“Caring people sometimes experience pain as a direct result of their exposure to other’s traumatic material. Unintentionally and inadvertently, this secondary exposure to trauma may cause helpers to inflict additional pain on the originally traumatized. This situation – call it Compassion Fatigue, Compassion Stress, or Secondary Traumatic Stress – is the natural, predictable, treatable, and preventable unwanted consequence of working with suffering people” (p. 4)
- B. Hudnal Stamm: Secondary Traumatic Stress
“I know I’m burned out,” said a recent participant in my Compassion Fatigue seminar, “I don’t have any energy or enthusiasm as a social worker anymore. The strange thing is, when I get home from work I can’t go to sleep. No matter how tired I feel I can’t seem to turn my mind off. I can stare at the T.V. for hours, but all I see are the faces of patients I didn’t have the time or energy to help. All I want to do anymore is just go numb….”
A great and growing crisis exists in care giving. Healthcare professionals from nurses to social workers in hospitals to those working in nursing homes are experiencing more stress and burnout than ever before. Particularly since the national trauma of September 11th, 2001, healthcare professionals are being called upon to give more of themselves to help others. More of their time, energy, attention, and intention have been called upon to help alleviate the pain and suffering of others. Their response has been consistent with the care giving personality—they have given, and given, and given.
Although the events of September 11 and the ongoing “War or Terrorism” have certainly placed an immediate and additional strain on healthcare providers —particularly those who work with trauma survivors—the healthcare industry has been facing its own crises for a number of years.
According to a “60 Minutes” investigation reported on June 9, 2002 there are currently 120,000 open nursing positions nationwide with an expected 400,000 open positions in the next twenty years. In fact, the shortage of qualified nurses is so severe that companies are recruiting from third world countries where pay and benefits are low, although need is high.
Nursing is not the only profession within the healthcare industry to experience stress. Social workers, psychologists, mental health therapists, case managers, and residential care facility workers are just a few of the other care providers who are also experiencing stress. They all face increasing caseloads of severely physically, emotionally and mentally ill patients. As if this were not bad enough, they also face continually diminishing resources.
One of the results of this kind of increasing care provider stress is compassion fatigue, also known as secondary traumatic stress.
Compassion fatigue is the result of unconsciously “freezing” and internalizing traumatic Energy in MOTION into the very cells of your body as body memory. As one participant put it: “I can feel myself getting heavier as the week goes by; It’s as though I am carrying more and more of the weight of my caseload – the paperwork and even my organization on my neck and shoulders each day. By Friday I am so tense in my neck I can barely move my head.”
Compassion fatigue is secondary traumatic stress. It is often, although not exclusively, experienced by healthcare professionals who work with physically and/or psychologically/emotionally traumatized patients. It may manifest as disturbances in information processing similar to some of that reported to us by our patients with Post Traumatic Stress Disorder (PTSD).
Compassion fatigue presents a “Crisis in Care Giving” because like the Chinese character for crisis indicates, it signifies both danger and opportunity.
The danger is clear and present. With increasing caseloads and diminishing resources, care providers are required to “multi-task.” Translated into caregiver experience this often means more time and energy being spent on crisis stabilization, documentation and resource allocation and less on education and long-term management—resulting in risk management rather than health management.
For care providers this is likely to be frustrating as well as exhausting. It also renders us more susceptible to unconsciously absorbing and internalizing the “frozen” energy of secondary trauma.
The opportunity is less clear although very present.
Compassion fatigue can be transformed into flow. Flow is a condition of mind and body that is experienced when challenges and skills are in balance. As
University of
Chicago Professor Mihaly Csikszentmihalyistates in his book Finding Flow: “When goals are clear, feedback relevant, and challenges and skills are in balance, attention becomes ordered and fully invested. Because of the total demand on psychic energy, a person in flow is completely focused. There is no space in consciousness for distracting thoughts, irrelevant feelings. Self-consciousness disappears, yet one feels stronger than usual.” (p.31)
When the frozen energy of compassion fatigue is absorbed and internalized one of two things happens: the energy accumulates and exacerbates compassion fatigue; or the energy is discharged through conscious breathing and mindful movement that transforms “energy residue” into flow and peak performance.
