Compassion Fatigue Solutions

Wébinaire en Français sur l'usure de compassion

2010-10-04T12:34:00.003-04:00

French Webinar on Compassion Fatigue, sponsored by the Canadian Counselling and Psychotherapy Association

Webinaire : Pour mieux comprendre l’épuisement professionnel et l’usure de compassion

Présentatrice: Françoise Mathieu, M.Ed., CCC
Langue: Français
Date: Le mercredi 13 octobre 2010
Heure: 12h-13h HNE
Lieu: En ligne
Coût: 45$ membres de l’ACCP | 55$ non membres *Taxes en sus
# d’UÉP: 1

Description du webinaire: L'usure de compassion est un problème courant chez les travailleurs en soins de la santé, les intervenants en service sociaux, les policiers et les éducateurs spécialisés. Cet atelier explique ce phénomène mal compris et explore les obstacles personnels et professionnels qui nous menacent. L'atelier explorera des stratégies de dépistage précoce, les conséquences du surtravail et les éléments protecteurs contre le burnout et l'usure de compassion.

Présentatrice: Françoise Mathieu, M.Ed., CCC
Françoise Mathieu détient une maîtrise en psychologie (counselling) et a plus de 15 ans d'expérience en tant que psychothérapeute dans divers environnements: urgences, centre de soins de santé mentale et universités. Conférencière chevronnée, Françoise œuvre comme spécialiste en usure de compassion et burnout depuis 2001. Elle offre des ateliers de formation partout au Canada et est l’auteur du livre “The Compassion Fatigue Workbook.”Pour plus d’information: www.compassionfatigue.ca

Cliquer ici pour s'inscrire

"Grâce aux webinaires, l'ACCP est dorénavant en mesure d’offrir à ses membres de nouvelles possibilités de perfectionnement professionnel. Tous les webinaires donnent droit à des unités d’éducation permanente (UÉP). Les places disponibles sont en nombre limité et l’inscription est obligatoire. Nous ajouterons constamment de nouvelles dates et de nouveaux cours.

Nouveau! Téléchargement des webinaires

Veuillez noter que vous pouvez acheter un enregistrement des webinaires passés en contactant le siège social au 1-877-765-5565 ou au reception@ccpa-accp.ca. Ces enregistrements sont également admissibles pour un crédit d'UÉP."

Changes afoot

2010-09-25T08:28:00.006-04:00

I have not been posting as often as I normally do, because I have been busy putting the final touches on my new website and that has eaten up all my free computer time. In a couple of weeks, I will be merging my blog, bookstore and website over to a new system so I can make updates and changes myself instead of having to rely on a husband/webmaster to do it for me (although he's been wonderful - thank you Randy!). So stay tuned for some a whole new look and a bit of a name change. Nothing drastic, just cleaning things up a bit. The website address won't change so you can just wait and see - when the look of this blog changes, you'll know I've migrated.

Meanwhile, for those of you who are technically inclined, I have joined twitter: I can be found @compfatigue. Now I need to learn how to tweet! I have been working with a lovely and very patient web designer who is gently trying to educate me to the ways of the websphere.

This week, I'm off to St Johns for a nursing conference and to Toronto for ATSS. I am really looking forward to this conference to meet colleagues and share ideas about where things are going in our field.

Life's Missing White Space by Leo Babauta

2010-09-17T09:26:00.002-04:00

This is reprinted, with permission, from Leo Babauta's blog, ZenHabits, which I love to read:

I’m not a designer, but I’ve always been in love with the design concept of white space.

It’s the space in a design that isn’t filled with things — as you can tell from the design of Zen Habits and my other blog, mnmlist, it’s something I use (perhaps too) liberally.

But white space can be used in the design of our lives as well, not just the design of magazines and websites and ads. By using white space in our lives, we create space, balance, emphasis on what’s important, and a feeling of peace that we cannot achieve with a more cramped life.

Let’s look briefly at how to do this.

The principles of white space

Some of the things white space accomplishes in design:

greater legibility
feeling of luxury
breathing room & balance
more emphasis

These same concepts can translate to our lives:

Clarity. Instead of legibility, white space can give clarity to the things in our lives — whether they’re possessions, projects, tasks, or just things that occupy our time and attention. A nice piece of furniture is more beautiful when it’s not surrounded by clutter. A well-prepared piece of food is more tasty when it’s not smothered in sauces and piled with fries and cheese. A presentation is more effective when we don’t use Powerpoint and have only a few points to make.
Peace. When our lives are cramped, and our homes and workspaces are cluttered, we feel stressed. When we have fewer things on our schedule and fewer things around us, we feel peaceful.
Breathing room & balance. Many people talk about finding “work-life balance”, but this is very hard to do if you have no white space. Leave space between things to find the breathing room you need, and to easier achieve balance.
Emphasis on the important. When our days are non-stop busy, everything is important and nothing is important. But put white space between things, and those things acquire more weight, and we place more importance on each individual thing.

Achieving white space

In theory, achieving white space isn’t difficult: you remove non-essential items from your life, your workday, your surroundings, your possessions, and leave the essential items with space around them.

But of course in practice it’s a bit different, and requires experimentation, learning, practice. I’d suggest starting small, with one area of your life, and making small bits of white space. Start by identifying what’s important, and the slowly removing the non-essential things to create the white space.

Some ideas:

Breathe. Simply take a couple minutes between tasks, meetings, anything that you do, to breathe. After a meeting, for example, return to your desk and just sit still for a couple minutes, focusing on your breath going in and out. When you get home, pause and breathe. When you’re done with a task on the computer, close everything and breathe, before starting on the next task. This creates space between tasks and allows you to focus on each one.
Schedule. Don’t overschedule. Leave space on your schedule, between tasks, instead of putting things back-to-back. The space gives you time to go between tasks, to recover, to refocus, to breathe.
Projects. Do fewer projects at a time. Instead of juggling a bunch of projects at once, try to do one for as long as you can before switching to the next (sometimes you need to switch because you’re waiting on information or on someone else to do something). If you can, take a short break between each project — as long as you can afford.
Sit. Start your day with the white space of just sitting still for 10 minutes. It can be a meditation session, or simply sitting still with a cup of coffee or tea. If you like this, try putting it in the middle and end of your day as well.
Remove clutter. Pick a few important things on your desk, or in your home, and remove the rest. This will give you visual space and create a more peaceful atmosphere.
Savor. Slow down and savor everything you eat, everything you do. Breathe before you take each bite, and enjoy each bite.

—

Read more about simplicity in Leo’s books, The Zen Habits Handbook for Life & The Simple Guide to a Minimalist Life.

Public Service Announcement: Upcoming Workshop of Interest

2010-09-15T09:47:00.003-04:00

LET THE LIGHT IN:

Managing Loss and Depression through Mindfulness, “Meaning Making” and Laughter

With Dr. Robert Buckman and Dr. Kathleen Corcoran

Friday, October 29^th, 2010

William Osler Health System - Mental Health and Addictions Program

Dr. Robert Buckman

DR. ROBERT BUCKMAN lives in Toronto, Canada, where he is a medical oncologist at the Princess Margaret Hospital, and Professor in the Department of Medicine at the University of Toronto. He qualified as a physician from Cambridge University in 1972, and completed his training in medical oncology at The Royal Marsden Hospital in London including laboratory research leading to a Ph.D. He emigrated to Toronto in 1985. He has written many articles on various aspects of medicine and oncology, concentrating in the last fifteen years on doctor-patient communication and breaking bad news. In 1994 he was made Canadian Humanist of the year, and in 2003 received the Fleming medal of the Royal Canadian Institute for the Advancement of Science.

Dr. Kathleen Corcoran

Dr. Kathleen Corcoran is the Director of Training, Psychology Internship Program at the Centre for Addiction and Mental Health (CAMH), responsible for overseeing the APA/CPA accredited internship program in Psychology. She has her PhD is Clinical Psychology from the University of British Columbia and practices as a Psychologist privately as well as with the Cognitive Behaviour Therapy Clinic, Mood and Anxiety Program at CAMH. In addition, she is an Assistant Professor at the University of Toronto in the Department of Psychiatry.

For more information please contact: theresa.riehl@williamoslerhs.ca

The New Face of AIDS: Podcast from CBC The Current

2010-09-13T12:49:00.002-04:00

From September 10, 2010 CBC The Current:

"Twenty years ago today, CBC Television put a man named Peter Jepson-Young on the evening news. They brought him back every week and for 111 episodes, he documented his days as he died of AIDS. A lot has changed since then. But a lot has stayed the same. We revisit the Dr. Peter Diaries" Click here to hear the podcast.

Upcoming events for this Fall and beyond

2010-09-01T16:13:00.009-04:00

Hi to you all. I am back from a highly restorative month off where I had the wonderful opportunity to spend lots of time with friends and family that I had not seen in several years, travel, eat obscene amounts of cheese and baguette and drink rosé in olive groves. Not bad at all. Now I'm back at work, the kids are nearly back at school (and it's just about time for them to go back, if you know what I mean - though I love them to bits).

Here are some news:

1) Compassion Fatigue Train the Trainer - Ottawa - November 4-5, 2010. Do not forget that you are required to have completed the one day Walking the Walk workshop prior to attending. Walking the walk is being offered on October 15th in Ottawa. To register for this event click here.

The Kingston Train the Trainer workshop, scheduled for November 16-17 is now full.

2) The First Compassion Fatigue Conference with Gabor Maté and Laura Van Dernoot Lipsky, will be held in Kingston in June 2011! More information on this event will be coming soon. To receive the program, which will be ready towards the end of the month, be sure to join our mailing list.

Other news: Workplace Health

Did you hear about this? The Quebec-based GP2S, a non-profit agency dedicated to the promotion and education in workplace health have created a new "Healthy Enterprise Certification Program" through which agencies can apply for a healthy enterprise certificate. The agencies have to successfully demonstrate that they truly have healthy workplace initiatives that promote the wellness of their staff. Agencies can apply for an audit kit from GP2S. Here's a quote from their website: "GP²S mandated the Bureau de normalisation du Québec (BNQ) to design a certification program that specifies the minimum standards for prevention, promotion and organizational practices favorable to the health of organization's personnel." The idea behind this initiative is to have standardized certification guidelines that will allow current and prospective employees to gauge their agency's commitment to employee wellness. Interesting.

I will write more in the weeks to come, but just wanted to reconnect and say hello. I hope you will have a good start to the Fall and for those of you who have school-aged children, I hope you will not get sucked into the stress vortex too quickly (but perhaps I am projecting...)

Workshop in London with Dr Janina Fisher, November 8-9th

2010-08-02T17:42:00.003-04:00

Public Service Announcement

New Solutions in the Treatment of Trauma Dissociation with Dr Janina Fisher
November 8th and 9th, 2010. London, Ontario.

Treating the legacy of childhood trauma and neglect is not simple for even the most experienced clinician. The work is frequently complicated by dissociation-related challenges including shifting states of consciousness, paradoxical responses to treatment, autonomic dysregulation and impulsivity, problems with memory and continuity, shame and selfsabotage, and crises in the therapeutic alliance.

This workshop will offer a conceptual model for treating the effects of trauma and dissociation and present techniques to engage clients who are resistant, overwhelmed, impulsive, preoccupied with internal stimuli and unable to effectively process verbal input. These verbal and somatic approaches emphasize present moment experience and help clients to better integrate the therapeutic work by fostering internal coherence and mindfulness and strengthening capacities to deal with the challenges of daily life. Because they are inherently stabilizing they are appropriate for clients presenting with any trauma-related diagnosis, including Borderline Personality Disorder and bipolar disorder as well as Dissociative Identity Disorder and other Dissociative Disorders.

Dr. Janina Fisher is an Instructor and Senior Supervisor at The Trauma Centre, an outpatient clinic founded and directed by Bessel van der Kolk, and maintains a private practice in psychotherapy and consultation in the Boston area. She is also an EMDR International Association Consultant, a trainer for the Sensorimotor Psychotherapy Institute, past president of the New England Society for the Treatment of Trauma and Dissociation, and a former Instructor in Psychology, Harvard Medical School. Dr. Fisher lectures and teaches nationally and internationally on topics related to trauma, dissociation, and the integration of the neurobiological research into clinical practice.

This workshop will enable participants to:

− Develop their understanding of dissociative phenomena, including the differences between “state” versus “trait” dissociative symptoms.
− Utilize mindfulness techniques to counteract dissociation-related symptoms and impulsivity.
− Employ cognitive and body-centered techniques that decrease regression and resistance in therapy.

Cost: $245 plus HST

For more information contact Solutions On Site at 519-640-2030 or Visit www.SOSWorkshops.ca for details

Safely in Our Hands: Helping our Helpers Stay Healthy - Association of Traumatic Stress Specialists 2010 Conference

2010-08-02T07:13:00.002-04:00

September 30-October 2, 2010, Toronto.

In addition to 30 conference workshops to choose from, ATSS has arranged for opportunities to network and socialize with colleagues and friends. The President's Luncheon will give attendees an opportunity to learn more about ATSS and its future.

A sample of some of the presenters:

Creative Tools for Transforming Compassion Fatigue and Vicarious Trauma - Françoise Mathieu
Meditation, Mindfulness, and Right-Brain Healing in the Trauma Crucible - Dawn Bret
Voices of Experience - Priscilla de Villiers, Kent Laidlaw and Edward Leonard
CISM in the Correctional Service of Canada - Pamela Scott and Dorothy Reid
Question and Answer Session: Preventing and Healing Compassion Fatigue - Dr Angie Panos
Keynote address by Lt. Col. Stephane Grenier MSC, CD -Operational Stress Injury (OSI) - Special Advisor, Ottawa Canada
and many more.

For more information click here.

Upcoming events of interest

2010-07-01T15:32:00.006-04:00

Summer is here and I am done with workshops for the season. Phew! Although I thoroughly enjoyed meeting wonderful folks all across the country, I am in need of a little R&R after a rather punishing pace since the Fall. I will only be blogging intermittently during the next couple of months as I am taking part of July and the entire month of August off. Being self-employed is not always all it's cracked up to be (no job security, no pension, no sick pay), but one real bonus is having control over your schedule.

Here are some upcoming events that may interest you:

The next Compassion Fatigue Train the Trainer sessions will be held in Ottawa November 4-5th and in Kingston November 16-17th. The pre-requisite course, Walking the Walk, will be offered on October 15th in Ottawa and November 15th in Kingston. For more information on the Ottawa course, please visit Safeguards. For more information on the Kingston event, please visit www.compassionfatigue.ca

Back by popular demand - a workshop just for Managers with Dr Pat Fisher: June 13-14th, 2011 in Kingston. This manager's workshop received rave reviews last May. Please visit my website for more information.

Save the date! The first annual Compassion Fatigue Conference will be held on June 15-16th 2011 in Kingston with Dr Gabor Maté and Laura van Dernoot Lipsky as keynote speakers. Please visit the conference website for more information.

Toronto's Leading Edge Seminars has just published their Fall schedule, and wow, what a great lineup! In particular, I draw your attention to John Briere's workshop on "Deconstructing Trauma: Memory Exposure, Mindfulness and Existential Awareness in Psychotherapy". As many of you know, John Briere has had a great influence on my clinical work and I heartily recommend you go hear him if you have not already done so.

Moving out of the red zone of compassion fatigue: getting feeling back in our toes

2010-06-14T06:53:00.012-04:00

Last week I was at the drugstore with my 10 year old son. I was paying for my things when an elderly man approached the counter. He appeared to be in his late eighties and had deep red bags under his eyes. He looked, in a word, absolutely terrible. With a shaking hand, he took a photo out of his pocket and showed it to us and to the women behind the cash. "This is my wife" he said "She died two days ago, we were married for 58 years. She was the love of my life. Now I can't sleep and the doctor wants me to take these pills" We all fell silent for a minute and then I had a little chat with him. He told me his children all lived out of town, and that he was completely alone. When I left the store with my son in tow, I felt regret that I did not do more. My head was already buzzing with all the community resources I know about, how to link him with the right ones, how we should have taken him out for tea, etc. I was dying to case manage this man into getting support right on the spot but I also had to go home and cook dinner and take care of my family.

This is the constant challenge we face as helpers. Pain and suffering is all around us, it's not just at work. Where do you draw the line? Do you take every elderly widower out for tea? Do you tell every person with a funny-looking mole to go get checked out? Do you rescue every kitty you see? So what we do is we try our best to figure out boundaries. Sometimes we over-correct and we become like Fort Knox, not letting a single person inside our walls. Sometimes we go too far in the other direction and become ambulance-chasers, rescuing every stray dog and baking for every little old lady on our street.

In my workshops, I am always advocating that we need to gain a better understanding of our own warning signs along the continuum of compassion fatigue. Using traffic lights as an analogy, the green zone is where you are when you are at your very best (I sometimes joke that you are only in the green zone when you've been in the field for two weeks or when you have just returned from a 5 month yoga retreat in Tahiti). The yellow zone is where most of us live most of the time. We have warning signs emerging but we often ignore them. The red zone is the danger zone. The extreme end of the red zone finds us on stress leave, clinically depressed or totally withdrawn from others and wracked with anxiety.

We will all visit the less extreme end of the red zone several times in our career - it is a normal consequence of doing a good job.

What suffers first is our emotional and physical health, our family and friends, our colleagues and eventually our clients do pay the price as we become less compassionate, irritable and may make clinical errors.

But back to my story. The reason I am telling you this little anecdote is that I would not have always had this warm compassionate reaction to this man. In fact, my reaction is actually a sign for me that I am well out of the red zone of compassion fatigue (for the time being!). You see, there have been times where I have felt so depleted by all my work demands and difficult stories that I would have hardened myself to this old man's story and not talked to him at all. Not nice, eh? Have you ever noticed that in yourself or am I the only hard crusty person out there? Conversely, for some of you, being in the red zone would mean you would have jumped into rescuing this man and neglected your family's needs for the evening.

Research shows that compassion fatigue hits hardest among those of us who are the most caring. As helpers, we have a homing device for need and pain in others and we have this from childhood onwards (for many reasons: family of origin issues, birth order, heredity, etc.) So often for helping professionals the main challenge in their personal life is setting limits and not being a helper/rescuer to everyone around. But eventually, compassion fatigue makes us detach from others: often our colleagues, family and friends suffer far before our clients and patients. Although I am not proud of it, I know that I always seem to save the best for work and give the remaining crumbs to my loved ones. In my clinical work, I feel present, warm and loving towards my clients, even the most challenging soldier who has never wanted to come to counselling and hates being there. But when I am in the red zone I avoid my neighbours, ducking into my house as quickly as possible to avoid a chat, feeling slightly guilty and irritated at the same time. I avoid the phone: "why is my lovely dad calling me to say hi? grrr"

Each of us will have different warning signs. The key to developing an early intervention plan is getting better acquainted with your own. (If you want more resources on this, consider reading my Compassion Fatigue Workbook).

The fact that I feel ready to give again is a great sign of "green zonedom." Now the trick is keeping it in check and not overcorrecting and becoming depleted again. Keeping the balance, my friends, is a lifetime's work. I'm ok with that.

Getting a little r&r

2010-06-12T13:17:00.002-04:00

It's been a very busy month. Veeeery busy. I had to travel weekly for work and nearly every weekend for family reasons. Now, 90% of the time, I am speedy gonzales, always on the go, thinking about projects, recipes I would like to make, future ideas of all sorts. Then, once in a while when I've been going full spin for weeks, I need a little time off to do absolutely nothing. As you likely know, doing nothing is really hard!

Anyhow, that's what I'm doing now, lying on the couch, about to watch the World Cup (England vs USA), reading the paper and eating healthy foods to make up for the weeks on the road (way too much salt in everything and never enough greens).

There is a lot I want to write about: meeting amazing foster parents in Manitoba, being given a green smoothie along the way, last week's Train the Trainer (wow. What a great great group of people), the upcoming Compassion Fatigue Conference in June 2011. But that will all have to wait until this energizer bunny reloads.

I have three more trips before the summer break (Nebraska being the further afield, Oshawa and Guelph) and then....

A word that bothers me a lot...

2010-06-02T10:48:00.005-04:00

What do you think when you hear the word "syndrome"?

My first reaction when I hear that word is to think disease or disorder, that something really wrong and it is systemic within a person. Many genetic or chromosomal disorders are referred to as syndromes, often named after the scientist who first discovered the root cause of the anomaly (think of Down Syndrome, for example).

I am noticing that it is being used more and more in the websphere in conjunction with compassion fatigue (as in Compassion Fatigue Syndrome) and for some reason this really goes up my nose.

Compassion Fatigue (CF) is an occupational hazard -it is a normal consequence of doing our work well, it is not a disease or a disorder.

I feel that we helping professionals and caregivers already experience too much guilt and shame around CF without further pathologising it. Words are important, they have an impact on how we perceive ourselves. So can we stop using syndrome in association with compassion fatigue, please?

Your thoughts?

Upcoming Workshop - Coaching to Excellence

2010-05-20T16:50:00.003-04:00

Three day coaching workshop in Ottawa: June 21st, 22nd and 23rd, 2010
with Hélène Beauchemin, Professionally certified Integral coach

A great training opportunity for:

● Anyone intrigued by the possibility of having a positive impact on others through coaching;
● Managers, Human Resource professionals and Organizational Development practitioners who are regularly called upon to solve problems that could be more effectively handled by developing others’ competence;
● Independent professionals, consultants and coaches interested in bringing greater skill to their one-on –one conversations with clients;
● Therapists and social workers interested in building coaching competence;
● People considering applying for either the New Ventures West or the Canadian based Convivium© (www.convivium.com) Professional Coaching Course.

Here is information about this training from the presenter and organiser, Hélène Beauchemin (aka my mom!)

Coaching To Excellence

This coming June 21st, 22nd and 23rd, I will be offering a three-day coaching workshop here in Ottawa. Whereas Coaching To Excellence was previously a two day affair, the new three day format is much more complete and leaves participants with more capacities and confidence in applying coaching approaches in their every day relationships.

In this workshop participants are introduced to the principles and methods of James Flaherty’s New Ventures West successful approach to coaching and to human development (see www.newventureswest.com). The program allows for coaching experience that is applicable to the participants’ work place or current coaching practice, and their broader lives. Through structured exercises, demonstrations and simulations, we will explore together what it takes to evoke long-term excellence in others.

What Outcomes Will the Course Produce?

Developing excellence as a coach takes time, study and practice. Nonetheless, this three-day workshop will allow you to:

● Understand the key stages in any coaching relationship and the skills needed to guide clients through them;
● Recognize when someone is open to coaching and how to enroll them in a coaching relationship;
● Observe and listen to others in a profound way by paying attention, to their unique language, emotional mood, and way of interpreting the world;
● Assess your own competence as a coach and identify the next steps in your development;
● Open new possibilities for effective action in your work and in your life.

What Happens in the Course?
The course provides both conceptual frameworks and hands-on opportunities to put these frameworks into practice. After becoming familiar with New Ventures’ West unique methodology of Coaching, you will work individually with other participants in “trying on” the roles of coach and client. Then, through structured exercises, case studies and simulations, you will discover what is needed to intervene effectively in typical situations faced by coaches, managers and professionals each day. Finally, you will have the opportunity to work on a real- life “problem” situation from your life. You will learn to coach others in a way that results not only in resolving these problem, but also in them developing the competence to resolve it themselves in the future without your involvement.

Additional Benefit and Cost
This class satisfies the prerequisite for the Professional Coaching Course offered either in English or in French by New Ventures West and/or their associates, Convivium©. (www.convivium.com). The cost is $1200.00 plus taxes. Participants also receive a copy of the latest edition the James Flaherty’s book “Coaching To Excellence”.

