Compassion Without Fatigue Mindfulness, Boundaries, and the Practice of Empathy Presented by Rev. Roxanne Pendleton, MDiv ([email protected]) & Andrea Dalton, MA, MT-BC ([email protected]) Learning Objectives: • Participants will delineate secondary trauma, compassion fatigue, and burnout, and identify at least 3 things that can contribute to compassion fatigue. • Participants will identify the use of intra-personal boundaries as a protective practice. • Participants will list at least 3 “Rapid Reset” strategies and identify ways to release secondary trauma. • Participants will describe the relationship between mindfulness, boundaries, practicing empathy, and resilience. Additional Trainings from the Center for Trauma Informed Innovation (CTII): https://bit.ly/ctiitraining Contact the CTII: [email protected] 1 ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ 2 Secondary Trauma Risk Factors Protective Factors Pre-existing anxiety or mood disorders Male gender or older in age History of personal trauma Lack of personal trauma history Limited training in treating trauma- More years of experience related conditions Specialized training in trauma Younger in age, or new to the field sensitivity Unhealthy coping (substance abuse, lack Possessing high resilience, or the ability of self-care, lack of social support) to find meaning in and bounce back Lack of tolerance for strong emotions from stressful life events or adversity High caseload of clients with trauma- Personal autonomy in the workplace related disorders Positive personal coping styles From: Trauma Informed Care Train-the-Trainer, TMC, 2017 Signs that you are growing fatigued (Smith, 2013) Excessive blaming Legal problems, indebtedness Bottled up emotions Reoccurrence of nightmares and flashbacks Isolation from others to traumatic event Receives unusual amount of complaints Chronic physical ailments such as from others gastrointestinal problems and recurrent colds Voices excessive complaints about Apathy, sad, no longer finds activities administrative functions pleasurable Substance use or abuse to mask feelings Difficulty concentrating Compulsive behaviors (overspending, Mentally and physically tired overeating, gambling, sexual addictions) Preoccupied Poor self-care (i.e., hygiene, appearance) In denial about problems Red Flags for Burnout (National Child Traumatic Stress Network) Sleep disruption Reinforcing harmful messages Feeling numb Creating hard/fast rules (lack of flexibility) Inability to maintain healthy boundaries Dual relationships Physical ailments Expecting people to be respectful/grateful Ignoring/dismissing the people you serve Not recognizing your own attitudes, biases Not being able to de-escalate and discourse Not listening or validating concerns Black and white thinking 3 4 Compassion Without Fatigue: Mindfulness, Boundaries, and the Practice of Empathy. Practice the and Boundaries, Mindfulness, Fatigue: Without Compassion Pendleton & Dalton (2016). (2016). & Dalton Pendleton 5 September 2019 ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ 6 September 2019 ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ 7 September 2019 True self-care is not salt baths and chocolate cake, it is making the choice to build a life you don’t need to regularly escape. --Brianna Wiest Prepare In the moment Metabolize Self-Care Cards Planning ahead of time to sustain your wellbeing with a “Self-Care Card” will provide you a snapshot of specific activities that set you up for a good day, are useful when you experience a stress response, and help you release your stress at the end of the day. You can create your own “Self-Care Card” using an index card folded in thirds. Label each section as follows: Prepare: Reduce your stress each morning and as each new week begins with thoughtful, individualized practices that enhance your sense of calm. In the moment: Know your triggers, notice when you have been triggered, and practice mindful tools to rapidly reset yourself to a place of calm. Metabolize: Regularly pursue ways to break down and release the chemicals that stress produces in your body, allowing your nervous system to regain a state of calm. In each column, list 3-5 practices or tools you can use to enhance your wellbeing. 8 September 2019 Rapid Resets 5-4-3-2-1 Mindfulness Practice In your mind, describe in detail: 5 things you can see 4 things you can touch 3 things you can hear 2 things you can smell 1 thing you can taste SBNRR Mindfulness Practice Stop what you are doing Breathe for a moment Notice where in your body you feel tension or strong emotion Reflect on why you may be feeling that way Respond mindfully Try These Rapid Resets: • Press your toes into the floor • Tense and relax your muscles • Massage a pressure point • Notice your breath and heart rate, take deep breath • Notice things around the room, such as the colors or objects • Visualize calm places and favorite things • Think of something you are looking forward to • Think of someone you love • Silently repeat a prayer, mantra, positive affirmation, scripture verse • Touch fabric or jewelry • Take a drink of water • Concentrate on an aroma • Do some small stretches • Mentally add a soundtrack • Lean in and really focus on listening to each word • Mentally count backwards from 100 by 3s 9 September 2019 10 September 2019 11 September 2019 ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ 12 September 2019 References for Compassion Without Fatigue Davidson, R. J., Kabat-Zinn, J., Schumacher, J., Rosenkranz, M., Muller, D., Santorelli, S. F., ... Sheridan, J. F. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine, 65(4), 564-570. Davis, D. M. & Hayes, J. A. (2011). What are the benefits of mindfulness? A practice review of psychotherapy-related research. Psychotherapy, 48, 198-208. Figley, C. R. (Ed.). (1995). Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. New York: Routledge. Grepmair, L., Mitterlehner, F., Loew, T., Bachler, E., Rother, W., & Nickel, M. (2007). Promoting mindfulness in psychotherapists in training influences the treatment results of their patients: A randomized, double-blind, controlled study. Psychotherapy and Psychosomatics, 76(6), 332-338. Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85(2), 348. Hanson, R. (2011). Just one thing: Developing a Buddha brain one simple practice at a time. New Harbinger. Harrison, R. L. & Westwood, M. J. (2009). Preventing vicarious traumatization of mental health therapists: Identifying protective factors. Psychotherapy Theory, Research, Practice, Training, 46, 203-219. Illing, S. (2017). The case against empathy (Interview with Paul Bloom). Retrieved from https://www.vox.com/ conversations/2017/1/19/14266230/empathy-morality-ethics-psychology-science-compassion-paul-bloom Kanter. J. (2007). Compassion fatigue and secondary traumatization: A second look. Clinical Social Work Journal, 35, 289-293. Klimecki, O. M., Leiberg, S., Ricard, M., & Singer, T. (2014). Differential pattern of functional brain plasticity after compassion and empathy training. Social Cognitive and Affective Neuroscience, 9(6), 873-879. Lieberman, M. D., Eisenberger, N. I., Crockett, M. J., Tom, S. M., Pfeifer, J. H., & Way, B. M. (2007). Putting feelings into words. Psychological