Burnout and Compassion Fatigue

1. Burnout and Compassion Fatigue Karen Fairchild, LCSW Early Intervention Staff Training October 7, 2013

2. Two-Pronged View: yourself and the Caregivers You Serve

3. Definitions of burnout • BURNOUT is a state of physical, emotional and mental exhaustion caused by involvement in situations that are emotionally demanding-accompanied by disillusionment and negative feelings.

4. Burnout occurs on a continuum. • In the early stages you have less energy and need to make more of an effort to deal with everyday pressures. • You may be more negative, quick to anger, have a reduced sense of accomplishment, feel tired more often, become more withdrawn and experience increased interpersonal conflicts. • You feel numb, disillusioned, hardened and overwhelmed. • You may have more colds and in the later stages suffer more severe health problems.

5. Definition of Compassion fatigue • Compassion fatigue is a type of burnout that can include all of the above plus being persistently “on,” re-playing scenes from families' traumatic events and absorbing their emotional suffering. You become preoccupied with the trauma, suffering intrusive thoughts and helplessness. • The long- term effects include reduced empathy, diminished sense of personal safety, a reduced sense of control and hopelessness. You may indulge in escape activities, chronic over eating/drug or alcohol use.

6. The impact on work performance includes low morale, absenteeism, feeling unappreciated, task avoiding, low motivation and apathy. • Learn to prevent, counteract, and work through burnout and compassion fatigue. • Recognize the unique stress involved in helping others. • Identify attitudes that limit your attention to self-care.

7. How do YOU know when YOU are experiencing burnout? • Emotional exhaustion • I often feel fatigued during work. • I miss a lot of work and social events. • I often have difficulty sleeping because of thoughts of work or home. • I don’t have the energy I used to. • I’m just plain worn out. (Mind-Body connection)

8. Lack of professional efficiency • I frequently find myself not listening to what is being said. • I find reasons to delay beginning work or hasten to its end. • If it ain’t in my job description, I ain’tdoin’ it. • During work I frequently glance at the clock and hope that time is passing fast. • I am frequently bored. • I find it more difficult to come up with solutions for problems at work or home.

9. Attitude • My sense of humor isn’t as good as it was. • I feel like I am giving more than I am getting. • I am pessimistic about my professional future. • It doesn’t matter how hard I work on a project, I’m never appreciated. • Whenever a supervisor announces an “improvement”, things get worse.

10. What gets to YOU and When? Sources of Burnout • Personal • I almost never exercise. • I’m not getting enough sleep. • My eating habits are not good. • I’m not aware of how my body experiences stress. • I almost never take time off. • I have few hobbies or outside interests. • I can’t say no.

11. Interpersonal • I am a stoic. I don’t talk about problems with others. • I am lousy at maintaining boundaries. • My only social contacts are in a work setting – with families and coworkers. • There is little camaraderie or support in my organization. • I don’t believe in seeking therapy. • My friends are not there for me when I need them most.

12. Professional • My professional and personal workload is overwhelming. • No matter how hard I work, I can’t get my job done. • People in my job don’t understand or appreciate what I do. • Sometimes I think I chose the wrong profession. • I had thought I would be further ahead in my profession then I am. • I don’t stay current on developments in the field. • My job is quite monotonous. http://myselfcare.org/ Self-Care Quiz

13. What do YOU do to take care of yourself? Self -Care • Choose to live a balanced, healthy lifestyle • Relaxation • Meditation • Exercise • Diet • Adequate leisure activities • “Power nap”

14. Reduce personal and/or environmental stressors • Become self-aware! Be honest with yourself! • Identify life stressors • Make a plan for change • Commit to act • Set and maintain boundaries • If you work hard, you MUST play hard!

15. Develop healthy coping strategies • Re-evaluate your life goals • Improve time management • Acknowledge vulnerabilities • Compartmentalize work and life • Reward yourself • Change your attitude • Get training in assertion and conflict resolution

16. Modify the work and home environment • Work smarter and harder • Diversify work and personal tasks

17. Beware of the “Savior Complex” • The savior complex is a psychological construct which makes a person feel the need to save other people. This person has a strong tendency to seek people who desperately need help and to assist them, often sacrificing their own needs for these people. • False belief--“If I always help people in need, I will get their love and approval, and have a happy life.”

18. There is nothing noble in sacrificing yourself for others while you are starving at a psychological level. • Learn to give and to ask for what you want, to help and to be helped. This is the healthy way to use your people skills and to interact with others. http://www.peopleskillsdecoded.com/savior-complex/

19. Ask yourself these questions: • Is it easier for you to give than to receive? • Do you have the tendency to take on other people's suffering? • Do you go above and beyond what is expected of you? • Is it challenging to set limits?

20. Set limits more effectively • Physical Boundaries • Accessibility by phone • Remote access to work • Flex Time • Use your PTO and sick leave • Emotional Boundaries • Stay empathic but without taking on others’ problems. • Be completely with them in the moment but do not carry their problems with you at the end of they day. • “If you are thinking about your work families or responsibilities after hours you are taking too much responsibility.” • You did not create the problem. You will likely not be able to fix the problem. You may just help them take one step forward. That IS success!

21. Basic Responsibilities for self • I am responsible for my own choices and consequences. • I am responsible to make changes in my life. • I am responsible for identifying my own feelings. • I am responsible for clearly asking for what I want. • I am responsible to communicate my needs openly and honestly. • I am responsible for validating myself. • I am responsible for setting in place support people. • I am responsible for giving, taking, and creating equitable relationships. • I am responsible for having a sense of self.

22. Take Care of the caregiver • Be gentle with yourself. Be your own best friend. • Remind yourself that you are a loving helper, not a magician. None of us can change anyone else—we can only change the way that we relate to others. • Find a place where you can be a hermit—use it every day—or when you need to. • Learn to give support, praise and encouragement to those around you—and learn to accept it in return. • Remember that in the light of all the pain we see around us, we are bound to feel helpless at times. We need to be able to admit this without shame. Just in caring and in being there, we are doing something important. • Learn to vary your routine often and to change your tasks whenever possible. • Learn to know the difference between the complaining that relieves tension and the complaining that reinforces it. • Focus on one good thing that happened during the day.

23. Become a resource for yourself! Be creative and open to new approaches to old things. • Use the support you give to others or a “buddy system” regularly. Use these as a support, for reassurance and to redirect yourself. • Avoid “shop talk” during your breaks or when you are socializing with colleagues. • Learn to use the expression, “I choose to…” rather than expressions like, “I have to…,” “I ought to…,” or “I should…” • Learn to say, “I won’t…” rather than, “I can’t…” • Learn to say “no” and mean it. IF you can’t say “no,” what is your “yes” worth? • Aloofness and indifference are far more harmful than admitting to an inability to do more. • Above all else—learn to laugh and to play. Author Unknown—NAMI Family to Family Program 5/98

24. Conclusion • In dealing with those who are undergoing great suffering, if you feel "burnout" setting in, if you feel demoralized and exhausted, it is best, for the sake of everyone, to withdraw and restore yourself. The point is to have a long-term perspective.— Dalai Lama Acknowledgements • Kris Doty, Ph.D., LCSW • John Malouf, Ph.D