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Compassion Fatigue:
                     Caring for the Caregiver




•   This PowerPoint Presentation is designed to be part of an informational workshop
    on the subject of Compassion Fatigue. If is offered for educational and research
    purposes only. Please contact the author, Chaplain John TC Megahan
    (jmegahan@msn.com or (302) 367-6784 for additional information regarding
    Compassion Fatigue education and training from The Journey of Hope, Inc.
Compassion, Comfort,
  Counsel and Care




for the difficult moments in life.
Meet Our Presenter:
                        TC Megahan
•   I was born and raised in Turtle Creek PA. In 1983, I earned a Bachelor’s
    Degree from Valley Forge Christian College, and recently enrolled at
    Wilmington University to complete my Masters Degree in Clinical Mental
    Health Counseling. I have also earned numerous Certifications of Completion
    from the Massachusetts General Hospital Psychiatry Academy, Light
    University and the Federal Emergency Management Administration.

    I have been a key member of chaplaincy programs for Professional
    Baseball, Thoroughbred Horse Racing, and numerous amateur and Olympic
    sports programs like the 1994 World Cup Soccer and 1996 Olympic games. I
    was privileged to served for 9 seasons as the Chaplain of the Wilmington Blue
    Rocks (KC Royals), and the Oaklawn Park and Delaware Park race tracks as a
    Chaplain and Counselor.

    My wife Joanne and I reside in Bear DE and are the proud parents of 9 children
    (6 boys and 3 girls). Joanne owns and operates a daycare service, and we are
    both actively involved in our church and our community, especially when it
    comes to counseling families in grief and crisis.
Compassion
                   Fatigue:
               Caring for the Caregiver
    Our Goals:

•   1. Understanding what “Compassion Fatigue” is, and how we get it.

•   2. Recognizing the factors leading to Compassion Fatigue.

    3. Familiarize ourselves with symptoms of Compassion Fatigue.

•   4. Suggest practical ways of preventing Compassion Fatigue.

•   5. List the Steps to Recovery actions necessary for Compassion Fatigue .

•   6. Supply a Bibliography to support continued learning for Pastors and other

    Compassionate Care Givers.
“Understanding Compassion Fatigue”

•   Compassion: Deep awareness of the suffering of another coupled with the
    wish to relieve it.

•   Compassionate Mission: Any endeavor by individuals, groups of individuals or
    organizations of alleviate the suffering of others.

•   Compassion Fatigue: 1) A state of tension and preoccupation with the
    individual or cumulative trauma of clients as manifested in one or more ways
    including re-experiencing the traumatic event, avoidance/numbing of reminders
    of the event, and persistent arousal. 2) The natural consequence of stress
    resulting from caring for and helping traumatized or suffering people or animals.

•   Stress: The nonspecific response of the human organism to any demand
    placed upon it.

•   Suffering: A state of severe distress* associated with events that threaten the
    intactness of the person.

•   Burnout: a state associated with stress and hassles involved in your vocation.
Recognizing the factors leading
            to Compassion Fatigue
• The Messiah Complex: I will “fix” the problem…make
  everything O.K… I can save the world.

   –   I am responsible for outcomes and attitudes.
   –   If I care enough, long enough, everything will be O.K.
   –   The patient/family will appreciate everything I do for them.
   –   I will have enough resources (time, skills and training) to fix things.
   –   My family and friends will understand and support me while I invest in
       this compassionate mission.

• The Lone Ranger Complex: I know what I’m getting
  into, and I can do it alone.

• The Saint Complex: If I’m spiritual enough, I can deal with
  the stress of working with suffering people.
Stages of
           Compassion Fatigue

•   The Enthusiasm Stage
•   The Irritability Stage
•   The Withdrawal Stage
•   The Quitting Stage
•   Pathology vs. Renewal/Maturation
BALANCE, PERSPECTIVE
    AND ATTITUDE
• The key to enjoying all aspects of your life
  is 3 simple word that we all neglect from
  time to time in our lives.

  – BALANCE
  – PERSPECTIVE
  – ATTITUDE
Enthusiasm Stage

•   Committed, involved, available
•   Solving problems/making a difference
•   Willingly go the “extra mile”
•   High enthusiasm
•   Volunteers without being asked
The Irritability Stage

•   Begin to cut corners and take shortcuts.
•   Begin to avoid clients/patients.
•   Begin to mock co-workers and clients.
•   Begin to denigrate the people we serve.
•   Use of humor is inappropriate.
•   Oversights, mistakes and lapses of concentration.
•   Distancing ourselves from friends and coworkers
The Withdrawal Stage

• Enthusiasm turns sour and critical
• Clients become irritants, instead of people
• Complaints about our work life and personal life
• 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.
The Quitting Stage
• Our hopelessness turns to frustration /anger.

