Recognizing Stress, Burnout, and the Impacts of Vicarious Trauma and Countertransference in Our Body-Based Work

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.”
1
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.
3
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
COUNTERTRANSFERENC
E
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
11
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,

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.
25
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. 36
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