S4 E2: Understanding Compassion Fatigue and the Inherent Impact of Caring

CASAT Podcast Network

Hello and welcome to season four of CASAT conversations.

I am your host, Heather Haslem.

This season we will explore the impact of trauma on those who work in human services.

You’ll hear from researchers, authors, and people with lived experience.

We hope you enjoy today’s conversation today.

I’m happy to welcome Beverly Kyler.

Beverly is an author speaker and compassion fatigue specialist.

Welcome Beverly.

We’re so happy to have you here today.

Thank you heather.

I’m so happy to be here and honored to have this opportunity to talk to you about this most important subject.

Such an important subject and really important for our listeners.

So as we get started, please share with us a little bit about your story and how you came to write your book.

Alright, um let me be as brief as I can because this story is expensive but I’ll say this.

Um I’m armed with the idea of compassion fatigue.

From my own personal experiences.

I began my academic career whose academic career is um the only social worker in the pediatric oncology unit.

These are children with cancer leukemia and these are parents facing one of the major parents nightmares of Children with potentially fatal and fatal illness is helping them navigate the healthcare system and comply with the treatment protocols.

But that was my work for a number of years.

And then I moved from there because I got invited to work on a collaboration with the V A medical center psychiatric department and department of defense to be trained to work with veterans treat veterans with post traumatic stress disorder.

Coming back from Vietnam did that for a great number of years.

They eventually asked us to come in house from a program that was called operation outreach satellite offices all over the country.

But come in the house and work with the other veterans who were still there from Korea and World War Two.

Eventually the gulf war veterans as Wall did that for several years.

And then I went to child welfare and you well, no child welfare that using neglected as an equal opportunity predator.

And, you know, faced all of the horrors and distresses of what that meant to Children and working with their families as well.

Ultimately, in each of these roles.

At some point, I began to change and shift and struggling away that I didn’t necessarily understand what other people saw changes in my behavior, my emotions, my mood swings, my clumsiness, my impatience with my family and I had compassion, fatigue and didn’t even know it.

But ultimately what happened.

And I think I want to attribute a great deal of that to working with Children being victimized, violated in horrific ways.

I suffered heart failure and I didn’t only suffer it once.

I suffered it twice.

My wonderful management team at the time downsides my work got me some support, but me, like many workers in the field of child welfare or any adult protective services went back to my own patterns and so I suffered heart failure again the second time.

But that was the big wall up three months of intensive rehab and what that did.

Uh it opened my eyes, it made me sit down because I couldn’t do anything else.

But thank retrospectively, uh not just about myself and what happened and how could this happen?

Because to my estimation, I didn’t fit the profile, if you will, whatever that means for heart failure.

I enjoyed the work.

I was passionate about, the work committed, about the workflow out the bed, dedicated, that was my purpose in life.

But this happened to me.

It’s sort of like I thought like uh the love I felt for these Children, these families, these veterans.

Uh some would make me immune to getting sick in the execution of work.

Also thought a lot about the colleagues I’d work with, whether they were my correct co workers or the collaborative relationships, you know, the other agencies we work with, um that have fallen away, broken down changes in their behavior and their characteristics, and staff conflicts, the depression, the suicides among colleagues, uh alcoholism and stuff.

And it all kind of came together.

Made me do a lot of research and I discovered a multiplicity, a plethora of illnesses that were all directly related to stress or let me say toxic stress syndrome work related now, that also made me take a look at personal factors to not just the professional ones, but combined.

That’s what spilled out.

And the research made me realize it was so much to talk about, so much to know because this is what I did on a survey.

Personal surveys I did is understand that most of the people who do this work the front line workers wherever they are, whatever capacity they work in.

We don’t realize that distresses taking ahold of us until it knocks us down.

So I decided to write the book and really inform the field various fields of services, human services, human service providers and all of the professions, all the fields and paraprofessional fields to let them know to inform about the risk uh manifestations with the sea had to have early awareness about it and what to do about it.

All the practical things, strategies and methodologies and habits that have developed to mitigate the effect is you’re gonna have compassion fatigue if you in human services, you’re gonna have some, but you can mitigate the effects, you could reverse it.

You could not let it get so bad that it really impact your health in detrimental ways.

So that was why I wrote the book.

Yeah.

So this really personal experience that you’ve had and also noticing it in your colleagues.

And the part that I really struck about is the importance of pure relationships because it sounds like you didn’t recognize it in yourself and other people likely didn’t recognize it in themselves, but that you recognized it in each other.

Um, and then that you had people that cared enough about you really to say, hey Beverly like we’re going to create you some space so that you can take care of yourself, which is really beautiful and powerful to pull your coat to pull your leg to alert you.

You see it at the conference table when people are talking too much and don’t realize they’ve lost their audience when they’re too pressured when they’re too controlling all of a sudden out of character.

Even had a white male colleagues say to me one day in the kitchen, the office not even Beverly your face is turning gray, which is a risky thing for him to say, I knew him enough.

I just said, oh my God, I need to exfoliate, but what he saw, which was gonna happen two days later I had, I went into heart failure, he saw it coming.

Yeah.

So we do need those relationships to notice what we don’t notice while we’re intensely involved in the work, in the service.

You know, when you’re putting your heart and soul into your work.

Um, and you know, you spoke about leaping out of bed and just wanting to be there for the people that you’re serving and giving everything your all, it is hard to see what, what the impact is at times.

And even if you have some idea, you know, one of the things we do is minimize and rationalize, I was short of breath, but probably a few weeks before I.

So you got to lose some weight.

And like I said with my white male colleagues at your faces in the grass.

I gotta X poly eight.

I had a rationale for everything we minimized because what’s important to us is them whoever they are.

Uh, so we don’t notice.

