proximity Personal Factors Sensory Information Imprint of Horror (Learner, 2005) Perceptions, Belief system Current coping mechanisms Implementation of self-care techniques Support system 15. Symptoms of Poor Self-Care Cognitive Diminished concentration Confusion Loss of meaning Decreased of self-esteem Apathy Rigidity Self-doubt Perfectionism Minimization 16. Symptoms of Poor Self-Care Emotional Powerlessness Anxiety (Survivor) Guilt Anger/rage Numbness Fear Sadness Helplessness Depression Hypersensitivity Overwhelmed Depleted 17. Symptoms of Poor Self-Care Behavioral Impatient Withdrawn Moody Regression Sleep Disturbances Appetite changes Elevated startled response Hyper vigilance Use of unhealthy coping skills Accident proneness Losing things Self-harm behaviors 18. Symptoms of Poor Self- Care Spiritual Questioning the meaning of life Loss of purpose Lack of self-satisfaction Pervasive hopelessness Angry at God Questioning prior beliefs Soul Sick (Bill OHanlon) 19. Symptoms of Poor Self- Care Interpersonal Withdrawn Decreased interest in intimacy Mistrust Intolerance Loneliness Projection of anger or blame 20. Symptoms of Poor Self- Care Physical Shock Sweating Rapid heartbeat Aches and pains Dizziness Impaired immune system Restlessness 21. Impact on Professional Functioning Performance of JobTasks Decrease in quality & quantity Low motivation Avoidance of job tasks Increased mistakes Setting perfectionist standards Obsession about details 22. Impact on Professional Functioning Morale Decrease in confidence Loss of interest Dissatisfaction Negative attitude Apathy Demoralization Lack of appreciation Detachment Feelings of incompleteness 23. Impact on Professional Functioning Interpersonal Withdrawal from colleagues Impatience Decrease in quality of relationship Poor communication Staff conflicts 24. Impact on Professional Functioning Behavioral Absenteeism Exhaustion Faulty judgment Irritability Tardiness Irresponsibility Overwork Frequent job changes 25. Compassion Fatigue Secondary Trauma How do I get rid of it? 26. When you discover you are riding a dead horse, the best strategy is to dismount - Dakota Tribal Saying 27. Primum non nocerePrimum non nocere - Claudius Galen, born in 129 AD, chief physician to the gladiator school in Pergamum First Do No HarmFirst Do No Harm 28. First do no harmFirst do no harm to Selfto Self - Gentry & Figley, 2007 Created adage after discovering correlation between compassion fatigue and ethical violations 29. Self-Care may involve Re-evaluating an unhealthy relationship Listening to your body & staying within your limits Advocating for your rights Commit more time to planning Not assuming responsibility for others & their problems Lose all-or-nothing thinking; be more flexible Not feeling compelled to fix/solve another persons problem Not anticipate the needs of others 30. Self-Care may involve Re-think trying to please others; explore being satisfied with self Appreciate your mistakes opportunity to learn & grow Not over-committing Giving yourself plenty of time so you dont feel harried or pressured Quit blaming and shaming selfthen others Stop taking things personally 31. Self-Care may involve Keeping up with dentist & doctors appts. Taking restroom breaks when needed Accepting myself for who I am Not feeling the need to control; accept some things are out of my control Forgive yourself when you make a mistake Quit trying to prove youre good enough Stop tolerating behaviors that you dont want to tolerate Trust yourself 32. Compassion Fatigue Secondary Trauma How do I keep it from coming back? 33. Back to the CF Process Detachment (M. Beattie, 1992) Opposite of attachment excessively worried or preoccupied w/ person or problem Its Not: Cold,Withdrawn, Hostile, Ignorant Bliss Based on premise that each person is responsible for himself & we cant solve problems that arent our own & worrying doesnt help 34. Detachment cont. It doesnt mean we dont care. It means we learn to love, care & be involved without going crazy (M. Beattie, 1992) When we allow people to be who they are, then we stop trying to change things we cant. (M. Beattie, 1992) 35. Sense of Satisfaction Shades of Gray (D. Burns, 2005, Cognitive Motivational Therapy) When things dont work out as well as youd hoped, you can think of the experience as a partial success or learning opportunity. Question: Are you wanting your client to provide for you a sense of satisfaction? Youre OK then Im OK 36. Sense of Satisfaction cont. Reframe the Pay-Out Appreciation Approval Attention Acceptance Affiliation Admiration Acknowledgement Affirmation Accomplishment Affection 37. Standards of Self-Care 1. Respect for dignity & worth of self 2. Responsible for self-care 3. Universal right to wellness 4. Physical rest, emotional rest & nourishment 5. Seek, find & remember appreciation from supervisors & clients 6. Make it known that you wish to be recognized for your service Adapted from Standards of Self Care for the Practitioner, Green Cross Foundation, Inc., 2004