Indication of Interest
Would you like to join us? Do you have a friend or colleague who would benefit from this offering? If so, I would appreciate you forwarding my message to them, or alternatively, sending us their email address so we can write to them directly.

An indication of interest by June 1, 2010 would be appreciated. Please write either to myself, Hélène Beauchemin at helenekathleen@rogers.com, or contact my assistant Barbara Best at barbara@hkbp.ca. A registration form including location information will then be sent to you.

Thank you for your interest, I look forward to getting your reactions, comments or questions about this workshop that I am anxious to share with colleagues in Ottawa.

What participants had to say after attending a Coaching To Excellence workshop:
“Very informative, enough material for everyone – experienced or rookies!”
“You made James’ book come alive.”
“A fantastic introduction to coaching and a solid methodology.”

Hélène Beauchemin, President HKBP Inc.

A stunning interview - from CBC The Current

2010-05-20T10:31:00.002-04:00

This interview stopped me dead in my tracks. Take a listen: Pt 3: The Global Forest -
"The potentially powerful and altogether untapped healing properties of trees. We all know trees give us oxygen, food and fuel. But according to Diana Beresford-Kroeger, some of them -- the Hawthorn for example -- have powerful healing properties."

Webinars for counsellors: New service offered by the Canadian Counselling and Psychotherapy Association (CCPA)

2010-05-19T18:19:00.004-04:00

(Public Service Announcement)

CCPA is now offering members a way to attend professional development opportunities by offering a series of webinars. All webinars are eligible for continuing education credits (CEU). Enrolment is limited and registration is required. Additional dates and courses will be added on an on-going basis.

Webinar: Social Justice Interventions: 10 Ways to Make a Difference 
Presenter: Christina Schmolke
 Language:English 
Date: Wednesday, June 2, 2010  Time: 12pm-1pm ET
 Cost: $50 CCPA members | $60 non members  # of CEUs: 1

Webinar Description: Across Canada, thousands of individuals face barriers to improving their mental, emotional, and economic status. In an effort to address the environmental factors (e.g., poverty) that impede client well-being, a growing number of counsellors have become interested in social justice interventions. For counsellors, social justice interventions involve actions that are designed to improve the equitable distribution of resources and services. This may include advocacy, outreach, and prevention. This webinar focuses on helping counsellors integrate social justice interventions into their roles.

Webinar: Le potentiel des groupes au service du counseling 
Presenter: Dr Jacques Limoges 
Language: French 
Date: Tuesday, June 8, 2010  Time: 12pm-1pm ET 
Cost: $50 CCPA members | $60 non members 
# of CEUs: 1

Webinar Description: L’orientation et la gestion de carrière reposent, du début à la fin, sur l’interpersonnel. Même un bon bilan de soi ne peut se faire sans que le client réfère aux autres qui furent, qui seront ou qui sont. Logiquement donc c’est l’intervention groupale qui convient le mieux à ces enjeux, leur assurant une plus grande efficacité. Dans ce webinaire nous explorerons le potentiel groupal selon que l’objet de l’intervention ou du counseling groupal est l’extra (i.e. l’Information scolaire et professionnelle, la connaissance du marché du travail), l’intra (i.e. la connaissance de soi) ou l’interpersonnel (i.e. les compétences et l’action).

Webinar: Counselling in a Small World: Ethics in Rural & Remote Practice
 Presenter : Judi L. Malone 
Language: English
 Date: Wednesday, June 9, 2010 
Time: 12pm-1pm ET  Cost: $50 CCPA members | $60 non members  # of CEUs: 1

Webinar Description: Rural communities and their counselling needs have been changing. Certain ethical dilemmas can be more common or more complicated when practicing in rural, remote, or small communities. This presentation will review some of these specific to managing professional boundaries, community pressure, generalist practice, interdisciplinary collaboration, and attaining professional development. Join us to explore the context & ethical challenges of rural counselling practice, consider the Canadian Counselling and Psychotherapy Association’s Code of Ethics, and to share insight for dealing with the demographic and practice characteristics that may instigate ethical issues in rural practice.

Webinar: Exceptional Possibilities: Multiplying Client Exceptions Through Narrative Meaning-Making  
Presenter: David Paré, Ph.D. 
Language: English  Date: Wednesday, June 16, 2010  Time: 12pm-1pm ET
Cost: $50 CCPA members | $60 non members  # of CEUs: 1

Webinar Description: The “exception”—an instance when the problem is absent—is the cornerstone of Brief Solution Focused practice, a doorway into new realms of possibility where the problem is absent. This webinar explores how exceptions can be multiplied by joining clients in what Anthropologist Clifford Geertz called “thick description”. These practices are drawn from narrative therapy, which focuses on action, rather than behaviour—the difference being that actions are seen as expressions of agency, purposes, values, and intentions. These practices go beyond “do more of what works” to rich story development and the generation of multiple exceptions, the basis for future action.

To register or for more information go to www.ccpa-accp.ca/en/webinars or contact Roxanne@ccpa-accp.ca.

Cdn military chaplains suffering burnout, compassion fatigue at high rates - Brandon Sun

2010-05-16T17:25:00.002-04:00

Cdn military chaplains suffering burnout, compassion fatigue at high rates - Brandon Sun

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The passage of time...

2010-05-09T20:31:00.004-04:00

My son turned 10 today...This led me to reflect on a ton of things, which I won't bore you with, but thinking about it all also made me look at the photo on my blog profile and think, yikes, it's time to age that photo a bit! I think it was taken when he was two.
Ahem. I will put that on my summer to do list. (yay)

Meanwhile, I am travelling a whole lot this month and am starting to plan a Compassion Fatigue Conference for June 2011. Stay tuned for that! In a week or so, there will also be an announcement of the launch of a new web-based resource for those of you wanting to start a private practice or improve your small business. This is very exciting but I can't tell you more until it's ready. So please come back or join my mailing list to hear all about it when it launches.

Meantime, if you are a nurse or a hospital worker, you must get your hands on the great new show Nurse Jackie. It's just brilliant (though if you are easily offended, you may wish to take a pass). Edie Falco is superb as Jackie - a senior ER nurse who hates bureaucratic BS and who puts her patients first, even though she leads a highly imperfect life.

CANADA'S PREMIER BULLYING PREVENTION CONFERENCE in HAMILTON ONTARIO MAY 28, 2010

2010-05-04T11:45:00.004-04:00

PREVNet's 5th Annual Conference will take place at McMaster University in Hamilton May 28, 2010. The theme of this year's conference is "Healthy Relationships, Healthy Development, Healthy Communities".

This is Canada's foremost national bullying conference and we believe it will be an invaluable learning experience. You will have the opportunity to attend 3 workshops from a choice of 24. See attached brochure for more information.

Led by two of Canada's foremost experts in the field of bullying, Dr. Debra Pepler and Dr. Wendy Craig, PREVNet (Promoting Relationships Eliminating Violence) is a national network of 62 Canadian researchers from 27 universities and 50 national non-government and government organizations, dedicated to stopping bullying in Canada. Teachers, counselors, parents, volunteers, youth, and any others interested in bullying prevention will be able to network, and to learn of the latest knowledge and practical tips from Canada's foremost researchers and national community organizations: Over 500 participants are expected!

Click here to register

Please register early as space is limited!

The registration fees (tax include) are:
$240 CAD
$115 CAD for students

Note: Fees include lunch, breaks, workshop materials, and a copy of Volume 3 of the PREVNet Series

One day Compassion Fatigue Workshop in Salt Lake City

2010-05-02T22:16:00.003-04:00

3rd Annual "Renewing the Spirit of Caregiving Conference" with Françoise Mathieu, M.Ed. CCC.
Thursday, May 20, 2010
8:30am-4:30pm
University of Utah, College of Social Work
Goodwill Humanitarian Bldg.
395 South 1500 East
Cost: $100 (Before May 17)
Group: $85 (5 or more)

Evening session for Caregivers
Wednesday May 19th
7:00pm-8:30pm
Cost: $35 or free with conference registration

Register online or call Wendy Anderson (801) 571-2111

2010-04-25T16:50:00.006-04:00

(Françoise à la plage by NF)

I am back from a week away in Florida. We had tons of sun, saw dozens of dolphins and stingrays, collected shells, walked on the beach and ate lots of ice cream. I read a mediocre mystery novel right until the last page, and my kids did not watch a minute of tv or play on computers. A real getaway.

Now, a week is not really long enough to "décrocher" completely, as we say in French (the literal translation is to "unhook" which doesn't really work, let's say to tune out, check out) but it was a nice break.

I have been speaking to folks at the Association of Traumatic Stress Specialists (ATSS).
"ATSS is an international organization dedicated to serving the needs of professionals working with the traumatized. Our members benefit from education, networking, resource linkage, and certification. Members may obtain one of our three certifications to help set them apart in the provision of trauma treatment and response including the Certified Trauma Specialist, Certified Trauma Services Specialist and the Certified Trauma Responder." (from their website)

Safely in Our Hands: Helping Our Helpers Stay Healthy
2010 Conference, September 29th - October 3rd, 2010.
Toronto

ATSS is holding a conference in Toronto in October that may be of interest to many of you. Registration has not opened yet but you can join their mailing list to be notified when it does. I am one of the presenters at this event, and am really looking forward to hearing Lieutenant Colonel Stéphane Grenier speak: "Lieutenant Colonel (LCol) Stephane Grenier joined the military in 1983. He has served in several missions abroad, most notably nine months in Rwanda in 1994/95 and Kandahar, Afghanistan in 2007. He was also deployed for much shorter periods of time and has travelled to many regions of the globe including: Cambodia, Kuwait, the Arabian Gulf, Lebanon, Haiti, Norway and the Czech Republic, to name a few. Faced with his own undiagnosed PTSD upon return from Rwanda, he took a personal interest in the way the Canadian Forces was dealing with mental health issues. In 2001 he coined the term Operational Stress Injury (OSI) and conceived, developed implemented and managed a government based national peer-support program for the Canadian military named the Operational Stress Injury Social Support (OSISS) Program. Today OSISS is a highly successful program that delivers peer support to CF personnel, Veterans and their families affected by mental health issues, and assists those who have suffered the loss of a loved one through a Bereavement Support Program" (from the ATSS website)

Check it out: www.atss.info

Signs and Symptoms of Compassion Fatigue and Vicarious Trauma

2010-04-19T13:24:00.006-04:00

Excerpted from "The Compassion Fatigue Workbook"

Learning to recognise one’s own symptoms of compassion fatigue and vicarious trauma has a two-fold purpose: First, it can serve as an important check-in process for a helper who has been feeling unhappy and dissatisfied, but did not have the words to explain what was happening to them, and secondly, it can allow this helper to develop a warning system for themselves. Developing a warning system allows you to track your levels of emotional and physical depletion. It also offers you tools and strategies that you can implement right away. Let me give you an example.

Say, for example, that you were to learn to identify your compassion fatigue symptoms on a scale of 1 to 10 (10 being the worst you have ever felt about your work/compassion, and 1 being the best you have ever felt).

Then, you learn to identify what an 8 or a 9 looks like for you i.e. “when I’m getting up to an 8, I notice it because I don’t return phone calls, think about calling in sick a lot and can’t watch any violence on TV” or “I know that I’m moving towards a 7 when I turn down my best friend’s invitation to go out for dinner because I’m too drained to talk to someone else, and when I stop exercising.”

Being able to recognize that your level of compassion fatigue is creeping up to the red zone is the most effective way to implement strategies immediately before things get worse.

But look back to what also emerges in this process: you are starting to identify the solutions to your depletion.

If I know that I am getting close to an 8, I may not take on new clients with a trauma history, I may take a day off a week, or I may return to see my own therapist.

In order for you to develop your warning scale, you need to develop an understanding and an increased awareness of your own symptoms of compassion fatigue and vicarious trauma.

I suggest that you begin by reading through the signs and symptoms below, and circle those that feel true to you.

CF and VT will manifest themselves differently in each of us. This is not a diagnostic test but rather a process whereby we begin to understand our own physical and psychological reactions to the work that we do.

Saakvitne and Pearlman (1995) have suggested that we look at symptoms on three levels: physical, behavioural and psychological.

Physical Signs of Compassion Fatigue

Exhaustion – feeling exhausted when you start your day, dragging your feet, coming back to work after a weekend off and still feeling physically drained.

Insomnia

Headaches

Increased susceptibility to illness – getting sick more often.

Somatization and hypochondria

Somatization refers to the process whereby we translate emotional stress into physical symptoms. Examples are tension headaches, frequent stress-induced migraines, gastro-intestinal symptoms, stress-induced nausea, unexplained fainting spells, etc. The ailments are very real, but the root cause is largely emotional and stress related. You may be able to identify which organ/body part is your vulnerable area: many people say it’s their gut, stomach, or head. Someone I know has an upset stomach every time she is anxious or stressed. She used to think it was food poisoning, but finally had to come to the conclusion that not all restaurants in our fine city could possibly have tainted food!

Hypochondriasis refers to a form of anxiety and hypervigilance about potential physical ailments that we may have (or about the health of our loved ones). When it is severe, hypochondria can become a debilitating anxiety disorder. Mild versions of hypochondria can happen to many of us who work in the health care field. A good example of this is a colleague of mine who worked as a physician in a dermatology office and who became convinced that every mole on her body was likely cancer. If you work in cancer care, particularly at the diagnostic end, you may find yourself overworried about every bump and bruise on your child or yourself. The media and the internet can fuel the flames of hypochondriasis. Many people who live in Ontario say that they had some mild phantom symptoms of listeria during the summer of 2008 following a large scale tainted meat recall.

Again, any of these symptoms do not, on their own, constitute a serious problem. The goal here is for you to begin to notice your own vulnerabilities and how the work that you do may be contributing to these vulnerabilities.

Behavioural Signs and Symptoms

Increased use of alcohol and drugs

There is evidence that many of us are relying on alcohol, marijuana or over the counter sedatives to unwind after a hard day. And as I say in my workshops: Have you seen the size of wine glasses these days? Some of them are bigger than my fishbowl. So the “one glass after work” you are having is possibly 1/2 of a bottle of wine…

The difficulty with increased reliance on drugs and alcohol is also that there may be a lot of shame associated with it, and it is not something that we necessarily feel we can disclose to anyone. Is the child protection worker going to tell his supervisor that he smokes a big fat joint every night when he gets home to unwind? Is the nurse going to tell her colleagues that she takes a few Percocets here and there from her mother's medicine cabinet?

Absenteeism (missing work)

Anger and Irritability

I could write an entire book chapter on this topic alone. Along with cynicism, anger and irritability are considered two of the key symptoms of compassion fatigue. This can come out as expressed or felt anger towards colleagues, family members, clients, chronic crisis clients. You may find yourself irritated with minor events at work: hearing laughter in the lunch room, announcements at staff meetings, the phone ringing. You may feel annoyed and even angry when hearing a client talk about how they did not complete the homework you had assigned to them. You may yell at your own children for not taking out the garbage. The list goes on and on and it does not add up to a series of behaviours that make you feel good about yourself as a helper, as a parent or as a spouse.

Try this: spend a full day tracking your anger and irritability. What do you observe? Any themes, recurrences? Any situations you regret in hindsight or where your irritability was perhaps out of proportion?

Avoidance of clients

Examples of this can be: not returning a client’s phone call in a timely fashion, hiding in a broom closet when you see a challenging family walking down the hall, delaying booking a client who is in crisis even though you should see them right away. Again, these are not behaviours that most of us feel proud of, or that we are comfortable sharing with our colleagues and supervisors, but they do sometimes occur and then we feel guilty or ashamed which feeds into the cycle of compassion fatigue.

Many of us work with some very challenging clients. If you do direct client work, I am sure that you can easily conjure up, right now, the portrait of an individual or a family that has severely taxed your patience and your compassion. One telephone crisis worker put it perfectly: “Why on earth is it a thousand times easier for me to talk to 25 different crisis callers in a day than if the same caller calls me 25 times in a row? I am, after all, paid to answer the phone and talk to individuals in crisis for 7 hours a day. That’s my job. What is so depleting about the chronic caller?" And, I would add, why do we start feeling particularly irritated, avoidant and unempathetic towards the chronic caller? More on this below.

Impaired ability to make decisions

This is another symptom that can make a helper go underground. Helpers can start feeling professionally incompetent and start doubting their clinical skills and ability to help others. A more severe form of this can be finding yourself in the middle of an intervention of some kind, and feeling totally lost, unable to decide what should happen next. I once had a mild version of this in the middle of a grocery store after a grueling clinical day (I was working as a crisis counsellor at the time and was dealing with very extreme situations and a very large volume of demand). I remember standing in the middle of the A&P thinking “should I buy the chocolate chip cookies or the oreos?" And being unable to decide between the two for what felt like hours. Difficulty making simple decisions can also be a symptom of depression.

Problems in personal relationships

I am a couple’s counsellor and have worked with hundreds of couples seeking help with communication, parenting, sex and intimacy and other relationship challenges. Many of my clients are helping professionals and when the topic comes to sex and intimacy, many women helpers confess that they have no interest whatsoever in having sex with their partners. When we explore this further, they say they feel spent, “done” by the end of their day, with nothing left to give. Others say they find themselves being impatient with spouse and children, thinking internally: “How dare you complain about that, do you have any idea what I saw today?”

Attrition

This refers to leaving the field, either by quitting or by going on extended sick leave.

Compromised care for clients

This can take many forms: using the label “borderline” for some clients as a code word for “manipulative” is one common example. Whenever a diagnosis is being used in a way that pigeonholes a client, we are showing our inability to offer them the same level of care as to other clients. There is evidence that clients with a BPD (borderline personality disorder) label often do not receive adequate care in hospitals, are not assessed for suicidal ideation properly and are often ignored and patronised. Granted, clients with personality disorders can be extremely difficult to work with, but when we lose compassion for them, and start eye rolling when we see their name on our roster, something has gone awry.

If you ever have the opportunity to go hear Dr John Briere present, I highly recommend that you do. Dr Briere is a leader in the field of trauma treatment and research, with a particular specialisation in working with individuals who have experienced childhood trauma. He is the director of the psychological trauma program at LA County and University of South California medical centre, as well as co-director of the USC Child and Adolescent Trauma Program. During his talks, Dr Briere presents a wonderful perspective on the use (or rather, the misuse) of the diagnosis of Borderline Personality Disorder. He believes that the term is used to label clients who are in chronic emotional distress as difficult and draining (which they can be) but that the field is also misusing it as a dismissive and damaging label. He argues that a very large proportion of clients diagnosed with BPD have in fact complex post traumatic stress disorder, not BPD, and are very damaged because of their trauma experiences. They end up being revictimized by a system that cannot cope with their complex and frequent needs.

There are many other examples of compromised care for clients but I think this is a particularly illustrative one.

Psychological signs and symptoms

Emotional exhaustion

Distancing

You find yourself avoiding friends and family, not spending time with colleagues at lunch or during breaks, becoming increasingly isolated. You find that you don’t have the patience or the energy/interest to spend time with others.

Negative self image

Feeling unskilled as a helper. Wondering whether you are any good at this job.

Depression

Difficulty sleeping, impaired appetite, feelings of hopelessness and guilt, suicidal thoughts, difficulty imagining that there is a future, etc.

Reduced ability to feel sympathy and empathy

This is a very common symptom among experienced helpers. Some describe feeling numb or highly desensitised to what they perceive to be minor issues in their clients or their loved ones’ lives. The old stereotype is the doctor who lets his child walk around with a broken arm for three days before taking him to hospital as he has missed the symptoms and minimised them as a slight sprain, or oncology nurses who deal with patients in severe pain who feel angry or irritated when a family member complains of a non life-threatening injury.

Reduced ability to feel empathy can also occur when you are working with a very homogeneous client population. After seeing hundreds of 20 year old university students come through my crisis counselling office, I noticed two things happening: One, I would silently jump ahead of their story and fill in the blanks (“I know where this story is going”). Two, if I had just seen someone whose entire family had died in an automobile accident, I found it very difficult to summon up strong empathy for a student whose boyfriend had just broken up with her after two weeks of dating.

There are of course inherent risks associated with this reduced empathy and “jumping ahead/filling in the blank”. Clients are not all the same, and we risk missing a crucial issue when we are three steps ahead of them.

We always need to navigate the fine line between not being ambulance chasers who think every single person is a suicide risk, and being numb to the point that we fail to ask basic risk assessment questions to everyone, including the person who looks just fine. The good news is that the solution to this is very simple: vary your caseload to stay fresh.

Cynicism

Cynicism has been called the “hallmark” of compassion fatigue and vicarious traumatization. You may express cynicism towards your colleagues, towards your clients and towards your family and friends. Eye rolling at the brand new nurse who is enthusiastically talking about an upcoming change or idea she has to improve staff morale, groaning when seeing a certain client's name on your roster and cynicism towards your children’s ideas or enthusiasm.

You can probably conjure up an image of the crustiest, most negative and cynical helper that you know. Now think of that person as suffering from advanced CF and VT instead. Does that change the picture somewhat?

Resentment

Resenting demands that are being put on you by everyone. Resenting fun events that are being organised in your personal life. Resenting your best friend calling you on your birthday. Resenting taking an extra shift because your colleague is away on stress leave.

Dread of working with certain clients

Do you ever look at your roster for the day and see a name that makes your stomach lurch, where you feel total anticipatory dread? What if that starts happening with greater frequency?

Feeling professional helplessness

Feeling increasingly that you are unable to make a difference in your clients' lives. Being unable to help because of situational barriers, lack of resources in the community or your own limitations.

Diminished sense of enjoyment/career (i.e., low compassion satisfaction)

Depersonalization

Dissociating frequently during sessions with clients. Again, this is a matter of frequency - many of us space out once in a while, and this is normal, but if you find that you are dissociating on a more frequent basis, it could be a symptom of VT.

Disruption of world view/heightened anxiety or irrational fears

This is one of the key symptoms caused by vicarious traumatization. When you hear a traumatic story, or five hundred traumatic stories, each one of these stories has an impact on you and your view of the world. Over time, your ability to see the world as a safe place is severely impacted. You may begin seeing the world as an unsafe place. Examples of this are: A counsellor who works with children who have been sexually abused becomes unable to hire a male babysitter for fear that he will abuse her children. A physician forbids his children to ever chew gum after seeing a tragic event happen with a child and gum at his work. A prison psychologist develops a fear of home invasion after working with a serial rapist. An acquired brain injury therapist develops a phobia of driving on the highway after doing too many motor vehicle accident rehabs. A recent workshop participant told me that after working at a youth homeless shelter she became obsessed with monitoring her teenage children’s every move, convinced that they were using drugs and having unprotected sex. She finally realised she had gone too far when she started lecturing her 12 year old son’s friends about methamphetamines and condoms, only to see their horrified faces at the breakfast table. The list can go on and on.

Some of this is completely inevitable. We call VT and CF occupational hazards for this very reason: It is not possible to open our hearts and minds to our clients without being deeply affected by the stories they tell us. But what is important to notice is how severe these disruptions have become. We can also sometimes mitigate the impact by doing restorative activities (working with healthy children for example, working on a quilt for AIDS sufferers, etc.)

