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Compassion Fatigue

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This has been a most timely subject. I had just attended a workshop for mental health workers. Professionals were across the spectrum as this was a huge conference; we had physicians, nurses, LCSW, LMFT’s , CAC and CAADAC certified as well as early childhood mental health supervisors from various county organizations.

When I picked one of my “breakout sessions”, I was interested to see if there was anything new in the way of information for Compassion Fatigue.

It had been a long time interest that started when I was a young nurse and finally was making the transition to counseling. I observed that nurses were absolutely the worst at self -care. I decided to donate my time to 2 of the psychiatric hospitals nursing staff and conduct weekly group workshops on self -care. I was miserably surprised at the results. The first battle was being even able to do such a thing in a hospital without being seen as invasive or self -serving. I decided it had to be free.

Then I discovered it had only taken me 2 years to try and get them individually or even as a team to take their lunch breaks and 15 minute breaks. This was with the head nurse’s complete agreement since it was the labor law. The nurses had actually engaged in opposition to the meetings. Finally, I let my partner continue the work (which was now a paid position) as the head nurse had seen the importance of these groups. I was irritated and sad. I figured that they would find out in due time the ignorance of not heeding the warnings I had attempted to share. I shared my own personal horror of finding hospitals that did not take care of their nurses and example after example of how I had been guided by my therapist to take care of myself. Clear examples I showed them how I had been saved from personal injury and the reputation of myself in my job. For some reason, they had felt it would never happen to them. Later, I did have some of the nurses seek me out after the fact where there had been serious incidents.

I decided to put that behind me and now work only on myself in this area. I certainly had lots of stress with a young daughter I was raising on my own, no help from family, and working 2 jobs and going to school through a divorce. I was lucky in that I had learned while I was in college, that therapy and counseling would help me since I didn’t know where else to turn in life matters. They helped me survive 2 divorces, years of a child custody battle, and other situations I was not equipped to handle even on my best days. I knew that maybe there might have been some problems in my family. It became more and more apparent that although I was equipped to do well academically, I was not at all equipped emotionally.

I also learned that this put me at risk when I was working in the field with clients. I remember being troubled when I felt so strongly when i was working with other adult children of alcoholics in a crisis unit. I insisted that I not be given any more of these kind of clients. My supervisor told me that if I learned this well, I could be more effective than anyone else. That I owed it to myself and to these clients to get the help I needed in therapy. I am most grateful to him for his advice.

Luckily, when I went to school, they strongly encouraged personal therapy anyway. I was shocked to find other schools did not even mention it. Psychiatrists and other professionals were not required to do this to be licensed. It made it very difficult to see entire staffs of trained professionals acting out and projecting onto their clients. It was useless to try and teach them. I observed with sadness the entire scene.

Then, if they weren’t projecting to begin with, the years of working with traumatized patients in a dysfunctional system were affecting them anyway. It was a nightmare. It was a repeat of my own family dynamics. I had unconsciously recreated my family with where I was working.

I had been with a physician and nurse educated mother and father who valued intellect and academics but were completely ignorant when it came to emotional maturity. Worse, there was the entire secrecy of the alcoholism in my military family, where promotion was everything. Denial, minimizing and rationalizing became the norm. This was repeated in my jobs.

One particular thing I remember most poignantly. I was upset because I believed that the head counselor of the adolescent chemical dependency and mood disorder unit was alcoholic. I shared my concerns with his high blood pressure and vital signs he had asked me to take. I saw them as withdrawal symptoms when I smelled alcohol on his breath after going to Mexico over the weekend. I told my program supervisor. She said that I was only smelling shaving lotion, drawing conclusions and was mistaken. She had never observed any such behavior. Years later, he was fired, after they found his credentials had been forged. He had ended up changing from alcohol to pills in the meantime. It had only had been detected at the end when they were looking for things to fire him for.

These kind of behaviors were to become the rule rather than the exception in most of all the many hospitals and rehabs I was to work in. Ironically, places that were meant to heal the patients with drugs, pills and alcohol, became a place for those who were staff could justify “only using recreationally”. I have to believe in retrospect that it was a symptom of the PTSD that they were suffering, albeit nobody ever addressed that.

