16. Stress Management and Compassion Fatigue

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Summary of 16. Stress Management and Compassion Fatigue

Animal Protection Society Management 1 16. Stress Management and Compassion Fatigue STRESS MA�AGEME�T Introduction What is Stress? What Stress Can Do To You Causes of Stress How Can I Tell what is Optimal Stress for Me? Goals of Stress Management Stress Management Strategies Effective Time Management COMPASSIO� FATIGUE Introduction Symptoms of Compassion Fatigue �eed for Help Shelter Workers Prevention and Management What to Do If You Have This Condition Stress Management Introduction Stress is an enormous problem in the animal protection movement. The potential workload is massive, and many animal protection societies attempt to tackle far too many issues. Also, mission-driven staff does not like to refuse to tackle any issue, or to turn away any suffering animal. This leads to overload, stress and eventual burnout for many. Stress and burnout are key factors in staff absence and rapid staff turnover. There can also be serious physical results in the case of prolonged stress. It is vital to recognise this problem, and to tackle it in the workplace. Stress is an effect that our bodies can experience as we struggle to cope with our continually changing environment; it has physical and emotional effects on us and can create positive or negative feelings. Stress is not necessarily bad. For example, the stress of exhilarating, creative, busy, but successful and productive work is beneficial and provides a thrill and a ‘high’. As a negative influence, it can result in feelings of being overwhelmed, distrust, rejection, anger, and depression, which in turn can lead to health problems (see below). Most of our work stress comes from things like work overload, conflicting priorities, inconsistent values, over-challenging deadlines, conflict with co-workers, unpleasant environments and so on. Not only do these reduce our performance as we divert mental effort into handling them, they can also cause a great deal of unhappiness. The effects of stress are increasingly recognised: - � 1992 UN report called Job Stress ‘The 20th Century Epidemic’. � The World Health Organization called job stress a ‘World Wide Epidemic’. � The U.S. National Institute for Occupational Safety and Health reports stress related disorders as fast becoming the most prevalent reason for worker disability. � It is estimated that around 40% of worker turnover is due to job stress. Animal Protection Society Management 2 What is Stress? There are various definitions of stress, and this is further complicated because we all intuitively understand what stress is – although different people feel stress very differently. The most commonly accepted definition (mainly attributed to Richard S Lazarus) is that: - ‘Stress is experienced when a person perceives that demands exceed the personal and social resources that the individual is able to mobilise’. Signs of stress include: - Physical symptoms � Loss of appetite or craving for food when under pressure, frequent indigestion, heartburn or stomach upsets � Sleeplessness, constant tiredness, fainting or dizziness � Headaches, migraine, backaches, cramp of muscle spasms � Impotence, frigidity, frequent tears or the urge to cry Mental symptoms � Frequently feeling irritated � Difficulty in relaxing � Obsession with fear or disease � Feel hated or neglected � Are unable to make decisions � Lack of interest in other people � Suffer from guilt and/or sense of failure � Are afraid of open or confined spaces, or being alone What Stress Can Do To You The effects of stress can be seen and felt in a number of ways. For example, you can: - � Feel anxious, depressed, frustrated, irritable, lonely and weary – perhaps all at the same time � Behave carelessly, be accident prone, over emotional, eat or drink to excess, tremble and become incoherent � Lose concentration, find difficulty in making decisions or become hypersensitive Too much stress causes headaches, upset stomachs, rashes, insomnia, ulcers, aggravates asthma, increases blood pressure, and brings on angina, strokes or coronary heart disease. It can affect both your private life and your working life, perhaps by increased sick leave or by reducing your focus and effort. Causes of Stress People feel little stress when they have the time, experience and resources to handle a situation. They feel great stress when they do not see themselves as being able to handle the demands put upon them. Stress is then a negative experience. It is not an inevitable consequence of an event: It depends on both their real ability to cope with a situation, and on their personal perception of their situation. There are two types of instinctive stress response that are important to the understanding of stress and stress management: the short-term ‘Fight-or-Flight’ response and the long term ‘General Adaptation Syndrome’. The first is a basic survival instinct, while the second instinct is a long-term effect of exposure to stress. The third mechanism comes Animal Protection Society Management 3 from the way in which people think and interpret the situations in which they find themselves. Fight-or-Flight Some of the early research on stress (c. 1932) established the existence of the well-known fight-or-flight