Problems with intimacy

As I said earlier, I am a couples’ counsellor. I therefore hear many stories about relationship challenges including differences of opinion about money management, parenting, household chores and sex and intimacy. Many helpers confess that they come home completely uninterested in the idea of having sex with their spouses. As one client said to me “I come home, after giving and giving to all of my patients all day. Then I give to the kids, then I clean up and get ready for the next day. Finally, it’s 9:30 pm and all I want to do is collapse in bed with a trashy novel. Then my husband comes upstairs and wants some nookie and I feel like saying “are you kidding me? I’m all done. Please leave me alone” And these are not necessarily couples with significant marital problems or certainly no preexisting marital problems. The depletion caused by the job is the problem. Of course, communication and educating spouses about the realities of CF can help greatly here. If you work with sexual abuse survivors you may also have to deal with the added challenge of intrusive imagery from their stories.

Intrusive imagery

This is another symptom of vicarious trauma: Finding that your clients’ stories are intruding on your own thoughts and daily activities. Examples are: having a dream that does not belong to you; having difficulty getting rid of a disturbing image a client shared with you; being unable to see a rope as a benign rope, after someone has shared a graphic suicide story with you; or having certain foods be unappealing to you after hearing about certain smells or sounds from a war veteran. It is not unusual for those intrusive images to last a few days after hearing a particularly graphic story, but when they stay with you beyond this, you are having a secondary traumatic stress experience. (You can read an excellent description of this in Eric Gentry’s Crucible of Transformation article).

Hypersensitivity to emotionally charged stimuli

Crying when you see the fluffy kittens from the toilet paper commercial; crying beyond measure in a session that is emotionally distressing (welling up is normal, sobbing is not).

Insensitivity to emotional material

I used to know someone who was a family doctor who eventually realised that she was struggling with VT. She used to share, at our dinner table, extremely graphic stories of medical procedures of horrible growths or cancerous tumours (usually in the nether regions) with our 3 and 5 year old children sitting with us. She seemed completely unaware of the children’s horrified looks on their faces, never mind the adults.

Other examples are finding that you are watching graphically violent television and it does not bother you in the slightest while people next to you are cringing. Sitting in a session with a client who is telling you a very disturbing or distressing story of abuse, and you find yourself faking empathy, while inside you are either thinking either “I’ve heard much worse” or “Yup, I know where she is going with this story, I wonder what’s for lunch at the canteen.”

Loss of hope

Over time, there is a real risk of losing hope. Losing hope for our clients (that they will ever get better) and maybe even hope for humanity as a whole.

Difficulty separating personal and professional lives

I have met many helping professionals who, quite frankly, have no life outside of work. They work through lunch, rarely take their vacations, carry a beeper/blackberry at all times and are on several committees and boards related to their work. They also help their families and are the “caregiver extraordinaire” for everyone around them. I once knew a helping professional who carried her work cell phone at all times. I used to see her at daycare, frequently answering client calls at 7:30 am while dropping her children off. I was very curious about this and asked her later what her working hours were and she said “Oh, I start at 9am but clients can reach me any time of day or night.” Now this person worked at the local hospital, and belonged to a large roster of social workers there, with their on-call beepers on a rotating basis. None of the other social workers at the hospital took client calls at 7:30 am unless they were at work or on call.

Failure to nurture and develop non-work related aspects of life

Many of the helpers that I meet confess that they have lost track of the hobbies, sports and activities that they used to enjoy. Some tell me that they collapse in bed at the end of their work day, too tired to consider joining an amateur theatre group, go curling or join a book club. Yet, “having a life” has been identified as one of the key protective elements to remaining healthy in this field.

© Françoise Mathieu 2009

Sources: Saakvitne (1995), Figley (1995), Gentry, Baranowsky & Dunning (1997).

Writing exercise from The Compassion Fatigue Workbook

2010-04-12T13:10:00.004-04:00

This exercise was inspired by Saakvitne and Pearlman's book Transforming the Pain

Make sure you have some undisturbed time to work through the five following questions:

1) Where do the stories go?

What do you do at the end of a work day to put difficult client stories away before you go home?

2) Were you trained for this?

Did your training offer you any education on self-care, compassion fatigue, vicarious trauma or burnout? If it did, how up to date are you on those strategies? If it didn’t, how much do you know about these concepts?

3) What are your particular vulnerabilities?

There are two things we know for sure about the field of helping: one, that a large percentage of helpers have experienced primary trauma at some point in their past, which may have led them to being attracted to the field in the first place; two, that personality types who are attracted to the field of helping are more likely to be highly attuned and to feel empathy towards others which makes them good at their job and also more vulnerable to developing CF, VT and Burnout.

What are your vulnerabilities?

4) How do you protect yourself while doing this very challenging work?

5) On a blank sheet of paper, write out the story of your career as a helper

What have been the biggest challenges in your current job? Think broadly – client challenges, organizational challenges, interpersonal, societal, other? Thinking more specifically about your current job - what have been or are the biggest challenges – your work schedule, colleagues, office layout etc.

How did you come to realize that your work was having a significant impact on you and on your life?

Once you have written your story, take some time to review what you have written, and look for themes and patterns. What aspects of your CF/VT have to do with the nature of your work? What aspects have to do with your own history/family of origin? Can you see how the nature of your place of work may have impacted on your levels of CF and VT? Can you see how your own history/family of origin may have contributed to your levels of CF and VT?

If you feel comfortable doing so, consider discussing this with a colleague, friend or counsellor.

(This is an excerpt from The Compassion Fatigue Workbook © Françoise Mathieu 2009)

2010-04-12T12:52:00.004-04:00

Today, I am excited.

I'm giddy like a little kid who is about to go away on holidays to Florida (which I am), excited like someone who has just started working on a new very cool project and who would happily spend hours on it each day (more news on this in a couple of weeks). I'm stoked, pumped, jazzed. You get the idea.

This new project is going to take a fair bit of time in the next little while and may eat into my blog writing time, so I thought I would share with you some excerpts from the Compassion Fatigue Workbook until I come back with more information about this new venture. Stay tuned!

Photo by Jon Whiles/FreeDigitalPhotos.net

List of Self Care Ideas from SAN Conference Ottawa

2010-03-31T10:59:00.003-04:00

This list of self care ideas was compiled by participants at last week's one day Compassion Fatigue workshop which was held in Ottawa on March 26th, 2010. Take a look! Could you commit to one of these in the week to come? A springtime resolution perhaps?

Self Care Strategies at Home
-listen to the birds for 5 minutes
-dance uninhibited to one song
-play in the dirt
-play with your children and/or grandchildren
-colour mandalas or colouring book
-play wii - nintendo fitness
-chanting
-karaoke
-manicure/pedi/facial at home uninterrupted
-treat yourself once a week
-enjoy the sun
-express positivity once a day to those you love
-have a fun day
-start work late one day a week and pamper yourself (music, bath, long shower)
-read how much and however you want when you arrive home
-learn to yodel (or another new fun skill that makes you laugh)
-borrow a neighbour's pet
-discover a new musician or poet
-put on different music and dance with your children
-share what you are grateful for every night
-have "me time" once a week
-have flowers once a week
-have sex with yourself or with a partner once a week
-belly dance
-all day in bed - music, books, meals
-go to a park and play on the swings
-have a family pedi/manicure
-have a nerf ball fight in the home with the whole family
-put on some music and dance
-have all you need for the next day ready and waiting in the morning
-movie night
-try a new recipe to cook for yourself
-try to delegate without nit-picking
-take time to enjoy walking your dog
-take time to release - crank up the stereo, dance and go wild
-take up a new hobby
-plan to be organised i.e. meals

Self Care Strategies at Work
-leave your office and enjoy your lunch break
-screen your calls and prioritize them
-leave your briefcase "on a tree"
-plan and organize
-learn to say no
-carpool
-go for a walk
-have movie time for release, maybe at a staff meeting
-hold a staff fun day e.g: drumming day
-never miss lunch/don't eat it at your desk/don't work during lunch
-have a pot luck lunch with your team
-stretch every day
-pack a cooler with healthy foods, drinks, snacks
-meditate with a bell/chime to remind you of time
-put a stretch reminder on your work computer
-music for work during down time/breaks
-wear slippers all day at work/at your desk
-once a day email a funny video to colleagues
-introduce yourself to someone new once a week
-lunch time yoga or after work
-watch a movie at lunch
-community soup lunch with recipe to share
-bring pet or baby in for a visit
-share what you are grateful for at staff meeting
-read a non-related book at work
-deal with confrontations one-on-one
-look at alternative ways to debrief (drawing, dance, etc)
-discuss with other organizations "best practice"
-social field trips (i.e. white water rafting, friday bbq or potluck)
-dancing
-watch or listen to comedy (Ellen, Loreta Laroche, youtube)
-play cards
-have a memory box full of happy memories
-wave breathing
-journalling
-fill 5 pages with what pisses you off about your life. When you are done, put them in a sealed envelope and then shred it
-bring fresh flowers to your desk

Restorative practices - What do you do?

2010-03-28T18:00:00.000-04:00

My 9 year old son: "this morning, at my sleepover at Z's house, I woke up at 6am, but I knew I had to let him sleep in, so I lay there until 740am when he woke up".
Me: "wow, that's a long time to lie there. What did you do with all that time?"
My son: "Oh, it was totally fine, I just thought about lots of stuff"
Me: "Oh yeah? Like what - What you are going to do when you grow up? Things that worry you? (ever the shrink...)
My son: "Nah, I thought about all the great moves I could do next time I play on my wii hockey game. Time just flew by!"
Ah, gender differences...

Yesterday, I had a chance to enjoy several peaceful hours doing two of my favourite things: cooking meals for the week while listening to CBC radio's Eleanor Wachtel (this time, I took in an interview Zadie Smith, the author of White Teeth and a very bright and reflective person. Thoroughly enjoyable). Wachtel is a truly gifted interviewer and it is always a treat to listen to her show. These two activities are very restorative practices for me - going into another person's universe for a while (in this case, the authors she interviews), chopping vegetables for the meals of the week and most importantly, doing all of this alone and in silence. For me, a perfect restorative day would start with making bread, I would then go for a long run, come home and make soup and then while the soup is cooking and the bread is baking, lie on the couch and read the entire Saturday newspaper from cover to cover. Ah..., I feel relaxed just thinking about it.

You notice that in my scenario there are no kids, no partner, no friends calling on me. That does not mean that I don't love them and cherish my time with them, but there are times when I need to be completely alone to recharge my batteries.

The work that we do requires us to be 'on' all the time, for our clients, our colleagues and the families we work with. In fact, some of us are so used to being 'on' that we have difficulty switching off and may spend the evening avoiding silence and solitude because we have lost the art of slowing down. Some helpers are never alone because they are so overcommitted in their personal and professional lives that others have access to them 24/7. Some other helpers are so fried that they have no energy left to talk and socialise with others on weekends and evenings - ever - and this can end up feeling lonely and depressing.

In addition, a lot of helpers tell me that they feel very guilty about wanting to spend some time on their own and have no idea where to begin.

My example above (cooking, podcast etc.) may not be your idea of a good time, so I would like to invite you to think about your own restorative practices. What do you enjoy doing to recharge and reconnect with yourself? How do you carve out the time among all your family and work responsibilities?

Photo from: www.flickr.com/photos/mharvey75/374461385

The green smoothie

2010-03-28T17:44:00.005-04:00

During my travels last week, I met some lovely people and enjoyed several great chats over lunch and during breaks during the training sessions. One of these conversations was about green smoothies (as in smoothies made with greens) - yes, you heard me right. Let me explain what this is all about.

Several months ago, I came across an article on the health benefits of eating raw foods. I had heard about raw foodism in the past and was always rather sceptical about this approach to nutrition. In a nutshell, raw foodism advocates eating foods in their least processed and most natural forms. The argument is that cooking food destroys important enzymes and make foods less nutritious and less digestible. I have no idea about the science behind this, but I do know that eating mostly plant-based foods in their least processed forms can't be a bad thing and that most of us eat far too much salt, fat and preservatives.

I decided to try introducing more raw foods in my diet in October and within two weeks, I noticed significant changes in my overall health. After a lifetime of low blood sugar crashes, for once in my life I started feeling actually satiated between meals. I no longer got that shaky headachy feeling if I didn't get lunch right on time. I also noticed a whole host of other improvements to my overall health and energy. Eating more raw food is not about dieting or depriving yourself. Rather, it's a way of introducing more plant-based foods in your life.

Anyhow, if you want to know more about raw food, you can read all about it at the sites I mention below, all I really wanted to tell you about today was green smoothies.

I don't think that many people will argue with the concept that eating more greens is good for all of us. Raw Divas recommend a very painless way to do this: drink a green smoothie once a day. For starters, they suggest making this very simple green smoothie: (you need a blender for this): 2 ripe or frozen bananas, a handful of spinach, a cup of water and a few ice cubes if your bananas were not frozen. Start with a little bit of spinach and add more after you are used to the taste. Try having a green smoothie at breakfast, as a midafternoon snack or in the evening instead of your usual cookies and milk. Tera Warner of Raw Divas also has a very tasty banana ice cream recipe on her website. Here is a cute video of her and her son making the ice cream.

I have no affiliation with these raw food sites but thought I would list a few that I like to visit once in a while for inspiration:

The raw divas website mentioned above has lots of recipes on the site if you navigate around a bit.
www.rawmazing.com (she has the best recipes, I find)
www.kristensraw.com (she is hard core raw vegan but offers a lot of recipes on her blog)
Choosing raw has very nice lunch ideas and other recipes worth trying

Whether or not you decide to go the raw food way, try a green smoothie and let me know what you think.

Photo by Nillerdk @ wikicommons

On the road again...

2010-03-22T11:40:00.004-04:00

A child in a state of full March break. Photo by FM

I am back after a week at home with kids. I laughed when, on Friday, lining up at the cash while trying to break up a bickering little fight between my two, the cashier said to me: "only a few more days, hang in there" referring to the fact that kids would soon be back in school. I do love them to bits but for a working mother, a week at home with kids is not always particularly restful or peaceful. For once, however, I wisely did not make unrealistic plans before the break (as in "I will read the following three novels this week, and clean up my basement, and nap daily, and ..."). No, this time, I was clear in my goals: "Other than going for a run daily, I will not have an agenda and we will do fun family-centered activities all week." And that is what we did, and although I am a little nap-deprived, I am happy with that. We had a lot of laughs and I learned that Ontario is the biggest peanut producing province in Canada, did you know that?

This week I start travelling again and I have many trips scheduled from now until June with nary a week without a visit to one part of Ontario or another. Time to haul out the photo of my daughter pouting again (if you've been to one of my talks recently, you know what I'm referring to). This week I'm in Hamilton and Ottawa, next week in London, Ont, then Ottawa again, Hamilton and Brampton. Going on the road is very rich with new learnings for me, and the workshop continues to grow and change as I make new connections and hear new stories. Those encounters hugely compensate for the downsides of being a road warrior, as my husband lovingly calls me. I look forward to meeting you if we have not yet met.

Guest post: Fragile People

2010-03-22T11:34:00.003-04:00

by Lindsay

After donating blood a friend of mine wrote in a google buzz, “Why are health professionals so rough??? I’m fragile people!”

Sadly, we often are rough. We spend so much time patching people up that pretty soon we’re like factory workers putting bolts on a widget. It’s a form of “compassion fatigue.” We’re faced with so much sadness and suffering that we slowly, subconsciously, learn to hold our patients at a distance. But somehow, some patients, some situations, find their ways deep into our hearts.

This weekend I was changing a dressing on a particularly nasty bed sore on a sweet young lady that is close to my age. The sore was so nasty, and the patient so young that I couldn’t help but my let my heart go out to hear and to feel pained for her situation. I did my best to let her see and feel my empathy and made sure to talk to the next shift about a few things that could be done to make her more comfortable.

To respond to my friend’s comment, we health professionals are also fragile people, but we’ve wrapped our hearts away so that we can do our jobs professionally and efficiently. But we’re grateful for comments like yours, and for patients like mine that remind us that we’re all fragile people.

End of guest post. Thank you Lindsay for letting me reprint this from your blog.

Of interest...

2010-03-17T07:11:00.004-04:00

International Telehealth Palliative Care Symposium - April 27-29th, 2010

Topics include:

-So Many Patients Die After We Get Close to Them: How do we heal ourselves?
-Best Practices for Palliative Pain and Symptom Management: How can I confidently change from dosing for cure to dosing for palliative care? What can I do when access to high-level care is limited?
-Who Cares? What People Near the End of Life Say About Caring
-Maintaining Hope and Trust: How can I be honest with a patient about their prognosis?
-Managing Delirium for a Peaceful End of Life Journey
-Traditional Healing among the Inupiaq: Importance of Caring for the Body, Mind, Spirit

To register or for more information phone: (907) 729-1900 or email: palliativesymposium@anthc.org

Leading Edge Seminars: Gabor Maté, Janina Fisher and John Ortiz in a small classroom environment... but not all at once!

The Master Class Series is a way for prominent speakers to further share their research, work and insights with you at a level of complexity that is usually not possible with larger audiences. This is a rare opportunity for more one-on-one exchanges and learning with experts and your peers. Learn in an intimate and collaborative group setting:

Smaller group (maximum 35-40 participants)

Customized seminar content based on questions and case studies submitted in advance by YOU. More time for questions and detailed follow up on issues arising from discussion. Bring your toughest cases and questions to the class.

Upon registration, Master Class participants are invited to submit case studies and questions (articles, notes, video clips and audio files are all welcome) at least two weeks before the date of the class for the speaker's consideration. Cases will be chosen by each Master Class instructor.

New Study looking at Compassion Fatigue in Public Defenders

"The Wisconsin State Public Defender is participating in a study of compassion fatigue on lawyers and support staff. The State Bar of Wisconsin Lawyers Assistance Program (WisLAP) will use the results to develop training materials and techniques to benefit lawyers and law office staff across practice areas and environments. The results of this initiative will be shared with legal professionals in Wisconsin and across the nation. [...]

The study is being conducted by Dr. Andrew Levin, medical director of the Westchester Jewish Community Services, Westchester, N.Y., and Linda Albert, State Bar of Wisconsin WisLAP coordinator. Quoted from Karle Lester of State Bar of Wisconsin

Quick March Break post

2010-03-16T08:02:00.002-04:00

I'm on March Break with my kids this week so I'll just write briefly.

I am happy to report that the 5/30 challenge has been a raging success with my kids. My daughter asked me for a bowl of grapes yesterday at the usual "cheese and cracker" time of the day and said to me "you know, I'm actually starting to actually like eating fruit mom!" music to my ears. We were skiing this weekend and my son got an apple at the snack shack along with his, ahem, poutine. Ok it's not perfect but it seems that it has injected an awareness that was not there before. Plus, I never actually promised them anything if they completed the challenge, I just said "here's what you're supposed to be doing, at a minimum, let's track it for a while ok?" and they were off to the races.

As we move into Spring, I suggest taking stock of your basic self care needs: healthy eating, getting enough sleep, having non-trauma related hobbies and leisure activities, exercising 30 minutes a day, having an activity that replenishes you, going on a media fast for a week, resting each day for a little while. How are you doing on these? If you're not sure where to start, I suggest going back through my blog archives and reading through to see if something strikes your fancy. I also suggest not going at it alone - enlist a friend with whom to share your self care goal, someone who will cheer you on and keep you accountable in a gentle way.

Finally, start small: make one self care goal for Spring and stick to just that one goal and don't beat yourself up about the rest.

Bits and bites...

2010-03-08T10:09:00.006-05:00

...Yes, from the tasty snack, which means I have lots of different things to write about and also means that I ate way too much salty food last night, watching the Oscars. I feel like a block of salt today. ugh. What was I thinking?

First of all, thank you to all the participants who took part in last week's Compassion Fatigue Train the Trainer workshop. I met twenty wonderful people and I think we all enjoyed having the opportunity to slow down and get a chance to talk to each other for two days (and be incredibly well fed, to boot). You were all very much in my thoughts as I visualised each of you making your way back home, either close to Kingston or all the way East. Thank you for your willingness to share in the way that you did, to take risks and to offer us, in turn, the gift of the wisdom of your experiences.

It was a gorgeous sunny weekend in this part of the world. There was much premature celebration of Spring going on in Kingston with many people running outside in, brrr, shorts even though it was only about 5 degrees (we get a bit spring crazy, us Canadians don't we?). My brother - who is also one of my best friends, and his wonderful family were visiting and we took many long walks, talked and ate and and talked some more. There was also a surprise visit from my beloved, gorgeous, super smart, trilingual 23 year old sister Doudou. Doudou is a graduate student in Montreal studying international development. She has lived in Mali, Nicaragua and Kashmir (so far) and is currently planning on returning to Africa and India as soon as her thesis is done. She is very thoughtful and extremely well informed about international aid and the challenges facing developing countries. After three years of living abroad, she is also dealing with reverse culture shock, coming back into our profligate consumer culture.

In Kashmir, Doudou lived for many months with a family that had not one stitch of furniture in their home and very little to eat. Ditto in Nicaragua and in Mali. In Paris, she worked with the homeless for several months. Yesterday, as we were sitting and chatting, she told a story about this wonderful wise homeless man she used to work with and finished by saying "oh, and then one day, he was stabbed 19 times and died. That was really upsetting."

From these experiences, I see, through her eyes, that the world is never going to be quite the same again. There is a richness to what she is learning and a huge passion for the work that is still to come, but, as her older sister, I feel this protective urge to spare her the pain of what she is going to continue seeing. Of course, then, when she starts talking, I realise that she has already seen too much for me to prevent any vicarious trauma from occurring. It has already happened and it is a normal consequence of the work that she has been doing.

One thing that surprises and angers me is that in her preparatory training to deploy to these countries, she did not receive much, if any, VT training from the NGOs. I thought we were doing better than that in this day and age.

Hearing Doudou's stories, I also feel elated to see a young person who is truly a citizen of the world, and who brings a highly knowledgeable perspective to international work. I like to hold on to these encounters to combat the cynicism I sometimes hear from my slightly older friends who often launch into the old litany of "kids these days...." which they follow with a complaint about how entitled, materialistic, self-centered, what have you they perceive kids in their twenties to be. In fact, in my experience, many of the young people I speak to are not spoiled electronic brats who expect immediate gratification for everything. The people I am meeting across the country are really engaged and concerned about the society we live in, the environment, racism and poverty.

I think that sometimes, when we, the older generations, get tired and overwhelmed, we also get defensive and stop being open to the voices of people younger than us.

I, for one, am excited to hear what they have to say.

Take up the 5/30 challenge - Relevez le défi 5/30

2010-02-26T12:53:00.008-05:00

This wellness challenge is an initiative of heart institute of Montreal. For the next six weeks, you are invited to commit to eating 5 portions of fruit and vegetables per day and exercise for at least 30 minutes daily (these can be three separate 10 minute activities such as climbing the stairs, walking to the grocery store and going for a walk at lunch, or one thirty minute exercise session).

You can make this commitment on your own, with friends or, if you are reading this on or before March 1st, you can enroll in the challenge online

Relevez le défi 5/30! Une initiative de l'institut de cardiologie de Montréal. Pour les 6 prochaines semaines, optez de manger au moins 5 fruits ou légumes par jour et de faire 30 minutes d'activité physique. Vous pouvez vous inscrire sur le site ou relevez votre propre défi au bureau ou avec votre famille! Visitez leur site pour plus d'information.

(Tonight, when they come home, I'm going to challenge my kids and hubby to this and see if they can rise to the challenge. We'll see who wins - full disclosure is that I already do both of these things on most days so I am pretty sure I am going to win but let's see who gets the silver medal in our home!).

Photo from Image: Suat Eman / FreeDigitalPhotos.net

Back from Whitehorse

2010-02-22T11:30:00.004-05:00

Wow, what a wonderful trip.