So here was I, a seasoned veteran of over 30 years of experience in this field, at this conference. I was thinking that I was going to be learning more of what I had seen and heard about Compassion Fatigue in this workshop. The presenter stated that she was surprised that the number of people attending her workshop was so large each year. She gave some very real and clear examples of how to combat it and how real it was. We learned about the neurology, the most recent and updated information, and were taught some techniques in mindfulness, yoga, meditation and good old fashioned self-care. I was thrilled. I decided I would write an article on this much needed subject and I bought the most recent book on the subject.

Then came my own surprise. I have had in my history a repeated strange mental blank spot that says because I know something means I am doing it. Time and time again, I have been surprised when it has been pointed out that I wasn’t doing what I was teaching. I always teach “watch what they do…not what they say” when working with any of my students.

I had gotten a speeding ticket on the first day going to the conference. I hadn’t had one of those in so many years I can’t remember. One week later, I was in a car accident that nearly totalled my car. Granted, I didn’t cause it, but it was a clear red flag warning from the Universe to slow down. My wise mentor suggested that I take some time out. My coaches suggested I see a doctor. Finally, one of my recovery coaches said after our session. “With all due respect, Michele, you aren’t acting like yourself. You need to see someone. You would require us to do the exact same thing if we were in a car accident and you know that.” I was embarrassed. I was cornered into doing the very self -care treatment that I needed and was trying to avoid. When I did, I found injuries I had not noticed and I had been unknowingly in a brain fog. It was clearly frightening. My mentor offered me her house for a week, to reflect on my life. I needed a time out and I needed to surrender.

I had been on a freight train trying to get things done for my new business and the other things I had committed to. I was so responsible. I didn’t want to stop and “let everyone down”. But that is exactly what I needed.

In the silence, I took a huge inventory of my behavior. I had not even realized the sound violations that were apart of my daily existence from early morning till late at night. Living in Hollywood, I heard the helicopters day and night landing on one of the 12 nearby hospitals, along with the usual fire engines and police cars that are apart of LA city life. I was inundated with people needing something from me, from room-mates, my own adult child and grandchild, to my clients and colleagues. Even the pets were not without their constant wants and needs. Although I had kept a ritual of quiet time in the morning and again at night, it was clearly not anything like I had experienced in this week of solitude.

When I was younger, I had been to a series of Catholic schools. Many times we had silent retreats. I had forgotten how refreshing they were. I read spiritual books, slept in or swam in the pool during this time. I did whatever I wanted to in this oasis including just pretending everything would get done somehow. I forgot how to be stressed and be fearful. I remembered again just who I was and what I was supposed to be doing with my life. I realized I had been running out of fear, although I didn’t know it.

It finally went from my head to my heart what faith meant. I just couldn’t seem to make it happen although I knew everything about it.

I experienced a soul peace that I hadn’t remembered for a long, long time.

Ironically, one of my biggest items with a deadline on my “to do” list was to write my article on Compassion Fatigue. I couldn’t. I literally could not do it.

Now, after coming back, and keeping that experience in my heart and mind, I am back at work. Now, I am writing of my experience because I want to. My coaches all were happy to see that I listened to their advice. They cheered me on as I took the time off. They saw the “coincidence” of this paradise oasis that was given to me just for this reflection. They knew that this place to heal that was offered to me out of the “blue” had been no accident.

I realize that I need to be surrounded by other recovering people, who themselves have had experience with self -care. They can see in me what I can’t see. They have the courage to speak and say what they observe. And for me, this is the humility to listen and the surrender to take the action that is required to maintain the work that I do. It is also the greatest blessing I have been given to work among those who require this for themselves as a standard. They hold themselves to this hard standard of self -care. It isn’t convenient. It isn’t understood by most. It is met with resistance, opposition and in some cases mislabeled as “irresponsible and selfish”. However, it is the only standard which allows me to be able to continue to do the work I love. It is the most with effective intervention. I must walk like I talk. I must lead by example. This is what I am called to do for “much is expected to whom much has been given.” I am most grateful for this timely lesson.

Michele Downey