• We begin to dislike people…any/all people

• Others appear incompetent or ignorant to us

• We develop a real distance from our clients

• We have…no patience…no sense of
  humor…no time for fun
Victim vs. Victor

• Overwhelmed and leaving the profession
• Somatic Illness
• Perpetuity of Symptoms
                  OR
• Hardiness and strength
• Resiliency and Integrity
• Transformation and Stability
A word about “symptoms”
• Nervousness/anxiety    • Changes in
• Anger and                appetite, sleep or
  irritability.            other habits.
• Mood swings.           • Physical changes
• Flashbacks             • Depression
• Trouble                • Self-Medication
  concentrating          • Feeling less trusting
• Lowered self-esteem.     of others and the
• Withdrawing from         world
  others                 • Self-Entitlement
Symptoms of Compassion
         Fatigue (intrusive)
• Thoughts and images associated with the client’s
  problems and pain.
• Obsessive or compulsive desire to help certain
  clients
• Client/work issues encroaching on personal time
• Inability to “let go” of mission related matters
• Perception of clients as fragile and needing your
  assistance
Symptoms of Compassion
      Fatigue (intrusive, cont.)

• Sense of inadequacy
• Sense of entitlement
• Perception of the world in terms of victims
  and perpetrators
• Personal activities interrupted by the
  mission
Symptoms of Compassion
         Fatigue (avoidance)
• Silencing Response (avoiding client’s stuff)
• Loss of enjoyment/end of self-care activities
• Loss of energy
• Loss of hope/dread working with certain clients
• Loss of sense of competence/potency
• Isolation
• Secretive self-medication/addition
  (alcohol, drugs, work, sex, food, spending, etc.)
• Relational dysfunction
Symptoms of Compassion
         Fatigue (arousal)
• Increased anxiety
• Impulsivity/reactivity
• Increased perception of demand/threat
  (in both job and environment)
• Increased frustration/anger
• Sleep disturbance
• Difficulty concentrating
• Change in weight/appetite
• Somatic symptoms
“Steps to Regaining Balance”

•   “Intentionality”
•   “Connection”
•   “Anxiety Management/Self-soothing”
•   “Self-care”
•   “Narrative”
•   “Desensitization and Reprocessing”
•   “Self-supervision”
A Caregiver’s Self-Care Plan

 Gain self-knowledge and understanding

 Begin self-examination and evaluation

 Develop your resources and support

 Have realistic expectations

 Create a self-care strategy

 Plan for enjoying a normal life outside work
“When Compassion Fatigue
 leaves, the Joy of Caring
          returns.”
A Word about Sleep
• Sleep Disruption is a key symptom of
  Compassion Fatigue

  – When a care giver’s sleep pattern is
    disrupted for an extended period of time, this
    is a key warning sign that something is
    wrong. If normal sleep patterns aren’t
    reestablished, this combined with other
    symptoms may indicate that the caregiver is
    developing “Compassion Fatigue”.
A Word about Sleep
• Sleep disruption is both:

  – One of the primary causes of Compassion
    Fatigue


  – A key indicator of Compassion Fatigue, and
A Word about Sleep
• Disruption of Normal Sleep Patterns can be a
  primary cause of Compassion Fatigue

   – It is during normal “deep” sleep that much of the
     processing of the traumatic experiences occur. When
     sleep is disrupted (either shorten or disturbed), the
     traumatic experience can become lodged in the
     sympathetic nervous system. Over time an
     accumulation of these unprocessed traumatic
     experiences can lead to Compassion Fatigue.
Some Final Thoughts

1. Compassion Fatigue is always a
   possibility for those who care for others.
2. There is limited compassion fatigue when all
   our caring is “successful”.
3. If you don’t care for yourself, physically,
   emotionally and spiritually, then eventually
   there will not be enough of you left to
   care for anyone else.
4. Compassion Fatigue – It’s not a character flaw!
Tidbits
• When it comes to spiritual matters, you are the one
  responsible for your task, God is responsible for the
  outcomes…remember your role, you’re not God.
• The need will always be greater than the resources.
• Use care in how you measure “success”
• Value small victories and maintain BALANCE.
• Who you are (INTEGRITY) is as important to the
  mission as what you do.
• Their pain cannot become your pain, don’t take them
  and their pain home with you.
• Remember to care for your spirit, emotions and body
  so that there will be something left to give.
The Journey of Hope