Yeah.

Mm.

So as we dive in, I’d love for you to share with us really your definition of compassion fatigue.

All right.

Uh, it’s a broad definition.

But most people will understand the two clinical terms for compassion fatigue and they are secondary trauma and vicarious trauma.

The secondary trauma is what we feel on behalf of something awful that this happened to somebody else about the shooting, the bombings, the fires, that this that the kidnappings.

And we could feel outraged.

We can feel deeply grieved.

We could feel horrified in behalf of that.

And I dare say when you get a case file, the circumstances that brought that person to your agency, you’re already feeling some secondary distress in behalf of them.

And how those things may not have the outcome.

You want one of my uh compulsions was if I had a disaster on a school shooting whatever case burning of a church or bombing of a synagogue or something like that.

And I get to looking and looking and looking.

I want to see an outcome.

Somebody else to save somebody else’s rescued.

Some people survived.

They found a missing child or the missing parent who went hiking.

That secondary trauma, the other one is vicarious trauma and that talks about our constant exposure and therefore absorption of the tragedies the crisis, the chaos that other people face.

Because we’re in the midst of that we have some level moderate to great level of responsibility for the well being of these people.

That’s why carriers coming.

Let me tell you what it has done for most, if not all of us, it changed us because we know, unlike people who don’t work in human services, the worst that could happen.

And it’s changed us in a way that idea say that all of us are far more hyper vigilant and hyper alert have more startle response than the rest of the people who work in what I call the rigid world are respectfully to say which because they work on stuff not human tragedy, crisis suffering tragedies and stuff like that.

So, those are the two clinical terms for compassion fatigue, which is it is a syndrome that very much mirrors post traumatic stress disorder very similar to what the veterans face.

Of course their life threat.

The threat to their lives is far more dangerous.

But chemically we have the same kind of reactions were triggered by similar events, sights and sounds and smells and all the audio things and the touch kinds of things we can experience that it is said by some that it is simply the cost of caring, I think dr Charles Figley who came up with the construct of compassion fatigue said this very wisely.

He said, uh the very qualities of caring and compassion and empathy that allow us to do this service to help others puts us in the direct path of compassion fatigue.

There’s no way of really avoiding it because you do care.

See, we’re not flipping hamburgers, we’re working with people who are suffering, he says.

But the good news, if you understand it as a predictable come and I’m talking about in levels, everybody doesn’t get hit with the worst aspect of it.

Someone give me mild moderate or whatever, but he says, if you understand it, it’s a predictable outcome of the work.

The service that you do, then what is predictable, It’s preventable.

The name of the game is have early intervention.

And again, that will largely come from your colleagues, your your relationships with notice so that you could reverse the effects always.

But that’s an ongoing thing.

So that that’s basically how it would capitalize that definition called compassion fatigue.

I just love that term.

I do too.

I love that.

Um I love this kind of imagery, it sounds weird, but like swimming, it’s, you know, the work in human services, you’re swimming essentially in other people’s trauma and there is an inherent impact on it.

And I’m curious, like, I’m not sure I want to wear this, but I really like in some, you know, like in some ways we try to train people not to feel such as sometimes in medicine, um looking at parts of people um, or I’m thinking of even like veterans or first responders in certain ways, like just turning it on, getting the work done and moving on.

Um, and then in social work, I feel like training is a little bit different.

So I’m curious if you um think that there’s like a difference in the way that people are trained in how we’re showing up and dealing um with other people’s trauma and if there’s a best practices when it comes to training because these are human, um, it is human suffering that we’re dealing with on all differing levels.

I don’t know if that makes sense, but it makes perfect sense to me and people would argue on my opinions and my experience about it.

I don’t really, really a trust that the words that we use largely in social work school and I did train with veterans to work with veterans, they use words like being objective, watch your boundaries kind of keep your place almost like it’s a message in their built in there that says, if it bothers you, this is not a good fit, if you feel emotional about something awful that has happened to another warm blooded human being, that’s something wrong with you.

So I have issues with that and I noticed some people could be rather stoic when they face tragedy to see horrible things happen.

But I wonder what do they do about it?

You see one of the things that killed 57,000 veterans when they came home from that war is they didn’t talk about it.

They didn’t say anything about it.

They stopped using all of that repressed uh, memory repressed atrocities that they face and experience and the things that trigger them when they get back to the homeland, the mainland again.

Uh that’s what killed the maternal part.

So what are these people doing who do put up this exterior call objectivity and clear boundaries and stoicism?

Are they drinking?

Are they depressed?

What is the nature of their relationships?

Like when I used to come home from work with Children dying in the cancer unit, Some of them dying while I’m sitting at the bedside and I get home and I go through my door and my beautiful Children come running to mommy!

Mommy!

Mommy, look at this.

I want you to see this.

And one of them will always be complaining, particularly the preteen.

It’s not fair.

It’s not that.

And I’m thinking about the child who died, you know, and I just want to say go away.

I like my husband said we got to talk and I want to say go away.

But what do you if I don’t do something?

I said I you know, he figured out, he said baby, you need to cry, come on, come on, come on in the room or something.

You want me a nice bubble bath and I do need to cry and a puppy need to cuss I need to probably go someplace and scream, I need to express and release that stuff.

So one of my major strategies which is really jumping the gun that I feel that everybody who works in human services should learn Beverly’s three Rs and that is to release to reboot and recharge every single day.

Get it off your chest and whatever form that your personality or your faith based practice allows to do, but don’t hold on to that, acting like it doesn’t touch you if you’re a human being at you, even if it enrages, it does touch you.

This makes me think of first responders or as my colleague dr Stephen Nicholas says warrior servants and they have to go in and be hypervigilant in certain situations and be armored and ready to deal with certain things.

