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Antidotes to Compassion Fatigue

7/18/2016

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In May, ICTG Advisor Jessica Bratt Carle described how compassion fatigue impacts clergy and faith leaders, as well as the need for more research and understanding. Among several important points, Carle highlighted the potential of viewing compassion as a renewable resource. 
While the idea of compassion fatigue can conjure up an image of an empty tank, as though we can just 'run out' of compassion like a care might run out of gas, there's also an opportunity to think of compassion as a renewable resource. An individual caregiver might struggle with compassion fatigue, but when compassion is enacted in community, the loneliness of the caregiving burden can be addressed more effectively.
Compassion literally means to suffer with mourners or survivors. As compassion-givers work alongside compassionate colleagues, rather than in isolation, they share burdens and multiply healthy impacts that counter debilitating effects of trauma. They create and expand relief and buoy spirits.

Moreover, when compassion-givers honor mourners and survivors, they discover and witness to the expertise of those who are suffering rather than only the expertise of those offering care. By recognizing mourners and survivors as experts in their unique experience of trauma and healing, and sharing best practices with one another rather than doling out prescriptions, compassion-givers also receive nourishing kindness and compassion. 

Along with being part of a community of care, Carle notes how practicing self-compassion while offering compassion to those who are mourning or surviving trauma acts like an antidote to fatigue.  
Self-compassion goes beyond self-care; it encourages us to show kindness to ourselves, rather than judgment, and to connect with the reality that all humans are limited and imperfect. These efforts can help us remain in the crucial relationships of support that will sustain us in our caregiving efforts.
As more and more faith leaders today are practicing forms of compassion, including nonviolent protest of institutionalized harm, building community after violence, and creating new forms of community care, pacing and bolstering themselves with practices of self-compassion and community will increase resiliency and counter fatigue. 

Here are some examples of a few more best practices: 
  • Communicate regularly with trustworthy colleagues who encourage and inspire you
  • Practice healthy habits, including eating well, sleeping, and exercising
  • Sing, pray, dance, and create art to express your experience and remind yourself of blessings in life
  • Consider what it means and find ways to bind your wounds, even as you bind the emotional and spiritual wounds of others
  • Seek out and request opportunities to be blessed and restored by other leaders 
  • Find ways to partner with colleagues to build community resilience
What else have you been finding to be helpful in and around your congregation? Share in the comments below. 

Rev. Kate Wiebe, PhD, serves as the Executive Director of the Institute for Congregational Trauma and Growth. 
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Compassion Fatigue and the Wounds of Caregiving

5/4/2016

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“Who can take away suffering without entering it?”
 – Henri Nouwen, The Wounded Healer, 1972
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For many years now I’ve been fascinated not only by the emerging research about the effects of trauma on those who experience it directly, but also by the new explorations of how trauma impacts those who serve as caregivers to trauma victims. This “secondary trauma,” it turns out, has an enormous impact on caregivers and can burden caregivers in ways that significantly jeopardize their capacity to provide care for the long haul.

Early research about secondary traumatic stress and related concepts such as burnout began to spike after the events of September 11, 2001. Now, trauma research looks at the effects of secondary, or “vicarious” trauma, in many populations of caregivers—not only emergency responders, but also health care workers, social workers, therapists, and many others.
 
A major contributor to the research on secondary traumatic stress is Charles Figley. He suggested the phrase “compassion fatigue” as a synonym for secondary traumatic stress, hoping it would be less of a stigmatized term. While many researchers define compassion fatigue in slightly different ways, Figley describes compassion fatigue as a state in which a caregiver experiences tension and preoccupation with the traumatized persons he or she is serving, often re-experiencing the traumatic events associated with the client, along with avoidance,  numbing, or persistent states of arousal (such as anxiety) related to reminders of the client’s trauma.[1]

Burnout is a similar and often overlapping phenomenon, which is often brought about not simply by witnessing others’ trauma but by providing care in an institutional culture or environment that lacks adequate support for caregivers. Burnout usually develops over time, but compassion fatigue can emerge rapidly in response to witnessing the trauma of others. Compassion fatigue and burnout can leave caregivers unable or uninterested in hearing more of others’ traumatic experiences.
 
