*** Compassion Fatigue (Part 2)

RemediesA common sense, Cost vs. Benefit Analysis (CBA) of your situation while under stress will often point to obvious changes you can make in order to change and improve the situation. For instance, working fewer hours is permitted! If you are exhausted, you will be less than fully effective and may unintentionally even become a burden or a liability yourself to the caregiving endeavors. Taking some time off for a break, to recharge your batteries and restore your healing perspective may be advisable. Breaks during the day as well as days off for rest and recuperation allow for release of tensions and rejuvenation.

Stress is a word whose meaning has completely changed. It used to be a medical condition. Now it's often seen as something positive. For many people, it's an aspiration. Our role models are busy, busy, busy… Many people whose lives are not frantic suffer from 'stress envy.' They've accepted a new definition of the good life: It's not the quality of life, it's the quantity. Success is measured by how much you can squeeze in. Time has become a currency… But we're also going to have to learn to turn things off. Employers are going to have to help people step away occasionally – to demand that people take a holiday or go on sabbatical. Without punctuation marks, life can become jumbled and incoherent. -- Martin Hayward

If you have identified limited, specific issues that trigger your fatigue, you might ask not to be assigned to people who have those types of problems – until you can work on and clear the issues within yourself that are asking for attention.

Working with a team and having support from peers (Collins and Long 2003; Young 1994) is very helpful, preventing the feeling that you are alone in the fray or solely responsible for the problems of those you are helping. On the other hand, having to deal with bereaved relatives, particularly if they are angry, can contribute to the development of compassion fatigue.

De-stressing for the caregiver is essential to being able to be fully present and congruent with teaching de-stressing techniques to careseekers. Reminders and updates for caregiver through periodic refresher courses on preventing compassion fatigue can be helpful.

Sharing what you are experiencing with others is often a relief, particularly if they are familiar with the type of work you are doing. Regular planning, debriefing and ongoing assessments with colleagues can go a long way towards preventing and relieving compassion fatigue.

A problem shared is half a consolation. – Israeli observation

Eye Movement Desensitization and Reprocessing (EMDR) can be helpful in releasing traumatic memories and emotions from recent and distant stressful experiences ( www.emdr.com ). EMDR has been well validated as a treatment for PTSD but is best done in the presence of the therapist because it can bring about intense emotional releases that could panic or retraumatize a person.

Emotional Freedom Technique (EFT) involves tapping at a series of acupressure points while reciting an affirmation focused on the trauma. This provides immediate, rapid release of the emotional residues of a PTSD without a clinical abreaction (strong expression of emotions). It then allows the installation of positive feelings, beliefs and attitudes ( www.emofree.com ).

WHEE – the Wholistic Hybrid derived from EMDR and EFT – is a method of self-healing that releases stress and psychological distress. It is very rapidly effective, rather like a vacuum cleaner that allows you to clear away old junk that you carry around with you from hurtful experiences. WHEE not only relieves stresses but can also transform your attitude towards stress - from one of annoyance to one of gratitude that you are being offered further opportunities to clear the bucket of ‘stuffed’ junk that you carry with you, and to reprogram your hard drive (which you let a little child program for you).

Critical Incident Stress Debriefing (CISD) has been recommended for caregivers prior to and after experiencing acute stress. In its full implementation, this involves pre-stress planning and training; a detailed review of the incident with a trained debriefer following the incident, over several sessions if needed; and follow-ups for discussion and (if necessary) treatment of post traumatic stress disorders. While for many people this may provide relief, for others this can be a retraumatizing experience –reviving all the intensity of the emotions of the original stress – particularly when the primary or sole intervention is the debriefing. This may leave stressed people feeling worse than before – particularly when they did not choose to undergo the treatment but were required to do so by their employers. Numbers of experts are questioning the efficacy of this approach.

Journaling can provide substantial release from the multitude of issues and feelings that trigger compassion fatigue. A journal can also provide self-feedback on how you are dealing with the stresses because in a challenging situation it is easy to lose perspective and overlook how your responses are shifting over a period of time.Many more techniques are available for de-stressing.

Its not stress that kills us, it is our reaction to it. – Hans Selye

Clearing the vessel through which healing flows is a lifelong process. Compassion fatigue or any other, similar distress can become much less stressful, once caregivers are aware that current distress may be stirring old, buried hurts and are in the habit of clearing these as a matter of routine.

Ten year-old Charlie was traumatized by a shooting on the street in front of his home. He heard several shots and the sound of a car speeding off with screeching tires. Over the subsequent days and weeks he found he could not fall asleep at night unless the lights were on and a member of his family was present at his bedside.

When Charlie shared his story with me, my heart started pounding and I found myself much more agitated than I would have expected from previous experiences of having worked with other children who had been much more severely traumatized. From years of clearing issues, I recognized that his story had stirred something from my past. Later that day, allowing myself to feel again the anxiety when I focused on his story, I found memories of spending nights in a bomb shelter in Jerusalem when we were under siege in 1947-1948 and shells were falling nearby. Using WHEE, I was able to clear my buried anxieties and fears so that I could focus on Charlie’s story without stirring my old emotional responses.

Inner child work may be appropriate in response to compassion fatigue. This is a special case of clearing the vessel, often with profound insights and clearings of old hurts. Childhood psychological residues often resonate with the situations that produce compassion fatigue, such as feelings of inadequacy to deal with stresses, being unable to adequately aid or cure people you want to help, and being overwhelmed with situations that defy explanation or full comprehension.

ConclusionsSecondary traumatic stress is a hazard that caregivers at all levels can prepare for and address – with the help of peer and therapist support as well as with many self-healing techniques. It is also an invitation to clear our own vessels of the old traumas which leave us vulnerable to stress responses.

Resources
Benor, Daniel J. 7 Minutes to Natural Pain Release: WHEE for Tapping Your Pain Away - The Revolutionary New Self-Healing Method, Fulton, CA: Energy Psychology Press (in press, August 2008 )
Benor, Daniel J. WHEE for Wholistic Healing: Wholistic Hybrid derived from EMDR and EFT, Medford, NJ: Wholistic Healing Publications 2006.
Benor, Daniel J. Healing Research, Volume II: (Popular edition), How Can I Heal What Hurts? Medford, NJ: Wholistic Healing Publications 2005
WHEE (Wholistic Hybrid of EMDR and EFT) http://www.wholistichealingresearch.com/Articles/Selfheal.asp
WHEE for trauma and re-entry problems http://www.heal911.com/C-6a.asp
Further references on Compassion Fatigue at http://wholisticHealingResearch.com/References/CompassionFatigue.asp