And when you go home, what are you doing to take that the armor off?

And so I love these three Rs because there’s you know, there’s this balance between people keeping themselves and others safe and how do you deal with the atrocities that you’ve seen in the work that you do.

And so it’s a really, I don’t know, it’s a really interesting balance that I don’t think we’ve necessarily long because it’s not like a switch, you can just turn off internal.

But I know that I’ve heard from thousands of veterans and thousands of frontline workers I work.

It is hard to, once you’re in that mode of protection and uh prevention and you’re angry and you’re rage, you’re holding it and you’re being super alert and ramped up for the next thing that can go wrong when you get home or get with other relationships where you should have your warmer, more human connective self.

It’s almost impossible to switch to switch, flip the switch And come on down.

This is this is not 100.

You can put up an exterior, you can put up with the facade and pretend that you’re okay.

But inside ICI studied a great deal of neurophysiology to understand how trauma works in the human body.

The body never forgets, I’ll never forget.

It holds on to that stuff matter of fact of stores and different places, different mechanisms and it is so easily heather, easily triggered by something.

The body will always remember what it smelled, what it heard, what it felt, what it, so what it tasted, you know, tasted bile backs up in my mouth and horrible situations.

And so you have a similar situation that sounds like, feels like uh those those those those senses activated and then you’re back in that situation even if you had a birthday party or sitting at church, you know, the synagogue to go to a wedding or a cookout with the family.

If this comes back in the body is triggered the the minus trick and maybe you don’t even cognitively understand why you’re so upset, why you’re so acutely grieved for no apparent reason, but it’s there.

So I I think it’s more work, more understanding we need to do about people who are turned to this, turn it off in a moment.

You need to stay yourself.

Yes, But I still say when the situation, the crisis has subsided and you’ve done what you needed to do, then you need to release every boot and recharge before you go back into the next situation.

Mhm.

Yeah, I can, I can definitely see the value in that and the need for that.

And we do need to understand really the impact of this.

Um, the impact of trauma witnessing that um, other people’s trauma on the physical body.

It’s really interesting as you start to dive in, he had a body, it is really impacted.

Mhm.

Um so what are some of the professions, I think we’ve named a few of them.

Um, but that may experience compassion fatigue that a person might not think of.

Well, the obvious people, we know the medical teams, you know, the mental health teams, you know, the law enforcement, you know, uh, expect the rescue and recovery teams, you know, that they get it.

But people really think of some groups like teachers and uh I spent prior to Covid, I think I spent 11 years consulting with schools that had traumatized kids in the classroom, They struggling with behavior but they don’t even know what walked in the classroom with that.

But the demand on the teachers, the impact on the teachers, which was difficult before Covid, but I’ll use this term that when it comes to child abuse and parents who have issues of abuse and the resulting behaviors, the schools have become the first line of defense because those Children walk into school having been victimized having been abused, having been severely neglected.

And teachers have to deal with those behaviors that they think that they came to teach, but they’re trying to control behaviors without knowing what motivated behaviors also.

Uh, clergy people don’t think about that.

But it’s actually a high incidences of suicide because they’re trying to be confidential to, you know, the seal of confession.

But other, you know, in the protestant other face, they do a very similar thing.

And another thing I know about clergy because I come from a pastor or family is these people, these men and women do not delegate, they will show up to the hospital, show up to the funeral, show two services a day, but they hear the stories, they hear the horrors and they don’t know and I don’t think that too many of them are clinically trained to know what to do with what they hear except for console or to comfort.

And like I said, keep it to themselves.

So they hold a lot of distressing, uh, content traumatic material within themselves.

The justice system, lawyers and attorneys.

I had so many clients that come forth and a lot of them were severely injured by the covid thing also because of the quarantine period, but they couldn’t get to Children where they knew there were allegations of abuse because they couldn’t hold courts, They couldn’t do this.

They couldn’t, you know, the hearings, they couldn’t make the visitation and they know that the kids were in the predators hands may be in the same house.

Uh, incidentally, uh, I don’t know if you want to say this one, but the child fatality rate almost doubled in the first two months of the pandemic because they couldn’t get to them and the guilt, they failed of having failed and having abandoned.

I’m talking about court officers.

I’m talking about judges and I’m talking about lawyers because they spoke to me about that, uh, non direct care services in the offices.

Uh, they is often thought or mistakenly thought that because they don’t necessarily have hands on direct care of your clients.

And let’s see in the child services, the family services, the adult protective services or whatever the case is.

They’re exposed to the atmosphere, the environment, the distress, the anger to rage, the pressure, the demands of what’s going on in the atmosphere of that office.

And they are very, very subject to vicarious traumatization notwithstanding.

There may also be dealing with the emotions and attitudes and behaviors of people who are hurt, hurt people, hurt people.

And the person at the desk is just a subject to get the light back.

Is anybody else.

So we don’t think of them enough.

The main group, I want to say that we need to take a look at and help them to see it coming or family caregivers.

The only thing they could be taking care of their parents.

They can be taken care of spouses, uh, their own sisters and brothers who are adults who are taking care of their Children.

Statistically they make it very sick and they may die before the people are taken care of because there’s no cut off, they may go to work.

They may be stay home people, but they’re taking care of their house and they’re taking care of other people.

They’re taking care of their families and taking care of something.

And you know, with the appointments, the visitations, the former ecology, the meals and all of that stuff.

The pressure demand, the needs of people who are hurting and in pain and just need you to be available.

It’s this constant, constant demand and they come apart.

Um, and maybe they do or maybe they just get sick because they to think that, you know, I talked to any of them.

And if you talk to them, they say, well, I love my mother and I love my dad and I love my brother now that I love, you know, you love their Children and stuff and their spouse, but that does not make you immune to.

