Helping Others May be dangerous to your health

1. What you don’t know CAN
hurt you!
Compassion Fatigue

2. Definitions

3. I dunno. What
do YOU think it What do you
think it
means? Beats me!! means?

4. Vocabulary
• Compassion Satisfaction
–Positive aspects of working as a helper

5. Compassion Satisfaction
• The positive aspects of helping
Providing care
The system
Work with colleagues
Beliefs about self
Altruism

6. Vocabulary
• Compassion Fatigue
–Negative aspects of working as a
helper

7. Compassion Fatigue
Aka as secondary traumatic stress
disorder evidenced by:
• hopelessness
• a decrease in experiences of
pleasure, constant stress and anxiety
• and a pervasive negative attitude

8. Compassion Fatigue
CF describes the emotional, physical,
social and spiritual exhaustion that
overtakes a person and causes a
pervasive decline in his/her desire,
ability and energy to feel and care for
others.

9. CF results from the combined effects of
primary trauma, secondary trauma, and
burnout to produce painful symptoms in
caregivers.
CF is the gradual loss of empathy for
others over time due to emotional and
physical overload.
.

10. CF refers to the emotional and physical
exhaustion that helpers (nurses,
doctors, social workers, police officers,
chaplains, caregivers, the list goes on
and on) experience over time when
working in these challenging and
rewarding fields.

11. CF is a state experienced by those
helping people in distress; it is an
extreme state of tension and
preoccupation with the suffering of
those being helped to the degree
that it is traumatizing for the
helper.

12. Vocabulary
• Burnout
–Inefficacy and feeling overwhelmed

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. 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. Vocabulary
• Work-related traumatic stress
–Secondary traumatic exposure to event
due to a relationship with the primary
person (Vicarious trauma)

16. Secondary Trauma Stress
Secondary trauma stress is work-
related, indirect exposure to extremely
stressful events such as working with
child abuse victims, treating war-
related causalities and responding to
disasters.

17. It often begins soon after exposure to
another person’s specific traumatic
event but it can also be cumulative
with repeated exposure to others’
traumatic situation.
Karen Dickason, LCSW, CFAP

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. People Bring Themselves
People bring a past and a present to
anything 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. Stages and
Symptoms

21. Compassion Fatigue
Trajectory
• The Zealot Phase
• The Irritability Phase
• The Withdrawal Phase
• The Zombie Phase

22. Zealot Phase
• Committed, involved, available
• Solving problems/making a
difference
• Willingly go the “extra mile”
• High enthusiasm
• Volunteers without being asked

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. • Use of humor is inappropriate
• Oversights, mistakes and lapses of
concentration
• Start distancing ourselves from
friends and coworkers

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. • 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. The Zombie Phase
• Our hopelessness turns to
rage
• We begin to hate
people…any/all people
• Others appear incompetent
or ignorant to us

28. • We develop a real distain
for our clients
• We have…no patience…no
sense of humor…no time for
fun

29. Where are you?
• What phase do you think
you are in right now?

30. Not me. I’m a
trained Me, either. I’m
professional.. too mentally
Nope, not me tough.
There must be something
wrong with me. I think
I’m developing it.
WHO IS AT RISK?

31. EVERYONE

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. 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. Signs of CF
• Emotional Signs
• Social
• Physical
• Intellectual
• Spiritual
• Professional

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. 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. • Difficulty separating work life from
personal life
• Diminished functioning in non-
professional circumstances
• Increases in in-effective or self
destructive self soothing behaviours

38. Physical
Intrusive thoughts / images
Headaches
GI symptoms
Insomnia / nightmares / sleep
disruptions
Decreased immune response
Lethargy
Becoming more accident prone

39. Spiritual
• Questioning the meaning
of life
• Questioning prior religious
beliefs
• Increased scepticism
• Loss of hope

40. PROFESSIONAL
• Difficulty separating work life
from personal life
• Withdrawal from colleagues
• Feelings of therapeutic
impotence
• Diminished functioning in non-
professional circumstances

41. Solutions

43. Organizational Personal
Professional
Three Areas to
Consider

44. ORGANIZATIONAL

45. Indications of Organizational
Compassion Fatigue
• Increased absenteeism
• Constant changes in co-worker
relationships
• Staff sniping at one another
• Negativity toward management and
clients

46. • 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?”

47. 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

48. • Encourage team work rather than
competition
• Discourage over-time, excessive
client load

49. • Educate staff about what they might
expect to experience
• Hold in-service activities
• Have managers be aware of changes
in behaviour of staff

50. PROFESSIONAL

51. Professional Strategies
• Supervision – ask for it and use it
• Be clear and aware of potential
Boundary violations
• Self-awareness

52. 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.

53. PERSONAL

54. 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

55. Personal Strategies
Complete this sentence five times, in
five different ways: “I sometimes find it
difficult to balance
______ with ______.” (Hint, think about
demands, responsibilities, and desires
across
different people, roles, and situations in
your life).

56. More Healthy Strategies
• Take some time to decompress after
difficult sessions
• Don’t think about work away from
work
• Personal journals
• Good nutrition

57. More Healthy Strategies
• Breathing (deep)
• Take vacations – don’t be a
martyr
• Engage in exercise,
recreation and hobbies
• Develop a strong support
system

58. 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

59. QUESTIONS????