Recognizing Stress, Burnout, and the Impacts of Vicarious Trauma and Countertransference in Body-Based Work. Presented in Bangalore (Bangaluru), India.

1. DR. MAYA ANGELOU
“As you grow older, you will discover
that you have two hands;
one for helping yourself,
the other for helping others.”
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Sara R. van Koningsveld, MA, BC-DMT, LPCC, GL-CMA, RYT 200 – Stress in Body-Based Work, December 2023

2. Recognizing Stress, Burnout, and
the Impacts of Vicarious Trauma
and Countertransference in
Our Body-Based Work
Sara R. van Koningsveld, MA
NCC, BC-DMT, GL-CMA, RYT 200

3. Learning Objectives
oAttendees will develop an enhanced understanding of the terms:
body-based transference and countertransference, burnout and
compassion fatigue, self-knowledge, mindfulness, resilience, and
mind-body connection as approaches to stress management and
burnout prevention.
oAttendees will increase self-awareness and body knowledge,
through breath-work, body sensing, and application of various
dance/movement therapy techniques (creative movement, body
scan, etc.).
oAttendees will integrate theoretical understanding of self-
awareness, body knowledge, and mind-body wellness with
accessible, time sensitive, and restorative practices for every day,
preventing burnout and increasing resilience.
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Sara R. van Koningsveld, MA, BC-DMT, LPCC, GL-CMA, RYT 200 – Stress in Body-Based Work, December 2023

4. agenda
WELCOME &
INTRODUCTION
EXPERIENCES OF
SERVICE PROVIDERS
STRESS AND BURNOUT
PREVENTION
VICARIOUS TRAUMA AND
COUNTERTRANSFERENCE
MAINTAINING WELL-BEING
THROUGH SELF-CARE

5. introduction
• First generation university graduate
• Body-based practitioner
• classical ballet
• jazz/ musical theater
• modern/contemporary
• somatics: yoga, Pilates
• Mind-body professional
• psychotherapist & counselor
• dance/movement therapist
• yoga teacher
• wellness coach
• Professional trainer
• Neurodivergent
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Sara R. van Koningsveld, MA, BC-DMT, LPCC, GL-CMA, RYT 200 – Stress in Body-Based Work, December 2023

6. experiences
of service
providers

7. terminology
oStress
• Eustress
• Distress
oAutonomic Nervous System
• Fight, flight
• Freeze, fawn
oThe Brain
• Amygdala: implicit memory
• Hippocampus: explicit memory
• Cortisol, adrenaline, dopamine
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Sara R. van Koningsveld, MA, BC-DMT, LPCC, GL-CMA, RYT 200 – Stress in Body-Based Work, December 2023

8. mood
emotions
feelings
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Sara R. van Koningsveld, MA, BC-DMT, LPCC, GL-CMA, RYT 200 – Stress in Body-Based Work, December 2023

9. terminology
oCountertransference
• Somatic countertransference
oCompassion fatigue / “empathy fatigue”
• Secondary trauma
• Vicarious trauma
oTherapist distress
• Occupational stress
oBurnout
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Sara R. van Koningsveld, MA, BC-DMT, LPCC, GL-CMA, RYT 200 – Stress in Body-Based Work, December 2023

10. wounded healer
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o Archetype concept by Carl Jung
o Examining where we can grow, recognizing areas
where we need support, and doing our own healing
work allows us to be more effective in our work.
o If we are not conscious of our own wounds, we
might unconsciously bring the pain/suffering into the
space with a client.
Sara R. van Koningsveld, MA, BC-DMT, LPCC, GL-CMA, RYT 200 – Stress in Body-Based Work, December 2023

11. healing the healer
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oCompassion satisfaction
oSelf-compassion
oSelf-regulation
oSelf-efficacy
oMindfulness
oSocial and collegial support
Sara R. van Koningsveld, MA, BC-DMT, LPCC, GL-CMA, RYT 200 – Stress in Body-Based Work, December 2023