A beautiful place and amazing people. I received an incredible welcome in Whitehorse and was treated like royalty...Imagine the re-entry shock when I got home: "ahem, my water bottle is empty...(cue to my family sitting on the couch watching the olympics, ignoring me) ahem...I need to be driven to the store, someone? No? Say what? Do it myself? Oh..."

Things I learned while I was away:

1) If you live in Whitehorse and your windshield gets cracked by flying gravel, don't bother replacing it. It will only get cracked again (percentage of cracked windshields of cars I was driven in: 99%, pretty strong data I would say.)

2) If you notice, just as you are about to check in for your return flight home, that you have mistakenly booked your flights for March 20th rather than February 20th and are flying through Vancouver, the busiest airport in Canada this weekend, just cross your fingers and pray that somehow the Air Canada guy (ACG) is in a good mood. Plan B, start crying loudly. Luckily, I was just about to start working on Plan B when some miracle happened and ACG got me a seat on all three connecting flights even though they were all overbooked. Thank you ACG.

Today, instead of travelling across the country to give a talk, I am going...across the street to St Mary's of the Lake (isn't that a beautiful name for a hospital? It always makes me think of Arthurian legends for some reason).

I will post something deep and meaningful related to Compassion Fatigue later on this week. For now, I am adjusting to being back home and trying to catch up on life.

Contest winner! I would like to congratulate Mezaun on winning a copy of The Compassion Fatigue Workbook. I will be sending it to you this week.

Stillness is a Powerful Action

2010-02-14T06:42:00.003-05:00

By Leo Babauta, author of the book "From Zen to Done"
Go see his website: www.zenhabits.net

“Activity conquers cold, but stillness conquers heat.” ~ Lao Tzu

It’s a bias of our culture that stillness is regarded as lazy, as being stuck in inaction, as a negative.

It’s not. It’s an action, and a powerful one.

What’s more, it can change your day, and in doing so change your life.

You’re in the middle of a frazzled day, swamped by work and meetings and emails and interruptions, or hassled by kids and phone calls and errands and chores.

You pause. Stay still for a minute, and breathe. You close your eyes, and find a stillness within yourself. This stillness spreads to the rest of your body, and to your mind. It calms you, centers you, focuses you on what you’re doing right now, not on all you have to do and all that has happened.

The stillness becomes a transformative action.

Stillness can be a powerful answer to the noise of others. It can be a way to push back against the buzz of the world, to take control. It can remind you of what’s important.

How to Practice
Stillness, oddly, doesn’t come naturally to many people. So practice.

1. Start your day in stillness. Whether it’s sitting with a cup of coffee as the world awakes, or sitting on a pillow and focusing on your breath, stillness is a powerful way to start your day. It sets the tone for things to come. Even 5-10 minutes is great.

2. Take regular stillness breaks. Every hour, set an alarm on your computer or phone to go off. Think of it as a bell that rings, reminding you to be still for a minute. During this minute, focus first on your breathing, to bring yourself into the present. Let the worries of the world around you melt away — all that is left is your breath. And then let your focus expand beyond your breath to your other senses, one at a time.

3. When chaos roars, pause. In the middle of a crisis or a noisy day, stop. Be still. Take a deep breath, and focus on that breath coming in, and going out. Find your inner stillness and then let your next action come from that stillness. Focus on that next action only.

Let stillness become your most powerful action. It could change your life.

“Through return to simple living Comes control of desires. In control of desires Stillness is attained. In stillness the world is restored.” ~ Lao Tzu

Found online: Free Webinar on Compassion Fatigue

2010-02-14T06:07:00.003-05:00

This free webinar came across my google alerts this morning:

March 3, 2010 - Compassion Fatigue
LCDR Pamela Herbig - Psychiatric Nurse Practitioner, Clinical Nurse Specialist and Director, Uniformed Services University of Health Sciences as Director of the PMH-NP program.

I don't know the organisers or the presenter, but Rocky Mountain Learning seems to be a really interesting agency who specialises in bringing training to folks through webinars and other distance learning modules.

As I gear up to leave my young kids for five days (nearly the longest ever), the idea of doing more and more web-based training is highly appealling to me, let alone the significant cost savings for all involved (no travel, no hotels, etc.)

So, if you're free on March 3, consider signing up for this training and let me know what you think, both of the content and the learning medium.

What movies have nurtured you?

2010-02-09T06:15:00.004-05:00

This week, I will be brief in the interest of taking care of my sore wrist (typing overuse, an occupational hazard). It will be fine but it needs a little break.

I am going to Whitehorse next week and am very excited about that. I apparently timed the trip perfectly to coincide with the arrival in Whitehorse of the mushers from Yukon Quest, a 1000 mile international dog sled race. How cool is that?

It brings back a lot of memories for me. When I was very small, we lived in a village in Northern Quebec called Povirnituq or POV, near Hudson's Bay, above the tree line. POV was a small village with wooden sidewalks, no sewers and lots of sled dogs. Apparently, at around age three, I used to be an early riser (still am) and used to get fully dressed (snowsuit and all) and go for walks in the village before my family awoke. I would get returned by someone or my parents would get a phone call saying I was having breakfast at so and so's house....I thought this was the most normal thing in the world to do. But the sled dogs had a huge place in the village and we used to see them huddled together during big snowstorms. We were taught to fear and respect them and stay well away from them. Anyhow, that was a little burst of the past coming into my head.

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GET A FREE Compassion Fatigue Workbook!
Here is my question for you this week - What are your pillar movies? You know, the films that have moved you deeply and left you feeling changed in some way? I want to focus on the inspirational films, not the harrowing ones (us helpers have enough of that in our day jobs). What are the movies that have inspired, nurtured you and left you feeling replenished? Post them in the comments and we'll compile a list. Please let us know what it was about the film that moved you so. I will randomly pick one comment upon my return from Whitehorse and that person will receive a free copy of The Compassion Fatigue Workbook.

mush mush

Call for presentations: “Safely in Our Hands: Helping Our Helpers Stay Healthy”

2010-02-01T09:53:00.003-05:00

Are you a compassion fatigue/vicarious trauma educator and/or practitioner? Are you interested in sharing your ideas/new approaches to helping other helpers who are facing compassion fatigue and vicarious trauma? The Association of Traumatic Stress Specialists will be holding its annual conference September 29 – October 3, 2010 at the Delta Airport Hotel – Toronto, Canada.

Click here for more information.

2010-01-24T10:41:00.002-05:00

Last week was very rich and stimulating as I had the opportunity to spend three consecutive days with a small group of helping professionals in the context of a compassion fatigue train the trainer workshop. It is always a real treat to have a small group to work with, as we get to actually talk things through and explore ideas in a way that I don't get to do with larger audiences. (Thank you to all of you for your willingness to take part in this process and for putting up with the many bizarre hotel-induced mishaps which took place during our time together!)

This week, I am off to Ottawa for a one day workshop with victim service workers and then to Cornwall to present to a group of helpers who work for correctional services. The challenges for both of these groups are complex, but one main issue is related to vicarious traumatization - being exposed to difficult client stories, even in a secondary way. If your job is to read crime reports day in and day out, eventually these stories have an impact on how you see the world. They simply do. If you work in a correctional environment, the very air you breathe is filled with trauma stories. What to do with this reality? How do we protect ourselves from trauma content? One suggestion (many more are included in my book, The Compassion Fatigue Workbook) is to read the wonderful book Trauma Stewardship by Laura van Dernoot Lipsky. Laura offers an excellent conceptualisation of trauma work and its impact on us, but also provides strategies, which she anchors conceptually in what she calls the Five Directions: "As we do our work, we continually seek strength by finding our center in the present moment. At the same time, we strive to enhance our self-knowledge by focusing consciously and concretely on the basic elements of our lives. The things we learn at the four outlying points of our compass of trauma stewarship will become the tools we can use to build a daily practice of centering ourselves." If you work with victims of crime or with survivors (who are sometimes perpetrators as well), I encourage you to take a look at her work.

"One in four hospital workers report they plan to leave their jobs"

2010-01-20T07:24:00.005-05:00

"Almost three in every five health-care workers are suffering from "role overload", a situation that is damaging their physical and mental health and putting many on the fast track to burnout, a new study suggest." These quotes (the title quote as well) are from an article by André Picard, published in yesterday's Globe and Mail (January 19, 2010) reports the findings from a recent study by Linda Duxbury on Ottawa area hospitals. To view article click here.

I am glad to hear that health care workers are finally getting the attention they deserve. Anyone working within the system could have told you that this was happening but maybe, just maybe, if the data is there to back it up, something will be done.

Starting the year at warp speed. Not what I had planned...

2010-01-17T21:19:00.003-05:00

I did not expect the new year to start with quite the bang it did in our house. The minute the kids went back to school, things quickly got busy on many fronts: at home, my children announced that they had long term projects that required nightly help from me (one involved building a diorama of the North American prairie bison’s habitat, to give you an idea…), my hubby decided that it was time to get organized and started clearing out and decluttering not one, but four areas of our house at the same time (“they are all interconnected, you see” he explained to me). The process was a little hairy: we were assembling storage cabinets at 9pm after having taken kids to hockey or soccer, helped them with homework (aka plasticine bison), cooked a (usually) nutritious meal and cleaned the dishes. Whew. My partner is a night owl and he starts hitting his stride at around 9:30pm, just as I am winding down…way down. For last two weeks, he has been bouncing out of his office just around that time, holding a piece of paper triumphantly in his hands: “I’ve got it! The perfect design for [fill in the blank] room.” He is wonderfully creative and I am delighted with the results, but the process made my head spin a bit. I had to bite my tongue and take an allen key and smile and get to work.

Being a morning person, I did take my revenge in the mornings, standing at the foot of the bed at 730am, asking him a million questions in a very perky voice, fully dressed and showered, having a) done an hour of work b) gone for a run c) taken the ikea boxes to the recycling depo and d) done the groceries. Even though we have been together for nearly 20 years, this diurnal/nocturnal mismatch in our relationship always catches me by surprise: “You want to discuss what? But it’s past 9pm, I have no opinion whatsoever about that. None. I am basically asleep. Yes, I know, I am walking around, but I’m not actually here, not at all.” My poor hubby.

Things started out rather quickly on the work front too. Right before going on vacation, I was offered a very interesting contract with a very tight timeline, and this is what I have been working on for most of the month so far. The contract involves carrying out a full organizational health assessment of a unit in a hospital. I have had the opportunity to interview many staff members, speaking to nurses, physicians and allied health professionals to find out what is challenging and rewarding about their work in the unit. Given that I am normally doing large group presentations, I don’t often get the chance to sit down to talk one on one with helpers and it was wonderful to have a chance to do this.

My training schedule is pretty full in the coming months. This week I will be offering three days of compassion fatigue training in Markham. This training is organized by Safeguards and will be offered again in London, Ontario in March 2010. These workshops are open to any helping professional wishing to register. Next week I will be in Ottawa and Cornwall, working with victim services and with corrections Canada.

And for those of you who are wondering (hi mom) how I am looking after myself with such a busy schedule, I am making sure to eat really healthy foods, run regularly, go to bed early, take naps, read books unrelated to work, watch movies, spend time with kids (laughing mostly) and go out for dinner with friends.

Soon, this busy first month of the year will end, and I will have a very organized home and enough leftover plasticine to make a full herd of bisons!

Haiti Earthquake - Please consider making a donation

2010-01-14T08:56:00.003-05:00

My thoughts are with the people of Haiti and all of those in Canada who have loved ones over in Haiti. Please consider making a donation online to the Canadian Red Cross, earmarked to the Haiti Earthquake Fund.

Donations can also be made by calling toll-free 1-800-418-1111 or by visiting any Red Cross office.

A blog for palliative care workers (and the rest of us too)

2010-01-11T08:30:00.003-05:00

I recently came across this lovely little blog: palliativechronicle.blogspot.com

I don't know anything about the author (known on the blog as simply JL), except for what she writes on the heading of her blog: "FROM ANESTHESIOLOGIST TO PALLIATIVE MEDICINE PHYSICIAN" and I take it from her profile that she is currently doing a fellowship training in palliative care.

If you work in end of life care, you may find useful resources and musings there.There are some very good links to other resources, postings of recent articles in the field and JL's posts which recently spoke of mindfulness meditation in connection to keeping CF at bay.

I personally enjoyed visiting and will definitely be going back.

Upcoming events of interest

2010-01-08T09:50:00.002-05:00

Ice fishing rocks! Photo by F. Mathieu

2010-01-08T09:45:00.005-05:00

Skating on a very frozen lake. Photo by Françoise Mathieu 2009

Happy New Year to you! I am back at work after two great weeks off. I had a chance to skate all over a beautiful lake in the Laurentians (after much safety testing, I should add), go ice fishing for the very first time -not entirely my cup of tea, but I have a seriously hooked (no pun intended) 9 year old and he was completely over the moon. He stayed out there for hours in the frigid cold and came in only when forced to. I don't really get it, but there you go. I also had a chance to catch up with friends and family, read books and eat a ton of shortbread. Yum.

I wanted to tell you about some upcoming events that may be of interest to you.

Mindfulness-Based Stress Reduction Course With Sandy Williams - OTTAWA

Wednesdays February 24th to April 14th 6:30 to 9:00 p.m. Full Day: Saturday April 10th 9:30 to 3:30 p.m.
Location: Fourth Avenue Baptist Church (at Bank)

An 8-week program designed to support you to cope more effectively with stress through mindfulness meditation. Mindfulness is the practice of paying attention, to the present moment, with acceptance. This practice is beneficial as it can help you to gain a deeper understanding into your feelings, thoughts and beliefs. People come to the program seeking relief from family, work and financial stress, sleep disturbances, anxiety, headaches, fatigue, pain and illness. Others choose to participate because they want a better way to cope with the often out of control pace of their lives. The program is for anyone who would like to learn to relate consciously and compassionately to the challenges of everyday life. The group meets weekly for 2 1/2 hours with a full day session after the 7th week.

Cost: $425.00 (Includes 2 compact discs and handouts) Supplementary health insurance may apply.

Sandy Williams, MSW, RSW is a social worker leading Mindfulness-Based Stress Reduction programs in the community. She has participated in the Mindfulness-Based Stress Reduction professional training with Jon Kabat-Zinn. She believes that our difficulties are “workable” and the practice of mindfulness supports us to take responsibility for our well- being and to do something for ourselves that no others can.

For information call Sandy at 613-371-0795 or email: sandra.williams@sympatico.ca

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CAST Canada: Addiction & Trauma - Consumer Panel: Workshop for General Helping Professionals

Friday, February 19th, 2010, 9:00 a.m - 4:00 p.m.
Barrie, ON ( Holiday Inn, Fairview Rd.)
Cost: $140 + gst Before February 28th ~ lunch not provided ~

For the past 4 years CAST Canada has held more than 60 Addiction & Trauma Consumer Panel workshops. Over 2,000 frontline workers have worked directly with CAST Canada volunteer consumers to identify unique, relevant ideas around what worked ( and what didn't ) in helping relationships. The learnings from this process will be available to you.

Who Should Attend?
You are a frontline worker or any general helping professional where your clients often have addiction and/or trauma issues. The day is popular with shelter, housing support, O.W. , ODSP, all outreach and Children's Aid workers, therapists, counselors, correctional and probation officers, professors, teachers, guidance counselors, EAP professionals, all hospital staff.

You will:
- Witness moving, open testimonials from consumers who have been helped by professionals
- Participate in highly interactive discussion
- Receive solid, safe and effective tools
- Interact with and learn from peers from other sectors and other areas

Some Themes:
"Role of Relapse" - Learn to discuss this volatile topic
"Nature of Cravings" - Simple to deliver, productive, builds relationship & empowers the client
"How do I ask? " - Asking hard questions around suspected substance abuse or trauma
"Roles, Goals & Boundaries" - Critical insights, easy implementation

Details and registration: CAST Canada Webpage

*The day is intended for 'general' helping professionals as opposed to addiction or trauma workers who find the tools and insight helpful but the introduction and background basic

Signing off until the New Year

2009-12-18T06:43:00.004-05:00

That's me, baking Christmas cookies...I realised a few years ago that I am a bit of a cookie tyrant around this time of the year as the cookies are gifts for the guitar teachers, caregiver etc. My family sometimes ask "can we have one little cookie?" and I glare at them and say: "maybe, once I've made all the gifts, you can have the broken ones." Nice, eh? Now I am aware that this is not a lovely trait of mine. So this year I'm going to make a second batch just for them...

I am taking a few weeks off with my family. I will post again in January (likely January 11th or thereabouts). Thank you for your readership this year. I wish you and your loved ones a peaceful and restful holiday season.

Françoise

Forced mindfulness…

2009-12-13T19:35:00.002-05:00

I have been travelling backwards on a train for the past hour. We were about an hour away from Toronto when something went wrong with the train in front of us. I don’t know the details (as none have been communicated to us) but it means that we have had to travel backwards and now have to wait to connect with the broken train and tow them all the way to Toronto. This, we were told, is going to take “a very long time”. Since then, we have gone backwards, forward, backwards again for long stretches of time.

This means that I have missed my connecting train and that every minute that goes by, I am travelling further and further away from my destination.

Now this is a good time to be mindful! One of my best friends has told me that I am “the queen of the positive reframe” and she wasn’t feeling warm and fuzzy when she said it, as she felt very irritated by a contretemps we were experiencing and I was telling her "look on the bright side, at least we don't have to climb THAT hill over there!."

So, here is the positive reframe, (Just for you, Mary, ☺). Five good things about this mishap:

1) No one is waiting for me at the station if and when I arrive so I'm not putting anyone else out.
2) One of my dearest friends gave me a cd for my birthday with 89 songs on it, many from our days as punk rockers in Montreal. So I’m having a very enjoyable walk down memory lane. (Thank you Jimmy!)
3) I could be on the other train, the broken one, where there has been no heat and no washrooms for the past hour and a half...
4) I could have two toddlers with me
5) It might turn out that I am sitting on my connecting train as this train changes identity once it gets to Toronto. Which will mean I have not missed my connection at all.

Plus, what the heck can I do and what is the point of making it a miserable time for myself?

So there you go, that’s my positive reframe. Talk to me again in a couple of hours and see if I’m still feeling perky.

Upcoming Training in Markham and London: Special Rates for Children's Mental Health Staff

2009-12-11T06:42:00.003-05:00

Safeguards Training for Children and Adult Services is sponsoring four of my Compassion Fatigue workshops this Winter: Two in Markham and two in London. If you are a member of CMHO, OARTY, ONTCHILD/YPRO, ANCFSAO or Community Living Ontario, the price of these workshops is extremely low.

In addition, a non-sponsored version of these training sessions are being offered in Kingston. Visit my website for more details.

Walking the Walk: Creative Tools for Transforming Compassion Fatigue

January 18, 2010 - Holiday Inn & Suites, Toronto (Markham)
or
March 29, 2010 - Delta London Armouries, London, On.

Description
Françoise Mathieu, M.Ed., CCC.Certified Counsellor, Compassion Fatigue Specialist and Director of WHP will present this one day training (this will be followed by the Trainer-the-Trainer session so you can take this valuable training back to your agency.)

Compassion fatigue is characterized by deep emotional and physical exhaustion and by a shift in a helping professional's sense of hope and optimism about the future and the value of their work. It has been called "a disorder that affects those who do their work well" (Figley 1995). The level of compassion fatigue a helper experiences can ebb and flow from one day to the next, and even very healthy helpers with optimal life/work balance and self care strategies can experience a higher than normal level of compassion fatigue when they are overloaded, are working with a lot of traumatic content, or find their case load suddenly heavy with clients who are all chronically in crisis.

Compassion fatigue is a normal consequence of working in the helping field. The best strategy to address compassion fatigue is to develop excellent self care strategies, as well as an early warning system that lets the helper know that they are moving into the caution zone of Compassion Fatigue. This is a highly interactive one day workshop, incorporating a combination of solo, small group and whole group activities.

Registration Details & Fee(s):
Members: Training Fee: $0 plus $50 Admin Fee+GST
Non Members: Training Fee: $99 plus $50 Admin Fee+GST

To register click here

Compassion Fatigue Train the Trainer: 2 day course

January 19-20, 2010 - Holiday Inn & Suites, Markham
or
March 30-31, 2010 - Delta London Armouries, London

Description
Françoise Mathieu, M.Ed., CCC.Certified Counsellor, Compassion Fatigue Specialist and Director of WHP has designed a two day, intensive train-the-trainer retreat on Compassion Fatigue.

This train the trainer workshop offers tools, handouts, strategies, training material and marketing strategies to adapt Walking the Walk to your agency's specific needs (and to your own presentation style).

The train the trainer workshop is designed to take you deep first, to gain a true and thorough understanding of your own relationship to CF. Then you will learn the didactic details (what to teach, how to teach) and finally talk about the mechanics of the whole process (how to customize this for your own work needs/goals etc.).

Spaces limited to a maximum of 20 participants.Certificates of Completion will be provided

PREREQUISITES**
Prior attendance to the full day or half day workshop Walking the Walk is required. (You may have attended a session at your workplace, or in a different community in the recent past). For those who have not attended this workshop in the past, Walking the Walk will be offered on the day prior to this training. If you have attended Walking the Walk at an earlier date, please indicate when that was on your registration form.

Outcomes
You will Learn:
·How to use the Compassion Fatigue Workbook
·What are Compassion Fatigue, Caregiver Stress, Vicarious Traumatization and burnout
·Signs and symptoms of CF/VT/Burnout
· Assessment tools
· Warning signs
· Resiliency skills
· Self Care Strategies
· Academy of traumatology standards of Ethics
· How to offer psychoeducation on this topic
· Experiential activities that work with audiences
· How to design your own workshop: what is your target audience

Pricing
Member fee $52.50
Non-member fee $260.40

To register click here

For more information contact:
Contact Name: Donna Stevens
Contact Phone: (905) 889-5030
Contact Fax: (905) 889-7155
Contact Email: donna@safeguards-training.net

A One Day Workshop with Gabor Maté: Exploring the mind-body-emotional connection and the impact of stress on the immune system

2009-12-06T11:39:00.010-05:00

Gabor Maté's workshop in Toronto last week attracted so much interest that the location had to be changed: Within days of posting the event, five hundred participants had signed up. The organisers had to scramble and find a new location for the event and settled on a movie theatre. I was a bit sceptical when I settled myself in for the talk: there were no visual aids, just a gaunt man dressed in black standing at the front of the theatre with a few newspaper clippings in his hands. And then, the day began and I lost track of everyone else in the room. Dr Maté is a gifted and riveting speaker.

Instead of trying to explain his message in my own words, here is an excerpt from his website which describes the message in the book and in his workshop:

"Can a person literally die of loneliness? Is there a connection between the ability to express emotions and Alzheimer's disease? Is there such a thing as a "cancer personality"? Questions such as these have long surrounded an often controversial debate regarding the connection between the mind and the body in illness and health. As ongoing research is revealing, repressed emotions can frequently lead to stress—which, in turn, can lead to disease.

Provocative and beautifully written, When the Body Says No provides the answers to these and other important questions about the effects of stress on health. In clear, easy-to-follow language, Dr. Gabor Maté lucidly summarizes the latest scientific findings about the role that stress and individual emotional makeup play in an array of diseases, including heart disease, diabetes, irritable bowel syndrome, multiple sclerosis, arthritis, cancer, and ALS, among others.

Offering profound insights into the link between emotions and disease, When the Body Says No explores the highly debated effects of stress on health—particularly of the hidden stresses we all generate from our early programming. Dr. Gabor Maté explains how, when the mindbody connection is not optimal, various illnesses can crop up—everything from heart disease and eczema to irritable bowel syndrome and ALS. He presents the scientific evidence that a connection exists between the mind and the immune system—along with illuminating case studies from his years as a family practitioner that reveal how one’s psychological state before the onset of disease may influence its course and final outcome.