response. This showed that when an organism experiences a shock or perceives a threat, it quickly releases hormones that help it to survive. In humans, as in other animals, these hormones help us to run faster and fight harder. They increase heart rate and blood pressure, delivering more oxygen and blood sugar to power important muscles. They increase sweating in an effort to cool these muscles, and help them stay efficient. They divert blood away from the skin to the core of our bodies, reducing blood loss if we are damaged. In addition to this, these hormones focus our attention on the threat, to the exclusion of everything else. The ‘Fight-or-Flight’ response is not only triggered by life-threatening danger. It also comes into play when we encounter something unexpected. We become excitable, anxious, jumpy and irritable, which reduces our ability to work effectively. The intensity of our focus on survival interferes with our ability to make fine judgments and makes us more accident-prone. General Adaptation Syndrome While the Fight-or-Flight response works in the very short term, the General Adaptation Syndrome operates in response to longer-term exposure to stress. Researchers identified that when pushed to extremes, organisms react in three stages: 1. First, in the Alarm Phase, they react to the stressor. 2. Next, in the Resistance Phase, the resistance to the stressor increases as the organism adapts to, and copes with, it. This phase lasts for as long as the organism can support this heightened resistance. 3. Finally, once resistance is exhausted, the organism enters the Exhaustion Phase, and resistance declines substantially. In a work environment, this exhaustion contributes strongly to what is commonly referred to as ‘burnout’. How Can I Tell What is Optimal Stress for Me? There is no single level of stress that is optimal for all people. We are all individuals with unique requirements, and our physiological and psychological responses to stress vary greatly. What is distressing to one may be a joy and pleasure to another. It has been found that most illness is related to unrelieved stress. If you are experiencing adverse stress symptoms, you have gone beyond your optimal stress level; you need to reduce the stress in your life and/or improve your ability to manage it. Goals of Stress Management There is a recognised relationship between pressure and performance. When pressure is low, performance is normally low, as other activities compete for attention, and we may even feel bored and depressed. When pressure and stress are high, anxieties and disturbances can overload our thinking, reducing our ability to concentrate on a task, and Animal Protection Society Management 4 thereby reducing our performance. However, there is an optimum level of pressure, at which we can concentrate effectively. At this level, we become involved and immersed in our work, and produce the best results without adverse personal impacts. The goal of stress management is to help us to manage stress so that we can maintain this state of optimum involvement and deliver exceptional performance. Stress Management Strategies There are three major approaches that we can use to manage stress: - � Action-orientated: In which we seek to confront the problem causing the stress, often changing the environment or the situation; � Emotionally-orientated: In which we do not have the power to change the situation, but we can manage stress by changing our interpretation of the situation and the way we feel about it; and � Acceptance-orientated: Where something has happened over which we have no power and no emotional control, and where our focus is on surviving the stress. An action-oriented approach is often best used when you have some power to change a situation. Where you do not have power, it may be appropriate to take an emotionally oriented approach. With this approach, you seek to change your understanding of, and response to, the situation. Lastly, when you have no power, and a changed appreciation of the situation is not appropriate, then an acceptance-oriented approach may be best. Action Orientated Action-oriented approaches are best where you have some control over your situation: - � Recognise what you can change. � Change your stressors by avoiding or eliminating them completely. � Reduce their intensity (manage them over a period of time instead of on a daily or weekly basis). � Shorten your exposure to stress (take a break, leave the physical premises). � Devote the time and energy necessary to making a change (goal setting, planning and time management techniques may be helpful). � Review your obligations from time to time and make sure they are still good for you. If they are not, give them up. Emotionally-orientated Where you do not have power, it may be appropriate to take an emotionally oriented approach: - � Become aware of your stressors and your emotional and physical reactions. � Notice your distress. Don't ignore it. Don't gloss over your problems. � Determine what events distress you. What are you telling yourself about the meaning of these events? � Determine how your body responds to the stress. Do you become nervous or physically upset? If so, in what specific ways? � Reduce the intensity of your emotional reactions to stress. � The stress reaction is triggered by your perception of danger. Are you