vicarious trauma and the importance of self care...2019/03/13 · “self-care is an ethical...
TRANSCRIPT
Building Resiliency: Effective Management of Vicarious Trauma
and Secondary Traumatic Stress
Nicky MacCallum LMFT, NCC
Remember to Keep Yourself Safe
Content might make you
anxious or remind you of
past traumas or losses
Take a moment to
prepare yourself
Throughout the training
do what you need to
take care of yourself
© Nicky MacCallum LMFT, NCC 2017 2
The Cost of Caring
“The 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.”
(Rachel Naomi Remen)
© Nicky MacCallum LMFT, NCC 2017 3
© Nicky MacCallum LMFT, NCC 2017
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Direct/Indirect
Changes in:
Frame of reference
Psychological needs
Affect
Behavior
Challenges Compassion Fatigue
Trauma
PTSD
Vicarious Trauma
Secondary Traumatic
Stress
Strengths Compassion Satisfaction
Resilience
Post Traumatic Growth**
Trauma Exposure
Possible
Impact
Possible
Outcomes
Vicarious Trauma Can Disrupt Personal BeliefsFrame of Reference
Identity - Feel less effective, helpless. Over identification with client
Worldview - See world as more dangerous, less hopeful. See others as vindictive/evil
Spirituality – Lose connection with source of spiritual strength
Areas of psychological need
Self-Esteem – Difficulty holding positive self-value
Sense of Safety – fear/vulnerability, excessive concerns for self and others
Ability to Trust - Inability to trust instincts/others
Sense of Control - helplessness /powerlessness. Can lead to “Super Provider”/Micromanaging
Intimacy - Alienation/estrangement/ withdrawal/difficulty with small talk/ continuous small talk to avoid being alone
( Adapted: from Figley)© Nicky MacCallum LMFT, NCC 2017
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• Survival coping
• Intrusive thoughts
• Nightmares/
Flashbacks
• Sleep disturbance/
sleeplessness
• Compulsive
engagement with
trauma related
material
• Avoidance of
tasks/work
• Inability to listen/
avoidance of clients
• Social withdrawal/
isolation
• Decreased interest
• Hopelessness
• Inability to recall
information
• Negative moods
• Difficulty feeling
positive or happy
• Overly negative
about oneself or
the world
• Guilt
• Excessive self-
blame or blaming
others
• Anger and cynicism
• Hypervigilance
• Inability to embrace
complexity
• Loss of creativity
• Minimizing
• Insensitivity to
violence
• Fear
• Chronic exhaustion
• Physical ailments
• Disconnection
• Poor boundaries
• Diminished self care
Symptoms and Conditions Associated
With Secondary Traumatic Stress
(NCTSN, MacCallum)© Nicky MacCallum LMFT, NCC 2017
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Factors that can Increase Resiliency/Vulnerability
for VT and STS Impact
Personal History/Identity – The multitudes of self
Family of Origin
Racial
Cultural
Economic/class
Ability
Belief system
Education
Justice system impact
Sex (biological)
Gender (cis gender, transgender, gender fluid, gender non-conforming, gender queer)
Sexual orientation (heterosexual, lesbian, gay, bisexual, asexual)
Trauma experience
Roles/Stereotypes
Work style
Copyright © Nicky MacCallum LMFT, NCC
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Factors that can Increase Resiliency/Vulnerability for VT and STS Impact
Ongoing experience with trauma
Day to day stressors (sick relative, economic challenges)
Presence/Absence of social support
Societal attitudes
- Traumatic events occurring in community/ society
- Population being served
- Providers/programs
© Nicky MacCallum LMFT, NCC 2017
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Dynamic
Put Your Own Oxygen Mask
On First!
“Self-care is an ethical imperative.
We have an obligation to our clients -
as well as to ourselves, our colleagues,
and our loved ones - not to be damaged
by the work we do.”
(Saakvitne & Pearlman)
“You can’t poor from an empty cup”
(unknown)
© Nicky MacCallum LMFT, NCC 2017 9
Remember
Show yourself
the same kindness, compassion,
and non-judgment,
as you show those you serve
© Nicky MacCallum LMFT, NCC 2017 10
The ABC’s of
Effective VT & STS Management
Awareness
of one’s own needs, limits, emotions
and resources
Balance
of work and play, of taking care of
others and taking care of yourself
Connection
to oneself, to others and to something
larger
© Nicky MacCallum LMFT, NCC 2017 11
Awareness Examples of coping strategies
that can have negative impact
Smoking/using tobacco
Too much caffeine
Too much alcohol
Overuse of over the counter medications/prescription medications/drugs
Overeating/under eating
Spending excessively
Angry outbursts as tension release
High-risk situations/relationships
Too much TV/streaming
Over-engagement with social media
Withdrawing from others
Ignoring/denying stress symptoms
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Creating Balance
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Balance is not something you find, it is
something you create
It is important to create healthy balance
between work, rest,& play!
Balance In the Workplace Start with what you already know
works for you
Start the day with a centering
practice
Create a healthy work space
Balance work schedule and life
demands where possible
Balance more and less challenging
tasks
Schedule time for
paperwork/supervision
Consider two phones/different tones
Take breaks
Establish a “buddy system,” with a
reliable colleague
Set appropriate limits around your
responsibilities and overtime
Before committing to a project or task,
first consider your needs and available
resources
What could you do to add balance to
your workplace?
© Nicky MacCallum LMFT, NCC 2017
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Balance between Self and Others
Spend time with people
whom you don’t have to
take care of or rescue!
Find a balance between
caring for others and being
cared for
© Nicky MacCallum LMFT, NCC 2017 15
Connection & SupportConnection (to oneself, to others and to something larger)
Having connection with others and being willing to receive support can:
Assist during uncertainty
Build emotional strength
Allow space to address fears,
hopes, and dreams
Create feelings of being seen and
understood
Provide space for problem
solving/encouragement
Assist in identifying stress/
distress
© Nicky MacCallum LMFT, NCC 2017
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Proactive Management of VT and STS
Helps us cope with, transform, and inoculate against
the impact of work related stress, vicarious trauma,
and secondary traumatic stress
Should reflect the individual’s needs, experiences,
interests, resources, culture, and values
© Nicky MacCallum LMFT, NCC 2017 17
Building an Self-care On the Spot (S.O.S.) Plan
Start with what already works for you
(E.g., Traditional/indigenous practices)
Breathing
Relaxation
Physical Activity
Imagery
Grounding
Aromas
Positive Self-Talk
Spiritual practice
Support System
Music
Photographs
© Nicky MacCallum LMFT, NCC 2017 18
Building Resiliency
Developing a Lifestyle Self-Care Plan
Include at least:
1 individual & 1 Social
activity from each domain
Spiritual
Emotional
Physical
Mental
© Nicky MacCallum LMFT, NCC 2017 19
How do I keep myself on track?
• Keep plans visible
• Add plans to your calendar
• Set monthly/quarterly/annual calendar
reminders so you can:
– Complete the Professional Quality of Life
Measure (found at proqol.org)
– Re-visit your planning and adapt as needed
© Nicky MacCallum LMFT, NCC 2017 20
Nicky MacCallum LMFT, NCC
Training, and Consultation
MFT#31528, NCC#29263
www.nickymaccallum.com
Copyright © Nicky MacCallum LMFT, NCC 21