As Dr. Maté wrote in The Globe and Mail: “When we have been prevented from learning how to say no, our bodies may end up saying it for us.” When emotions are repressed, this inhibition disarms the body’s defenses against illness. And, in some people, these defenses go awry, destroying the body rather than protecting it. Despite a rapidly accumulating body of evidence attesting to the mind-body unity, most physicians continue to treat physical symptoms rather than persons. When The Body Says No argues persuasively that we must begin to understand the mindbody link in order to learn more about ourselves and take as active a role as possible in our overall health.

Dr. Maté explains how the dynamics of self-repression operate in all of us. With the help of dozens of moving and enlightening case studies and vignettes drawn from his two decades as a family practitioner, he provides poignant insights into how disease is often the body's way of saying "no" to what the mind cannot or will not acknowledge.

Above all, When the Body Says No promotes learning and healing and helps improve physical and emotional self-awareness—which, Dr. Maté asserts, is at the root of much of the stress that chronically debilitates health and prepares the ground for disease." from www.whenthebodysaysno.ca.

Dr Maté will be returning to Toronto for an encore in June.

**Addenda: I have just received the flyer for Dr Maté's next presentations: June 28th 2010 at the AGO in Toronto and June 29th at the Cinémathèque in Montreal. For more information visit the Hinks Dellcrest Centre.

Organizational Health: The Place to Start

2009-12-01T17:21:00.000-05:00

I am posting a bit late this week - I was in Toronto yesterday, attending Dr. Gabor Maté's workshop on stress. I will write more on this later as it was a very rich day of learning and Dr Maté deserves his very own post.

Last week, I had the privilege of sharing the podium with Dr David Kuhl at a conference hosted by the Elizabeth Bruyere Continuing Care Centre in Ottawa. Dr Kuhl is both a physician and a psychologist and he is the director of the Centre of Practitioner Renewal (CPR) at Providence Care in Vancouver. The CPR was created several years ago to offer support to staff members of the hospitals of the Providence Care network. At the CPR, Dr Kuhl and his colleagues offer counselling and education to health care workers and carry out research related to compassion fatigue and helper wellness. They work with individuals and also with entire teams to try and improve staff relationships and enhance the quality of care.

Dr Kuhl is a very erudite and skillful presenter and his session was inspiring and illuminating. I really appreciated the focus he puts on teams and the challenges they are facing in health care.

Conference participants had many questions for us about organizational challenges and expressed their frustration at the current state of affairs in health care. Their anger and exasperation towards the system was expressed strongly throughout the day. This is not an isolated case: I have the opportunity to meet hundreds of health care professionals each month from across the country and the evidence is overwhelming: physicians, nurses, allied health professionals and hospital managers are struggling. Health care workers all over Canada describe having to do more with less resources and trying to deliver quality of care when staffing has been cut beyond what is realistic. Last week, one nurse told me about mandatory overtime where nurses are not allowed to say no when the hospital calls. She talked about nurses who work in remote communities who get a knock at their door when they don't answer their phone - in order to force them to come to work.

Taking a step back, how can quality patient care be delivered when you have been coerced to come to work for an additional shift? It simply does not make sense.

What happens, of course, is that we all suffer, patients and health care workers alike: we turn on our colleagues, we resent any extra time off they take (I call it the "must be nice phenomenon"), we blame our managers whom, we feel, "don't understand". Perhaps that is sometimes true, but I meet with different managers weekly and they say they feel like "the peanut butter in the sandwich", squeezed between upper management, ministry demands, staff needs and concerns and patient care. A very difficult position.

So, what to do about all this? Sometimes we can try going the advocacy route, protesting to the upper echelon in various ways, not voting for a government that doesn't value health care workers (and also doesn't believe in a restorative justice system, but I digress). But sometimes we feel that we do not have a voice. We feel stuck.

In my opinion, to find our voice within this deeply flawed system, we need to gain a better understanding of organizational health. This is what my esteemed colleague Dr Pat Fisher does. Dr Fisher is an organizational psychologist as well as a trauma specialist and she has spent the last two decades working within our system. She has developed an approach to diagnosing and enhancing organizational health and the results are very convincing: a year after her interventions, agencies report a significant improvement in decreased absenteeism, productivity, decreased job stress and employee wellness. Pat has developed the 4 tier, 12 factor model of organizational health. I invite you to go read more on her important work.

Clean Slate

2009-11-22T07:39:00.002-05:00

Not by my own choosing, mind you, but my computer crashed last weekend. It was kaput, finito, dead as a doornail. Apparently the hard drive was damaged and "could have gone at any moment" said the repair person. The good news is that I have been pretty good about backing up my files (not perfect, though and not unlike a break-in, it's only weeks later that you think "where's that thing? I haven't seen it in ages" only to realise it was part of what went missing.) But I'm in pretty good shape, all things considered.

So, for those of you who are lackadaisical about backing up your files, a word to the wise. My computer savvy hubby says we should all back up our computers every single night at the end of a day's work. He also recommends using gmail as an email server, as it will store both received and sent mail from your computer and you will never again lose your sent mails (which is a big issue for me as it is where I do the bulk of my work). I am sure some things will fall through the cracks though, so if you emailed me recently and have not heard back from you, can you write again? Thanks and sorry in advance.

Last week was rather training-intense, with two half day sessions with oncology and palliative care staff in Montreal, and three days with York Region's community and health services. I had a lot of fun. I enjoy meeting new people and hearing about the work that they do, with its challenges and rewards and pitfalls along the way. I particularly appreciated the training space at York Region's Newmarket site. When you do a lot of training, you become pretty attuned to group dynamics and the impact that a training space has on people who are, after all, kind of trapped together for a whole day. This space had a ton of natural light (big windows), high ceilings, carpet on the floor (good acoustics), comfortable chairs and enough space to move around. It really makes a difference to the whole experience. Thank you to Nancy Hogue for driving me all over the GTA and not laughing at my geographical dismay!

Now I am back in quiet little Kingston where driving my boys to the football game took approximately 1.5 minute (go gaels go) and getting front row seats to the santa claus parade meant arriving 5 minutes early and sitting in a local restaurant with front row (warm) seats for the show. I cannot say enough about the quality of life offered by living in a small community.

On the menu this week: The two day Compassion Fatigue Train the Trainer workshop (if you are interested in attending this training down the road, please visit my website and also note that there are only 20 seats per session and that this course fills up very quickly) I will not be offering a June session this year as I cannot get the training space that I want, so after the March session, I will likely not be offering this course again until the Fall. I am then going to Elizabeth Bruyere in Ottawa for a palliative care conference.

Have a great week, don't forget to tell your computer that you love it, and after giving it a big wet kiss, back it up right away.

November is always a hectic month

2009-11-14T14:09:00.004-05:00

Hi, how are you? Have you started your Christmas shopping yet? :-)

I had a very interesting week and had the pleasure of presenting at the stunning Dundurn Castle in Hamilton to professionals working in developmental pediatrics at Hamilton Health Sciences and in the community. Thank you for your warm hospitality and for tolerating my big booboo at the train station (basically I made someone wait for me for 1.5 hours due to a comedy of errors...so sorry...)

The week ahead is a busy one: I will be presenting at the CHUM in Montreal on Tuesday, working with health care staff from palliative care and oncology. Then, it's off to Newmarket to work with Ontario Works staff from York Region, for three days of training. Next week is the two day Compassion Fatigue Train the trainer back home in Kingston. For those of you who may be interested in attending the next Train the Trainer, which is being held in March, please note that there are only 20 spots available and that registrations are coming in fairly steadily, therefore to avoid disappointment, please consider registering soon. Please also note that from March onwards, there will be a prerequisite to attend the Train the Trainer workshop: you must have completed a full day or half day "Walking the Walk" session at some point in the past or simply attend the one day training being offered on the day prior to the Train the Trainer session. For more information click here.

Something new: I will be offering an e-learning session for a private group in a couple of weeks via a process called Fireside Chat: it's a very simple and affordable process whereby participants use their laptop and a phone line to take part in a teleconference while being able to view the power point slides. If I like it, I might use this to start offering some distance learning sessions in the new year.

I am changing decades in two weeks. Gulp.

Finally, if you are building a christmas wish list for yourself, I would like to recommend some good old standbys from my library:

Take time for your life by Cheryl Richardson
Mindfulness-based stress reduction cd package by Jon Kabat-Zinn
50 ways to simplify your life by Patrick Fanning

In peace,

Françoise

Debating the Texas shooting: Where to go to read something that makes any sense on this topic

2009-11-07T06:08:00.009-05:00

I received several emails this week from people who read this blog. It was very nice as it puts faces to my readers and I'm never sure who is "out there" actually reading these posts. So, Hello dear friends and colleagues (Hi Deb - it was lovely to have tea yesterday, we should do that more often. Go write that book, it's going to be a fantastic resource!).

I am posting my blog post early this week as I am taking Monday off - it's been a hectic past few weeks with a lot of travelling and presenting, and it's time for a bit of self care for this workshop presenter.

This was an interesting week: I presented a one hour talk on PTSD to a second year Abnormal Psychology class at Queen's University (weird timing given the Texas shooting, I'll return to that in a minute) and offered an evening and a one day session for the Alzheimer's Society here in Kingston. The evening session was for family caregivers and the day for helping professionals. I learned a lot during both events. I can tell you one thing: when I am elderly and in need of long term care, I hope to receive care from people such as the ones on the panel. These folks, most of whom have been looking after elderly patients with dementia for 20-30 years, radiated with compassion for their clients. When they described why they love their work, their faces started lighting up. I can't quite capture it now, as it is 6am and I'm about to take my son to play hockey, but it was something very moving. Everyone on the panel also spoke of their self care strategies and it was clear that they have remained compassionate and resilient because, in part, they had learned to care for themselves both physically and emotionally. All of them exercise on a regular basis, try to eat well and have a strong support network.

It was also wonderful to present to family caregivers. These folks have been caring for a loved one with for years, often on their own, often in their homes until they can no longer do it. I hope I was able to offer a little bit of support to them, in my limited ways. It was certainly an honour to meet you all.

I will not wade into the massive speculation that took place in the media this week surrounding the psychiatrist who went postal and killed a dozen military personnel in Texas. If you have google alert you will have been deluged with posts discussing and speculating on whether this man suffered from vicarious trauma and whether that is what led him to kill. The problem with the internet, of course, is that there is a lot of rubbish being written by pretty much anyone who can type, and there is some good stuff in among all that. I found a good discussion on the topic, written by Drs Figley and Pearlman and other solid sources, so I invite you go read this to if you want a sensible analysis of the few facts that are known at this time.

As for me, I'm off to Hamilton this week to present to helpers who work in developmental pediatrics. I also want to rake leaves, make soup and go for a run in the crisp November air. I hope you also have a good week and can fit in some time to exercise, stretch and breathe.

Namaste.

Staying afloat in the eye of the flu storm: An online course for Health Care Workers

2009-10-29T14:22:00.007-04:00

Last week, both my children came down with the flu (likely the most popular strain currently deluging the media). So my husband and I juggled: we shared the home care for the week (I was co-teaching a three day Crisis intervention course) and washed our hands like mad and tried to resist giving hugs and kisses to them (now, that was hard). They are back in school and seem to be on the mend and we are trying to catch up on missed deadlines and the lot.

It was nothing very serious, but it reminded me of the incredible stress of having younger children and getting the dreaded call from the daycare, which normally meant that not only Poopsie was sick today, but he/she was going to be banned from daycare for the following day, until they were deemed to have been fever-free for a full 24 hours. As soon as I would see the daycare number on call display, my mind would start racing, thinking about coverage for the following day, what was I going to do with the suicidal client I had just safety contracted with (the deal being that they would come back to see me on the next day), who would see the couple who had travelled 2 hours to come for a session who were already on their way to the office, and where would I fit in all the people who had been moved to the following day. Of course, it always worked out, somehow, but the stress involved was significant. And I'm talking about minor ailments here, not the catastrophic illnesses that so many people cope with.

Working as a front line worker has many rewards but the challenging reality is that you have to be "on" when you're at work. You were up all night with a sick family member? Too bad, you have to be 100% focused right now. There are no half measures really. Of course, there are many ways to help each other out - family and friends can step in, if they live nearby, but the stress of the unkwown never really goes away when you are a front line health care worker.

Of course, with the flu outbreak this week, hospital and public health workers are facing a mounting workload and having to deal with many stressors all at once - the hours-long lineups for vaccination speak for themselves, as do the crowded flu clinics.

This morning, I heard a very topical radio interview on CBC's The Current on the impact of the pandemic on health care workers. On the show was Dr Robert Maunder, a psychiatrist at Mount Sinai Hospital in Toronto who is part of a team who have developed The Pandemic Influenza Stress Vaccine, an online course for health care workers to help us develop resiliency skills while facing the pandemic. He said that several studies found that health care workers who were in the thick of things during the SARS epidemic were found to have lasting psychological effects from working in the SARS environment (more fearful of contamination for long periods of time following the end of the SARS outbreak).

Let me quote from their press release: "A computerized course for health-care workers worldwide to build their resilience during a pandemic. Based on the SARS outbreak in 2003, Mount Sinai experts understand that the spike in health-care workers' stress-related absenteeism results from fear of contagion, concern for family health, job stress, interpersonal, isolation, and perceived stigma. That's why Mount Sinai researchers Dr. Robert Maunder and Dr. William Lancee led a pilot study of computerized training for 150 Mount Sinai health-care workers in 2009. The results suggest that the training improves health-care workers' belief that they can handle the changes a pandemic brings, confidence in support and training, and interpersonal problems. This also suggests that the training may be able reduce stress-related absenteeism. From these findings, the researchers are launching The Pandemic Influenza Stress Vaccine course, which will be an education tool and also the basis of pandemic resilience research.

The course is available over the Internet making it widely accessible at no cost for the health-care workers. The goal is to reach 3,000 health-care workers worldwide.

The course is now live. It is part of a randomized control trial. Hospital-based health-care workers can register at
www.msh-healthyminds.com/stressvaccine. The pilot study was funded by Canadian Institutes for Health Research."

I have not yet had time to go take a look at the course, but Dr Maunder suggests that if you are a health care worker facing the onslaught right now, it may be very worth your while to take a few minutes out of your day to take the course now, rather than wait until you are not in the eye of the storm.

Raising awareness, one hockey game at a time

2009-10-26T06:50:00.000-04:00

(photo from Tema)

A few days ago, my daughter and I caught a public service announcement (PSA) on TV that took our breath away. Maybe you've seen it - During the first few frames, cute little kids in various emergency personel uniforms state their career dreams: "I want to be a police officer" says a sweet 6ish year old girl, "I want to be a firefighter" says a gorgeous nine year old boy, and so on. Then, the ad returns to each one and they continue: "But I'm scared..., (and now I am basing the rest on recall) "I'm scared that my job is going to hurt me, I'm scared of the nightmares, the horrible images, of not being able to get them out of my head. I'm scared that helping other people is going to permanently damage me" and gradually you realise that this is an ad about PTSD (the ad was far better that my clumsy attempt at describing it!).

The hockey game were were watching was "Don Cherry Military Night in Kingston" - an OHL game in honour of Canadian military personnel. There were several PTSD awareness-raising messages throughout the night and the aim of the whole evening was clearly to convey to soldiers of all stripes that PTSD is a common problem for military personnel and that help is available.

Having worked with the military for the past decade, I believe that this message needs to be conveyed to military staff in as many ways as possible. There is still a huge stigma about PTSD among the Forces - many military clients have told me that they would never want the label as they see it as a sign of weakness and they fear that if they sought help for it, they might be demoted or, worse, discharged from the military. There is also a perception among many soldiers that it's a "copout label" - sometimes, they say, used dishonestly to seek a pension and benefits. Perhaps that is true on occasion, but my own clinical experience and the data shows that there are far more genuine cases of PTSD than malingerers and this perception is yet another obstacle for soldiers who really need help.

So with PTSD, we are battling many layers of cultural assumptions, prejudice, institutional dysfunctions and shame. An uphill battle indeed. Meanwhile, the soldiers with undiagnosed PTSD continue to struggle on their own, often using alcohol to numb out, turning their domestic lives into total turmoil, lashing out at their spouses, their children and at themselves.

But let's go back to the TV ad with the kids:

It turns out the PSA was produced by a Canadian organisation called Tema: the Tema Conter Memorial Trust. Maybe you have heard of it? They are not an organisation I know anything about, so I went to their website to take a look.

Their story is as follows:
The charity was founded by Mr. Vince Savoia, an attending paramedic at the murder scene of Ms. Tema Conter in 1988. Upon coping with post-traumatic stress as a result of this horrible episode, Mr. Savoia created the Tema Conter Memorial Trust. The trust’s purpose is two-fold: to honour the memory of Ms. Tema Conter and call attention to the acute trauma encountered by emergency services workers. These courageous and compassionate individuals are haunted by the scenes they encounter on a regular basis, and they need our help. Because heroes are human.

If you go to their website they also have a very powerful second ad called "Hands".

On a personal level, it was a great ad as it led my daughter and I into an interesting discussion. She said "That's the work you do, isn't it mom? Help people who are hurt by their work?" and I said "Well, yes, and I help the people who help the people who are hurt by their work and that, in turns sometimes hurts them too." "Wow", she said "What a strange job you do!" And I thought "Yes, what a strange, painful, moving, wonderful, rewarding job."

There was a PTSD awareness-raising Major League baseball game this summer. It was for US military personnel and had a similar message: this is common, this is normal, get help, you are no less of a man for suffering from this.

Now, it would be pretty cool if we had a PSA about vicarious trauma one day, but I wonder how it would go over? How would we, the helpers feel? How would the public react to hearing how hard we sometimes find our jobs? A PSA about Vicarious Trauma. How about that?

Book Review: Trauma Stewardship An everyday guide to caring for self while caring for others by Laura Van Dernoot Lipsky (2009)

2009-10-19T11:01:00.005-04:00

I am right in the middle of reading this book but wanted to share it with you as it is such a find. The author has over 20 years of trauma work under her belt and brings a very fresh look to vicarious trauma.

She explains the use of the term stewardship in the following way: "As I see it, trauma stewardship refers to the entire conversation about how we come to do this work, how we are affected by it, and how we make sense of and learn from our experiences. In the dictionary stewardship is defined as "the careful and responsible management of something entrusted to one's care." (Van Dernoot Lipsky, 2009)

I was instantly grabbed by the book's introduction, called On the Cliff of Awakening, which articulated something I could completely relate to (so could thousands of helpers I have met along the way.)

To quote from her intro:

"Are you sure all this trauma work hasn't gotten to you?" He asked.
We were visiting our relatives in the Caribbean. We had hiked to the top of some cliffs on a small island, and for a moment the entire family stood quietly together, marveling, looking out at the sea. It was an exquisite sight. There was turquoise water as far as you could see, a vast, cloudless sky, and air that felt incredible to breathe. As we reached the edge of the cliffs, my first thought was, "This is unbelievably beautiful." My second thought was "I wonder how many people have killed themselves by jumping of these cliffs." Assuming that everyone around me would be having exactly the same thought, I posed my question out loud. My stepfather-in-law turned to me slowly and asked his question with such sincerity that I finally understood: my work had gotten to me. I didn't even tell him the rest of what I was thinking; "Where will the helicopter land? Where is the closest Level 1 trauma center" [...] this was the first time I truly comprehended the degree to which my work had transformed the way that I engaged with the world. " (Van Dernoot Lipsky, 2009)

I will share more about this book as I read on, but so far, it's very engaging.

Chapter headings are:
Part One: Understanding Trauma Stewardship
Part Two: Mapping your Response to Trauma Exposure
Part Three: Creating Change from the Inside Out
Part Four: Finding your Way to Trauma Stewardship

Little weekend break

2009-10-19T10:40:00.008-04:00

Hi! Here I am, after a bit of a silence. Last week was Thanksgiving and thus no Monday post.

I am just back home after a long weekend in Chicago. Once every two years or so, I try to arrange childcare (my wonderful friend and I have a great arrangement where we help each other out) and get enough air miles to join my partner as he attends a scientific conference. The kids and I teasingly call him and his friends "neuronerds" as they are all neuroscientists and really into their science. The nerd quotient was fairly high this time around (25 000 attendees). But nerds can let their hair down with the best of them, I assure you.

Chicago is a beautiful city with stunning architecture. We walked a lot, visited the Art Institute of Chicago and ate one of the best meals I have ever had (no joke) at Topolobampo. If you love authentic mexican cuisine and are going to be in Chicago consider booking a table (way ahead of time) at this spot.

Upon my return, I had an interesting exchange with my eleven year old daughter. She reported feeling upset about all my travelling, and said that she liked it better when I didn't do so many speaking engagements, but rather stayed home all the time. I said to her "but sweetie, when I was doing clinical work 5 days a week, I often came home exhausted and grumpy, I was short-tempered with you, and I never had time or energy for anything. Now when I am not travelling, I am home a lot more, I can pick you up from school, we bake cookies, we have time for crafts, for errands...things are way better now." and she turned to me and said: "You were never grumpy. I never noticed that." Now, I don't think that is actually true, as her only goal at this time is to make her mother never leave the house again, but I thought "maybe I faked it better than I thought."

Ah, the joys of being a parent - guilt on tap every time you turn around.

In actual fact, I am home far more than I am away, and this is by far the best career choice I have ever made (and the most professionally satisfying choice to boot.) But it did make me think about the juggling most of do between all of the demands on our time.

It's never simple to simplify our lives. Ironically.

Book Review: The Resilient Clinician

2009-10-06T07:08:00.003-04:00

by Robert J. Wicks, Oxford University Press

This short, reflective book was written specifically for clinicians: psychologists, mental health counsellors and social workers. It will be most useful to those with a background in clinical psychology who do face to face work with clients on a regular basis.

Dr Robert Wicks is a psychologist and a professor at Loyola College in Maryland. "A recognized expert in the prevention of secondary stress, in 1994 he was responsible for the psychological debriefing of relief workers evacuated from Rwanda during that country's bloody civil war." (from his book bio)

I was thrilled to see that Dr Wicks centers his approach on the use of positive psychology and mindfulness.

Robert Wicks explains his goal in writing the book as: "to introduce and highlight those areas that can help renew clinicians in today's challenging climate. It is amazing how little it can take to change the emotional tide in favor of such a beneficial move. Small alterations can sometimes jumpstart a positive step to a healthier attitude more than disputing dysfunctional thoughts ever can."

Chapters headings are:

Sensing the dangers: Chronic and acute secondary stress
Enhancing resiliency: strengthening one's own self-care protocol
Replenishing the self: Solitude, silence and mindfulness
Daily debriefing; Mindfulness and positive psychology

My conclusion: A lovely erudite book on self care for clinicians who are ready to reflect on their own journey of compassion fatigue and self care.

Update after Yellowknife

2009-10-04T07:01:00.006-04:00

I am just back from Yellowknife where I presented at a conference organised by the Federal department of Justice called "Northern Responses and Approaches to Victims of Crime: Building on Strength and Resilience." Over 250 victim support workers from across Canada met for three days to share ideas, research findings and to connect with each other. This was the first meeting of its kind and it was, in my opinion, a complete success. I had the opportunity to meet victim assistance workers from all areas of Canada, from Whitehorse to Rankin Inlet to Thompson Manitoba to Kuujjuak (my childhood villlage) in Northern Quebec. I have been to many conferences over the years, and this was the friendliest, most well organised of them all.