viewing your stressors in exaggerated terms and/or taking a difficult situation and making it a disaster? � Are you expecting to please everyone? Animal Protection Society Management 5 � Are you overreacting and viewing things as absolutely critical and urgent? Do you feel you must always prevail in every situation? � Work at adopting more moderate views; try to see the stress as something you can cope with rather than something that overpowers you. � Try to temper your excess emotions. Put the situation in perspective. Do not labour on the negative aspects and the ‘what if's’. � Don't let one thing dominate you, such as your animal protection work – strive to achieve balance. � View life as challenges to seek, not obstacles to avoid. � Take responsibility for your life and your feelings, but never blame yourself. � When worries start to build up, talk to someone. Acceptance-orientated When you have no power, and a changed appreciation of the situation is not appropriate, then an acceptance-oriented approach may be best: - � Learn to moderate your physical reactions to stress. � Slow, deep breathing will bring your heart rate and respiration back to normal. � Learn and practice relaxation or meditation skills. � Try to avoid the use of sleeping pills, tranquillisers, and other drugs to control stress, if possible. Learning to moderate these reactions on your own is a preferable long-term solution. � Build your physical reserves/keep fit. � Eat well-balanced, nutritious meals. � Maintain your ideal weight. � Avoid nicotine, excessive caffeine, and other stimulants. � Get enough sleep. Be as consistent with your sleep schedule as possible. � Maintain your emotional reserves. � Develop some mutually supportive friendships/relationships. � Pursue realistic goals that are meaningful to you, rather than goals others have for you that you do not share. � Expect some frustrations, failures, and sorrows. � Always be kind and gentle with yourself - be a friend to yourself. � Protect your personal freedoms and space. Do what you want and feel, but respect the rights of others. � Find a time and place each day where you can have complete privacy. Take time off from others and pressures. � Mix leisure with work. Take breaks and get away when you can. � Open yourself to new experiences. Try new things, new foods, new places. Effective Time Management Time Management is an important part of stress management. There is a separate information note on ‘Project & Time Management. Animal Protection Society Management 6 Compassion Fatigue Introduction Compassion fatigue, sometimes known as ‘vicarious trauma’ or ‘secondary traumatic stress,’ affects people who are exposed to the traumatic suffering of others. This is a recognised psychological condition, and is known to affect animal protection workers who deal with animal suffering and abuse, and shelter workers who have to deal with euthanasia, – as well as doctors, nurses, emergency-service personnel, counsellors, social workers, charity workers and clergy members. Nearly everyone who performs emotionally intense animal protection work (particularly investigations, rescues, cruelty case work and euthanasia) can be susceptible to compassion fatigue Compassion fatigue is an emotional and spiritual fatigue or exhaustion that takes over a person and causes a decline in his or her ability to experience joy or to feel and care for others. Compassion fatigue can affect individuals who are giving out a great deal of energy and compassion to others over a period of time, but are not able to get enough back to reassure themselves that the world is a hopeful place. Compassion fatigue may result in poor job performance and plummeting self-esteem, and can even drive some people who experience it out of animal protection work entirely. It is not the same as ‘burnout’, but can cause this. Those who suffer from it can also experience tension in their home lives, and can even fall into clinical depression or other mental-health problems. Professionals who witness or listen to the stories of fear, pain and suffering of animals may feel similar fear, pain and suffering – simply because they care. Indeed, it is often this ability to emphasise that brings people to work in the animal protection field in the first place. If you ever feel as though you are losing your sense of self, and you capacity for enjoyment, and that your job is the only thing that matters to you, then you may be suffering from compassion fatigue. The concept of compassion fatigue emerged only in the last several years in the psychological literature. It represents the cost of caring about and for traumatised people or animals. Compassion fatigue is the emotional residue of exposure to working with suffering and traumatic events. Professionals who work with people or animals, particularly those who are suffering, must contend with not only the normal stress or dissatisfaction of work, but also with the emotional and personal feelings for the suffering. Compassion fatigue is not ‘burnout’. Burnout is associated with stress and hassles involved in your work; it is very cumulative, is relatively predictable and frequently a vacation or change of job helps a great deal. Compassion fatigue is very different. Compassion fatigue is a state of tension and preoccupation with the individual or cumulative trauma of animals