The constant pressure would turn off.

And it’s another thing that puts them at risk as many other people.

Um usually in many, many families this is a cultural thing, but I pay attention to that.

There’s a designated person who’s doing all the work and the caregiving, but the other families kind of leave that responsibility to them and it too don’t necessarily delegate to, well to call.

Somebody said I needed to take mom to disappointment.

I need you to pick up some groceries that she needs to go to the pharmacy, make that run for me.

Um, so these are some of the other folks, uh, that may experience, but they need us to consider and pay attention to that.

Pay attention sometime died navigate and something I was looking forward to in groups is coaching in the, in the future because they don’t see and they don’t see a way out.

They just work uh, what you call that multitasking to the, to the degree Well and I think about family caregivers right?

There is no time where you’re off really.

Um, it’s, it’s 24/7 and um, you can be called called upon at any time as a family caregiver and that you can see where that could become challenging really quickly.

And what you said about um, love doesn’t make us immune to compassion fatigue.

The impact on our body minds is this is a lot of bodies taking a beating.

So as you talk about the impact or what we can look out for, see um, what are some of the symptoms of compassion fatigue.

So there I had divided them between professional symptoms and personal symptoms and I’d like us to really look at them in totality because again, we tend to minimize some things.

But in the professional arena you would see things like low morale avoiding tasks, particularly those tasks that remind you or re trigger you of some awful distressing or traumatic work related event apathy.

Now that’s something people can throw up back like nothing touching them.

Uh, because they’re supposed to be objective or keep their boundaries but don’t trust apathy because it may not look like empathy, but it may be that wall that goes up because the body mind says, I can’t take another thing, I can’t take another thing.

So you want to notice that core work commitments, Obviously, staff conflicts, people get irritable, They get intense.

They feel judged.

Even if you ask them a question, they get the defendant what they were doing or if something goes wrong when their case a child or adult or senior person is injured and something like that, you would notice that they start defending.

I did and I did, I did because that’s something that rises to the surface first, exhaustion.

Um, I look at exhaustion this way.

There’s physical and there’s emotional, physical, you may be able to get a second win but emotional will hit you to such extent.

Sometimes can’t get up and face another day.

You’ll notice that and obviously that will lead to a lot of absenteeism, work related accidents and stuff and withdrawal from colleagues personally culturally some people don’t want you to know, don’t hope you don’t see and notice that they’re struggling and so they kinda recede into the shadows and those are the very people you need to go after and engage them because they’re in trouble.

They’re in trouble now in the personal impacts.

And I really say look for these things because the sooner you as a coworker and colleague or supervisor or manager can notice, you could do with what I like to call early intervention, which is always the best method.

You don’t let it just go all the way down the rabbit trail.

But you do something right away.

But there’s like six impact areas for compassion, fatigue and they are cognitive and emotional and behavioral interpersonal relationship, spiritual and physical.

Never minimize forget the spiritual part of people’s life under the cognitive, you know, just be things like the space penis or confusion, which is easy or rigidity.

I used to live in my own self rigidity because that’s where people just kind of fly and use the same intervention just like, you know, it just kind of fly off and do that, but they never worked the first time, but it’s kind of like a narrowing of the box.

You know, we get tunnel vision when we’re under too much stress and a part of the brain doesn’t allow you to see outside of the box, it doesn’t mean they’re not confident and this means there’s too much going on.

Self doubt.

Self doubt.

That was probably one of the most painful things about my first post graduate work experiences that I began to question myself and I’ve had when I tell that story, a lot of people say my due to, I wasn’t knowing at some point that anything I did was really making a difference.

I questioned my mom, I didn’t even uh felt as confident about my own competence anymore.

And if you talk to many people that could get like that any emotional, obviously more emotional roller coasters and anxiety and feeling overwhelmed, feeling fair and you can’t put your finger on what you’re anticipating the next thing, you can’t even relax when things are calm because like I said that that that that that that by carriers that have you looking for something that is gonna go wrong, it’s not gonna last, that that that kind of thing going on acute sadness, depression now, I want to say this because I’ve done this in my training for years.

I think most if not all of us are depressed in this way.

I’m not talking about a clinical depression, I’m talking about a depletion depression because there’s little, there’s some things to celebrate in our work, there’s some outcomes that we feel really, really good about it.

But much of what gets to happen on a day to day basis is uh it doesn’t work out the way we want.

So we’re most often times and what I call a depressed state, just low energy, constantly, constantly struggling, which means in the body, the physicality of a person, it depletes all of our energies, creative energies, emotional energies, physical energies, all kinds of energy.

It just kind of pulls us, pulls us, pulls us down and what that does, it goes over to the physical impact.

All of us have some challenges to our immune system.

The body has to figure out how to compensate for that draining and depletion of energy so it goes over to the immune system and drains on it, taps on it and will actually shut it completely down.

And that’s medically documented.

I was really really concerned when they talked about who was at risk with the first level of the virus of covid 19.

I said human service providers at risk because they depleted the immune system is compromised.

I’ve always encouraged people to do some things about that too.

Um in the behavioral arena move happiness and cleanliness and the hypervigilance is there?

Um, I would say how that worked at my household because I worked in child welfare.

My Children didn’t get to spend the night in nobody’s house.

It was if there was a man or a cousin or big brother, mm and some women too, I just, they didn’t trust it was, you know, they had very little opportunity.

People come to my house, their friends, but they weren’t going, does that make sense to, I watched them in a different way?

They forgave me.

But you get my point that that that has changed us to uh use of negative coping skills.

I’ll be the first one to admit when I’m upset emotionally, I eat all the wrong stuff.

You like a bag of barbecue potato chips, the party size bag, you understand what I’m saying?

I drink too much.