Why hold a victim support conference with a special focus on the North? Here is some sobering data from the Policy Centre for Victims Issues (PCVI) press release:

"According to the 2004 General Social Survey, residents of the territories were three times more likely than provincial residents to experience a violent victimization such as sexual assault, robbery or physical assault (315 versus 106 incidents per 1,000 population). Residents of the North also experienced higher levels of spousal violence than their counterparts in the provinces.

Approximately 12% of northern residents reported being the victim of some form of violence at the hands of a current and/or previous spouse or common-law partner in the five years preceding the survey. This compares to 7% of the population in the provinces. Residents of Nunavut were also far more likely to have been victims of spousal violence (22%) than residents of the Northwest Territories (11%) and the Yukon Territory (9%).

Similarly, police-reported crime rates in the territories were substantially higher than rates in the rest of Canada. Specifically, in 2005, crime rates in the North were over four times higher than rates in the provinces (33,186 compared to 7,679 incidents per 100,000 population). In 2005, the Northwest Territories had the highest police-reported crime rate among the three territories at 41,245 incidents per 100,000 population. This rate was 1.3 times higher than the rate in Nunavut, 1.8 times higher than that in Yukon and nearly three times higher than that in Saskatchewan, the province with the highest provincial crime rate (14,320)."

We heard a captivating and reflective keynote address by Justice Gerald Morin, Deputy Judge of the Territorial Court of the NWT and creator of the Cree Court in Saskatchewan. We were also were incredibly fortunate to have an evening performance by Leela Gilday, an award-winning Yellowknife singer and songwriter. Leela's songs were deeply moving and her voice was incredible. I was very glad that my meek keynote address came before her and not after her powerful performance!

Conferences such as this one offer all of us the opportunity to stop for a few days (well not really stop, it was a jam-packed agenda and people were working hard) but certainly the chance to get out of the trenches to connect and reflect on the work that we do. I met some victim support workers who had some significant challenges in their own lives (dealing with fostering several children with fetal alcohol syndrome, to name just one) and the complexity of offering services in a remote community, where everyone knows you and where you are often the end of the line. To all of these workers, I offer my most sincere thanks for their warmth, their open hearts and their willingness to participate in the workshops I offered.

A quick note in transit

2009-09-27T11:48:00.005-04:00

This will be a short post as I am just touching down in between trips, coming in from Charlottetown, doing my laundry, kissing the kids and heading straight back out to Yellowknife. (Well, I did bake some banana-bran muffins too, in a probably futile attempt to have my kids eat healthily while I am away, and, yes, I know I have control issues...). This week, I will be taking part in a large conference for professionals who work with victims of crime, organised by the Department of Justice for the North West Territories and Nunavut.

During my pit stop in Kingston, I had a chance to go hear some music. Live music can be so good for the soul (when it's good, I heard some pretty awful stuff last night) but I also heard the fantastic Canadian folk duo Dala. They can harmonize like nobody's business and have a great sense of humor and wonderful musical sense. It was such a treat.

I'll write more when I am back from Yellowknife. I hope you all have a good week, with a bit time to listen to some music perhaps?

Photo from MNR

Les Impatients: Quand l'art thérapeutique combat les préjugés

2009-09-21T17:33:00.004-04:00

Vous connaissez l'initiative d'art thérapeutique montréalaise des "Impatients," dont la porte-parole est Clémence Desrochers? Sinon, lisez un peu et voyez ce que vous en pensez...Quelle superbe projet!

Voici une citation du site web des Impatients:

"Le centre Les Impatients est un lieu d’expression et d’interprétation de l’art thérapeutique et de l’art brut. Il a comme double mission :

-D’offrir un lieu d'expression artistique aux personnes atteintes de problèmes de santé mentale.

-De favoriser les échanges avec la communauté par la diffusion de leurs réalisations.

Historique
 En 1989, la Fondation des maladies mentales, de concert avec l’Association des galeries d’art contemporain de Montréal, expérimente un atelier d’art-thérapie à l’Hôpital Louis-H. Lafontaine sous la direction de madame Suzanne Hamel, art-thérapeute.

En 1992, la Fondation des maladies mentales appuie la mise sur pied de la Fondation pour l’art thérapeutique et l’art brut du Québec qui ouvre un nouvel atelier à Pointe-aux-Trembles.

En 1999, la Fondation pour l’art thérapeutique et l’art brut du Québec choisit de se faire connaître sous l’appellation Les Impatients et ouvre ses portes en plein cœur du centre-ville afin de permettre à un plus large public de bénéficier des ateliers d’art-thérapie et de musicothérapie. Ces nouveaux locaux offrent des espaces pour la diffusion des œuvres des Impatients en présentant une programmation riche et diversifiée d’événements.

Parle-moi d’amour, événement principal de l’année, est une exposition-encan réunissant des artistes en arts visuels et des Impatients. Cette campagne de financement, qui a lieu au mois de février, est une source de revenus essentielle à la poursuite des ateliers qui sont offerts gratuitement aux participants. À cet événement s’est ajouté l’édition du coffret Mille mots d’amour."
Fin de la citation

Mille Mots D'amour

"[...] Cette année, Mille Mots d’amour en lecture en est à sa cinquième édition et on y trouve des lettres aussi prestigieuses que celles de Clémence DesRochers, Fred Pellerin, Rita Lafontaine, Lise Dion, Carole Laure, Nancy Huston, Leonard Cohen, même une inédite de Jacques Brel adressée à Clairette, son amie.

Mille Mots d’amour en lecture est un coffret qui regroupe 141 lettres d’amour de célébrités, journalistes, médecins, jeunes du secondaire et «impatients» qui profitent des ateliers de création de la Fondation Les Impatients. Grâce à la vente du coffret, cet organisme peut continuer d’offrir ses services à quelque 300 personnes atteintes de maladie mentale chaque année. On espère cette année amasser 80 000 $." Agnès Gaudet, Extrait du journal de montreal, 18-01-2009

Pour ma part, après avoir entendu une lecture d'une lettre d'amour au futur de Jacques Attali, j'ai immédiatement commandé mon coffret des lettres de 2009. Cette lettre m'a complètement bouleversée. J'aimerais bien quelle soit lue le jour (très lointain) de mes funérailles, mais je m'inquiète que dire cela à mes proches sera perçu comme une requête sinon inquiétante, du moins bizarre! Enfin, c'est l'effet que ça m'a fait - c'est une lettre pleine d'espoir et j'aimerais bien que ça finisse comme ça, quand j'aurai 100 ans.

Why are the four basic self care strategies so hard to implement in our lives?

2009-09-18T11:46:00.011-04:00

I recently asked an audience of about 100 people how many of them practiced or had ever tried relaxation training and/or meditation. Approximately 10 people raised their hands.

This is not an anomaly, it's the usual response I get. It's similar to the response I get when I ask groups how many of them would say that they:

1) Get enough sleep on a regular basis
2) Eat 3 healthy meals per day, with lots of fruit and vegetables, reducing caffeine, saturated fats and salt.
3) Exercise 3-4 times a week
4) Take breaks during the day to refuel and just chill out

Last time I asked this question, one person out of 150 said yes.

hmmm.

For those of you who are regular readers of this blog, you know that I feel very strongly about the importance of eating healthily for many reasons (cancer prevention, keeping diabetes at bay, increasing our immunity, weight control, the list goes on) but I am also very aware of the many obstacles we face: time crunch, financial constraints, food dislikes to name a few.

The exercise piece is tricky. A lot of people say to me "I'm not in good enough shape to go to the gym, I feel very self-conscious" and I totally respect that. A friend of mine (who went on to lose a significant amount of weight and run a marathon) could not walk around the block with me without having to stop to catch her breath. But she persevered, walked a bit faster each week, then started alternating running with walking (10 minutes of running, one minute of walking), an approach to running that is highly recommended by coaches at running clinics. It took a long time and a lot of hard work, but she started out small and eventually the results were life-changing.

Isn't that always the best way? To take small, realistic steps?

I invite you to reflect on the four categories above and see whether there is an area that you can celebrate. Is there something you are feeling particularly pleased with, in terms of self care? These can be very small steps (increasing my vegetable intake by one serving, taking 5 minutes off each day for the past week, etc.).

What would you commit to working on that is realistic and achievable for the week to come?

Take a couple of minutes to laugh

2009-09-15T09:23:00.003-04:00

I heard about this great blog yesterday called 1000 awesome things. The author's goal is to compile 1000 every day activities that bring you joy: "1000 Awesome Things is just a time-ticking countdown of 1000 awesome things. Launched a few months ago and updated every weekday."

So, take a break from your work and go read this hilarious blog. I really liked #679 Old School Sugar Cereal and #722 Watching seniors do water aerobics.

Sidetracked

2009-09-11T11:05:00.008-04:00

This was supposed to be a post about positive psychology and learned optimism. I normally mull over my posts all week and write them on Fridays but on Thursday night, I went to a lecture on burnout aimed at new medical students and I was uncomfortable with some of what I heard so I was forced to use my writing time for that instead. (forced by no one but myself, but you know how sometimes you feel strongly about things and so you can't focus on anything else? That kind of forced. Compelled, I guess, is more accurate.)

Although I enjoy public speaking, writing and blogging on my own terms, I am not very comfortable in the limelight of op-ed. Some people are incredibly good at it. You know: the witty yet caustic artfully crafted letters to the editor, the inflamed yet articulate caller on the radio phone-in show. Neither of those are within my comfort zone (or talent zone). In fact, my last brush with op-ed fame was about 6 years ago. It was a slow news week in the middle of July and a local print journalist became interested in my opinions related to playground safety (a long, boring story). The day after my piece was published, my friend tried to buy all the newspapers in our neighbourhood so I wouldn't read the incendiary letters to the editor mocking me and the position I had taken on this issue...Not a big deal, but not very comfortable either.

When it comes to public debate, I am more of a muller - when I experience something that troubles or upsets me, it often happens to me in slow motion, and I almost always need time to reflect and chew my ideas over before making a point or jumping into an argument. That does not make me a very strong debater, sadly, (although I am learning over time at the feet of a master of debate, my partner, who win arguments even on topics he knows nothing about! It's sometimes enraging but also kind of sexy).

But here goes nothing. My op-ed piece.

Dr Patch Adams: A muddled message about burnout

On Thursday night I attended (along with hundreds of young medical students) Dr Patch Adams' presentation "The Joy of Caring" which was held at the Biosciences complex on Queen's Campus, organised by the Aesculapian Medical Undergraduate Society. We were invited to hear "an inspirational talk including the exploration of burnout prevention for caregivers, and the power of care, not only in the patient’s life, but also in the caregiver’s life."

As a compassion fatigue specialist and someone who devotes nearly all of my time to providing education on burnout to health care professionals, I was very interested to hear Dr Adams' thoughts on this topic.

I was moved and rather awed by Dr Adams' total devotion to his life's goal (which is to offer free medical care to all), and the love and acceptance that he conveys towards his patients across the globe, particularly the most neglected members of society.

However, as I heard Dr Adams speak, I grew increasingly uneasy about one aspect of his message.

Throughout his talk, Dr Adams described his routine of working from 7am to 3am daily and having rarely, if ever, taken a day off work in his many years as a physician and therapeutic clown. He also spoke of a twelve year period where he and other physicians lived with their children and spouses in a six bedroom house which they ran as a free hospital, co-habiting with "5 and sometimes 50 patients at one time, sharing bathrooms, living rooms and bedrooms. Having no privacy whatsoever." Although he was not advocating that we all do the same, I wondered how his lifestyle was coming across to medical students around me - I wondered whether this was seen by some of them as something to aspire to, a gold standard of self-sacrifice - the sign of a truly dedicated doctor.

Then, I was startled by Dr Adams' main message which was that, in his opinion, "There is no such thing as physician burnout when you offer [the kind of medical care he offers]. Burnout is not possible when you care." I do agree with Dr Adams that it is often the system that burns us out rather than the patients themselves: the increasing volume of work, insufficient staffing, inadequate referral resources, etc.

But to state that "burnout does not occur when you care" is simply not true.

Based on very strong research (from 1995 onwards, see Figley, Stamm, Saakvitne and many others) the medical and other health care professions are recognising that there are serious problems with burnout that are intrinsic to helping others. It is in fact well established that there are serious consequences to overwork both to patients and physicians. We now know that working with patients can lead to the serious effects of compassion fatigue, vicarious trauma and burnout. Burnout is a term that has been widely used to describe the physical and emotional exhaustion that workers can experience when they have low job satisfaction and feel powerless and overwhelmed at work. Compassion Fatigue refers to the profound emotional and physical erosion that takes place when helpers are unable to refuel and regenerate due to the pace, volume or nature of the patient work they do. Vicarious Trauma has been used to describe the profound shift that workers experience in their world view when they work with patients who have experienced trauma. Helpers notice that their fundamental beliefs about the world are altered and possibly damaged by being repeatedly exposed to traumatic material. Vicarious Trauma occurs when the stories we hear from our patients transfer onto us in a way where we are secondarily traumatized and have difficulty ridding ourselves of the images and experiences they have shared with us. These problems can degenerate into clinical depression, post traumatic stress disorder, anxiety disorders and lead to alcoholism, suicidality and serious clinical errors, to name a few.

The good news is that there are simple and effective strategies that can protect us and help to mitigate these effects. We can provide care without suffering, and the answer is certainly not to deny or blame ourselves for experiencing burnout.

My concern is that Dr Adams' take home message to medical students Thursday night was that if you do not devote every waking hour of your life to patient care, you are a failure and possibly also a shallow, selfish, materialistic human being. Dr Adams may be thriving with his own pace of life and is clearly accomplishing wonderful things in the world. But I believe that for the rest of us mere mortals the best way to provide care to others is to first and foremost start within ourselves: Dr Charles Figley, the highly respected founding father of compassion fatigue says it best: "First, do no harm to yourself in the line of duty when helping/treating others. Second, attend to your physical, social, emotional, and spiritual needs as a way of ensuring high quality services to those who look to you for support as a human being. " (Green Cross Academy of Traumatology, Standards of Self Care Guidelines.)

This isn't a zero sum game: you do not take away from others by caring for yourself - it is, in fact, quite the opposite. We are far more effective caregivers if we have our own emotional house in order.

Community Events for Helpers in Eastern Ontario

2009-09-11T07:08:00.008-04:00

Here are three upcoming events that have come across my desk. Please note that I am passing these along for information purposes only. I am not involved in these events and cannot endorse them as such. But, if you do end up attending one of these events and want to recommend them or write a brief feedback for others, please email me: (whp at cogeco dot ca).

Beautitude: Where Beauty and Attitude Meet
This one day workshop is designed for women of all ages to begin taking better care of themselves. Through interactive activities, tools for self-discovery, media comedy and take-home materials you will learn strategies for refueling those empty tanks and enjoy a day of pampering and fun.

Where: Spa on Adelhi - 186 Adelphi Street, Napanee
When: Saturday, November 7, 2009; 9:30am-3:00pm. Morning refreshments and lunch included
Fee: $50 includes refreshments, lunch and materials
For more information or to register please contact:
Cheryl Shurtliffe at 613-358-2571 or beautitude@roomtomove.com

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Practical Tools – Addiction and Trauma Tools for General Helping Professionals

With Tom Regehr, Director CAST-Canada
Date: 20 Nov 2009 - 09:00
Where: Kingston ON
Cost: $140.00 + GST = $147.00 CAD
Click here for more information

Since 2004 CAST Canada has held 49 Consumer Panel discussions around central Ontario. Over 1,800 frontline workers have worked directly with CAST Canada volunteer consumers to identify these special ideas as valuable and work together with them to create relevant, practical tools. The ideas were then workshopped further in the ToolBuilder series of small groups of workers around the province. The product is a set of finely tuned, extremely practical tools.

Tom Regehr began offering speeches about his healing from trauma, addiction and homelessness in 2003 while promoting a self-help group he founded named “Come And Sit Together” (CAST). After noticing high energy and emotion in the questions around these issues he held events with several friends healing from the same issues to answer this need.

“We call ourselves addicts usually, but it is more than that, you might say ‘Addicts, healing and helping.’ “

Audiences include frontline helping professionals, universities and corporations. From this process has evolved specialized trainings and workshop based on women’s issues, youth and homelessness.

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Providing Therapy for Adult Survivors of Childhood Abuse

Mondays, September 28 - December 15, 2009
5:30 pm to 8:00 pm
Location: 234 Concession St, Suite #200
Fee: $600 for 12 Weeks

This course is intended for professionals who work with, or want to work with, clients who are adult survivors of childhood abuse. It will provide practical training in various aspects of how to do this specialized therapy. Each class includes explanations of the main topic and what to do about it in session with the client. It is organized as a small group, in a comfortable setting, to encourage maximum participant involvement in questions and discussing the course material.

This training will cover topics including:

* How this work changes you as a therapist
* How it is different to be raised by abusive people, by rapists
* Why children blame themselves
* Traumatic bonding
* Adult symptoms of child abuse
* Problem therapies and problems with some therapies
* Why & how therapy works
* The practical details of how to conduct client-centred therapy through the three main stages of good child abuse therapy

Class for the first session begins Monday, September 28 to Monday, December 15/2009.
12 weekly evening classes are from 5:30 pm to 8:00 pm at the Centre’s office.
The cost for all 12 classes is $600. This is an introductory price for the first ever offering of these classes. Space is limited.
Certificates will be presented upon completion, and this course can be used as a tax deduction.

Download a registration form here
For more info email: therapycentre@cogeco.ca

Mindfulness-Based Stress Reduction: an Important Tool in Mitigating Compassion Fatigue in Helpers

2009-09-03T11:13:00.015-04:00

Mindfulness-Based Stress Reduction (MBSR) is a holistic mind/body approach developed by Jon Kabat-Zinn at the University of Massachussets Medical Center in 1979. MBSR is "[...] based on the central concept of mindfulness, defined as being fully present to one’s experience without judgment or resistance". (Cohen-Katz et al, 2005) The MBSR program recommends using meditation, yoga, relaxation training as well as strategies to incorporate these practices into every day life.

Research on the effectiveness of MBSR is highly conclusive: over 25 year of studies clearly demonstrate that MBSR is helpful in reducing emotional distress and managing severe physical pain. In fact, MBSR has been used successfully with patients suffering from chronic pain, depression, sleep disorders, cancer-related pain and high blood pressure. (Cohen-Katz et al, 2005) Based at Toronto's CAMH, Zindel Segal has developed a mindfulness-based cognitive therapy program for treating depression that has shown to be highly effective.

MBSR and Compassion Fatigue

Researchers recently turned their attention to the interaction between MBSR and compassion fatigue (CF), to see whether MBSR would help reduce CF symptoms among helpers. One study of clinical nurses found that MBSR helped significantly reduce symptoms of CF, as well as helping the subjects be calmer and more grounded during their rounds and interactions with patients and colleagues. (Cohen-Katz et al, 2005) Another study investigated the effects of teaching mindfulness-based stress reduction to graduate students in counseling psychology. The study found that participants in the MBSR program "reported significant declines in stress, negative affect, rumination, state and trait anxiety, and significant increases in positive affect and self-compassion." (Shapiro, 2007)

The Full MBSR Program

"The MBSR is taught as an 8-week program that meets approximately 2.5 hours a week and includes a 6-hour daylong retreat between the 6th and 7th weeks. Participants are asked to practice the mindfulness techniques 6 days a week as “homework” and given audiotapes to facilitate this. Group sessions include a combination of formal didactic instruction on topics such as communication skills, stress reactivity, and self-compassion and experiential exercises to help participants integrate these concepts. The program is described in detail in Kabat-Zinn’s textbook “Full Catastrophe Living: Using the Widsom of Your Body and Mind to Face Stress, Pain and Illness.” (Cohen-Katz et al, 2005)

As you are reading this, you may be thinking: "I don't have time to take part in a 2.5 hour, 8 week program!" Nor do you have to - let's extract the main features of MBSR and see how you might integrate them in your own life routines.

Incorporating MBSR into Your Life

The key strategies of MBSR mirror the best compassion fatigue reduction techniques described in my book The Compassion Fatigue Workbook: developing self awareness, self-regulation (how to cope when events are overwhelming and/or stressful) and how to balance the competing demands in our lives. (Shapiro, 2007)

In the Shapiro study with counseling students, five mindfulness practices were taught, adapted from Kabat-Zinn's program:

1) Sitting meditation: This is the cornerstone of MBSR - To develop, over time, a sitting meditation that is done daily, if possible. It involves the "concentration of attention to the sensations of breathing, while remaining open to other sensory events, and to physical sensations, thoughts and emotions."

2) Body scan: A very effective exercise from the field of relaxation training and stress reduction. The full version of the body scan encourages you to focus on each part of your body one after the other, to identify where you are holding tension. This process is normally done lying down, in a quiet room. If time does not allow you to do the full scan, you can also carry out a modified version of the body scan:

Sitting in a quiet, peaceful room, close your eyes and focus on your breathing. Notice what is happening in your body: Working your way down from the top of your head, notice how your jaw, neck and shoulders are feeling at this moment. Remember to keep breathing and, if your mind wanders, gently bring it back. If that is all the time you have, take three, slow deep breaths through your nose and gently open your eyes. If you have more time, work your way down your body, noticing how your shoulders, arms, stomach, calves and toes feel right now.

Where to find the full body scan exercise:

Web: Through Google, I was able to find several audio and scripted body scan exercises in a matter of seconds. Here is a free body scan exercise script and audio.

CD: Creating Inner Calm by Mark Berber (only available at Indigo/Chapters, not Amazon)

Books: The Anxiety and Phobia Workbook by Edmund J. Bourne (2000)

3) Hatha Yoga consists of "stretches and postures designed to enhance mindful awareness of the body and to balance and strengthen the musculoskeletal system." (Shapiro, 2007)

4) Guided loving-kindness meditation: A meditation practice which focuses on developing loving acceptance towards oneself and others. You can find examples of loving-kindness meditation on the web.

5) Informal practices: Exploring ways to bring mindfulness into our everyday life (while waiting in line at the grocery story, stuck in traffic, dealing with a challenging patient, etc.)

Want to know more? Where to start?

You can learn more about MBSR on your own or by taking a course or attending a workshop.

On your own

Audio Cds: Kabat-Zinn has produced a collection of mindfulness meditation CDs that can be purchased on his website and on amazon/indigo. Your local library may also have them. Kabat-Zinn's site also has a useful FAQ which describes the different CDs and guides you on which one to buy. He also has an informative blog and resources.

Reading:
Kabat-Zinn, J. (year) Full Catastrophe Living: Using the Widsom of Your Body and Mind to Face Stress, Pain and Illness.

Kabat-Zinn, J. (1995) Wherever you go, there you are: Mindfulness Meditation in Everyday Life.

Segal, Z. et al (2002) Mindfulness-Based Cognitive Therapy for Depression.

Video:
If you can get your hands on it, a good introduction to MBSR is offered in Bill Moyers' 1993 PBS Special "Healing and the Mind" featuring Kabat-Zinn in the Stress Reduction Clinic.

Courses/Workshops
Many mid to large sized cities offer MBSR programs several times a year. Contact your local meditation/yoga centers to see if one is being offered in your community.

Final thoughts

If you are new to meditation practice, the most important thing to remember is that you cannot fail at meditation. There will be times where you can meditate with ease, and other times where your mind will be racing and you will have great difficulty focusing on being mindful. (You may also fall asleep). All of those are part of the process of mindfulness practice. Try not to judge your meditations. Simply try to refocus on your breath and on the meditation itself. It takes time and practice but it could literally save your life.

