How to Manage Compassion Fatigue in Caregiving | Patricia Smith | TEDxSanJuanIsland
## Speaker Context - Speaker identity: Speaker (Professional giving a talk). - Setting, occasion of the talk: Presenting information on compassion fatigue and caregiving; the speaker mentioned this talk brought her to the "4th Century" and "here today." - Framing the speaker establishes: The core of her teaching/education is to try to teach/educate caregivers that they can't just go through the whole process of caregiving every day; they actually have to be well. ## People - Charles Figley + psychologist/first responder + noticed something unusual happening with Wounded Warriors. - Dr Charles Figley + researcher/author + coined the phrase compassion fatigue. - Elizabeth + daughter + youngest. - Dr Beth hudnell Stam + professional + director of The Institute for Rural Health at Idaho State University. - Li Li Balia + individual (mentioned by speaker) + said the phrase, "too often we under estimate the power of a touch a smile a kind word a listening ear an honest compliment or the smallest Act of caring." ## Organizations - College textbook publishing firm + employer + where speaker worked as editor. - San Mercury News + source material + where speaker worked as a correspondent. - Humane Society Silicon Valley + employer + where speaker was hired as training and development manager around 1999. - The Institute for Rural Health at Idaho State University + organization + where Dr Beth hudnell Stam was the director. - R McDonald House at Stanford + place/organization + where speaker took a job as director of programs. ## Places - Vietnam + location + where Charles Figley was a young psychologist and first responder. - UC Santa Cruz + location + where speaker enrolled in a year-long certification course. - Idaho State University + location + where The Institute for Rural Health was located. - Hawaii + location + suggested destination for therapy. - Capa + village + location where speaker moved to, on the coast of California. - Depot Hill + location + street in Capa where speaker lived. ## Tools, Tech & Products - Craigslist + platform + where speaker found her job around 1999. - Professional quality of life self test + assessment tool + work of Dr Beth hudnell Stam. ## Concepts & Definitions - Compassion fatigue + state experienced by those helping people or animals in distress + an extreme state of tension and preoccupation with the suffering of those being helped to the degree that it can create a secondary traumatic stress for the caregiver. - Secondary traumatic stress syndrome + condition experienced by Charles Figley + resulted from taking on the pain and suffering of the Wounded Warriors. - Self-compassionate caregivers + state of being + doing something for themselves every day. - Body Mind and Spirit + concepts + the integrated human beings structure. - Other directedness + pattern + learning that it's more important to take care of others before taking care of ourselves. - Self-directed + state of being + the goal of overcoming other directedness. - Personal boundaries + concept + essential for the journey to wellness; deciding what you will and won't allow in your lives. - Mindfulness + practice + being 100% present in what we're doing. ## Numbers & Data - 1995 + year + when Charles Figley coined the phrase compassion fatigue. - Three + number of kids the speaker was a single mom with. - One year + duration + of the certification course at UC Santa Cruz. - Around 1999 + approximate year + when the speaker looked for jobs on Craigslist. - Four + number referring to the "4th Century" referenced in the talk. ## Claims & Theses - Suffering is not simply being alive, but to be well. - Caregivers must be well, not just go through the process of caregiving every day. - The rhythm of a healthy caregiver is fill up empty out fill up empty out fill up empty out every single day. - If we deplete, deplete, deplete, we get a set of symptoms. - Compassion fatigue is a state experienced by those helping people or animals in distress. - The problems, the challenges, the answers are all out there, leading us to set up a them versus US mentality. - Healing is an inside job from the inside out, not from the outside in. - Strong personal boundaries are necessary; without them, everything and everyone gets into our lives, which is often hurtful. - Learning to become from other directed to self-directed is the most difficult Journey. - We have the ability to be more resilient. - We have the ability to change the world and change a life. ## Mechanisms & Processes - Secondary traumatic stress syndrome + process described by Charles Figley + taking on the pain and suffering of the Wounded Warriors. - Emotional Outburst + process mechanism + comes from