as manifested in one or more ways including re- experiencing the traumatic event and avoidance/numbing of reminders of the event. Although similar to critical incident stress (being traumatised by something you actually experience or see), Compassion fatigue is more like secondary post-traumatic stress. Symptoms of Compassion Fatigue The signs of compassion fatigue can mimic those of post-traumatic stress disorder, which can afflict people who have survived a traumatic event like combat, rape, or assault. Animal Protection Society Management 7 Sleepless, irritability, anxiety, emotional withdrawal, avoidance of certain tasks, isolation from colleagues, feelings of helplessness and inadequacy, and even flashbacks, are amongst the symptoms. Frank M. Ochberg, a Michigan psychiatrist who founded ‘Gift From Within’, a non-profit group for people who suffer from post-traumatic stress disorder, says compassion fatigue happens when ‘the milk of human kindness dries up. You forget why you wanted to help [people] in the first place.’ It can, he says, lead to excessive drinking or other unhealthy behaviour. Compassion fatigue develops over time - taking weeks, sometimes years to surface. Basically, it’s a low level, chronic clouding of caring and concern for others in your life. Over time, your ability to feel and care for others becomes eroded through overuse of your skills of compassion. You also might experience an emotional blunting - whereby you react to situations differently than one would normally expect. �eed for Help Those who experience compassion fatigue, says Charles R. Figley, a professor in the School of Social Work at Florida State University who founded the Traumatology Institute, find it is usually alleviated simply by acknowledging the problem and getting support. "The people who experience this are often the best and the brightest. They have extra sensitivity," he says. And not giving these workers help can undermine not only an organisation but also its long-term mission. "If we don't do something about compassion fatigue, we're going to lose people." Shelter Workers Employees of animal-related charities, such as shelters that euthanise unwanted pets, can be hit hard by compassion fatigue. This can contribute to the high annual turnover rates at some shelters. Unlike every other type of charitable work, killing is a part of the job at most animal shelters, notes Diane Less Baird, President of ‘Angels for Animals’, a shelter and pet-owner education centre in Greenford, Ohio. "You can only hold so many animals in your arms and feel the life go out of them," she says, "without it starting to suck the life out of you." What's more, says Carol A. Brothers, a clinical psychologist in Annapolis, Md., who conducts compassion-fatigue workshops for animal shelters around the USA, shelters tend to encourage workers to remain stoic when euthanising or turning away unwanted pets, and those workers may be less likely than other charity employees to get support from people outside of work (because often friends and family do not understand the level of empathy with animals and their suffering). Prevention and Management Personal Prevention Preventing compassion fatigue is really the key. It is much easier to stop it from occurring in the first place than it is to repair things once it sets in. You have to continually practice good emotional health maintenance along the way and maintain some sort of balance in your life. You should learn to take in your life, as well as to give. Treat yourself sometimes, and schedule space for relaxation. You also need to put yourself in situations Animal Protection Society Management 8 in which you see the positives in life, for example, attending a field trip with your child where you are truly enjoying the experience, or volunteering where you are able to give and receive. Sometimes, you cannot prevent compassion fatigue from occurring. However, practicing some of these techniques can restore your ability to feel compassion and energy. Warn �ew Employees Animal protections society managers should always tell new or prospective employees what to expect and advise them of appropriate preventative measures to take. Many do not yet do this, but awareness is greater in human charities. At the Bridges Center, a grief counselling organisation in Louisville USA that is associated with a chain of non-profit hospices, managers tell new workers about resources, such as support groups for staff members, during orientation and encourage their use, says Barbara L. Bouton, the Centre Director. "We recognise that compassion fatigue is probably inevitable in the work we do," she says. Establish Support Systems Giving employees opportunities to talk about the emotional aspects of their work can help keep compassion fatigue from taking hold. Where possible, some organisations might consider rotating people out of particularly tough jobs after a period of time. Support groups can make a world of difference in keeping charity workers on the job and effective. Informal support can also help, such as providing relaxation rooms for employee use. Some organisations find creative ways to combine both the need for acknowledging loss and for lightening up. Encouraging workers to talk about their feelings can also help. After a particularly traumatic event occurs at work, start a