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Greg carlsson

  1. 1. Vicarious Trauma: It Seems to be Taking Over My Life! Presentation by Greg Carlsson, L.M.F.T. Pasadena, California (626) 568-7991
  2. 2. Activity Part 1 Mindful Breathing: Mindfulness is “paying attention, in a particular way; on purpose, in the present moment, and non judgmentally.”
  3. 3. Objectives 1. Understand the working definitions of: Vicarious Trauma Secondary Trauma Compassion Fatigue Burn Out 2. Understand the ‘parallel trauma process’ between students and care providers. 3. Gain a better understanding of where trauma is held in our bodies. 4. Learn clinical tools to work through identified traumas.
  4. 4. To be trusted with another’s trauma is not to be taken lightly. Trauma may not be what we signed up for... but its part of the job. If we are to continue with this work, we must embrace our reaction to trauma, learn from it and move forward.
  5. 5. Trauma, Fatigue and Burnout.
  6. 6. Primary Trauma: A traumatic event that has happened to you. Primary trauma can happen at work or stem from our past trauma history. As helping professionals it’s important that we address our own trauma history. Research shows that about 60% of helping professionals have a trauma history of their own. Our own trauma history may play a role in why we become involved in a helping profession. If our own past trauma is not addresses, we may become more vulnerable while doing the work. Adapted from The compassion fatigue workbook: creative tools for transforming compassion fatigue and vicarious traumatization, Francoise Mathieu
  7. 7. Secondary Trauma: You are not at the event but learning about it at a later date. Secondary exposure refers to not experiencing the trauma first hand but hearing about it, reading a report describing it, or maybe seeing photos of the traumatic event. Both Primary and Secondary Trauma can cause Post Traumatic Stress Disorder (PTSD) Adapted from The compassion fatigue workbook: creative tools for transforming compassion fatigue and vicarious traumatization, Francoise Mathieu.
  8. 8. Symptoms might be characterized by: Nightmares Having intrusive thoughts about the traumatic event. Depression The lack interest in important areas of life. Becoming immobilized in certain parts of your life.
  9. 9. . Vicarious Trauma: The profound shift that you may experience in your world view when you work with individuals who have experienced trauma You may begin to see the word in a different way. Vicarious Trauma also occurs when the stories we hear transform us in a way that also traumatizes us. We find it difficult to rid ourselves of the stories we have been told. These images and experiences can stay with us for a very long time. It is not something that clients do to us; it is a human consequence of knowing, caring and facing the reality of trauma. Adapted from Saakvitne K.W., Perman, L.A., & Staff (1996) p. 25
  10. 10. Compassion Fatigue: A general erosion of our empathy, hope and compassion for life may begin to surface. A reduction in our ability to be genuinely compassionate may occur. Who: Teachers, psychologists, nurses and other helpingprofessionals Symptoms may include: A profound emotional and physical exhaustion A bitterness towards work Changes in our personal and professional lives. Becoming part of a toxic work environment. Adapted from The compassion fatigue workbook: creative tools for transforming compassion fatigue and vicarious traumatization/ Francoise Mathieu.
  11. 11. Burnout : Physical and emotional exhaustion that workers can experience when they have low job satisfaction, feel powerless and overwhelmed at work. Adapted from The compassion fatigue workbook: creative tools for transforming compassion fatigue and vicarious traumatization, Francoise Mathieu.
  12. 12. Exhaustion, irritability, and anger, caused at work, may be transferred to your loved ones. You may feel as though they should be as compassionate as you are! “Why donʼt they see this work as important as I do.” Your body may also take the impact.
  13. 13. Vicarious Trauma, Compassion Fatigue & Burn Out are not exclusive and can build on each other. We can begin to feel alienated at home and not feel supported by our families or friends.
  14. 14. Risk Factors that can cause one to be more vulnerable to S.T., V.T.: 1. A history of childhood trauma 2. Difficult life circumstances 3. The use of vices may be used to escape the overwhelming sadness coming from the trauma; Food, Drugs, Excessive work Excessive alcohol Sex...
  15. 15. Activity Part II 1. Think of a situation that might apply to one of the above areas. 2. Take three minutes, turn to your neighbor, and share your story. 3. Donʼt get too graphic. 4. While sharing, reflect on your feelings.
  16. 16. Your body can be a barometer. Notice where in your body you hold the tension. As you were sharing your story, did you feel parts of your body tensing up?
  17. 17. Activity Part III Butterfly Hugs, Bilateral stimulation & Mindful Breathing
  18. 18. 1. Complete the “Mindful Breathing” again while adding the Butterfly Hugs. 2. Notice where you hold the tension. 3. When breathing out, focus on releasing the tension from your body. 4. Notice if you are holding on to the tension.
  19. 19. When hearing about stressful situations first hand, do you notice your body becoming more tense?
  20. 20. Self Awareness - The relationship between physical and emotional health is paramount to understanding our relationship to trauma and stress.
  21. 21. Self Awareness in the present Self Awareness of the past Self Awareness for the future.