12. defining
trauma

13. defining trauma
oA deeply distressing, overwhelming, and/or disturbing experience.
oSingle event
oComplex
oProlonged
oIntergenerational
oBig “T” and Little “t”
oTrauma:
• Event
• Meaning
• [Existing Neural] Landscape
• Inescapability
Sara R. van Koningsveld, MA, BC-DMT, LPCC, GL-CMA, RYT 200 – Stress in Body-Based Work, December 2023 13

14. Individual
Interpersonal
Community
Systemic
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Sara R. van Koningsveld, MA, BC-DMT, LPCC, GL-CMA, RYT 200 – Stress in Body-Based Work, December 2023

15. becoming
trauma
informed

16. 16
https://www.washoeschools.net/cms/lib/NV01912265/Centricity/Domain/202/Secondary%20Trauma%20-%20April%202021%20-%20Final.pdf
Sara R. van Koningsveld, MA, BC-DMT, LPCC, GL-CMA, RYT 200 – Stress in Body-Based Work, December 2023

17. trauma informed care
SAFETY
TRUSTWORTHINESS
PEER SUPPORT &
COLLABORATION
EMPOWERMENT HUMILITY
Sara R. van Koningsveld, MA, BC-DMT, LPCC, GL-CMA, RYT 200 – Stress in Body-Based Work, December 2023

18. process terms
oWhole person
oActing-in/ Acting-out
• Re-enacting
oCoping
• Temporary relief
oHealing
oPrevention
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Sara R. van Koningsveld, MA, BC-DMT, LPCC, GL-CMA, RYT 200 – Stress in Body-Based Work, December 2023

19. creating safe environments
oBecome aware of triggering environments, situations, and stimuli.
• Establish and maintain clear boundaries.
• Communicate expectations, limitations.
• Be consistent.
oDevelop a trusting working alliance.
• Empower the client
• Individualize care
• Maintain a strengths-based lens
oRecognize your triggers and attend to personal needs.
oWork collaboratively, and/or seek support/mentorship/supervision.
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Sara R. van Koningsveld, MA, BC-DMT, LPCC, GL-CMA, RYT 200 – Stress in Body-Based Work, December 2023

20. 20
https://www.nicabm.com/trauma-how-to-help-your-clients-understand-their-window-of-tolerance/

21. JEAN SHINODA BOLEN
“When you recover or discover something
that nourishes your soul and brings you
joy, care enough about yourself to make
room for it in your life.”
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Sara R. van Koningsveld, MA, BC-DMT, LPCC, GL-CMA, RYT 200 – Stress in Body-Based Work, December 2023

22. well-being

23. 23
https://wellbeing.studentlife.umich.edu/what-well-being

24. living a balanced life
BALANCE UNBALANCE
MIND • Peace & gratitude
• Positive outlook
• Unresolved situations &
relationships
• Negative outlook
BODY • Varied exercise
• + Nutrition
• + Sleep patterns
• Inactive
• Pain
• − Nutrition
• − Sleep
SPIRIT/SOUL • Spiritual connection, religious
beliefs
• Purpose
• Morals
• Good Karma
• Limited/no connection
• Lack of purpose
• Negative Karma
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Sara R. van Koningsveld, MA, BC-DMT, LPCC, GL-CMA, RYT 200 – Stress in Body-Based Work, December 2023

25. mindfulness or meditation?
oMindfulness is a quality; Meditation is a practice.
oMeditation is one avenue to living mindfully.
oMindfulness does not have to include meditation.
oMindfulness can be practiced formally or informally.
oMindfulness is ONE aspect of Meditation.
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Sara R. van Koningsveld, MA, BC-DMT, LPCC, GL-CMA, RYT 200 – Stress in Body-Based Work, December 2023

26. mindfulness
oPaying attention
• Present moment – here & now
• On purpose – intentional
• Nonjudgmental – without opinion
oThoughts
oFeelings
oSensations
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Sara R. van Koningsveld, MA, BC-DMT, LPCC, GL-CMA, RYT 200 – Stress in Body-Based Work, December 2023

