compassion fatigue


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Helping Others May be dangerous to your health

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  • Pleasure and satisfaction derived from working in helping, care giving systemsWhat benefit do you derive from this job -
  • Compassion fatigue (also known as a secondary traumatic stress disorder) is a condition characterised by a gradual lessening of compassion over time. It is common among trauma victims and individuals that work directly with trauma victims. It was first diagnosed in nurses in the 1950s.[1] Sufferers can exhibit several symptoms including hopelessness, a decrease in experiences of pleasure, constant stress and anxiety, and a pervasive negative attitude. This can have detrimental effects on individuals, both professionally and personally, including a decrease in productivity, the inability to focus, and the development of new feelings of incompetency and self doubt.[2]
  • Leading traumatologist Eric Gentry suggests that people who are attracted to care giving often enter the field already compassion fatigued. A strong identification with helpless, suffering, or traumatized people or animals is possibly the motive. It is common for such people to hail from a tradition of what Gentry labels: other-directed care giving. Simply put, these are people who were taught at an early age to care for the needs of others before caring for their own needs. Authentic, ongoing self-care practices are absent from their lives.
  • Burn out is a state of physical, emotional, and mental exhaustion caused by long-term involvement in emotionally demanding circumstances.Usually, burn out has its origins in organizational issues – heavy case loads, hierarchical pressures, time constraints, and feelings of powerlessness. Burn out is a process, not a condition. Finally in burn out the symptoms are directly related to the cause, and workers are usually able to articulate the causes quite well. In CF the symptoms are often disconnected from the real causes; making the connection between what one is experiencing and the root cause is far more mysterious.Both share negative affectBurnout is about being worn outSTS is about being afraid
  • A complex problem that stems from working in a difficult work environment with people who have debilitating or serious illnesses or trauma.
  • compassion fatigue