It’s not the friday night glass of wine at the end of the workday, it might be a cocktail almost every evening during my crisis.

Does that make sense to you?

Too much possible?

If you ask people, they will consume all of the carbohydrates if you will when their stress, what’s one?

But there’s a lot of negative coping skills to do what I call retail therapy.

Too much spending, you name, you pick it, is this what people do?

Uh the spiritual piece, which is really sad and tragic because I’ve seen it so many times?

It’s a loss of purpose.

What am I doing?

What am I doing this?

What’s gonna happen?

Nothing is gonna work.

Um people who have more religious belief systems, uh makes them question God.

And I have a million people from all different ethnic groups say, how could God let this happen, you know, to innocent, elder, innocent uh man or woman or child or something like that.

Uh pervasive helplessness, that nothing I do is going to matter.

It’s not gonna work, it’s not gonna last even if I get it together uh in the interpersonal relationships where you can just imagine the uh projecting your anger onto somebody else being patients.

I felt with my own Children.

Uh the space and time.

I didn’t have my own husband because I’m working with people who are really suffering and mind my mind, my kids ain’t got nothing to complain about that, Which is unfair because Children are supposed to complain.

That’s part of the development right to do that.

Um uh yeah, but those kinds of things are kind of conflicts within your house, the mistrust that you could have that you’re being judged or the perception of that interfere with a lot of family relationships.

And of course, in the physical arena, like I said, the immune system is compromised.

I really encourage people to take a look at that uh include some alternative healthcare practices along with their traditional medicine to really dis always booster the system, shock syndrome, dizziness, breathing difficulties.

Some of us hyperventilate almost none of us in hell enough and exhale completely when we’re under a significant amount of stress.

And we have somatic complaints because that’s one of the way that the body has all of these little witches and twitches and pin sticks and needles.

And to me, I think that’s one of the body in former systems.

Just trying to say, I’m tired, heather, would you sit there?

I need to stop, but do we listen?

No, we just push and push and push.

But those are some of the things that we will notice, like I said before and others maybe long before they notice it in themselves.

And as your colleague, I don’t even have to be your dear friend.

But as your colleague, I’m gonna say, heather, I’m noticing and I just want you to know I’m here.

But I’m gonna suggest, you know, you take a pause, you take a walk, you take a breath because you’re doing too much girlfriend.

I’m gonna say that you don’t tell me to mind my business and my business will be back in 10 minutes.

We’re gonna take a walk, you know?

But that’s just the way it goes and I really encourage people to be loving meddlers to each other in the face of I wouldn’t get mad at you because you’re out of character and you get on my nerves.

I would stop and say that’s not her or his mode of operation.

They’re really struggling.

I’m gonna take a pause and you know I got you and I’m not gonna give up money but I see it struggling.

You don’t see it but I see it yeah and it’s that kind of cure bringing curiosity versus judgment to the person who’s acting out.

Absolutely.

You nailed it, you nailed it.

Mhm.

You know I’m struck by really a lot of the symptoms that you talked about are very similar to burnout.

And um what is the difference between burnout and compassion fatigue For me the best way to define it is to separate the workforce in the U.

S.

There’s a human service providers and the rest of the workforce.

I call them respectfully widget workers they work on stuff they make it design it beautiful stuff, they create stuff, they fix stuff, repair stuff and they could have burnout.

Yes from an overwhelming amount of functional tests you could just do too much is too much pressure is too much demand.

The time is relentless that burden on yourself.

You can get it.

The difference is in the human service arena you’re not working on stuff but you may be able to put out of your mind on friday and go to Happy hour.

Not so because human service provider because you’re working with human suffering human crisis human chaos human victimization and you have responsibility whatever that role is to help protect prevent the save to rescue to help the healing process and that makes sense.

I don’t know if you go to happy hour and you on that second pitcher of margaritas is still with you as a matter of fact it goes home with you for the weekend.

It states while you’re trying to have uh festivities with the family is always there.

So that’s one of the distinctions I made burn out by itself.

You know I work with my time in the federal government where some I was uh employee assistance, some human uh traffickers.

I mean the people who work on the airlines and different kinds of roles and stuff like that and they could get in a lot of trouble um with depression, loss of sleep, the illnesses that come from that too much, drinking too much nervousness and stuff and so it’s a reality but I want to keep it as functional task now here’s, here’s the trick though the people in the human services, not only do you work directly with the human but you’ve got a lot of functional pressures on you to something called documentation.

I ain’t never gonna forget that.

You never catch up.

It just keeps coming court reports, process reports, critical incident reports, summaries, quality assurance on all those pressures those meetings, those demands.

You can be burned out from that but you still feel the compassion fatigue from the human issues that you’re dealing with together.

There were perfect storm in this way when you’re so overwhelmed with your functional tasks.

Now I’m talking about myself and you can own this if you will I get an emergency call or walk in other human thing and I said Lord please don’t let that be too much because I’m so backed up here on this this paperwork.

But then you know I go down and see them and of course it’s too much and I got to come back and bring that and add that to my list.

But I’m so upset about the search uh circumstances, the situation that they’re in, the hurt, the pain, the grief, the loss.

They may have an experience that when I get back to the paper I can focus on the paper.

My mother part of my mind that that part of the brain, my short term memory, my my rational thinking, my critical thinking, my problem solving is shot.

Dr Bruce perry would say is hijacked is not working.

You see how it’s a perfect storm.

We struggle with both but don’t confuse one for the other and truth people need help with both.

Mhm.

To release reboot with the family the the human crisis and suffering but maybe do some restructuring, revamping how you handle the functional tasks set up other kinds of systems.

Set up new benchmarks to get things done that may be more realistic for you to do.

Don’t confuse the two.