27. approaches to self-care
oScheduled
• Planned and typically organized in nature.
oMomentary (“fast food self-care”)
• Happens in-the-moment, checking-in periodically.
Multifaceted approaches to well-being have the greatest impact on
stress reduction and burnout prevention!
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Sara R. van Koningsveld, MA, BC-DMT, LPCC, GL-CMA, RYT 200 – Stress in Body-Based Work, December 2023

28. JON KABAT-ZINN
“Mindfulness is a way of befriending ourselves
and our experience.”
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Sara R. van Koningsveld, MA, BC-DMT, LPCC, GL-CMA, RYT 200 – Stress in Body-Based Work, December 2023

29. 29

30. momentary self-care
oMovement Based
• Dimensional Scale by Rudolf Laban
• Rebounding
• Stretching/ Yoga asana
oBreath Based
• Three-Dimensional Breathing
• Yoga practice/ Pranayama
oOther
• Meditation/ Silence & Stillness
• Guided imagery
• Ritual practices : hand washing, lotion, etc.
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Sara R. van Koningsveld, MA, BC-DMT, LPCC, GL-CMA, RYT 200 – Stress in Body-Based Work, December 2023

31. planned self-care
oSocial events
oGoing to a class
oTaking a holiday
oParticipating in retreats
oDaily routines
oIntentional activities
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Sara R. van Koningsveld, MA, BC-DMT, LPCC, GL-CMA, RYT 200 – Stress in Body-Based Work, December 2023

32. self-awareness
oWhat belongs to me and what belongs to the other?
oListening to ourselves: senses/sensations
oBeing a healer vs. a “treater”
• Empathy/compassion
• Presence and connecting to other
o“Both interpersonal and intrapersonal attunement develop the
capacity for intimate relationships, well-being and resilience.”
(Siegel, 2007, p. 14)
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Sara R. van Koningsveld, MA, BC-DMT, LPCC, GL-CMA, RYT 200 – Stress in Body-Based Work, December 2023

33. body awareness
oHumane Effort…enables us to learn, grow, and change in
movement, building awareness of the relationship between mind
and body (Laban, 1988).
oKinesthetic Sense/ Kinesthetic Awareness: felt/sensory experience
allows the mind to assess and interpret a situation, take action,
and respond accordingly (movement which is interpreted by
others).
oBody Knowledge/ Body Prejudice
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Sara R. van Koningsveld, MA, BC-DMT, LPCC, GL-CMA, RYT 200 – Stress in Body-Based Work, December 2023

34. JENNIFER LOUDEN
“Self-care is not selfish or self-indulgent.
We cannot nurture others from a dry well.
We need to take care of our own needs first,
then we can give from our surplus,
our abundance.”
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Sara R. van Koningsveld, MA, BC-DMT, LPCC, GL-CMA, RYT 200 – Stress in Body-Based Work, December 2023

35. resources
Alkema, K., Linton, J.M., & Davies, R. (2008). A study of the relationship between self-care, compassion satisfaction, and burnout
among hospitce professionals. Journal of Social Work in End-of-Life & Palliative Care, 4(2), 101-119.
Barnett, J. E., Baker, E. K., Elman, N. S., & Schoener, G. R. (2007). In pursuit of wellness: The self-care imperative. Professional
Psychology: Research and Practice, 38(6), 603-612.
Christopher, J. C. & Maris, J. A. (2010). Integrating mindfulness as self-care into counselling and psychotherapy training. Counselling
and Psychotherapy Research, 10(2), 114-125.
Eastwood, C. & Ecklund, K. (2008). Compassion fatigue risk and self-care practices among residential treatment center childcare
workers. Residential Treatment for Children and Youth, 25(2), 103-122.
Fiscalani, S. & Rytz, T. (2010, September). Mind-body awareness in the treatment of eating disorders and obesity. Presentation
given at American Dance Therapy Association Conference, Brooklyn, NY.
Kabat-Zinn, J. (2005). Coming to our senses: Healing ourselves and the world through mindfulness. New York, NY: Hyperion.
Laban, R. (1988). The mastery of movement (4th ed., rev.). Plymouth, England:
cote House Publishers Ltd.
Lengerich, S. L. (2001). An investigative study of staff burnout using dance/movement therapy principles on an inpatient psychiatric
unit. Graduate Thesis. Chicago, IL: Columbia College Chicago.
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Sara R. van Koningsveld, MA, BC-DMT, LPCC, GL-CMA, RYT 200 – Stress in Body-Based Work, December 2023

