Compassion Satisfaction

I’ve started—and subsequently wandered away from—a handful of blogs about secondary trauma and compassion fatigue. I’ve managed to write about the beginnings of burnout and a lot about self-care and self-reflection. But I was having trouble writing about the intense issues of compassion fatigue and vicarious trauma. Let’s face it, these aren’t the cheeriest of topics. But last week I was fortunate to attend a continuing education program that inspired me to finally finish a post about the emotional risks we face as social workers and how to manage those risks.

The event was offered by my hospital for social work month. We watched a deeply moving video about ow to heal caregivers. First responders, firefighters, police officers, nurses, and, of course, social workers spoke about their experiences with secondary trauma. I cried a couple of times, feeling the pain of strangers who joined a helping profession to help and found themselves mired in suffering. They talked about how their bodies reacted to stress over time or how they found themselves unable to sleep. Each of them showed an enormous amount of vulnerability as they shared some of the low points of their careers.

It was riveting. And it also showed me some beautiful interventions for combatting vicarious trauma. What follows are some takeaways from the video that have really changed my perspective; I hope you have a similar reaction.

  • Do you have a safety plan for burnout? We use safety plans for our patients all the time: for those who live with abusive partners or those suffering from suicidal thoughts. It never occurred to me that as helpers, as witnesses to that kind of intense suffering, we too could benefit from a safety plan. It doesn’t have to be dramatic: my go-tos have always been long lunches and journaling. The occasional root beer float has also greatly helped me on the hardest days.

  • Do you honor your grief? The program’s facilitator pointed out that secondary trauma and compassion fatigue are often grief. We use ourselves in our practice: we open our hearts and humanity to others and share their pain. It only makes sense that over time, the grief begins to pile up. As helpers, we need to honor our losses. I can tell you the names of patients I loved, who touched my heart and changed me; I honor those relationships by holding their memories close, by telling stories about them and smiling.

  • Do you celebrate your successes? My favorite part of the program was hearing the phrase “compassion satisfaction.” Of course there is fatigue in caring for others, but we are also drawn to this work for a reason. As social workers, we are trained to constantly reflect on ourselves and our work but I think we tend to reflect on our challenges and our failures. Instead, the facilitator of this presentation encouraged us to focus on our successes. I challenge you to do the same: what have you done well? What joy did you get to take from your work?

I love being a social worker. It is one of the great pleasures of my life to do this work. As we end social work month, I hope you feel honored by your co-workers and by our profession. Share your joy; we are helpers and healers and we deserve to be recognized for our good and useful work.

The body knows

I had a tricky interaction with a patient a couple of weeks ago. A patient of mine (who has an extensive trauma history) made some comments about my children not being safe in daycare. She knows I have kids because she asked once and it’s such an innocuous question, I didn’t even think about answering it. In fact, I don’t generally have strong feelings around self-disclosure; sometimes I think it can be helpful to build rapport and trust so I don’t worry about answering mild questions from patients. This is all to say, I had no problem with this particular patient knowing a little personal information about me. That is, until she hit me with this nonsense about my kids being in danger because I’m not at home with them full-time. This is a touchy subject for me, because it’s a deeply personal choice that has several variables and the judgement around it feels absurdly sexist. When she said that I should be careful, that bad things could happen to them because they’re with strangers most of the day, I had to work very hard to be still and not let my face betray my internal, white-hot rage.

In the actual moment, it passed fairly quickly. I squashed it down and told myself that this woman thought she was being helpful; she wasn’t intentionally being cruel. (She even told me that she was being grandmotherly with her concern. Ok, lady). It was later, when I brought it up in supervision, that I realized just how very upset it made me. Telling my co-workers about the experience, my hands started to shake; I felt my breath quicken and my face get hot. And I realized, I was still really worked up about those few minutes!

It got me thinking about how we listen (or don’t) to our bodies when we’re working. I’ve written before about working with frustrating patients and suddenly becoming aware that my shoulders are up by my ears and my fists are clenched. How does it sneak up on me? Because I’m not really paying attention to my own body. There’s a lot we have to do when we’re with clients: listen actively, reflect back, read their body language, etc. But we also have to listen to what our bodies are telling us; often we react physically before we’re able to name what we’re feeling.

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Personally, I especially struggle with being in touch with my physical self when I’m uncomfortable with the energy in the room. Give me someone on a crying jag any day; I can sit with that heaviness and have no problem being in my body: breathing deeply, being still, creating a space for vulnerability. But when a patient touches a nerve (usually unknowingly), my fear or discomfort or anger arrive first in my body, try though I may to ignore those feelings. In those moments, I’m trying so hard to reserve judgement and be still and present that I ignore the warning signals that I’m about to emotionally check out. When I feel my toes curl in my shoes and my hands grip the sides of my chair, it’s usually a sign that I’m not going to be at my best, clinically. In those moments, I have to recenter: I take deep breaths; I practice stillness. Then I take my ass to supervision, because clearly I have some things to work out!

The body knows; we do better when we remember that and listen to what we’re being told: to slow down, to reflect, to breathe. And to utilize supervision!