Yeah really I really appreciate that distinction um between the functional tasks and its connection to burnout and the human caring connected to compassion fatigue.

Um That makes so much more sense to me because I’ve always it’s always felt fuzzy for me in my mind because there’s there’s very similar symptoms um in a lot of ways and I was like, how does this work?

But now that makes so much more sense.

Well for years, most of my career and it still exists today.

We have assigned much of the breakdown or doesn’t necessarily have to be breakdown but begin to be afraid in the workforce as we attributed to burn out.

Um And uh and that made sense because that’s all we had to work with.

But that was a mistake because for the most part, if all you really had a lot of functional tasks that can be adjustments made that can be reconfiguring of how you handle those responsibilities, the meetings, the the documentation and stuff like that.

So that has a better prognosis for recovery or getting yourself back on some, you know grounding.

You’ll never catch up with all that paper but you can still get to a different place.

Not so compassion fatigue.

This stuff is going into the grave.

Yeah.

Mhm.

So hopefully you can help clear up another thing that gets sticky in my mind and that is um really the role of empathy in compassion fatigue because this is sticky in my mind too.

Yeah, because it is sticky heather.

It really is uh empathy to me is one of those from heaven gifts is a wonderful quality.

Have uh it helps us to understand that, which doesn’t make sense.

Is out of the realm of our own personal experiences to be able to help somebody from a different culture, a different way of being a different loudest lifestyle, different kind of problems that people get in, that you would not necessarily get in there.

Don’t like I said, don’t make sense to you.

So the empathy is a beautiful gift to bring to the work.

Yet Empathy is a two edged sword because you care it gets to cut you deep and it will we feel for people, we could put ourselves in that place.

We could imagine the level of suffering and hurt and pain and fear and grief.

So it gets to cut us.

Therefore, in my estimation that the empathy, if you remember it as a gift that you bring to your service, your work than it is to preserve is to be nurtured, is to be taken care of somebody one of my eye.

I see a therapist.

Um and she also says, remember it’s a gift, Take care of it.

Be thankful that you have it to bring.

So you’ve been able to help, I’m talking to you have so many people because of your empathy.

But now that it’s injured when you go home, part of what you do to read and recharge.

So, you know, take care of it, put it back in that beautiful box with a beautiful bow on it.

If that makes any sense to you?

It does.

I, I feel that one for sure.

Um for sure because it’s, you know, I consider myself to be fairly empathic and it’s uh really a gift that makes me good at the work that I do and sometimes does it, it’s painful.

Um and what I’ve been recently learning about myself is that it’s sometimes hard for me to identify my own feelings and needs versus someone else’s because of that empathy.

So, I’ve been doing a lot of work around trying to uh feel the difference in that, okay, what’s mine and what’s this person’s um which is probably a practice of a lifetime for me.

You know, I heard a therapist that I work with, uh she was talking to some of our clients and she had a habit of saying this because I’m one of these people, I could be with you and you’re crying and I didn’t even ask you what happened, but I’m already crying cause I’m feeling for you.

I like I love you heather.

But she said, she would say to me and she said, well, Beverly what came up for you, which causes me to stop and think, what is it about your situation, your story in that moment that may have brought to the surface, something in my history, whether it’s current, whether it’s far in the past.

So to stop and reflect on what was triggered if anything was triggered or is it just I’m fulfilling deeply for you.

That makes sense to you and when you feel that too, it is good.

And I think it is wisdom and I think it is courageous and wise to feel what you feel and express it in whatever way that is to you.

If you need to cry.

If you need to do some gallows humor outside of the air, if you need to cuss, do it, spoken word journal, whatever you need to do, but really do uh nature and preserve your empathy.

Yeah, thank you.

I appreciate that.

That helps helps me.

Uh I don’t know, frame it, feel it differently how I’ll say.

Yeah.

Mhm.

So I want to make sure that we have time to talk about really interventions or treatment protocols that you recommend for compassion fatigue.

Well, what to say this I kind of all my um treatments, methods, techniques.

I boil it down to this that we must decompress the body at the moment.

There’s something hits us.

Whether we hear it, we see it, we feel that we sense it.

We smell it.

The body goes into instant constriction and what that means that the prostate tissue laying on top of the skeletal muscular structure tightens and races for the worst because it’s a part of the brain that didn’t identify what that did.

So that’s an automatic stress response.

The problem with us is because we’re not focused on us, we focused on them, whatever our role needs to be in their crisis, their emergency is that we don’t recognize it.

And so as we continue to work, we continue to wade through.

I think that’s the term you used.

I love that uh swim in their stuff and then we take on the next and the next.

That constriction gets tighter and tighter and so healthy blood flow, oxygenated blood flow and your body is curtailed as that makes sense to you.

And all systems begin to try to kick in and compensate for others.

So you’re you’re in a stress state which is unhealthy for the body.

So the techniques that I always recommend are things to decompress.

When I say to release yes, talking about cry and scream and I busted out, but then do something to decompress the body in the reboot.

Like the stretch or very specialized deep rhythm and kind of breathing that uh breaks the constriction, expands vocabulary so that the blood could flow through, tends to relax.

Kind of exercises.

Run for a minute to walk for a minute.

Uh do something.

There’s a whole list of a matter of fact, you’ll find it in the book.

List of those things.

But really the compressor that the body can begin to flow and the systems can get the blood and oxygenation that they need to operate in a more optimal level.

That’s critical to do.

And I say you don’t wait till you go home and please stop waiting for the weekend if I’m coming after you and I see you like you know, lost all the color in your beautiful face.

I said you’re gonna stop right now, we’re gonna stretch, we’re gonna breathe, we’re gonna do something now and like I said you may say but you need to leave me alone.

I got too much to do.