learning not good coping skills in early childhood, pushing down trauma until the body reacts. - Physical ailments + process mechanism + the body signaling overload (e.g., headaches, scratchy throat, back pain) when we don't listen. - Developing personal boundaries + process + involves deciding what will and won't be allowed in our lives. - Moving through trauma + process + can be done with rituals. ## Timeline & Events - During the Vietnam war + period + Charles Figley noticed the unusual phenomenon. - Early childhood + time period + where patterns of other directedness are established. - Many years ago + time period + when the speaker experienced severe burnout and compassion fatigue. ## Examples & Cases - Wounded Warriors + group of men + sharing stories of horror and trauma from the battlefield. - The speaker's early life + example of working two jobs (editor for College textbook publishing firm by day, correspondent for San Mercury News by night). - The speaker's professional breakthrough + applied a compassion fatigue training for the entire shelter at Humane Society Silicon Valley, despite knowing nothing about the term. - The speaker's realization of personal suffering + after reading material and taking the professional quality of life test, realizing she suffered from very very very high levels of compassion fatigue. - The personal story of the frog + an anecdote describing a wooden, handcarved frog on a pedestal in the parking lot of a restaurant in Capa, which signaled the speaker was ready to "jump." ## Trade-offs & Alternatives - Overcoming other directedness versus remaining other directed. - Self-medicating with unhealthy things (chocolate, overeating, gambling, pornography, drug abuse, tobacco) versus good food, exercise, and healthy relationships. - Staying in the crevice of compassion fatigue versus making changes through self-care and boundaries. ## Counterarguments & Caveats - The speaker cautioned that the symptoms of compassion fatigue are "not a disease; it is fixable." - The speaker warned that professional advice to "go to Hawaii for a couple of weeks" only makes you feel better for two weeks before falling back into compassion fatigue. - The speaker noted that the self-care plan is often dismissed with, "I don't have time for that, I'm too busy caregiving." - The speaker acknowledged that developing personal boundaries "sounds simple but I can tell it is the most difficult thing you'll ever do." ## Methodology - googling the term "compassion fatigue" + method used by the speaker when she first heard the term. - Diagnosis via the professional quality of life self test + tool used by the speaker to confirm her condition. ## References Cited - Dr Charles Figley + source of initial material on compassion fatigue. - Dr Beth hudnell Stam + professional credited with the professional quality of life self test. - The 4th Century + source of the quote: "this life is not merely to be alive but to be well." - Li Li Balia + person quoted regarding the power of small acts of caring. ## Conclusions & Recommendations - Caregivers must be well. - Caregivers need to learn to be self-compassionate caregivers every day, doing something for themselves. - To start making lives better, create a self-care plan; get up a half an hour earlier to run, walk, meditate, or do yoga. - It is okay to say, "This is hurting me" when something (like a photograph or post on Facebook) hurts. - Ask for help; caregivers are not good at asking for help. - Practice resilience and live a balanced life. - Be grateful that you've been called to caregiving. ## Implications & Consequences - If the cycle of depletion continues, the resulting symptoms are predicted. - If personal boundaries are not established, the result is being overwhelmed by others' needs. - If self-care is ignored, the result is falling back into the crevice of compassion fatigue. - The consequence of the trauma is that unresolved past pain and trauma remain within us. ## Open Questions - How to properly integrate oneself as an individual: what does it mean to be "well"? ## Verbatim Moments - "I'm taking on the pain and suffering of the Wounded Warriors and I am making it my own." - "I said to myself it's time to do something for me something that I want to do." - "it's not a disease it is fixable." - "we're fairy depleted." - "the body is saying to us stop stop you're hurting me." - "it's that lower back ache that keeps us from living a full happy quality of life." - "sadness and apathy and this is that veil of sadness that's that's over us all the time." - "a lack of strong personal boundaries." - "I've never noticed it I think they put it here last night." - "oh my dear no it's telling you you're ready to jump." - "jump and I do and it has made all the difference."