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Compassion Fatigue

  • 1. Compassion Fatigue: Caring for the Caregiver • This PowerPoint Presentation is designed to be part of an informational workshop on the subject of Compassion Fatigue. If is offered for educational and research purposes only. Please contact the author, Chaplain John TC Megahan (jmegahan@msn.com or (302) 367-6784 for additional information regarding Compassion Fatigue education and training from The Journey of Hope, Inc.
  • 2. Compassion, Comfort, Counsel and Care for the difficult moments in life.
  • 3. Meet Our Presenter: TC Megahan • I was born and raised in Turtle Creek PA. In 1983, I earned a Bachelor’s Degree from Valley Forge Christian College, and recently enrolled at Wilmington University to complete my Masters Degree in Clinical Mental Health Counseling. I have also earned numerous Certifications of Completion from the Massachusetts General Hospital Psychiatry Academy, Light University and the Federal Emergency Management Administration. I have been a key member of chaplaincy programs for Professional Baseball, Thoroughbred Horse Racing, and numerous amateur and Olympic sports programs like the 1994 World Cup Soccer and 1996 Olympic games. I was privileged to served for 9 seasons as the Chaplain of the Wilmington Blue Rocks (KC Royals), and the Oaklawn Park and Delaware Park race tracks as a Chaplain and Counselor. My wife Joanne and I reside in Bear DE and are the proud parents of 9 children (6 boys and 3 girls). Joanne owns and operates a daycare service, and we are both actively involved in our church and our community, especially when it comes to counseling families in grief and crisis.
  • 4. Compassion Fatigue: Caring for the Caregiver Our Goals: • 1. Understanding what “Compassion Fatigue” is, and how we get it. • 2. Recognizing the factors leading to Compassion Fatigue. 3. Familiarize ourselves with symptoms of Compassion Fatigue. • 4. Suggest practical ways of preventing Compassion Fatigue. • 5. List the Steps to Recovery actions necessary for Compassion Fatigue . • 6. Supply a Bibliography to support continued learning for Pastors and other Compassionate Care Givers.
  • 5. “Understanding Compassion Fatigue” • Compassion: Deep awareness of the suffering of another coupled with the wish to relieve it. • Compassionate Mission: Any endeavor by individuals, groups of individuals or organizations of alleviate the suffering of others. • Compassion Fatigue: 1) A state of tension and preoccupation with the individual or cumulative trauma of clients as manifested in one or more ways including re-experiencing the traumatic event, avoidance/numbing of reminders of the event, and persistent arousal. 2) The natural consequence of stress resulting from caring for and helping traumatized or suffering people or animals. • Stress: The nonspecific response of the human organism to any demand placed upon it. • Suffering: A state of severe distress* associated with events that threaten the intactness of the person. • Burnout: a state associated with stress and hassles involved in your vocation.
  • 6. Recognizing the factors leading to Compassion Fatigue • The Messiah Complex: I will “fix” the problem…make everything O.K… I can save the world. – I am responsible for outcomes and attitudes. – If I care enough, long enough, everything will be O.K. – The patient/family will appreciate everything I do for them. – I will have enough resources (time, skills and training) to fix things. – My family and friends will understand and support me while I invest in this compassionate mission. • The Lone Ranger Complex: I know what I’m getting into, and I can do it alone. • The Saint Complex: If I’m spiritual enough, I can deal with the stress of working with suffering people.
  • 7. Stages of Compassion Fatigue • The Enthusiasm Stage • The Irritability Stage • The Withdrawal Stage • The Quitting Stage • Pathology vs. Renewal/Maturation
  • 8. BALANCE, PERSPECTIVE AND ATTITUDE • The key to enjoying all aspects of your life is 3 simple word that we all neglect from time to time in our lives. – BALANCE – PERSPECTIVE – ATTITUDE
  • 9. Enthusiasm Stage • Committed, involved, available • Solving problems/making a difference • Willingly go the “extra mile” • High enthusiasm • Volunteers without being asked
  • 10. The Irritability Stage • Begin to cut corners and take shortcuts. • Begin to avoid clients/patients. • Begin to mock co-workers and clients. • Begin to denigrate the people we serve. • Use of humor is inappropriate. • Oversights, mistakes and lapses of concentration. • Distancing ourselves from friends and coworkers