I said I got to leave you alone for five more minutes but I’m coming right back here so do that kind of thing with each other.

Also my strategy is really in encourage people to engage in right brain activities and this is part of your recharge activity.

You could do it sometimes in the work days because I encourage staff and agencies to set up opportunities to play, to laugh for some games for some dance with some music for some ridiculousness.

And certainly by the time you go home but the right brain i activities are things like the appreciation of color and music and art and creativity, making things you know, using your fine motor coordination, design, um music, write poetry or whatever the case is.

Play craft.

Some people love, my managers love gardening and stuff or clay.

But the right brain if you reactivate that, which is kind of shut down because we basically operate too much in the left brain and that’s really important.

Your logical reason, you’re Matthew oral expression, that’s really important.

But that all by yourself kind of leads us a little neurotic because we’re always trying to make what makes sense.

Does that make sense to you?

So you want white brain releases endorphins, dopa minds the legal ones.

Uh serotonin that makes sense that those good kind of chemistries that allows us to think outside the box.

See a bigger picture when we hit the wall where you say, okay, what’s the next best thing when you think things are impossible?

You can see our array of possibilities so you want to engage in that stuff could be built into the work and I believe it should I do without getting yourself fired.

Stop, stop, stop and play.

But certainly by the time you get home me and my kids, they got into have it sometimes they get on my nerves at the door and then I break out and pretend I’m Frankenstein cause that’s what they were and they like to run and do hide and seek and something about that was really, really funny for me, I’ll be upset but I started laughing because they always run and hide in the same place where I could see them and they think I couldn’t see them.

They used to crack me up and that makes but did you do some things like that kind of, that chemistry from the right brain kind of overrides the negative chemistry where you’re in that service, push demand, high pressured mode and I encourage people to do those again, those, there’s listings of those things in my book, but play and have fun.

I don’t remember even Bruce Perry really highlighted that as a major healer for people to laugh to play.

I watch a lot of humorous things on tv on netflix.

So stand up comedy.

I don’t even care that they curse anymore.

I just made me laugh.

Made me so those are the things, but like I said, the main thing is to mitigate the effects of the work that you do and you do it that way.

Yeah.

Well, and it helps us to remember that there’s good and fun in the world versus just seeing all the dark.

That’s right.

You just reminded me of something engage in friends now that we got a lot of people in our lives, but some of our people, they kind of drain us engage in friends that put you into those button things.

The people who are closest to me are ridiculous and we’re gonna do this, we’re gonna do that.

I don’t feel like I said, no, you’re gonna do it anyway and don’t let us have to come over there and crash your house, but we’re gonna do and that’s the kind of people I need to pull me out of the dark into the light as you say.

Mhm Yeah, no, I that makes so much sense.

I love that I can think of people in my life and I’m like I’m not gonna do that.

It’s yes we need more of those people in our lives or I do the other folks in the balcony way in the back.

Yeah.

And uh I have to really check in with myself on if I can see those people some days like no I I don’t have enough energy for you today.

Uh Well I’ve been listed my people to come after me.

Don’t wait for me to think that I have time because we don’t in our mind.

You know what I’m saying?

I my my my my my call my posse they don’t wait for me.

They said Beverly I saw I know you’re home.

I just get a text.

They say my best friend Ray, he says it’s time.

He said you know we’re gonna cocktail a zoom and plan what we’re gonna do saturday.

They come after me because if they ask us when we have time and we’re gonna look at all our account and say we don’t.

So no first thing give them give them the task to come after you.

I love that.

Mhm.

So I know you do a lot of work with organizations really on um preventing compassion fatigue.

And so what are some of those best practices that you recommend to the managers.

I asked them to look at themselves first and know that they need to respect their compassion for t because they hold theirs and they hold their staff as well uh to monitor engage where they are in those moments as well.

And then to create opportunities for staff.

I believe that most the beginning of the week depending on how people some people emergency teams are in and out of office so they don’t have people in but do check ins at the beginning of the meeting grounding sessions at the beginning of the meeting grounding at the end of the meeting um End of the week check in the beginning of the week kind of check ins and don’t let people tell you about the cases.

How are you, what are you doing?

And I have a rule, nobody gets to tell me there’s no me for any period of time that I’m fine.

That’s a famous professional fit you’re not but you may be but I want you to stop and think engage.

Am I okay?

I want you to think you said well today’s a better day than yesterday are.

I’m not doing as good as I really could.

Maybe I wish I I want you to stop and kind of check that’s the kind of thing.

Building those little structures in the office depending on how your operations are, how your staff line up is who’s in who’s out one of the managers in a group where they work with babies who were born drug exposed and the nurses and the social workers run out on emergencies all the time.

And she hooked in the sound system.

I as a tibetan time Bolan had other people when they hear that chime go off there to stop wherever you are standing and sitting.

And she said she hooked it up to her sound system so you could just stop and decompress from him and then move back in and lasts about a whole two minutes and 40 seconds.

Just listen to that kind of thing.

Uh One of the veterans agencies is one stop.

They have everything the employment, the housing, the middle health the whole thing going and uh she has a dancer or she called it a crazy room and they get in there and put on some crazy music like the the wobble and it is the staff.

They just go crazy for a moment.

Uh Some people have games, competitive games at lunchtime or in the in the atrium or some teams take walks together or I had a club when I was at the V.

A.

And we would walk up the stairs together at the same time every day whoever was available and uh the competition who could make it up 10 flights of steps.

I had a great body back then.

So so you figure out ways to build in self care.

But the most important thing to me, one of the most important things is for managers to model self care so that staff from different kinds of cultures or ethics about work will feel safe to say I’m not okay.

I don’t know what the heck I’m doing today.

I’m really struggling today.

You don’t need to be the eyes behind my, my back uh to kind of notice me.

