Compassion Fatigue: An Insider's Perspective

At Gluckstein Personal Injury Lawyers LLP, we introduce our clients to the best service providers and rehabilitation companies across Ontario. We also believe in educating our clients and everyone we know about compassion fatigue.

Throughout the year, we hold compassion fatigue seminars in different cities, and every October we hold the annual compassion fatigue seminar in Toronto. To read about our past seminars, click here.

We have blogged about compassion fatigue in the past, and our blog followers have been requesting follow up blogs, so, avid fans, your wish has come true! Michele Meehan, Manager of Rehabilitation Services at Rehab First, was able to speak to this blogger about her experiences and observations. Michele is trained as psychotherapist. She is a Certified Rehabilitation Counsellor, who provides counselling and psychotherapy to people as they recover from traumatic injuries and chronic disabilities. She provides case management services as well.

How does Michele believe health care providers can practice self-care? By using your self:

• Take the time to identify what you are feeling;
• Find the source of how you are feeling;
• Be mindful: expand your capacity to realize and fully understand your situation;
• Choose to re-frame your experience so you can properly understand the context of what you are feeling;
• Vent to a colleague or good friend and express yourself;
• And of course, exercise, rest and partake in a healthy diet.

These tips help you to be clear-minded and resilient. It is also extremely important to leave space for your emotions: leave appropriate time and space for your own emotions, not just the emotions of others. We are only human. When we hear stories of tragedy and trauma, it's only natural that we may be reminded of something tragic or sad that happened in our own lives. This is a pattern that often emerges. These patterns also become triggers for emotional reactions. We have to become aware of these patterns.

As caregivers, and counsellors, according to Michele, we have a responsibility to keep track of these triggers and clear ourselves of the past. There is a responsibility to bring these patterns to our conscious awareness. We can't take on the emotions of others. We must learn to unburden ourselves by disconnecting past patterns. If we are able to stop associated sad situations with our pasts, we will learn to stop taking other people's burdens with us.

Caregivers and professionals must be present without absorbing, or taking too much emotion in. Don't be a sponge. The reality is that people in the helping professions hear upsetting stories and want to help and become upset for their clients or patients. A very compassionate thing to do. But going back to the sponge analogy, eventually a sponge gets soaked. Caring and compassionate individuals, especially in caring professions tend to try to take responsibility for emotions that don't belong to them. It is so important to believe in, and practice having a work-life balance. Leave work at work. Separate your work life from your home life.

Professionals like psychologists learn and hear about these deep emotions as they are hearing about more intense, deeper traumas, abuse, and utterly horrific events. Burnout can also be caused by the idea offeeling powerless. Often times, support workers will hear stories of despair and tragedy and feel helpless and powerless when clients aren't getting the help they deserve or need. Sometimes the feeling of powerlessness is harder than hearing the story itself. Professionals become very concerned when clients are not treated fairly and are denied something they should be getting in the way of treatment or medical attention. This contributes to burnout. Lack of resources or treatment denials also raises another issue. Caregivers and professionals worry about clients and patients "falling through the cracks". For example, people who develop addictions and are seriously injured are very hard to place in clinics. It would be very hard to find an addiction clinic that could accommodate a patient with a spinal cord injury and is wheelchair friendly. Another area of concern is people who are homeless who have suffered brain injuries: how can they be reached and treated? It is a vicious cycle. The feeling of powerlessness and burnout can also create a sense of sadness. This is why it is very important to practice self-care.

Find the time for your emotions. Create the space and time for that sadness and those other feelings you may incur from your job/profession. Express it to someone who can hold it: speak to a therapist if you have to. Emotional distress and emotional stress requires a whole over level of attention. Emotional stress and compassion fatigue affect us mentally, emotionally, physically and spiritually.

Another way caregivers and helping professionals can protect themselves from burnout is through spiritual practice. Generate the sense that you are connected to something that is bigger than your own personal life. As Michele explained, people who have faith can handle things better; it can help them to feel less helpless, less victimized and gives meaning and purpose to life. Think about it, accidents happen without reason or logic, sometimes a person is just in the wrong place at the wrong time. How can a person make peace with that? One way is in the spiritual realm. People need purpose to heal. This goes for caregivers and injured persons. "I thought I was the only one". Not anymore. Healing is about making connections. Humans have an innate drive to be productive, to help somebody else. This is the idea behind peer support and helping somebody else. There is value in giving back. When you know you're not alone, it makes such a difference. It creates a sense of community. Our culture is formed of many communities. Caregivers should come to rely on people in their communities to prevent burnout. Caregivers and those who suffer from compassion fatigue must also realize that guilt is not the enemy.

As the very wise Dr. Gabor Mate points out in his lectures on compassion fatigue and in his book, "When the Body Says No", guilt is actually healthy and means we are caring about ourselves. We learned guilt as a mechanism for protecting relationships. What happens when guilt meets compassion? Michele explained that one must have perspective and not let guilt drive you crazy. Guilt can actually cause you to redouble your efforts because you may feel that you are not doing enough. This is the wrong line of thinking. Michele couldn't stress enough the importance of investing in one's own well-being. Again, sleep, rest, diet. Have time to reflect on your own emotional needs. If this is not possible, do not be afraid to reach out.

Reaching out: Knowledge is power

• Community relationships/neighbours;
• Relatives;
• CCAC services- short term services;
• Attendant Care Services- for chronic stable services for indefinite injuries.

Many people tie their identities to their jobs. Being productive and feeling productive have a lasting impact. There have been many patients who have had spinal cord injuries and after recovery, held jobs and did succeed and were happy because of their jobs. Building a sense of community relationships is strongly linked to well-being. Even non-paid employment or volunteer work like a mentoring program is recommended. The worst thing for injury survivors is to be isolated at home. Wheel Trans has made strides, there are wheelchair accessible vans available, some wheelchair access at TTC stops. If a person has a will, there's a way.

Some general observations about caregivers that Michele has come across and shared:

• Caregivers suffering from fatigue show flat emotional presentation, and are emotionally numb;
• With respect to the injured person, caregiver abuse does occur from paid caregivers or family and there is a fear of "rocking the boat" as the injured person does not want to risk the relationship as he or she is dependent on that person. This causes self-esteem issues;
• People who handle the situations best have a broader social support network and are confident, educated, show good self-esteem and have a spiritual perspective to get through it

So, this is compassion fatigue from the perspective of Rehab First's Michele Mehan and from Gluckstein Personal Injury Lawyers LLP.

Things to remember: 1. Share your feelings with a colleague, therapist or someone who can take the information without internalizing it; 2. Create a community to help you and your family with your support needs; 3. Educate yourself as much as possible; 4. Break your pattern of associating sadness with sadness: disassociate and leave work at work; 5. Find your purpose; 6. Accept guilt- guilt is not an indication of who you are; 7. Do not hide how you are feeling.