Friday, October 06, 2006

COMPASSION FATIGUE IN THE ANIMAL CARE COMMUNITY Part One

COMPASSION FATIGUE IN THE ANIMAL-CARE COMMUNITY
by Charles Figley and Robert Roop
Humane Society Press, 2100 L Street, NW
Washington, D.C. 20037 $19.95
ISBN 0-0748400-7-6

This book is in three parts:
Part I: Compassion Fatigue: An Overview
Part II: Compassion Fatigue in the Animal-Care Community
Part III: Revitalization and Resilience

PART ONE:

The first part is meant to convince the reader that caring attention is what calls out trust and comfort when one is trying to help someone. They can feel whether you do indeed understand and “feel with” (empathize) with them. This is true of human beings and other animals, at least mammals. (Hard to tell about snakes, etc.)

If a person really “feels with” others, whether they are students, welfare clients, medical patients, pets or soldiers, the cost can be high and can result in phenomena in the helper that don’t help anyone. For instance, feeling powerless, being scared and paranoid, feeling guilty, getting into a rage (sometimes unpredictably), depression, hypersensitivity, sleep disturbances and simply being worn out. A person can begin to walk through the job, on the verge of incompentency.

This part spends some time on persuading the reader that compassion stress and fatigue are real, because denial is such a temptation, both for one’s self-regard and because of the need to look competent on the job. The section called “The Neurobiology of Compassion Stress” makes the point that there are detectable brain changes in someone who is sharing pain and loss with no hope of help. The evidence given is a little old-fashioned: left and right brain theory, fight or flight, stress hormone overload. The most recent excitement has been about “mirror cells,” which are tiny structures just behind the forehead bone that make it possible for us to “feel with” other beings. These are thought to be recently evolved and part of the unique nature of human beings, a basic element of bonding and community. (This is why one should avoid blows to the forehead!)

Recently there has also been quite a bit of investigation into why some resilient people “go down” under tragedy, emergency, and outrage but then rebound. Why are some ghetto children -- exposed to drug abuse, starvation and violence -- able not just to survive but also to dig themselves out of the troubles? And others, seemingly much the same, break and die?

Some definitions are introduced in order to draw attention to dimensions of compassion. “Stress is a sense of demand for action.” Feeling sorry is not enough -- DO something. Vicarious suffering might get out of control if it echoes some trauma in the helper that has never really healed. It can be a temptation to avoid painful confrontations. The work situation might be toxic, that is, critical of or punishing compassion. One might be putting in so much time on helping as to prevent one’s own recovery. It’s possible that the helper’s “real life” begins to weigh the helper down instead of refilling their energy tank. No one is immune from home tragedies, set-backs and hard times. It’s at this point in the book that Doug Fakkema’s five phases are introduced.

There might be unnecessary stressors in the job itself. Maybe the job is too high-pressure, too boring, too lonesome, or provided with too little training and equipment. One of the worst offenses is lack of clarity, particularly when the ambiguity is used to discredit achievement. (The old rule is that clarity gives energy -- if you are really focused, things get done.) Bad juju with other workers is a tough one. Unreasonable work conditions (crazy split shifts, too much night-time on-call duty, rigid schedules that don’t allow accommodations for real life, real danger from working conditions) are sure sources of stress. Maybe the worst one is a weak or insecure leader who never gives clear signals and is likely to turn on workers. None of this is unique to animal care workers -- it might apply to surgical nurses or combat lieutenants or even clerks at the 7-11. Those who are most idealistic and dedicated may be those most at risk.

The authors are at some pains to describe “burn-out” as a real, documented phenomenon and suggest that others can easily see it. In fact, it will soon lead to physical symptoms: hypertension, lethargy, maybe a heart attack. In shelters it often shows up as “bad backs.”

Secondary trauma is the reflected and empathized damage in families, friends and caregivers of the primary trauma victims. Secondary trauma can spread out and out through circles of friends and co-workers. Consider the huge and spreading impact of a catastrophe like 9/11. First the people actually destroyed, then those who pulled them out of rubble, then their families, their neighborhoods, and so on. Consider the marriages of cops, whose spouses must deal with secondary trauma.

Therefore, professional caregivers and emergency responders need to INSTITUTE routine strategies for addressing secondary trauma. They need to “download,” to share, to check themselves and their co-workers for signs of distress. Don’t deny, evade, postpone. Good management is always alert and checks out those who seem to be sleep-walking.

If someone gets really stuck -- knows they are burning out and can’t seem to get a handle on it -- there are strategies such as Green Cross Foundation programs called “Wellness Transformation” that might be available as weekend workshops.

They call their stages “building blocks:”

1. Motivation. Deciding you’re really going to commit to making whatever changes in one’s life that are necessary for survival. This takes more courage than might be guessed.

2. Assessment. Checklists, procedures, consultations or whatever will reveal lots of information.

3. Self-reflection. Feeling around inside to see how much of this information seems really true. Check out POSITIVE internal resources.

4. Transformation. Deciding what sort of person you want to be and making a plan to get there.

5. Evaluating. Go looking for the exercise, diet, stress management techniques, new habits, sense of humor, and all that other previously dumb-seeming stuff that will change your life.

6. Reviewing. Thinking about one’s previous life, maybe by journalling, maybe in a group, maybe with a trusted mentor or friend, and then -- as one gets stronger and more healed -- going back over that life plan for the future to fine-tune it.

7. Studying. Reaching out for more ideas, ways to grow. Hey, it’s a big world out there! And you’re part of it!

You might have to go through these steps again. It’s a process rather than an achievement.

Tomorrow I’ll go over the specifically animal-care part, Part Two.

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