  • 11. The Withdrawal Stage • Enthusiasm turns sour and critical • Clients become irritants, instead of people • Complaints about our work life and personal life • 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.
  • 12. The Quitting Stage • Our hopelessness turns to frustration /anger. • We begin to dislike people…any/all people • Others appear incompetent or ignorant to us • We develop a real distance from our clients • We have…no patience…no sense of humor…no time for fun
  • 13. Victim vs. Victor • Overwhelmed and leaving the profession • Somatic Illness • Perpetuity of Symptoms OR • Hardiness and strength • Resiliency and Integrity • Transformation and Stability
  • 14. A word about “symptoms” • Nervousness/anxiety • Changes in • Anger and appetite, sleep or irritability. other habits. • Mood swings. • Physical changes • Flashbacks • Depression • Trouble • Self-Medication concentrating • Feeling less trusting • Lowered self-esteem. of others and the • Withdrawing from world others • Self-Entitlement
  • 15. Symptoms of Compassion Fatigue (intrusive) • Thoughts and images associated with the client’s problems and pain. • Obsessive or compulsive desire to help certain clients • Client/work issues encroaching on personal time • Inability to “let go” of mission related matters • Perception of clients as fragile and needing your assistance
  • 16. Symptoms of Compassion Fatigue (intrusive, cont.) • Sense of inadequacy • Sense of entitlement • Perception of the world in terms of victims and perpetrators • Personal activities interrupted by the mission
  • 17. Symptoms of Compassion Fatigue (avoidance) • Silencing Response (avoiding client’s stuff) • Loss of enjoyment/end of self-care activities • Loss of energy • Loss of hope/dread working with certain clients • Loss of sense of competence/potency • Isolation • Secretive self-medication/addition (alcohol, drugs, work, sex, food, spending, etc.) • Relational dysfunction
  • 18. Symptoms of Compassion Fatigue (arousal) • Increased anxiety • Impulsivity/reactivity • Increased perception of demand/threat (in both job and environment) • Increased frustration/anger • Sleep disturbance • Difficulty concentrating • Change in weight/appetite • Somatic symptoms
  • 19. “Steps to Regaining Balance” • “Intentionality” • “Connection” • “Anxiety Management/Self-soothing” • “Self-care” • “Narrative” • “Desensitization and Reprocessing” • “Self-supervision”
  • 20. A Caregiver’s Self-Care Plan  Gain self-knowledge and understanding  Begin self-examination and evaluation  Develop your resources and support  Have realistic expectations  Create a self-care strategy  Plan for enjoying a normal life outside work
  • 21. “When Compassion Fatigue leaves, the Joy of Caring returns.”
  • 22. A Word about Sleep • Sleep Disruption is a key symptom of Compassion Fatigue – When a care giver’s sleep pattern is disrupted for an extended period of time, this is a key warning sign that something is wrong. If normal sleep patterns aren’t reestablished, this combined with other symptoms may indicate that the caregiver is developing “Compassion Fatigue”.
  • 23. A Word about Sleep • Sleep disruption is both: – One of the primary causes of Compassion Fatigue – A key indicator of Compassion Fatigue, and
  • 24. A Word about Sleep • Disruption of Normal Sleep Patterns can be a primary cause of Compassion Fatigue – It is during normal “deep” sleep that much of the processing of the traumatic experiences occur. When sleep is disrupted (either shorten or disturbed), the traumatic experience can become lodged in the sympathetic nervous system. Over time an accumulation of these unprocessed traumatic experiences can lead to Compassion Fatigue.
  • 25. Some Final Thoughts 1. Compassion Fatigue is always a possibility for those who care for others. 2. There is limited compassion fatigue when all our caring is “successful”. 3. If you don’t care for yourself, physically, emotionally and spiritually, then eventually there will not be enough of you left to care for anyone else. 4. Compassion Fatigue – It’s not a character flaw!
  • 26. Tidbits • When it comes to spiritual matters, you are the one responsible for your task, God is responsible for the outcomes…remember your role, you’re not God. • The need will always be greater than the resources. • Use care in how you measure “success” • Value small victories and maintain BALANCE. • Who you are (INTEGRITY) is as important to the mission as what you do. • Their pain cannot become your pain, don’t take them and their pain home with you. • Remember to care for your spirit, emotions and body so that there will be something left to give.