Relatively little research has been done on how compassion fatigue manifests among clergy and other religious caregivers. A few studies have looked at clergy burnout and how clergy may be at even greater risk for secondary traumatic stress because, compared with other occupations, they may have less forewarning about its effects and how to address them. I also suspect there are particular vulnerabilities shared by those of us who enter our caregiving roles with a sense of divine calling and with faith commitments that tug us toward responding to the suffering in our midst. Our motivations are laudable, but it is crucial that we equip ourselves with the knowledge and support to make our efforts sustainable over time. To share with others in their suffering, we must find ways to remain emphatic. This sounds so straightforward, but our capacity to empathize can be imperiled when vicarious trauma renders us unable to be fully present to others.
 
When we talk about the toll of caring for others, the image of the “wounded healer” often gets mentioned, especially in pastoral care literature. The wounded healer is a concept found in many cultures, but in pastoral care it usually refers to the wounded healer image articulated by Henri Nouwen, a Catholic priest, in his book The Wounded Healer (1972).  The image gets mentioned so often, I believe, because it resonates with our experiences of discovering the toll it can take on us when we seek to care for others’ burdens. I worry, however, that the image has been applied in sloppy ways, sometimes even dangerously affirming that the wounds of caregiving are just something we are supposed to accept or endure unquestioningly. Some talk of what it means to be a wounded healer can turn into a glorification of these kinds of wounds, and I don’t think that’s what Nouwen meant, nor what our faith commitments ask of us. When Nouwen articulated wounded healers in ministry, he meant to reassure us that we all come into ministry with wounds of some sort, wounds that don’t make us ineligible for ministry but rather can be woven into the fabric of our identity and ministry. He didn’t mean that our wounds are an excuse to care poorly for ourselves in the midst of trying to provide excellent care for others.
 
It’s remarkable to me that Nouwen named loneliness as perhaps the most common wound among those in ministry. A sense of isolation or alienation can ensue when we are experiencing secondary trauma and compassion fatigue. What are we to do with these wounds?
 
I don’t think Charles Figley was intending to invite theological reflection when he coined the phrase “compassion fatigue,” but in fact there is deep theological richness around the concept of compassion, which literally means to suffer with. While the idea of compassion fatigue can conjure up an image of an empty tank, as though we can just “run out” of compassion like a car might run out of gas, there’s also an opportunity to think of compassion as a renewable resource. An individual caregiver might struggle with compassion fatigue, but when compassion is enacted in community, the loneliness of the caregiving burden can be addressed more effectively.

In addition, calling to mind the bottomless nature of divine compassion can also remind us that we draw from a well that is much deeper than our own. In doing so, we also exercise self-compassion, which is actually beginning to stand out in research as an antidote to compassion fatigue. Self-compassion goes beyond self-care; it encourages us to show kindness to ourselves, rather than judgment, and to connect with the reality that all humans are limited and imperfect. These efforts can help us remain in the crucial relationships of support that will sustain us in our caregiving efforts.

Nouwen suggested that hospitality and community were the sources of potential healing in the face of our wound of loneliness. As future research continues to examine ways to understand and address compassion fatigue, I think we will continue to see affirmations of the importance of relationships and communities of support. I’m grateful that ICTG exists as one such vital community of learning and support for those who work so diligently toward healing in the midst of trauma.

[1] Figley, C. (2002). Compassion fatigue: Psychotherapists’ Chronic Lack of Self Care. Journal of Clinical Psychology, 58(11), 1433–1441.

* Learn more about self-care and congregational care practices on the ICTG Training Page. Here, you will find dozens of resources, including the ICTG Congregational Assessment Guide, seminars on becoming trauma-informed, modules, forums, and more!

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Rev. Jessica Bratt Carle, an ordained minister in the Reformed Church of America and an ICTG Advisor, is a Board Certified Chaplain with the Association of Professional Chaplains and currently pursuing her doctorate in Religion, Psychology, and Culture at Vanderbilt University, where she is a fellow in the Program in Theology and Practice. 