Sources:

Cohen-Katz, J., Wileys, S.D., Capuano, T., Bakers, D.M., Kimmel, S., & Shapiro, S. (2005). The effectis of mindfulness-based stress reduction on nurse stress and burnout, Part II: A quantitative and qualitative study. Holistic Nursing Practice, 19, 26-35.

Shapiro, S., Brown, K.W, & Biegel, G.M., (2007) Teaching self-care to caregivers: effects of mindfulness-based stress reduction on the mental health of therapists in trainining. Training and Education in Professional Psychology, Vol. 1, No. 2, 105-115.

photo from freedigitalphotos.net

September - A time for (achievable) resolutions?

2009-09-01T11:42:00.006-04:00

Whether or not we have children returning to school, many of us make resolutions in September. They often have to do with our lifestyle: to eat more fruit and vegetables, to sign up for a class, to go to the gym more often, to make menus and plan for the week ahead, etc.

Some of these resolutions become incorporated in our lifestyle, and others quickly fall by the wayside because they were either unrealistic, too ambitious or we got caught up in the busyness of life again and ran out of time. (Or, the therapist in me would suggest, we have not yet done the necessary emotional prep work to make this change possible.)

Suggested Activity:
Before the Fall gets too hectic, I would like to invite you to take a few minutes today to take stock of one of the following areas of your life:

Physical health
Physical exercise
Clutter
Finances

There are many other good categories we could explore, but this will do for today.

Take a blank sheet of paper and a pen (or your laptop) and select the first category that jumps out at you. Write this category down at the top of your sheet. Now, write down whatever thoughts or words come to your mind in reaction to this category. For most of us, these initial jots will likely be negative or "shoulds" e.g.: Physical health - haven't been to doctor in three years, back is sore, worried about mole on back, etc.

Write as many items down as can fill a sheet. Now turn the sheet over and write down all the positives about that category - your strengths or things that you have improved on.

Once you have written as many things as you can, have a think about one micro-movement you could make towards improving that area of your life. Micro-movements are a concept put forth by SARK in her book Make your Creative Dreams Real. It can be as small as you want. Examples would be: "I will book a doctor's appointment by the end of the month", "I will eat one more fruit per day starting tomorrow", "I will clean out one drawer in my messy office on Friday".

Once you have this mini resolution, write it down in your daytimer, agenda or calendar. To make this resolution even more solid, ask a friend of yours to be your accountability buddy or, if you want, you can post your commitment on this blog (it can be anonymous) in the comments section.

I am quite pleased with my own Fall resolution: I decided to delegate lunch making in my home. My children now make their own lunches - I still make the sandwich and they do everything else. I'm not sure how I ended up winning the easiest job but they both seemed really pleased with themselves when I said "ok, I'll do the sandwich and you do the three peanut-free, garbage free snacks which includes having to rummage through the plastic container cupboard in a futile search for the corresponding lid. Ok?" So I have now gained a full thirty minutes each morning (yes, that is how long it was taking me, don't ask, I don't know why, but it was).

Have fun with the resolution and make it realistic and achievable.

Back to school! C'est la Rentrée...

2009-08-27T11:01:00.010-04:00

I've always liked the French term for the start of the school year. It's called La Rentrée. For me, it evokes shiny red apples, plaid skirts and brand new, rather stiff black patent leather shoes. Of course, I'd always end up wilting in the heat of the school yard during the first weeks of September, but it felt important to start the year with Fall stuff.

Actually, I am not going back to school, but the whole world around me seems to be heading back next week. I am back at work however, and so this is my own little Rentrée. I took a long break this summer, working part-time, doing a lot of reading and spending time with my family. Every summer, my kids and I endeavour to make some new food product from scratch (my own little contribution to "Where Things Come From"). Last year we made butter and ice cream and this summer we tried our hand at yogurt, sprouts and mozzarella. My husband laughed himself silly when he found out that a small ball of mozzarella required 8 litres of milk but the kids enjoyed the process and the degustation. Now I need my own dairy cow I guess...

I am looking forward to this coming year and wanted to begin by telling you about upcoming events.

Upcoming workshops

This Fall, I will be offering the two day Compassion Fatigue Train the Trainer retreat in Kingston November 24-25th. This workshop is designed for individuals who have not yet attended a full day or half day Walking the Walk workshop. If you are interested in the Train the trainer but already have Walking the Walk under your belt, please consider the March 3-4th session which has been designed for those with past Walking the Walk experience (there is also the option to attend Walking the Walk the day prior to this training, on March 2nd, 2010). For more information on these workshops click here.

I am also co-teaching the three day Crisis Intervention Institute from October 26-28th 2009 in Kingston. The emphasis of this course is on developing a thorough understanding of crisis-intervention and crisis management and the development of effective, concrete crisis-intervention skills. It is suitable for professionals in the field of mental health (psychologists, social workers, nurses, counsellors, physicians, crisis workers), and students in these disciplines. Dr Mike Condra and I have been offering this workshop for the past 6 years every Fall.

Invited lectures/workshops

I will be travelling all over the country this Fall, from Yellowknife to Prince Edward Island. In fact, I am nearly fully booked until December. If you are interested in booking an event, please email me and I can either offer you a Winter/Spring date or one of my associates can come to your agency in the Autumn: I am now working with three highly talented compassion fatigue educators who work in the field and have received rave reviews during past workshops.

What's in the works?
I am currently working on the following projects:

The Compassion Fatigue Workbook: I am currently in discussion with a public agency and we are exploring turning this program into a web-based course. As some of you know, the Compassion Fatigue Workbook is now available for sale at our online bookstore.

I am also working on the Stories from the Frontlines book, based on interviews with helping professionals.

This Blog: I will be posting strategies and book recommendations every Monday starting next week. If you want to receive notification of new posts, consider registering as a follower of this blog (you will see a sign up box in the upper left corner of the page called "Subscribe to Blog").

Please do not hesitate to drop me a line via email or through this blog. I wish you a great Rentrée.

(photo courtesy of www.freedigitalphotos.net)

Alimentation et cancer: une entrevue avec le Dr Béliveau - à écouter

2009-07-07T12:50:00.002-04:00

As I wrote in a prior post on preventive medicine, Dr Béliveau has carried out a great deal of reseach on the link between cancer and the foods we eat.

Dr Béliveau is a biochemist who works as a research scientist at two Montreal Universities. He is an expert in cancer prevention and is also a gifted communicator who aims to bring his lab findings to our dinner tables. He has written three books on cancer prevention and nutrition: Foods to Fight Cancer, Cooking with Foods that Fight Cancer and his most recently released Eating Well, Living Well: Everyday Preventive Medicine which will be available in English in the Fall of 2009.

He was interviewed by Yannick Villedieu on Radio Canada in February 2009. I had the opportunity to hear it rebroadcast last Sunday. If you speak French, I recommend you follow the links to hear this highly informative interview.

If you don't speak French and you missed my original post, I invite you to return to read it. You will find the same take-home message in the post.

Summer Hiatus for blog and how to stay informed

2009-07-05T07:30:00.004-04:00

(free photo from Pediant, wikicommons)

I am going to be posting off and on this summer. I will not be posting every Sunday as I have been doing for the past year and a half but rather going to "summer hours". To receive information about new posts, I invite you to subscribe (see left column of the blog). You will then receive an email notification once I post again.

I am spending most of July working half time. I am able to do this thanks to an "x over y" plan that teachers are familiar with: you save part of your monthly salary each month in order to be able to take time off later. Being self employed offers no benefits, no unemployment insurance and no job security whatsoever, but it does offer the flexibility of being able to work or not work as you decide.

So I am spending the month dealing with home improvement projects that have been lingering for years (that darned basement..., the leaky taps, the paint jobs that have been waiting, many trips to the local charity dropoff and Habitat for Humanity to get rid of all the clutter that we have accumulated, god knows how.)

I am also simply taking time to enjoy the all too brief summer we have in this part of the world. One of the things I most enjoy is to bike down to the shores of lake Ontario and go watch the windsurfers on Richardson beach. This is nearly olympic-level surfing - a very wild patch of the lake, and I love watching them fly in the air and flip themselves around. I like to pretend to myself that I too, have the upper body strength and the skill to be there with them (I don't doubt my abilities to do other things, such as run a half marathon, but I seriously doubt my capacity to windsurf on this crazy lake! But it's fun to dream...)

I hope you have some time to breathe this month, and are able to carve out a bit of time for you.

Upcoming Compassion Fatigue Workshops

2009-06-28T15:47:00.004-04:00

peonies from my garden. A brief burst of colour to start the summer.

Walking the Walk: Creative Tools for Transforming Compassion Fatigue
March 2nd, 2010 Donald Gordon Centre, Kingston, On., 8:30am-4:00pm

Instructor: Françoise Mathieu, M.Ed. CCC. Compassion Fatigue Specialist

Workshop Description: Compassion fatigue is a normal consequence of working in the helping field. The best strategy to address compassion fatigue is to develop excellent self care strategies, as well as an early warning system that lets the helper know that they are moving into the caution zone of Compassion Fatigue. This is a highly interactive one day workshop, incorporating a combination of solo, small group and whole group activities.

Topics covered will include: Understanding compassion fatigue and vicarious trauma. Symptom checklist, targeting areas for strategic planning; Evaluating self-care, identifying triggers; Developing a personalised strategic plan for identifying and treating compassion fatigue.

*This workshop is also a prerequisite for the two day CF Train the Trainer workshop which will be offered immediately following the March 2nd training.

Who should attend? Helping professionals in the fields of mental health, health care, education, emergency services, corrections and law enforcement, volunteers and caregivers.

Cost: $165.00 (incl gst) includes lunch, breaks and handouts.

Compassion Fatigue Train the Trainer Retreat
March 3 & 4th 2010. Donald Gordon Centre, Kingston

Instructor: Françoise Mathieu, M.Ed. CCC. Compassion Fatigue Specialist

Workshop Description: This workshop offers tools, handouts, training material, strategies and marketing tips to adapt the one day Compassion Fatigue Workshop Walking the Walk to your community's specific needs (and to your own presentation style).

**Prerequisite: This workshop is aimed at helping professionals and educators in the helping fields. Prior attendance to full day or half day Walking the Walk is highly recommended. Walking the Walk will be offered on March 2, 2010. Please email whp at cogeco.ca for more information.

Cost: $598.00 (incl gst) which includes lunch, breaks, training manuals, power point presentation and handout templates. **Space is limited to 20 participants for this retreat.

More information and registration forms will be posted on the website next week

Interesting speech on Compassion Fatigue

2009-06-18T06:06:00.002-04:00

I came across this speech on the blogosphere. It was written by the Jeremy Adam Smith, senior editor of the Magazine Great Good, an online publication whose mission is described as follows on their site: "Greater Good highlights ground breaking scientific research into the roots of compassion and altruism. It fuses this science with inspiring stories of compassion in action, providing a bridge between social scientists and parents, educators, community leaders, and policy makers."

This speech was given as a talk to nurses of UC Berkeley Health Services on surviving compassion fatigue.

Low impact disclosure: Just a warning before you read it: the first portion of the speech describes a brief but violent attack (the author was mugged which is the beginning of the story) and some of you may not want to read it for that reason.

Try this at home: The Five Key Elements of a Self Care Retreat

2009-06-14T06:41:00.013-04:00

(Photo: Late June in Umea, Sweden)

I have just finished a busy past two weeks. I offered a full day training in Toronto, a shorter presentation at a PTSD conference and at a conference for community social services and finally the two day Compassion Fatigue Train the Trainer. I also had the opportunity to hear Babette Rothschild present grounding techniques from her very useful book "Help for the Helper". I have also been processing orders for the new Compassion Fatigue Workbook which I am very happy to now have available for helpers who are looking for more resources to work through CF strategies on their own or as a team.

Now, thankfully, there is a bit of time to process and digest it all, (and weed the garden a bit.)

I had a widely varied group of participants at the train the trainer workshop: veterinarians, managers from homeless and women's shelters, hospital social workers, addictions counsellors, to name a few. In our discussions, we discovered that the challenges we face are far more similar than they are different - whether you are working with pet owners or with humanoid patients, there is a strong human factor in the work: people are grieving, people are angry (often at us, for a flawed system, for a lack of resources, maybe for errors we make or errors they perceive we made). Dealing with loss, grief and anger takes its toll on us, and so does having to turn people away when we simply do not have the resources to help them.

Having a two day retreat with a small group of helping professionals is a rare opportunity to talk and reflect (in a very lovely environment - the centre where I hold these workshops is beautiful) and that alone is worth its weight in gold, in giving us all the opportunity to replenish ourselves.

I think that we need to look at small ways to create retreats for ourselves even if we do not have the time or money to go to a train the trainer workshop or an actual retreat. Here are some suggested steps:

A Retreat plan for yourself

1) Get your daytimer and book a day off (two is even better). Make sure that the entire day is free. If you have more financial resources, consider booking yourself into a local B&B and make this retreat an overnight event. You can also buddy up and plan the retreat with a colleague or two, but make sure they are committed to making this a replenishing experience and not talk shop.

2) Plan your day, making sure that you will include three key components: Stress Reduction, Relaxation and Resilience. What does this mean?

(The following text is excerpted from The Compassion Fatigue Workbook. If you would like to receive an excerpt of the book, please send me an email: whp at cogeco.ca or visit my website and click on Resources and Links.)

Eric Gentry, compassion fatigue scholar and co-developer of the Accelerated Recovery Program (ARP) for helpers with compassion fatigue, wrote a powerful article in 2002 called The Crucible of Transformation. I highly recommend that you read it. To obtain a pdf of the article, simply Google: Gentry crucible of transformation and then download the article from his website: www.compassionunlimited.com. (Make sure you do not download the one from the website Gift from Within as it is incomplete. For some reason, visiting his website directly does not work but googling does.)

In this article, Gentry offers two important principles that are critical to remaining healthy in the face of the challenges of our work:

“These two important principles, which have become the underlying goals for our work in the area of compassion fatigue, are: (1) the development and maintenance of intentionality, through a non-anxious presence, in both personal and professional spheres of life, and (2) the development and maintenance of self-validation, especially self-validated caregiving. We have found, in our own practices and with the caregivers that we have treated, that when these principles are followed not only do negative symptoms diminish, but also quality of life is significantly enhanced and refreshed as new perspectives and horizons begin to open.” (Gentry, 2002)

Let us highlight the two key concepts from that paragraph:

“(1) the development and maintenance of intentionality, through a non-anxious presence, in both personal and professional spheres of life, and

(2) the development and maintenance of self-validation, especially self-validated
caregiving.”

What does this mean exactly?

A non-anxious presence refers to the ability of being in the room with the client’s pain and suffering and being able to express empathy and compassion without taking on the other person’s suffering. In both the personal and the professional realm, it is about mindfulness, the ability to notice and control your physical symptoms of stress and anxiety, and your breathing. It is a concept that is explored in depth by Babette Rothschild, author of Help for the Helper: the psychophysiology of compassion fatigue and vicarious trauma (2006).

“Self-validated caregiving” refers to self-care that is guilt-free, self-care that is prioritised as a means of remaining healthy in this line of work.

So, reflect on this for yourself:

What stress relief strategies do you enjoy? Examples of stress relief are taking a bath, sleeping well or going for a massage.

What stress reduction strategies work for you? Stress reduction means cutting back on things in our lives that are stressful (switching to part time work, changing jobs, rejigging your caseload, etc.)

What stress resiliency strategies can you use? Resiliency strategies are relaxation methods that we develop and practice regularly, such as meditation, yoga or breathing exercises.

Ok, now let's return to our Retreat plan:

Step one (a discussed above): Carve out some protected time for yourself, either on your own or with a good friend/colleague.

Step two: Make sure that your day has the five following elements:

1- Plenty of unstructured time to rest, nap, read (something unrelated to work), sit, swing in a hammock, lie on your bed...

2- A physical component: sign up for a fitness class, go swimming, stretch, run, go for a long walk around your neighbourhood or if you need a change of scenery, take public transit or drive to a completely different part of your community. If you can afford it, book a massage for your retreat day.

3- A relaxation component: Consider downloading a relaxation tape from itunes, or purchase a relaxation cd from your local bookstore (I recommend Mark Berber's Creating Inner Calm, which is available at Chapters/Indigo) and trying out one or two relaxation or deep breathing activities.

4 -A stress resiliency activity: Consider taking a yoga class or trying out a brief meditation tape from itunes.

5-During this day, eat healthy, simple food, try to avoid caffeine and any other stimulants. If not drinking caffeine is a problem for you in terms of withdrawal, try and have just one cup in the morning and reduce the rest of your day's caffeine intake.

What may happen during this day: You may feel wonderful at the end of your mini retreat, or you may find that it was a very dificult day for you. This is important information. First of all, slowing down and letting go of our daily concerns takes time and practice. Secondly, working in this field, and having to live with compassion fatigue and vicarious trauma within us, sometimes stopping and slowing down means that we are letting our guard down. This guardedness is actually something we use as a protection mechanism during our daily working lives. So you may find that your day off is filled with images, thoughts about work or about certain clients etc..

If you find that this is very strong, and difficult to deal wtih, I strongly recommend that you consider seeking the support of a trained counsellor or psychotherapist who understands compassion fatigue.

You may also find that you need to practice being in a retreat mode and that it takes a few times to get it right. I recall the first time I ever tried mindfulness meditation was at an all day mindfulness retreat (no half measures for this gal...) and it was a very uncomfortable day for me. I felt twitchy, bored, restless and eager for the day to end. As we were walking out of the retreat day, my colleague who had come with me looked totally relaxed and blissed out. I said "so, how was it for you?" She replied "oh, wonderful, refreshing, so relaxing. I feel fabulous." I was lucky enough to experience the replenishing qualities of mindfulness meditation a few years later, but I learned that meditation takes practice and a lot of kindness towards ourselves: we can't necessarily speed our way through it.

Your retreat will be whatever it is - easy, hard, challenging, replenishing - set the bar low. The main step is to actually carve out time away from work and other family and life commitments. From there on, it's all gravy.

Let me know how it goes.

75 Self Care Strategies from the Leading Edge Seminar June 1st, 2009

2009-06-07T15:58:00.002-04:00

Here is, as promised, the list of the 75 self care strategies workshop participants came up with during the June 1st presentation of Walking the Walkin Toronto. I invite you to read through them and see whether you could make a commit to following through on three of the strategies in the coming month?

1. Try a new delicious sounding recipe
2. Hire a housekeeper
3. Leave the office at least 3 times per week at lunchtime
4. Get out of the city and reconnect with nature
5. Sit by the ocean/lake/water
6. Bike riding
7. Watch an emotional movie
8. Lose the fear of digital photography
9. Read more novels
10. Learn 1 new piece of music
11. Take your lunch to work
12. Take a walk at lunch
13. De-clutter at work
14. Be more respectful of work hours
15. Stop procrastinating with paperwork/admin
16. Develop and value transition ritual from work to home
17. Do something physical
18. Pack a lovely lunch once a week
19. Sit in a park once a week, walk in the woods and look at the trees
20. Outsource your least favourite household task or delegate to partner (eg cleaning the house, gardening, vacuuming the car)
21. Go out and have fun once a week
22. Explore community options (eg free yoga class at centre, AGO free on weds nights)
23. Arrange for regular peer consultation
24. Have lunch once a week with colleague
25. Have lunch once a week with a person in another field
26. Find a poem and share it with someone
27. Try a new restaurant/cuisine
28. Try something new: a language, music, hobby, skill, sport
29. Have a "media fast" for a week including cell phone if possible
30. Get outside into nature
31. Go out for ice cream in the middle of the day
32. Take a course that is not work-related
33. Tour of museum/gallery (i.e. learn from another expert)
34. Carve out 3 hours per week without a plan
35. Close your office door for 30 minutes per day
36. Step outside every day for 15 minutes
37. Exercise for 30 minutes per day
38. Listen to or play music for 20 minutes per day
39. Enjoy/pay attention when eating (don't multi task)
40. Take 15 minutes per day for quiet reflection
41. Go to bed 30 minutes earlier at night
42. Take breaks during work: walk, stretch, balance fluids, have a protein snack midmorning and midafternoon
43. Debrief with colleagues
44. Adapt schedule ie: don't schedule challenging clients back to back
45. Create a calming environment at work: plant, music
46. Create a nurturing environment at home: orderly, tidy
47. Break down dreaded tasks
48. Hire experts to get some of your chores done
49. Cook extra for lunches
50. Baths
51. Spend more time with partner/spouse
52. Once a month, clean your car inside and out
53. Buy yourself flowers regularly
54. Schedule 1 day per month off work for yourself
55. Get a massage
56. Organise your desk at work
57. Schedule a self-nurturing activity every two weeks (e.g. spa, nice meal, movies, etc.)
58. Sleep in
59. Drink water
60. Read something fun (not professional and not news)
61. Declutter your home and/or office
62. Take walks
63. Annual time off to prioritise and plan year
64. Be mindful
65. Get supervision
66. Get trainings by theme
67. Plan social get-togethers
68. Do something you've never done
69. Set limits, say no and don't backtrack
70. Spend quality time with loved ones
71. Have fun on a regular basis
72. Develop a hobby unrelated to work
73. Read fiction
74. Hang out with positive people
75. Plan menus in advance

The Compassion Fatigue Workbook is finally ready!

2009-05-31T11:03:00.003-04:00

The Compassion Fatigue workbook is based on the one day workshop Walking the Walk: Creative Tools for Transforming Compassion Fatigue, which has been offered across Canada to thousands of helpers in the fields of healthcare, community mental health, correctional services, education and the military since 2001. This Workbook was designed for distance learners and those who prefer working at their own pace.

The Workbook offers a comprehensive description of compassion fatigue and vicarious traumatization and leads the reader through experiential activities designed to target specific areas in their personal and professional lives. It provides concrete strategies to help the reader develop a personalised strategic plan for identifying and transforming compassion fatigue and vicarious traumatization.

Topics covered include:
Understanding compassion fatigue and vicarious trauma
Symptom checklist, targeting areas for strategic planning, understanding warning signs
Assessing contributing factors; Evaluating self-care, identifying triggers
Solutions: personal, professional and organizational strategies

No. of pages: 85 pages - Spiral bound
Copy Price: $59.00 CAN plus shipping
**Bulk rates available for orders of 20 copies or more. Contact whp@cogeco.ca for bulk orders

To purchase this workbook, you can visit the CF Solutions Bookstore.

Interesting interviews on CBC radio on two kinds of oil: the one we eat and the one we burn

2009-05-26T10:30:00.003-04:00

CBC Radio's The Current is an excellent current affairs show that airs weekday mornings. I caught two fascinating interviews in the past two days:

1) An interview with Jeff Rubin, former Chief Economist of CIBC World Markets on his new book "Why Your World is About to Get a Whole Lot Smaller: Oil and the End of Globalization" Listen to the podcast by clicking here.

2) This morning, Anna-Maria Tremonti spoke to Dr David Kessler about his new book "The end of overeating: taking control of the insatiable american appetite". Kessler is the former FDA commissioner under presidents Bush and Clinton. The podcast should be up by the end of today.

Nuts and bolts

2009-05-23T17:41:00.010-04:00

(Springtime in Umea, Sweden)

-Compassion Fatigue Workshop: If you would like to attend one day Compassion Fatigue Workshop, I will be presenting in Toronto on June 1st, 2009 via Leading Edge Seminars. I invite you to visit their website for more information.