    1. 1. What you don’t know CAN hurt you!Compassion Fatigue
    2. 2. Definitions
    3. 3. I dunno. Whatdo YOU think it What do you think itmeans? Beats me!! means?
    4. 4. Vocabulary• Compassion Satisfaction –Positive aspects of working as a helper
    5. 5. Compassion Satisfaction• The positive aspects of helping Providing care The system Work with colleagues Beliefs about self Altruism
    6. 6. Vocabulary• Compassion Fatigue –Negative aspects of working as a helper
    7. 7. Compassion FatigueAka as secondary traumatic stressdisorder evidenced by:• hopelessness• a decrease in experiences of pleasure, constant stress and anxiety• and a pervasive negative attitude
    8. 8. Compassion FatigueCF describes the emotional, physical,social and spiritual exhaustion thatovertakes a person and causes apervasive decline in his/her desire,ability and energy to feel and care forothers.
    9. 9. CF results from the combined effects ofprimary trauma, secondary trauma, andburnout to produce painful symptoms incaregivers.CF is the gradual loss of empathy forothers over time due to emotional andphysical overload..
    10. 10. CF refers to the emotional and physicalexhaustion that helpers (nurses,doctors, social workers, police officers,chaplains, caregivers, the list goes onand on) experience over time whenworking in these challenging andrewarding fields.
    11. 11. CF is a state experienced by thosehelping people in distress; it is anextreme state of tension andpreoccupation with the suffering ofthose being helped to the degreethat it is traumatizing for thehelper.
    12. 12. Vocabulary• Burnout –Inefficacy and feeling overwhelmed
    13. 13. Burnout• Occupational burnout, characterized by exhaustion, cynicism, and reduced professional efficacy within the workplace• Frustration and exhaustion stemming from a highly stressful workload and/or a non- supportive work environment• Stress that is cumulative, relatively predictable, and frequently can be helped through a respite or habit/life change.
    14. 14. Burnout and STS- Co Travelers• Burnout –Work-related hopelessness and feelings of inefficacy• Secondary Trauma Stress (STS) –Work-related secondary exposure to extremely or traumatically stressful events
    15. 15. Vocabulary• Work-related traumatic stress –Secondary traumatic exposure to event due to a relationship with the primary person (Vicarious trauma)
    16. 16. Secondary Trauma StressSecondary trauma stress is work-related, indirect exposure to extremelystressful events such as working withchild abuse victims, treating war-related causalities and responding todisasters.
    17. 17. It often begins soon after exposure toanother person’s specific traumaticevent but it can also be cumulativewith repeated exposure to others’traumatic situation. Karen Dickason, LCSW, CFAP
    18. 18. People Bring Themselves• Victim assistance workers include people with all types of education, training and income• Some workers bring with them histories of difficult lives that may include trauma• Some people have difficult family, economic, or other personal situations
    19. 19. People Bring ThemselvesPeople bring a past and a present toanything they do – Their schemas and beliefs – Their social support systems • Positive support • Negative reactions – Their history of trauma and illness – Their families and close others – Their economic situation
    20. 20. Stages andSymptoms
    21. 21. Compassion Fatigue Trajectory• The Zealot Phase• The Irritability Phase• The Withdrawal Phase• The Zombie Phase
    22. 22. Zealot Phase• Committed, involved, available• Solving problems/making a difference• Willingly go the “extra mile”• High enthusiasm• Volunteers without being asked
    23. 23. The Irritability Phase• Begin to cut corners• Begin to avoid clients/patients• Begin to mock co-workers and clients• Begin to denigrate the people we serve
    24. 24. • Use of humor is inappropriate• Oversights, mistakes and lapses of concentration• Start distancing ourselves from friends and coworkers
    25. 25. The Withdrawal Phase• Enthusiasm turns sour• Clients become irritants, instead of persons• We make complaints about our work life and our personal life
    26. 26. • Tired all the time, don’t want to talk about what we do• We start to neglect our family, clients, coworkers and ourselves• We try to avoid our pain and sadness
    27. 27. The Zombie Phase• Our hopelessness turns to rage• We begin to hate people…any/all people• Others appear incompetent or ignorant to us
    28. 28. • We develop a real distain for our clients• We have…no patience…no sense of humor…no time for fun
    29. 29. Where are you?• What phase do you think you are in right now?
    30. 30. Not me. I’m a trained Me, either. I’m professional.. too mentallyNope, not me tough. There must be something wrong with me. I think I’m developing it. WHO IS AT RISK?
    31. 31. EVERYONE
    32. 32. Symptoms• Can’t rid oneself of thoughts and images of a client’s situation and pain• Compulsive desire to work with certain clients• Client time leaches over into private time• You see the clients as fragile individuals who “need” you
    33. 33. Symptoms• Avoidance behaviour especially of certain clients or types of clients• Sleep disturbances which may contribute to forgetting and loss of concentration• Feelings of inadequacy (you can never do enough, be good enough)
    34. 34. Signs of CF• Emotional Signs• Social• Physical• Intellectual• Spiritual• Professional
    35. 35. EMOTIONAL • Feel depressed – may want to quit job • Sudden outbursts of anger • Feel sad, tears just below the surface • Feel cynical, numb, or hardened • Nightmares or flashbacks • High volatility of feelings
    36. 36. SOCIAL Loss of interest in previously enjoyed activities Avoidance of certain patients / clients Hyper vigilant response to certain cases Diminished sense of purpose / enjoyment
    37. 37. • Difficulty separating work life from personal life• Diminished functioning in non- professional circumstances• Increases in in-effective or self destructive self soothing behaviours
    38. 38. Physical Intrusive thoughts / images Headaches GI symptoms Insomnia / nightmares / sleep disruptions Decreased immune response Lethargy Becoming more accident prone
    39. 39. Spiritual • Questioning the meaning of life • Questioning prior religious beliefs • Increased scepticism • Loss of hope
    40. 40. PROFESSIONAL • Difficulty separating work life from personal life • Withdrawal from colleagues • Feelings of therapeutic impotence • Diminished functioning in non- professional circumstances
    41. 41. Solutions
    42. 42. Organizational Personal Professional Three Areas to Consider
    44. 44. Indications of Organizational Compassion Fatigue• Increased absenteeism• Constant changes in co-worker relationships• Staff sniping at one another• Negativity toward management and clients
    45. 45. • Inability of staff to complete assignments and tasks; or to respect/meet deadlines• Lack of flexibility among staff• Inability for staff to believe change is possible – “why bother?”
    46. 46. Organizational Strategies• Have established roles, clear policies and protocols, supervision sessions, reasonable expectations• Recognize the “banking analogy” – no withdrawal without a deposit• Quality more important than quantity, or how fast you complete treatment
    47. 47. • Encourage team work rather than competition• Discourage over-time, excessive client load
    48. 48. • Educate staff about what they might expect to experience• Hold in-service activities• Have managers be aware of changes in behaviour of staff
    49. 49. PROFESSIONAL
    50. 50. Professional Strategies• Supervision – ask for it and use it• Be clear and aware of potential Boundary violations• Self-awareness
    51. 51. Professional Strategies• Processing of events and emotions• Realize that not all cases are treatable and you are not inadequate because you did not seem to be able to help.
    52. 52. PERSONAL
    53. 53. Personal Strategies• Be aware – know the symptoms of CF• Health Promotion- Take care of yourself first. You can’t feed the hungry from an empty soup kettle•Learn to “Roll with the punches” – not everything is equally important•Talk to yourself in a positive way
    54. 54. Personal StrategiesComplete this sentence five times, infive different ways: “I sometimes find itdifficult to balance______ with ______.” (Hint, think aboutdemands, responsibilities, and desiresacrossdifferent people, roles, and situations inyour life).
    55. 55. More Healthy Strategies• Take some time to decompress after difficult sessions• Don’t think about work away from work• Personal journals• Good nutrition
    56. 56. More Healthy Strategies• Breathing (deep)• Take vacations – don’t be a martyr• Engage in exercise, recreation and hobbies• Develop a strong support system
    57. 57. REMEMBER• You can only do what you can do• You are not God• There will always be more need than resources• Their pain is not your pain
    58. 58. QUESTIONS????