Compassion fatigue: a symptom of caring

listening to their anguished voices she too became undone and the lines of life etched in the palms of her hands faded in all the wrong places . . .

Crawshaw, Caitlin. 2009-09-12. “Caring workers pay price: Compassion fatigue flies under radar.” Edmonton Journal.

“Compassion fatigue is often associated with nurses, who care for the sick and dying, but any worker who regularly deals with human suffering can become desensitized and detached. Beyond employees in the obvious professions–such as social work, nursing and counselling–chaplains, teachers, humane workers, midwives, personal support workers, lawyers, workers at women’s shelters, journalists and even those manning the phones at social insurance organizations can also be affected. Even those caring for others outside of the workplace, such as an elderly parent or sick spouse, can feel drained of their emotional and physical energy. “People who provide care with compassion and empathy can experience compassion fatigue,” explains Devon Tayler, an Edmonton social worker and compassion fatigue consultant. “That’s the good news about it — it’s a consequence of caring, and human beings care for each other. The downside is, we often don’t recognize that cost.” Those who suffer from compassion fatigue, or secondary traumatic stress disorder, often isolate themselves at work and limit communication with their clients or coworkers. They can become sick often and miss work, and ultimately become completely burned out, taking stress leave or quitting their jobs suddenly. “Burnout is a physical, social, emotional and spiritual situation where people have really lost themselves and lost meaning,” says Tayler. Those being cared for can also be severely affected. Some people with compassion fatigue start to dehumanize their patients, choosing to view them as case studies or clients, rather than as human beings. This can “block the story” of those receiving care and increase the likelihood of caregivers making mistakes. “We might gloss over something, thinking it’s not that important, when another person might think it really is important,” says Tayler. But this isn’t just a workplace problem. “Compassion fatigue impacts work . . . but it also impacts how we are in our families and in the community,” she says. Sufferers often stop doing the things they once enjoyed, as they feel utterly spent at day’s end. Many can do little more than zone out in front of the TV, disconnecting from their loved ones. Francoise Mathieu, a counsellor in Kingston, Ont., says awareness of compassion fatigue has improved since she started giving sessions on the subject in 2001, but many professionals still know very little about it. Also, she says students aren’t being prepared for this professional inevitability. “To me, it’s a huge issue that needs to be recognized as an occupational health and safety hazard in the workplace.” While compassion fatigue can be confusing for people who have dedicated their lives to the service of others, Mathieu assures people that it’s a symptom of caring. “The irony is that the best and most caring employees are the most at risk (Crawshaw 2009-09-12).”

Crawshaw, Caitlin. 2009-09-12. “Caring workers pay price: Compassion fatigue flies under radar.” Edmonton Journal.

shortlink http://wp.me/P2UqB-11

Glass Ceiling Fire Water II

Glass Ceiling Fire Water II

Perhaps Sarah was the only one who knew how serious it was. She was an Inuk and a grandmother. She knew the ripple effect of youth suicides.

I brought her with me to Carleton once and she felt something very uncomfortable there that made her shiver. By November 24, 2003 I was shivering all the time. I couldn’t get warm even when I returned south every three weeks. She brought me country food, and sewed special slippers and mittens without thumbs so I could get warm at night.

I still cannot remember the chronology of even the most important events that occurred after I returned from the Pangnirtung cemetery in June 2002?

I remember spending hours on this layered image using a very old version of Photoshop that came for free with a scanner? My screen was of such poor quality I couldn’t really see what I was doing.

I had taken a series of photos while canoeing on Bell Lake. There was one series in particular that I am fond of. The light that day illuminated a small forest of algae below us as we paddled silently just skimming the surface in our 1930s cedar canoe. The light played with ripples that mirrored the deep greens of the Gatineau in the summer.

I tried to be philosophical about what was happening . . . Glass half empty, half full.

I played with reflections from every angle. Reflexivity the metaphor inverted, rotated, fire, water, snow.

I had painted Angels of Fire and Snow first as a sketch and then as a large acrylic canvas in the 1980s in Pointe-Noire, Congo but we left it behind along with most of our belongings. When we returned to Canada I painted it again. It took me at least two months to complete it.

♦♦♦♦♦♦♦♦♦

Angels of Fire and Snow by Joany Lincoln 1970s from the album Reflections of a New World

Angels Oh, Angels

Angels of fire and snow

Oh, Angels Oh, Angels of fire and snow

Behold the moth as it circles the candle, clings to the flame and dies

Behold the candle as it shares its light, weeps away its life drop by drop.

You fly, you weep, you burn in your love

You fly, you weep, you die for your love,

You fly, you weep, you share of your love,

Were it not for the tears, you would burn in the fire of your love

Were it not for the fire, you would drown in your tears.