36. resources (continued)
Miller, B. (2002). The Resilient Therapist. California Psychologist, July 2002.
Newlove, J. (1993). Laban for actors and dancers. New York, NY: Routledge.
Porges S. W. (2009). The polyvagal theory: new insights into adaptive reactions of the autonomic nervous system.
Cleveland Clinic journal of medicine, 76 Suppl 2(Suppl 2), S86–S90. https://doi.org/10.3949/ccjm.76.s2.17
Richards, K. C., Campenni, C. E., & Muse- Burke, J. L. (2010). Self-care and well-being in mental health professionals:
The mediating effects of self-awareness and mindfulness. Journal of Mental Health Counseling, 32(3), 247-264.
Rothschild, B. (2000). The body remembers: The psychophysiology of trauma and trauma treatment. New York:
W.W. Norton & Company.
Rothschild, B. (2006). Help for the helper: The psychophysiology of compassion fatigue and vicarious trauma. New
York: W.W. Norton & Company.
Sadler-Gerhardt, C.J. & Stevenson, D.L. (2011, October). When it all hits the fan: Helping counselors build resilience
and avoid burnout. Paper based on a program presented at the ACES Conference, Nashville, TN.
Schultz, J. “5 Differences Between Mindfulness and Meditation.” Positive Psychology, 09 Jan. 2020,
positivepsychology.com/differences-between-mindfulness-meditation. Accessed: 10 August 2020.
Shanafelt, T. D. (2009). Enhancing meaning in work: A prescription for preventing physician burnout and promoting
patient-centered care. Journal of the American Medical Association, 302(12), 1338-1340.
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Sara R. van Koningsveld, MA, BC-DMT, LPCC, GL-CMA, RYT 200 – Stress in Body-Based Work, December 2023

37. resources (continued)
Siegel, D. J. (1999). The developing mind: Toward a neurobiology of interpersonal experience. New York: Guilford
Press.
Siegel, D. J. (2006). An interpersonal neurobiology approach to psychotherapy: How awareness, mirror neurons and
neural plasticity contribute to the development of well-being. Psychiatric Annals, 36(4), 248-258.
Siegel, D. J. (2007). The mindful brain: Reflection and attunement in the cultivation of well-being. New York: W.W.
Norton & Company.
Swetz, K. M., Harrington, S. E., Matsuyama, R. K., Shanafelt, T. D., & Lyckholm, L. J. (2009). Strategies for avoiding
burnout in hospice and palliative medicine: Peer advice for physicians on achieving longevity and fulfillment.
Journal of Palliative Medicine, 12(9), 773-777.
van Koningsveld, Sara R. (2011). Effort and personality according to Rudolf Laban: An artistic inquiry of Mobile State.
Graduate Thesis. Chicago, IL: Columbia College Chicago.
Wolf, C. & Serpa, J. G. (2015). A clinician’s guide to teaching mindfulness. Oakland: New Harbinger Publications.
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Sara R. van Koningsveld, MA, BC-DMT, LPCC, GL-CMA, RYT 200 – Stress in Body-Based Work, December 2023

38. thank you
sara r. van koningsveld, ma, ncc, bc-dmt, gl-cma, ryt 200
saravdmt@gmail.com
www.saravdmt.com
@saravdmt