I want people to be that safe to say that because to the extent that they could own that they’re struggling then they could get the help they need in the moment so they can move through the day.

I may say to my step, you know, it’s going downstairs and get a cup of tea.

Just take a pause to stop.

A no sense to me telling her or him to push through because the quality of the caliber of the workers or they’re gonna sit there staring at it because that part of the brain won’t cooperate.

I say that I noticed the same thing when you tell managers that when you’re looking at what appears to be procrastination, stop and consider that they’re in a heightened state of overwhelm and the brain is not going to cooperate.

Not so tell them to go ahead and take a pause given administrative leave day.

Don’t make no visitation if that’s possible and go work on some documentation.

Go find you a nice little smart in the atrium or wherever the cases or work in the cyber cafe across the street.

I don’t care because the benchmark is to come back with the work.

I don’t need to watch you do it if that makes sense to you.

So those are some of the encouraged people to do.

Ultimately it’s still all balls down to early intervention.

All of the managers, all of the co workers should notice that list of personal and professional impacts.

And when you see a sign of it, when I see you out of character of how you normally operate, your normal energy is just not there.

Then I take the mode that I’m concerned and I’m gonna talk to you and I’m gonna nudge a little bit and I’m going to let you know I’m here for you.

I get it.

I affirm and if I can’t get traction to then there’s another level where you see a staff member whom I would say because I lost a few staff colleagues to suicide.

When you’re in trouble.

I’m gonna talk to the supervisor.

I’m not I’m gonna say my friend is struggling and we can’t kind of get some traction.

Then we probably get you to the ap employees assistance or some additional kind of help and support if that makes sense.

Yeah, responsible.

Yeah.

But that’s my thing agencies to try to prevent the worst aspect of compassion, fatigue.

Yeah.

And it sounds like it really is um to a few things but there’s connection, making sure that people are seen and heard and that we’re stopping that automatic like dizziness of just going, going, going and getting people to not do the automatic like, hi, how are you?

Oh, I’m fine.

And then we just move on.

It’s like no, how are you?

Really?

Like I really want to know how are you um and having that space for people to to share.

Yeah.

Push to push the envelope.

That’s where I step out of the realm of boundaries.

And if I know, you know, it depends on the level that, you know, people sometimes, Is that okay?

The kids okay?

They get on your nerves because I know you are not just right.

Am I bring something up to kind of provoke you to talk about that, but take the level understand and respect people’s cultural differences, that gender issues or whatever their sense of pride and work ethic.

Uh you disrespected but don’t let that be the deciding factor when your colleague is struggling.

Don’t don’t don’t don’t do that.

He was respectful and do be that loving meddler help people get back on track.

And sometimes I admitted to, you know, I would say to you, um having had a serious situation with a child or parent.

I said, you know, uh I kind of saw that I noticed that thing and that thing really knocked me to rock me to the core, knocked the energy out of me.

And if you have any way that you’re coping with it, let me know because I’m not.

So I just let you know affirm your experience whether you’re ready to own it or not, but I’ve said that it got to me, which maybe makes it safer for you to say it got me too.

I don’t know what to do by sharing that.

I opened up a door for some conversation.

Mhm.

Yeah, and I think that’s that’s that vulnerability piece of saying like, wow this, this was a terrible case and it really hurt, it really hurt me or I really felt this one.

Mhm.

Yeah.

So as we begin to wrap up today, is there anything else that you feel is important for our listeners to know or be aware of?

Uh that would be accountability partners, accountability partners is in our workplace and even in our like community service is volunteer a lot before the quarantine, um appoint people to notice.

You give them permission to take that role to see when you’re kind of speeding up moving too fast doing to being too controlling being out of character, give them the permission to step out of boundary and to say Beverly you’re doing too much.

You need to take a pause, You’ve done a pretty good job here, slow it down.

Step off that wheel.

Take yourself to do that too because like I said, they will notice at first they just need to feel safe.

Um and I’m gonna tell you something else too, the people you pick is important, that is not always the people at home because sometimes for many of us, the people at home and our closer friends need us to be okay so we could be available to them so they don’t really want to hear too much about the job.

Okay, now what about us?

And so and I’m not mad at them, that’s just the reality.

Um the people that work get it, you know what you do, they know what the struggle is.

They know what the mission is.

They know the scope of things that could happen.

But still you pick the pick those people who have the strength of character to push the button boundary, like I would say um I have to say leave me alone, I have too much to do that kind of thing, but I’m picking you because you’re gonna say yeah I’ll leave you alone about five minutes.

But we’re gonna stop, we’re gonna call it a day and that’s why I want you because you got that you’re gonna have that little push to come back at me.

And I got to say, okay, okay, okay heather that makes me check myself.

So that’s what I want to say, make that decision.

Use the wisdom that would good be good to have accountability partner because I don’t trust myself to stop, I still don’t 40 years of experience in my best selling author on the subject.

I don’t trust myself to stop.

But I got my friend ready.

He will send me a text.

He said don’t let me have to come over there and knock on the door away from that computer.

I know what you’re doing.

That makes sense.

And that that’s what I want to say and and just do it for you.

Do it for you, pick those people uh to pull you away from the dark and into the light and engage you in fun and activities and uh can help you keep a better balance on separating you from the service you do.

Here’s a final thing I want to say.

This occurred to me is be careful not to over identify with your work or defining yourself by your service.

Uh what you your service is what you do, but you and your fun and your lifestyle is who you are.

Never confuse having a career with having a life.

That’s what I want to say.

Thank you Beverly, you have been a wealth of wisdom and just really a joy to connect with today.

Um it’s this conversation has been meaningful for me and I really want to thank you for being here with us today.

Thank you for having me have I really enjoyed talking to you.

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