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Spiritual Care after Trauma: Reflections on Red Cross Disaster Chaplaincy Training

7/20/2015

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I tend to remember anniversary dates, so as I write this post I am remembering a month ago today, when the mass shootings happened at Charleston’s Emanuel AME church, and a year ago today, when a plane was shot out of the sky in Ukrainian airspace, taking the lives of nearly 300 airline passengers and crew. Last year at this time I also remember watching news of the devastating impact of yet another war in Gaza. The ripple effects of these events, and many others, continue to exert a steady burden on so many people who long for relief from violence, war, racial injustice, and so many other life-threatening realities. Alongside the occurrences of unpredictable natural disasters, too, these events add to what feels like an ongoing timeline of tragedy punctuating our lives. Whether we experience tragedy and trauma firsthand, or are simply exposed to it through media, there is a pressing need for resources that will help us respond with compassion, resilience, and healing.

I learned about further resources when I recently attended a Red Cross Disaster Spiritual Care orientation with some other chaplains in the Association of Professional Chaplains. The Red Cross is currently expanding its Disaster Spiritual Care program, so there will soon be more opportunities for chaplains and local clergy to receive training in order to provide care at the community and regional level when natural or human-caused disasters occur. Spiritual care will be an integral component to disaster response, working in cooperation with physical and mental health care. This is a promising step, one that affirms the importance of responding to the needs of the whole person when trauma and disaster strike. Immediate physical needs for food and shelter are often accompanied by spiritual distress, especially when there is loss of life, livelihood, housing, or loss of a sense of personal and community safety.

As with any organization, the Red Cross has its own reporting structures, policies, and, of course, plentiful acronyms. I marveled as the trainers described the logistical feats of coordination that get put into action when the Red Cross works with a myriad of other organizations to meet the short and long-term needs of an affected population. I also learned more about the National Voluntary Organizations Assisting in Disaster, which contains many faith-based and denominational groups. ICTG has partnered with NVOAD representatives in the past, and you can see films from their presentations here.  I also recommend to you a resource that can be downloaded at the VOAD website, called “Light Our Way: A Guide for Spiritual Care in Times of Disaster.”

When I think about the related work of ICTG, I am reminded of the additional ways in which congregations themselves can be equipped to be places of supportive response and healing. After the initial trauma or disaster response wanes, congregations can provide a grounded, consistent presence in the long and often slow-going recovery process.

There was a phrase that stood out to me in the correspondence leading up to the Red Cross training. The trainers explained in an email that the Red Cross Disaster Spiritual Care programs “help create a safe place for survivors to feel the depth of their pain without embarrassment or alienation.” Without embarrassment or alienation. What a beautiful glimpse of what sanctuary can mean in times when it is needed most. What would it look like to continually cultivate congregations that offer a space where pain can be expressed and addressed effectively?

Part of that work, it seems to me, lies in honoring the sacred trust that we as spiritual caregivers and communities are expected to uphold. Particularly when disaster victims are in shock or disoriented, our responsibility to reflect a deeper source of love and compassion can be both a daunting burden and a holy privilege. When we can withstand the temptation to search too quickly for pat theological answers, and when we can instead truly be present to the pain and the questions as they arise from those in our care, we demonstrate our willingness to enter into vulnerable and confusing situations without having to direct them toward our own ends. This is what it means to be responsive and to pace ourselves according to the needs of others rather than the solutions we hope will one day materialize. The pain of trauma runs deep, and the process of healing and growth may come with many setbacks along the way, but to those of us—both individuals and communities—who have been entrusted with the call of spiritual caregiving, the process can become a deeply meaningful, challenging, and sacred journey.

* Discover more spiritual formation training resources on the ICTG Training menu, including the Spiritual Formation Resource Guide and Spiritual Formation Assessment.

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Rev. Bratt, an ordained minister in the Reformed Church of America and an ICTG Advisor, is a Board Certified Chaplain with the Association of Professional Chaplains and currently pursuing her doctorate in Religion, Psychology, and Culture at Vanderbilt University, where she is a fellow in the Program in Theology and Practice. 

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