Joany Lincoln and her family lived a number of years in French-speaking Africa, Bangui, Central African Republic where we met them. She’s also traveled to the Democratic Republic of the Congo, Congo-Kinshasa (formerly Zaire).

♦♦♦♦♦♦♦♦♦

Random reading on youth suicide in Nunavut:

Bell, Jim. 2003. “Tragedy takes toll among youth with suicides at an all-time high: Nunatsiaq News. November 7.

Depalma, Anthony. 1999. “In New Land Of Eskimos, A New Chief Offers Hope.” New York Times. April 4.

Health Canada’s First Nations & Inuit Health Branch, in partnership with Assembly of First Nations and Inuit Tapiriit Kanatami/National Inuit Youth Council published The National Aboriginal Youth Suicide Prevention Strategy in 2006.

Vicarious trauma among researchers working with at-risk populations

A substantial body of literature on epidemiological studies estimate that between 36 and 81 percent of the general population experience a traumatic event at some time in their lives which is far more often than previously believed (Cusack et al. 2004).

Flynn-Burhoe. 2003. A Fliction: Dawn among the Hummocks, Iqaluit, NU

A US study a team of researchers led by Karen J. Cusack, Ph.D. concluded that since Post Traumatic Stress Disorder (PTSD) is associated with some of the most serious psychosocial impairments and highest rates of mental health service use and costs than any other disorder, it is important to identify an individual’s lifetime trauma exposure history. Yet in publicly funded health services screening for and therefore treatment of trauma exposure is rare (Cusack et al. 2004).

Cusack’s team promoted an educational component directed at intake workers which included several reliable instruments for measuring trauma symptoms based on DSM-IV including a self-report PTSD Checklist.

Post Traumatic Stress Disorder (PTSD) occurs when one is traumatized directly (in harm’s way) (DSM IV APA, 1994 [1]). However parents, professional health care workers, teachers and others may be traumatized indirectly. Secondary Traumatic Stress, Vicarious Trauma, Compassion Fatigue are experienceed though different social pathways. According to Charles R. Figley, Ph.D. of the Florida State University Traumatology Institute, there are few reports of the incidence and prevalence of Secondary Traumatic Stress. He suggests that related concepts such as Burnout, countertransference and worker dissatisfaction may have masked this common problem (Figley 1995). See Figley (2004).

Vicarious traumatization, for example, refers to a transformation in the therapist’s (or other trauma worker’s) inner experience resulting from empathic engagement with clients’ trauma material. . .[and] vulnerable to the emotional and spiritual effects of vicarious traumatization. These effects are cumulative and permanent, and evident in both a therapist’s professional and personal life (Pearlman & Saakvitne, 1995, p. 151).

According to Figley (1997) Compassion Fatigue or Secondary Traumatic Stress Disorder, is nearly identical to PSTD, except it affects those emotionally affected by the trauma of another.

York University Professor Susan McGrath’s called attention to the growing concern

“by researchers and practitioners alike regarding the emotional impact of working with victims of trauma on those in the social services or so-called “helping professions”, as well as on those who decide the fate of these individuals, and it has been widely accepted that interaction with victims of traumatic exposure places people at high risk of secondary exposure (Stamm et al. 2003). Classical burnout theory such as work by Maslach (1982) defines burnout syndrome as a pattern of emotional overload and subsequent emotional exhaustion, characterized by depersonalization, and reduced personal accomplishment as a response to the chronic emotional strain of dealing extensively with other human beings, particularly when they are troubled or having problems.”

She noted that,

“The terms “compassion fatigue” (Figley,1995) and “secondary traumatic stress” (Figley, 1995; Stamm, 1999) have been used interchangeably to denote a syndrome of symptoms nearly identical to Post-Traumatic Stress Disorder except that exposure to a traumatizing event experienced by one person becomes a traumatizing event for the second person (Stamm, 1999). Finally, the majority of studies in this area have used the term vicarious trauma which has been defined as “the transformation that occurs in the inner experience of the therapist that comes about as a result of empathic engagements with clients’ trauma material” (Pearlman & Saakvitne, 1995, p.31).

York University offers special courses in Clinical Intervention for mental health professionals, including psychologists, social workers, mental health counsellors, family therapists, employee assistance professionals, clinical supervisors, and other practitioners who provide psychological treatment and therapeutic intervention for survivors of trauma. The certificate course provides participants will also develop an in-depth understanding of compassion fatigue and strategies for prevention and enhancement of practitioner resiliency, including how to effectively intervene with care providers who have become “compassion-fatigued” through their trauma response work (source).”

Notes:

1. DSM IV (APA, 1994) is the American Psychiatric Association’s diagnostic disorders manual which is updated every ten years.