  22. 22. Self Awareness in the present: Understanding how current tension in our lives effect our physical and emotional well being. Self Awareness of the past: The influences that our past life experiences - good and bad have had on our current work and life choices. Self Awareness for the future: Making changes now that will effect our future physical and emotional well being.
  23. 23. Activity Part IV The Empty Container For the time being, take the negative impact of the trauma or situation and “let it go” in to a container you have created in your mind. 1. Picture a strong container like a tupperware, treasure locker, ocean liner... 2. Practice opening it and closing it. 3. Feelings, thoughts or memories you don’t want to think about right now, flow from your head into your container.
  24. 24. 4. Take your time, this can take a while. When you have everything you want in the container, close it up. 5. Notice how your body feels. 6. You decide when you want to open your container and take out one item at a time 7. Use this when ever you want to temporarily set something aside.
  25. 25. Be aware of your own process. External: The way you interact with the rest of the world (Secondary Trauma, Vicarious Trauma, Post Traumatic Stress Disorder). Internal: The way your body holds the trauma e.g. Tension in parts of your body. Unable to fall asleep at night. lack of appetite. Bingeing on comfort foods. A Adapted from Trauma Stewardship: An everyday guide to caring for self while caring for others, Laura van Dernoot Lipsky with Connie Burk
  26. 26. In both the personal and professional realm, it is about mindfulness, the ability to recognize and control your physical symptoms of stress and anxiety, and your breathing.
  27. 27. The Parallel Process When a trauma is shared by a group, each person has their own trauma history which may impact their reaction to the current trauma. Based on our trauma history, we may share similar or different reactions to the trauma with the person we are helping. This process may parallel your student’s process. Be aware of your reactions internally and externally to the trauma.
  28. 28. With some trauma situations, you may not have the luxury of processing your own needs, if you are responsible for helping others. Use the breathing techniques taught earlier and utilize bilateral stimulation (the butterfly hugs) to help calm yourself and focus on those you are helping. Adapted from Compassion Fatigue, The Crucible of Transformation 2002 article, Eric Gentry:
  29. 29. Activity Part v Peaceful Place, Person or Animal: 1, Pick a place where you feel calm and peaceful, like the mountains or the beach. 2. If you don’t have a real place you can make one up. If this seems to be difficult, try imagining a favorite pet or a special person who brings you comfort. 3. Make sure you do not equate your place with anything bad. 4. Close your eyes and apply the butterfly hugs to the exercise.
  30. 30. As you tap, think about your place. Next, decide on a word that reminds you of your special place. You can use your word to “pull up” your special place.
  31. 31. What personal set of circumstances, helped develop the passion you hold for your work? Once you understand and embrace your past, you can use it to strengthen your current work situation.
  32. 32. Two key principles to help us address V.T. and C.F.: A non-anxious presence: To be in a room with a child’s pain and suffering and be able to express empathy and compassion without taking on the child’s suffering. Self-validated caregiving: The self-care that is guilt-free, self-care that is prioritized as a means of remaining healthy in the line of work.
  33. 33. Ways to process your trauma history if it comes up: 1. Mindful Breathing. 2. Where am I holding the tension in my body. a. Breathing the tension out of my body. 3. Butterfly bugs
  34. 34. 4. Debriefing: What do we say to whom, and when. Talking with a peer, (warnings of the content). 5. Asking permission to share, less is more. Do we really need to recap the entire session or can we just say, “wow, that was really difficult for me to hear”.
  35. 35. Transition time from work to home. Letting go of the work day and transitioning to your private time. 1. Special music for the drive home or listening to a book on CD. . 2. Stopping for coffee or tea before arriving home. Taking a walk first. 3. Going to the gym first. 4. Stopping a block away - Mindful breathing, butterfly hugs, empty container.
  36. 36. Self Care: Four Steps to Wellness. 1. Take stock in your body, your home environment and work place. Body Scan - Where is the tension? 2. Life /work balance. Work Hard... Play Harder. Refueling during the day. Mini breaks: peaceful place, Mindful Breathing, soothing music, soothing sounds, butterfly hugs. Planning trips for vacation
  37. 37. 3. Resiliency through Relaxation Training Yoga, meditation tapes, Walking, 4. Making a commitment to change. 5. You can hold yourself accountable to others. 6. Write down an area you would like to change and place it where you can see it each day. 7. Create a mantra that reminds you of the change.
  38. 38. Stop using rewards as a way to pay yourself back - In doing so, you may be setting up tension with yourself that may backfire – If you want it and you know it’s healthy, then have it because you want it.
  39. 39. Recapping our strategies: Mindful Breathing Body Scan, where am I holding the tension Peaceful place, person or animal Empty Container Butterfly Hugs
  40. 40. We need to develop a support system for ourselves. We can not work in a caring profession in isolation. We must develop and rely on systems and tools to support us if we plan to continue the work for a long period of time.
  41. 41. Our capacity to help others and the environment is greatest when we are willing and even determined to be helped ourselves.
  42. 42. “Be the change you want to see in the world.” - Gandhi.