Healthcare professionals are uniquely positioned to experience flow and peak performance in their daily work. It is a win-win situation in every respect. By learning to flow rather than freeze, healthcare professionals can transform the frozen energy of traumatic stress into synergy, harmony, and peak performance.
In my seminars on: “Transforming Compassion Fatigue Into Flow and Peak Performance,” I share three basic governing principles of the Healer-Warrior philosophy. These principles provide the foundation for each seminar; Self-honesty, personal responsibility, and self expression.
Each of these principles contains elements essential to the process of personal transformation.
Self-honesty is the key. It is the primary, essential process that allows a depth of access into parts of your personal self that cannot be attained any other way.
In this context, self-honesty means self-transparency—the ability to look inward to cultivate “in-sight.” Self-honesty is both a process and a skillful activity that can be learned and nurtured.
What is most essential to developing self-honesty is a courageous willingness to suspend judgment, to halt the automatic response of immediately categorizing a concept or idea according to an already existing category of what may be right or wrong, good or bad, possible or impossible.
It’s not an easy thing to do; it requires courageous willingness. Temporarily suspending your belief systems can cause you to feel uneasy, even lost. This is because most people rely on their unquestioned beliefs to try to make sense out of a world that becomes ever more unpredictable and traumatic.
Unquestioned beliefs have remarkable powers to shape our perception. What we attend to physically, mentally, and emotionally is selected and shaped to a great extent by what we unconsciously expect to experience.
To become aware of and suspend these beliefs is to invite you to look clearly and intently inside yourself as you read the words written in this book with as much courageous transparency as possible. Resist the temptation to immediately judge and classify the ideas shared before you have the chance to “try them on.”
Personal responsibility is the continual willingness to take ownership of my personal experience. The problem I usually run into with personal responsibility is my willingness tosurrender the need to be right.
The need to be right is one of our strongest and most strongly defended intentions. This is because the need to be right supports and enforces the ego-illusion that I alone am special, different, and somehow more entitled than others. It is the basis of our misguided concept of what it means to be independent.
Personal responsibility is the degree of my willingness to take both individual and collective ownership for my perceptions, thoughts, beliefs, emotions, and behaviors; my communication with self and others; all my relationships; and the conditions of my life that I am now experiencing.
This is not self-blame. To blame myself I must split myself into both; the part of me that is doing the blaming and the part of me that is getting blamed. This splitting of my self into opposing parts weakens my sense of self and distorts my perception of others.
The action of personal responsibility is looking, listening, and letting go. This is the art of surrendering.
Surrendering is the Warrior’s art. To surrender is to give in, not give up. Giving in is accepting the reality of the situation as it is without meeting my ego’s demand to be right. To surrender means, to bring my ego-perception more into alignment with my here and now, in the moment— in my body experience.
Self-expression is the magic of transformation. When you become clear and open to the intuitive signals— the music of your Natural Self—you will begin to experience a deep sense of enjoyment and empowerment. Self-expression is the dance of energy and enjoyment of the Natural Self when allowed to play.
The Natural Self is that place of connection between mind, body, Energy in MOTION, intuition, and insight that is in a constant state of flow; it is both in the heart and from the heart. To express myself honestly and with responsibility is to engage and empower my Natural Self to create and re-create itself spontaneously in my life.
The Natural Self is a wise, gentle, powerful, and playful being inside each of us that is usually invisible to the ego’s eye. This is mostly because the Natural Self lives in the heart and the ego lives in the head. The Natural Self perceives the world in terms of “us,” while the ego sees the world in terms of “me.” The Natural Self senses connection and commonality while the ego notices separation and specialness.
Self-expression becomes the action of clearly tuning into the music of the Natural Self and allowing that music to move you moment to moment as you dance in ever-growing harmony and synchrony. Self-expression is the spontaneous alignment of who you are with what you are doing.
As you read this book, remember to relax your shoulders and breathe fully from your diaphragm. Allow a sense of connection and flow between your head and heart to develop so that you can listen to yourself with your intuition as well as your conscious mind. Allow yourself to become immersed while observing moment to moment what is happening in your body and mind as you dance in harmony and empowerment with your Natural Self.
