Preventing Compassion Fatigue
Published in the FOCUS JOURNAL, September
2013, by the National Association
of Social Workers (NASW). Vol. 40, No. 6.
Lisa Wessan LICSW, CLYL, RM
Co-chair of the NASW Northeast Private Practice SIG
North Chelmsford, Massachusetts
expectation that we can be immersed in suffering and loss daily and not be
touched by it is as unrealistic as expecting to be able to walk through water
without getting wet.
Most of us become social workers because we want to contribute, be part of the solution, and help the world work better. Call it what you will, whether Tikkun Olam (Hebrew: Heal the World), Satyagraha (Hindi: the policy of nonviolent resistance for social justice), or Serenity NOW! (Seinfeld TV series2), caring for ourselves must be an integral part of caring for others.
In self care and the prevention of compassion fatigue, there are many paths up the mountain – the process begins with the search for what works for you. There is no one-size-fits-all relaxation technique, holistic healing modality, or sequence of protocols that works for everyone.
When the going is rough, remember the words of Dr. Annette Goodheart, a marriage, family, and child counselor: "Just because you're miserable doesn't mean you can't enjoy your life."3 Goodheart's paradoxical words are a core teaching that helps me stand for joy in the midst of all the absurdity, incongruity and injustice in our profession, in our clients, and in the world.
Many traditional treatments and preventative protocols for compassion fatigue are readily available online.4 Here is my contribution to that body of belief, my Top Ten List of Ways to Take Care of Your Precious Self and Prevent Compassion Fatigue:
1. Practice detachment. While our profession is often is fraught with codependency and excessive oxytocin syndrome5, the study of detachment in psychology is growing. Tap into learning about codependency and healthy detachment, seek out group supports, learn to meditate (a terrific tonic against compassion fatigue), get a black belt in detachment from Codependents Anonymous or from certain therapy rock stars. Here is my summary of this vast work:
DETACH = Don't Even Think About Changing Him/Her
May this acronym carry you to deeper peace, more bliss and dare I say it, clinical enlightenment! Once you realize, deep in your gut, that you alone cannot change anyone, and you seek out support for these natural principles, even in the face of challenges life becomes easier.
2. Practice good sleep hygiene. Our culture is unique in its pervasive disrespect for sleep. This is not only the media's fault, it is a perverse cultural error. In order to maximize the quality of your sleep, put away electronic devices and glowing screens large or small at least one hour before bedtime. We now know the stimulation of screens reduces melatonin levels in your brain by 22%, which in turn disrupts REM cycles and normal stages of sleep.6
Moreover, do not watch the news before bedtime. Why?
News = Negative Entertainment, Weather & Scandals!
The principal purpose of mass news media is to sell products, and to stimulate worry (which sells products). Watching the news at bedtime infuses toxic imagery into your mind. Let it go!
3. Highly Sensitive People (HSP). If you are a HSP, you are more likely to experience inflammatory reactions to artificial substances.7 And anything that challenges your immune system can accelerate compassion fatigue.
Explore the emerging research on orthomolecular psychiatry (i.e. how food affects mood). Be mindful of the effects of caffeine, refined carbohydrates, artificial colors, sweeteners, additives, alcohol, and the lotions and potions you put on your body. All of this affects mood, metabolism, personality and pending compassion fatigue.8
4. Daily Ecstatic Seizure (DES). Build into your day at least 10 minutes where you are able to do one or more of the following: laugh, dance, sing, listen to awesome music, do an entertaining cardio workout (e.g. Bollywood Aerobics), or have sex. The DES happens when you become a bit breathless, break a sweat, and feel a tremendous release from the activity. You can practice your DES alone or with others.
One of the easiest ways to access DES in public is to head for a Laughgasm, which can be contagiously beneficial.9 To learn more, investigate the age-old tradition of Laughter Yoga, which opens the laughter reflex. Laughter Yoga groups are meeting and laughing together in many local com-munities. The Laughgasm is one of the few socially acceptable DES experiences that doesn't require gym equipment, Wii, music, or a partner.
5. Meditation and/or relaxation practice. Quite simply, if you're too busy to meditate, you're too busy. You do have control over your busyness. Recent research with PET scans demonstrates how meditation increases your brain's cortices, improves memory and cognitive ability, increases creative problem solving, concentration, stamina, and more.10 But you knew that. So do that!
6. Schedule massage / bodywork appointments at least once a month. Since every thought becomes a chemical reaction in your body, toxic thoughts create toxic events in your muscles and personal chemical factory. Seek out Reiki, Qigong, T'ai Chi, the Emotional Freedom Technique (EFT) or energy medicine practitioners. 11, 12, 13
These self-care appointments are not luxury items. Find something that works for you and stick with it. You can learn to self-administer Reiki12 or EFT13 to yourself, which is easy and relatively inexpensive; and you can access these healing techniques anytime (e.g. at your desk, in a restroom, or on the train).
7. Call hotlines. You can't always reach your clinical supervisor, NASW peer support group, therapist, partner, spouse or confidantes. In a pinch, turn to hotlines for immediate anonymous relief, and to debrief when you think you might have a meltdown if you can't talk to someone.14 Remember NASW-MA’s Social Workers Assistance Network (SWAN), a free, confidential colleague assistance program. You can contact SWAN at 800-635-SWAN (7926).
8. Plan socially nurturing outings in advance. Make time to go be with the people who love you. Don't wait for the weekend to start making plans. As it is written, "If you fail to plan, you plan to fail." Don't wait for people to invite you out; be proactive in your prevention of compassion fatigue. Keep in mind the importance of the "MILK" of life:
MILK = Moments of Intimacy, Laughter & Kinship.
9. Declutter your home and office. No quantum leaping here. Do 15 minutes/day. Set a timer and take baby steps. If you have more complex clutter or hoarding anxieties, recruit or hire a helper. Find a fellow social worker ‘clutter buddy’ with whom you can offer mutual aid.15
As coaches say, “Beware of what you are putting up with,” whether a faulty door lock, leaking toilet, uncomfortable eyeglasses, or a disorganized living or working space.
Clutter serves as a mental energy sink, exhausting you and leaving you with little bandwidth for coping with life. Make changing it a priority.
10. Connect with fellow clinicians for peer support and debriefing. It is crucial to process your issues beyond your personal therapy and friendships. You can and should make or find a group of peers. Let the group share your burden. NASW's Private Practice Shared Interest Groups (in Newton and Methuen, MA) are great places to connect and find support. Set an intention to be part of at least one group that meet "offline" to deconstruct in more detail the harsh realities of working in healthcare.
You are the President of your life. Stand in your power. Say “yes” when you mean yes, and “no” when you mean no, and let the chips fall where they may. It's okay if people are angry or disappointed with you for practicing self care. Stop being codependent. You can take certain steps to prevent compassion fatigue, and enjoy a long, rich career as a social worker. Water the root, enjoy the fruit... you are a worthy social worker!
Edited by Bet MacArthur MSW LICSW Member, SWTRS
1Remen, R. (1996). Kitchen Table Wisdom: Stories that Heal. New York: Riverhead Books.
2Seinfeld. (1997). "Serenity Now!" http://www.tv.com/shows/seinfeld/the-serenity-now-2399/.
Article reprinted with permission of the author.
Web site: www.lisawessan.com
Offices in Westford and North Chelmsford, MA