conversation about it. The truth is that when people can show their feelings, they do better work. They have more energy. Keeping an eye on not only the work employees do but also the manner in which they do it can help prevent compassion fatigue from overwhelming workers. The Red Cross, for example, was diligent about monitoring the emotional state of its volunteers reuniting refugee families in Kosovo who had been separated by war. They would watch for the amount of anger they would express with refugees, the amount of times the volunteers would go out on assignments. They would also go to the bar in the hotel and see who was there, how often they were there, and how long they stayed… If a manager notices an employee's behaviour has changed, they could persuade them to take a self-test that measures compassion fatigue, encourage him or her to seek help if needed. If an employee needs help, it is also possible to advise a referral to a counsellor (who understands compassion fatigue) outside the organisation, where counselling can be carried out without fear of job loss, or ‘loss of face’. Organisations could also consider sponsoring a workshop led by an outside expert. Relaxation sessions, and Yoga, can also help. Some animal protection societies already organise lunchtime relaxation sessions for their employees, and this is an excellent idea. Employees should also be encourages to seek out stress-relieving activities outside of Animal Protection Society Management 9 work. The organisation could locate and make available information about suitable activities in the area. Professionals who suffer from compassion fatigue must be persuaded to give themselves a break. They should also be encouraged to focus on the things they are doing right, and not to become overwhelmed. The successes, however minor, should always be celebrated and remembered. These should be the focus, rather than the many suffering animals that the organisation is unable to help. What to Do If You Have This Condition The most critical need is to acknowledge that you may be experiencing it. All of us have multiple demands and energy drains in our lives - some positive, some negative - which all require a great deal of emotional and physical attention. There are, however, many hands-on things you can do to mitigate the feelings of compassion fatigue. For one, start refocusing on yourself. Before you can tend to and be sensitive to the needs of others, you have to take care of your own well-being. This can be as simple as getting plenty of rest, becoming more aware of your dietary and recreational habits, and cutting out negative addictions in your life like nicotine, alcohol and caffeine. Remember, the healing process takes time, as does the development of the problem. Holidays are healthy, restorative interventions that can head off negative feelings so that they don’t progress beyond the point of no return. Transferring to another unit either temporarily or permanently is another alternative. A job that’s more mechanical and less animal service-oriented can sometimes give people just the respite they need to regain their balance and their empathy. Further Resources Stress Management � � � � Web Sites Mind Tools – Stress Management http://www.mindtools.com/smpage.html International Stress Management http://www.isma.org.uk/ Stress Model http://www.stressfree.com/model.html Centre for Stress Management http://www.managingstress.com/ The Stress Management Society http://www.stress.org.uk/ Animal Protection Society Management 10 Books Stress Management for Dummies By: Allen Elkin Publisher: John Wiley & Sons Inc ISBN: 0764551442 The Book of Stress Survival By: Alix Kirsta, 1987 Publisher: Guild Publishing, London, UK ISBN: 0041320220 Complete Guide to Stress Management By: Dr. C. Patel Publisher: Vermilion (1996) ISBN 0-09-181366-2 Conquer Your Stress (Management Shapers) Creating a Balance By: Cary L. Cooper, Stephen Palmer Publisher: Chartered Institute of Personnel and Development (2000) ISBN: 0-85292-853-X At Ease with Stress By: Wanda Nash Publisher: Darton, Longman & Todd (1988) ISBN 0-232-513777-0 Teach Yourself Managing Stress By: Terry Looker & Olga Gregson Publisher: Hodder Arnold Teach Yourself (2003) ISBN 0-340-86007-3 The ‘Which?’ Guide to Managing Stress By: Mark Greener Publisher: Which? Books(2003) ISBN 0-85202-926-8 Emotional Intelligence By: Daniel Coleman Publisher: Bloomsbury (1996) ISBN 0-7475-2836-6 Compassion Fatigue � � � � Web Sites Compassion Fatigue, including self-test http://www.vaonline.org/care.html http://www.vaonline.org/doc_compassion.html Overcoming Compassion Fatigue http://pspinformation.com/caregiving/thecaregiver/compassion.shtml Animal Protection Society Management 11 How Compassion Fatigue Can Overwhelm Charity Workers http://philanthropy.com/jobs/2002/03/21/20020321-974239.htm Books Compassion Fatigue: Secondary Traumatic Stress Disorders In Those Who Treat The Traumatized By: Charles R. Figley Publisher: Brunner/Mazel Publisher; 1 edition (May 1, 1995) ISBN: 0876307594 Treating Compassion Fatigue By: Charles R. Figley Publisher: Taylor & Francis Group; (September 2002) ISBN: 1583910530 The Master's Touch: Coping with Compassion Fatigue By: Concordia Publishing House, Barrie E. Henke Publisher: Concordia Publishing House ISBN: 0570094348

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