-Compassion Fatigue Workbook: I have not been posting as regularly as usual because I have been busy working on the final revisions of the Compassion Fatigue Workbook, which is going to press next week. I have been toiling on this workbook for several years now (and, yes, let's be honest, procrastinating as well, which means that my office is completely free of clutter right now, down to the last paper clip), but finally, the workbook is ready. It will be available on the CF solutions bookstore in a week or so. It was designed as a distance learning version of the one day CF workshop - the goal is to offer the experiential and academic material in a user-friendly workbook format.

-Mindfulness: I have been truly enjoying simple activities that make life such a wonderful thing: flying a kite with my best friend last weekend - a chinese dragon with a very long tail (the kite, not my friend), going to sleep in crisp, freshly laundered sheets that were dried on the laundry line in the sun (there is no smell like it, no wonder soap companies try to match this fragrance, but it cannot be done). Eating a plate of freshly picked fiddleheads in vinaigrette. Planting beans and tomatoes and hoping the squirrels don't eat them all.

I am always amused by the way Spring lands on our doorstep in this part of Canada. It's not a gradual event, rather it's an explosion - two or three hot days and boom spring is here and the buds are exploding and everything is sprouting in a matter of minutes.

Totally unrelated: just came back from viewing the new Star Trek movie - loved it! If you were a fan of the original series, you will not be disappointed. If you have no idea what Star Trek is, you're clearly younger than me!

Now back to writing and proofreading. I hope you have a chance to enjoy simple moments of mindfulness too.

Upcoming workshops of interest

2009-05-13T07:13:00.001-04:00

PREVNet presents is 4th Annual Conference

Life without Bullying:
Highlighting the latest knowledge, tools and strategies to address bullying issues from infancy through adulthood with
Canada's leading experts.

June 5th, 2009
Metro Toronto Convention Centre
Toronto, On.

Click here for Online Registration

The registration fees are:
$270 CAD (tax included) after May 1, 2009
$100 CAD (tax included) for Students that show proof of full-time enrollment during sign-in at the conference.

Note: Online registration requires a credit card payment. If you prefer to pay by cheque, please contact Caroline Teske (PREVNet’s Administrative Coordinator) for mail-in registration forms at: prevnet@queensu.ca or phone: 613-533-2632.

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Grounding Trauma: 2 day national conference

June 23-24, 2009
Huron University College
London, On.

Cost: $280 plus gst
To register: email gt@cast-canada.ca
For more info: www.cast-canada.ca

The Grounding Trauma Conference:
The effects of traumatic stress and loss are a persistent factor for people working in the helping professions. Any lack of acceptance, training or comfort with traumatic stress and loss may cause pain to both clients and workers.

What is working well?
We are presenting many informative workshops about successes in working with trauma survivors as well as support for the worker and organization.

What more needs to be done?
Are post-secondary programs adequately preparing students to do this work? Are agency work environments as supportive to staff and clients as they could be? We will explore what needs to be done and how can we start doing it !

Highlights:

Dr. Rick Csiernik - "Trauma Exposure and the Social Work Practicum"
author of "Responding to the Oppression of Addiction." Prof Csiernik will present his research on trauma experienced during social work student practicums at one Canadian school of Social Work.

Hannah Sherebrin, RN ATR - "The Puzzle - an Art therapy Support group model" A hands on workshop. Hannah has been leading art therapy groups in Israel for parents whose children have been killed by terrorists or the army.

2009-05-08T11:31:00.002-04:00

I realise I haven't posted in a while as I have been travelling a fair bit. First port of call two weeks ago was Sarnia, then Brantford and now Winnipeg. I also had the pleasure of hosting Dr Pat Fisher for the 2 day Manager's workshop which was a very rich experience. I will post something longer when I return home. It is freezing in the Peg and snowflakes have been spotted!

Free ebook: Favorite Therapeutic Activities for Children and Teens

2009-04-22T11:50:00.002-04:00

"Practitioners Share their Most Effective Interventions: A collection of creative counselling techniques developed by practitioners from across North America" Edited by best-selling author Liana Lowenstein, available free of charge on her website.

Decluttering your life and your mind

2009-04-19T10:44:00.004-04:00

photo from http://www.freedigitalphotos.net

You may already be familiar with the benefits of decluttering and simplifying your home and work environments. In the past few years there have been several popular TV shows and books on the topic (The show "Clean Sweep", Julie Morgenstern's book "Organizing from the Inside Out", Patrick Fannings "The 50 Best Ways to Simplify Your Life: Proven Techniques for Achieving Lasting Balance" to name a few.) which all argue that getting rid of clutter is a great way to take control over our health and reduce stress in both our home and work life.

Our environment impacts us in many different ways - working with a supportive, positive colleague can make a highly stressful and demanding work environment much easier. Being unable to find any of the forms you need in a messy office can turn a simple task into a very stressful, blood pressure elevating exercise.

I have experienced first hand the benefits of getting rid of clutter and getting organised: when my living space is organised, I feel calmer, more serene. But I also know that when life is hectic, I often don't have the time or energy to get organised and the vicious cycle settles in: too tired to put thing away where they belong, frustrated because I can't find what I need, too frazzled to look properly etc.

Therefore, I am always on the lookout for new simple strategies that can be easily woven into the life of a busy person who works full-time and has young children at home. Here are some simple suggestions and resources:

Five minutes to being clutter-free:

Put 5 minute decluttering activities in your day timer. Cleaning all the drawers in your kitchen likely feels like an overwhelming (and rather unappealling) task. But what about cleaning one drawer out? You could likely do that while talking on the phone with a friend. I often schedule simple 5 minute activities in my daytimer. Example from last week:
Monday: "throw 2 curtains in the wash"
Wednesday: "clean out 1 kitchen drawer"
Friday: "clean bathroom cabinet"
Saturday: "clean one window"

And so on. Notice that I don't have a decluttering activity scheduled each day. These small activities make me feel that I am "taking care of the to do list" yet never facing a gigantic chore which will increase the likelihood of procrastinating and putting it off.

A useful resource is the Get Organized Now website. It is a neat site that offers a monthly calendar of small activities to help you get organised. I don't personally follow the schedule but I signed up for the newsletter and get a monthly notice that there are new ideas and strategies.

Create a sanctuary - Focus on one space in your home
Another approach is to focus on one space in your home and make it clutter-free and serene. If you have young children, it may be impossible to get all the clutter out of the shared living space. Instead, can you focus on one area, say your bedroom or a little nook in the house and make it yours?

If you would like to read more on this topic, I recommend visiting Leo Babauta's website Zen Habits: Zen habits and Cheryl Richardson's book "Take Time for your Life."

Take 10 minutes per day to breathe
If you work in a stressful and hectic work environment, it is important to build in some simple strategies to decompress at the end of your day. I suggest you find 10 minutes in your day where you will be undisturbed: whether it is sitting in your car before heading home, on the subway with your ipod plugged in, or when you get home. If you are easily distracted and have difficulty spending 10 minutes sitting undisturbed, I recommend you purchase a simple breathing or relaxation cd or download a track from itunes. I suggest: Dr Mark Berber's "Creating Inner Calm" cd, available at Chapters/Indigo and on itunes "Encres de chine" by Fabrice Tonnellier and meditations with Dr Siddarth Ashvin.

Struggling with Debt? Here is a website and blog to visit

2009-04-16T13:20:00.002-04:00

Many of you may have come across Gail Vaz-Oxlade's show "Till debt do us Part" on television. In it, she meets with overextended debt-riddled couples and challenges them to drastically cut back on their spending. The lessons are simple and realistic yet clearly still hard for many of us to achieve. How can we possibly look at improving our self care and reducing our work stress if we are buried in credit card bills?

I just came across Vaz-Oxlade's website and blog and was very impressed with the resources and suggestions she offers. Go take a look.

Workshop in Kingston May 7-8th, 2009: Sustaining Health Care Providers in the Workplace

2009-04-14T11:54:00.003-04:00

This workshop is being organized by the Southeastern Ontario Palliative & End-of-Life Care Network Conference. Unfortunately, I will be away in Winnipeg and will be unable to attend but if you are near Kingston, I urge you to consider attending.

Title: "The Threads that Bind"
Thursday, May 7, 2009: Plenaries & workshops featuring Bob Heath and David Kuhl
Friday, May 8, 2009: Sustaining Health Care Providers in the Workplace with David Kuhl & Hilary Pearson
Days Inn Kingston Hotel & Convention Centre

For more information contact Maggie George 613-544-8200 ext 4301

Take the Survey! Mental Health Commission of Canada

2009-04-14T11:44:00.003-04:00

You only have until April 19th 2009 to make your opinions known.

From a press release from the Commission:

The Mental Health Commission of Canada invites you to contribute to the development of a mental health strategy for Canada.

Click here for more information

Canada is the only G8 country without a mental health strategy. The Mental Health Commission of Canada has been given the responsibility to work with Canadians to address this gap.

An important part of this process is for the Commission to hear from as many individual Canadians as possible that have been affected by or are interested in mental health issues. The Commission is also committed to engaging with organizations or groups who are active in the area of mental health, mental illness and addiction.

With this in mind, the Commission has launched an extensive online consultation process to allow you, or your group or organization, to learn about and provide input on this very important topic.

Make your contribution to the development of a mental health strategy for Canada by visiting:

www.mentalhealthcommission.ca/strategy

The Commission also invites you to share this invitation with others who might wish to participate, or learn about mental health issues in Canada. We hope to hear from as many individual Canadians, groups and organizations as possible: it is only by working together that we will keep mental health issues out of the shadows - forever.

June Compassion Fatigue Train the Trainer is now FULL

2009-04-09T14:04:00.005-04:00

If you were hoping to attend, consider registering for the next session, November 24 and 25, 2009. For more information: www.compassionfatigue.ca

Please note that there are still spots for managers to attend the May 4-5th workshop with Dr Pat Fisher:

Are you a Manager in a High Stress Organization?
Come and learn how to handle difficult situations with your staff with one of the leaders in the field of Workplace Trauma and Organizational Health.

THE CRITICAL ROLE OF LEADERSHIP IN ORGANIZATIONAL HEALTH:
An Applied Manager Training Program

with Dr Pat Fisher, Ph.D., R.Psych., L.Psych.
Organizational Health and Employee Wellness specialist

May 4th-5th, 2009
Donald Gordon Centre, Kingston, On.

For more info: www.compassionfatigue.ca

Musings on facilitating workshops and the rewards of the work

2009-04-05T09:51:00.014-04:00

(Françoise's desk Sunday April 5th, 2009)

Before you start reading this post, I would like to describe to you my current working conditions on this lovely Sunday morning: we recently had a flood in our basement which wiped out the children's play area which means that they immediately invaded my home office with millions of tiny plastic toys that crunch underfoot and never seem to go back in their storage tubs. Defeated, I temporarily migrated to the dining room table, waiting for the basement to be back in use. So, while trying to write this post I have had: 1) a 30 minute fashion show by my 11 year old who just unpacked a bag of hand-me-downs from her cousins 2) two 8 year old boys eating peanut butter straight from the jar with gigantic spoons 3) a skunk walking in our backyard and 4) a sibling dispute to break up! But truth is, the house feels very empty when they are not here, and I will step on a crunchy plastic toy quite happily. The benefits far outweigh the costs.

During the past two weeks, I have presented to oncology and palliative care workers in a large Montreal hospital, nurses from Corrections and staff at a busy community mental health agency. The workshops offered were half day presentations on compassion fatigue and vicarious trauma.

I wish I could find the right words to accurately describe the energy that is present during these workshops. I think the reason for this intensity and engagement from participants has to do with all of us helpers being given an opportunity to reflect on and talk about the cost of caring. Being able to take a few hours out of our incredibly fast-paced work lives to take stock and look at the impact that this work has on us.

Reflecting on the past 7-8 years, I have often asked myself "why does this always feel like a brand new workshop, each time I offer it?" I think that this energy from participants is really the only way to explain that presenting the same workshop five times in two days remains a replenishing experience for me.

I think the same can be true of clinical work: Have you ever looked at a day's worth of client appointments and felt anticipatorily drained, only to wrap up the day feeling energized and think to yourself "wow, that went by very quickly." Yes, client work can be draining, but it can also offer us incredible rewards and opportunities for renewal. Laughter is one source of replenishment in our work ( I think there is probably more laughter in counselling work than outsiders might imagine, even in terrible situations), and so is watching someone make an amazing change in their life, take a risk, big or small, gain an insight, take a stand. I have sat in session many, many times, filled with admiration for the courage of the person in front of me, filled with awe and feeling honoured to be the holder of their testimonial. That is why we do this work, isn't it?

I feel the same way about facilitating CF/VT workshops. I also think that combining the two is a good blend: working with clients part time and offering workshops part time. I wonder what your ideal blend would be?

This week, I am going to Ottawa to offer a Vicarious Trauma retreat to Crown Witness Coordinators (CWCs). CWCs provide Northern victims/witnesses with assistance throughout the court process. CWCs travel the North West Territories, the Yukon and Nunavut along with what is called "Circuit Court" - a travelling court of justice that goes from region to region, offering court services across the north. I am very much looking forward to meeting these CWCs.

Till next time, happy Passover and happy Easter for those of you who observe these holidays, and happy Spring to you all.

How to make changes one step at a time...

2009-04-01T13:21:00.000-04:00

Change One Thing
by Bill O'Hanlon, 223 N. Guadalupe #278, Santa Fe, NM 87501 USA
www.billohanlon.com, PossiBill@aol.com

[You have permission to reproduce this handout as long as you keep my contact information on it and do not use it for money-making purposes without obtaining my explicit permission.]

Sometimes we don't make changes because they are too difficult of daunting or we are "fixin' to get ready," as my friend Helen says. One way to get change going is to consider the smallest change you can make and begin. Often inertia will continue to take you in the direction of change once you start. If not, at least you are moving forward a little. As Milton Erickson used to say, "If you fall on your face, at least you are heading in the right direction."

Identify the smallest change you can make and begin
If you want to write a book and aren't getting it done, try writing one word a day. I used to recommend five minutes a day (which is fine if that works for you), but if even five minutes seems too much, start with one word a day. Clean up, organize, or toss one piece from that stack of papers/mail/magazines cluttering your house or office.

Commit to a limited period of time for the change
You could commit to walking for five minutes a day for the next week. Or de-cluttering that pile of papers for the next three days. Forever is too daunting for most. Time-limited often works better.

Focus on only one thing at a time
Stop multi-tasking and experiment with doing only the thing you are doing. Or attend only to the person or experience you are with at the moment. Listen to and watch the person you are conversing with (rather than texting, glancing at the television, thinking about what you will do or say next, etc.). Eat when you are eating. Drive when you are driving.

Build a new habit one day at a time
Do the new habit for 5 minutes each day until it becomes ingrained, then expand the time or effort you put in.

Dismantle an old, unhelpful or unhealthy habit one piece at a time
Change one small thing about the old habit. Drink half a soda and half a glass of water with a meal instead of a soda. Park a little farther away from the store or your workplace and walk a little. Eat everything that is unhealthy with your non-dominant hand.

Introductory Workshop: Coaching to Excellence - Ottawa, June 2 & 3, 2009

2009-03-24T15:26:00.002-04:00

In this workshop, participants are introduced to the principles and methods of James Flaherty's New Ventures West successful approach to coaching and to human development (see www.newventureswest.com). The program allows for coaching experience that is applicable to the participants' work place or current coaching practive, and their broader lives. Through structured exercises, demonstrations and simulations, we will explore together what it takes to evoke long-term excellence in others.

Who would benefit from this course?

This course is designed for:
-Anyone intrigued by the possibility of having a positive impact on others through coaching;
-Managers, Human Resource professionals and Organizational Development practitioners who are regularly called upon to solve problems that could be more effectively handled by developing others' competence;
-Independent professionals, consultants and coaches interested in bringing greater skill to their one-on-one conversations with clients;
-Therapists and social workers interested in building coaching competence;
-People considering applying for the Professional Coaching Course.

For more information contact Hélène Beauchemin at belaylen@hotmail.com or Barbara Best at barbara@virtualworks.ca
Phone: 613-236-4847.

Back from March Break

2009-03-21T12:24:00.006-04:00

Hi dear reader,
(This is a photo of a beaver-chewed log taken by the shores of a frozen lake in the Laurentians)
I am back from a week off where I had a chance to read novels, do some spring cleaning and watch my increasingly independent children take a ski lift by themselves (gasp). It was a sun-filled week, which was great. The break was much needed for my whole family, I think.

I have been reading and thinking exclusively in French for the past few weeks, preparing for a two day visit with oncology staff at the CHUM (Centre Hospitalier de l'Université de Montréal) so I now have to put my English hat back on to write this post. I have come across some interesting French resources on Compassion Fatigue (que je mettrai bientôt sur mon site web).

One English resource was a series of podcasts produced by the CMA (Canadian Medical Association) called "Healthy Practices: A podcast on physician health" hosted by psychiatrist Dr Mamta Gautam. Follow this link to hear the podcasts.

This week, I will also be visiting a group of nurses who work in Correctional facilities near Kingston to offer them a much deserved half day on self care.

It's officially Spring! Time to dust off your rusty bike, rollerblades or snow shoes if you live up North and get out and get moving. We live in a crazy country really, (the snowiest in the world, I found out this morning, and the second coldest) so let's celebrate the arrival of Spring by making a renewed commitment to taking care of our bodies and souls.

Washago Ontario

2009-03-09T21:33:00.002-04:00

This is a picture of a garden shed, as you can see.

Well, this garden shed is about the same size (or slightly bigger) than the Washago train station. I kid you not! I was there today, on my way back from a training session with Corrections Canada in a beautiful ymca camp. I wish I had my camera. If someone has a photo of the actual train station, send it my way please.

Guest Post: Flying by the seat of your pants by Jack Henderson

2009-03-08T16:41:00.004-04:00

My dad earned his pilot’s licence before the start of World War 2 and, when I was a kid, he would often tell me stories about his flying days. When he enlisted he became an instructor and spent thousands of hours in the back seat of a Harvard aircraft “teaching young hopefuls to fly”.

After a student learned the basics of safe flying, it was necessary for them to know where the dangers were highest… how to recognize a potential problem and how to correct for it before it was too late.

Night flying meant learning to fly with instruments, not their eyes, and not just relying on their own sense of well-being. This is the core of the message that he taught me which would surface many years later when I became his caregiver during his journey through dementia. “Flying by the seat of your pants” became a wonderful metaphor - an image of how I needed to care for myself in order to continue to give quality care to him.

The lesson that I remember from him was that flying an airplane by instruments is very different from flying by our human senses. When we can see clearly, our eyes and our inner ear, which measures our sense of balance, reinforce and correct each other to ensure that we maintain proper orientation to the world around us. We can control ourselves by our senses or as the pilots say “Fly by the seat of our pants”. The pilot knows the sensation of what a safely operating airplane feels like.

At night there’s an additional challenge. The pilot’s eyes don’t give reliable information so the pilot is left with their sense of balance. Our amazing human bodies have limits of what can be detected. Although sudden or large changes are easy to recognize, one of our body’s weaknesses is identifying very gradual change. A pilot who tries to fly by the seat of his or her pants at night can’t detect if the airplane is very slowly going into a spin or a dive. Their body’s motion detector in their inner ear can’t be reoriented because their eyes can’t see in the dark. Their body might tell them “You’re level, you’re OK” but they are not…. dangerously not OK. Only the instruments can give them the feedback that tells them “Your feelings, your sensations, are getting confused. The instruments are correct. Make changes now for your safety and the safety of those with you.”

So what’s “Flying by the Seat of your Pants” got to do with being a caregiver for someone living with dementia? Caregiving means taking on additional challenges. Although we can see the changes in the person living with dementia for whom we are caring… the good days, the bad days, the losses in their capabilities… what we miss are the changes in ourselves, the constantly increasing changes in the demands on us as caregivers. It sneaks up on us. “I’m OK. I’m handling this fine” is such a common reaction… and usually it’s not true. Like the pilots, our bodies don’t detect those little changes that accumulate and our bodies and minds are not good at telling us that we’re not taking good enough care of ourselves… that we’re actually headed into a fatal dive. We tell ourselves that we’re doing fine when in reality we should be asking others for help.

So what’s the key to safety of the caregiver? How do we observe the necessary warnings so that we can ensure that we don’t do damage to ourselves by “Caregiving by the seat of our pants”? The answer is our “Instruments”. What are those external measurements telling us that we need to pay attention… information that doesn’t agree with how we feel but will help us change from a dangerous spin? There are many. Our friends telling us that “You’re looking tired” or “We’ve missed you” or “I’m concerned about your level of stress” are messages that we need to heed. Checklists for measuring Caregiver Burnout are another. The Alzheimer Society, the Victorian Order of Nurses, and several other groups have them. But don’t just measure yourself alone. Have a friend who understands the demands of dementia, knows you and will be honest with you, help you through the checklist. Listen to their opinions about how they think you are doing. If you become a damaged caregiver, then your setbacks limit the quality of care that you are able to give. Taking care of yourself means taking better care of the one living with dementia.

And if you catch yourself saying “No, really, I’m doing fine”, then you’re probably flying by the seat of your pants. It’s a good time to believe your instruments, change how you are taking care of your own needs, and stop your undetected fatal dive.

Jack Henderson, a former caregiver.
Been there… done that. And I also needed several family and friends to tell me “Listen Jack, you’re NOT doing OK. We know the signs. You’re headed for burnout. Take better care of yourself.”

©Jack Henderson, 2009 Feb 26

Interesting French/English resource on consumer trends

2009-03-01T16:36:00.004-05:00

Benoit Duguay is a professor at the ESG Business School in Montreal. He is an expert in consumer trends and a critique of overspending and overconsumption. Dr Duguay writes French and english blogs on consumer trends. The French blog is called "Causerie sur la consommation" and is updated regularly. The English blog is a little less information packed but has some interesting reflections nonetheless. It's worth a visit.

One of my good friends celebrated his 40th birthday last night. I was deep in conversation with a guest at the party, when I mentioned something that had happened in 1989 and he said to me "Um, I was three in 89, I don't really remember that event" which made me gasp and take a little step backwards. 1989? Wasn't that yesterday? Time just mercilessly keeps on moving forward doesn't it. Here's a special hello to all of you out there who think 1989 was two years ago.

This week, I am running the two day train the trainer and then going to run a one day retreat for a group of mental health professionals who work in a psychiatric setting. Sunday I am going north to present in a prison. I really enjoy the variety among the trades that I meet, it makes this work so live and interesting.

Bonne semaine à vous tous et toutes

Resources for animal care workers (and the rest of us too) and Help for managers

2009-02-22T09:54:00.008-05:00

I apologise for the longish silence but I have been busy writing up a report for an agency. I can now return to posting weekly as is my goal.

I invite you to visit the Compassion Fatigue Awareness Project: www.compassionfatigue.org and browse through the resources available. The web site has, in particular, good resources for animal care workers (click on Resources to find links and articles.)

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On Managers and Compassion Fatigue

Supervisors and managers who work in the helping fields end up in a tough spot: Most of the management staff I have met over the years are extremely concerned about the wellbeing of their employees and feel stuck between their staff's needs (for a reduced workload, for policies that allow for more flexibility in the schedule, for concrete actions that recognise the reality of compassion fatigue in the workplace) and the need to ensure that service delivery continues and that client needs are met.

I have lost count of the times I have had a manager, almost in tears, come to me at the end of a workshop and say: "How do we, the managers, juggle it all? How do we care for our staff without burning out ourselves?"

The answer, of course, isn't simple, but there are some strategies that can help. This was my motivation in bringing Dr Pat Fisher to present a two day course for Managers in Kingston in May. I will be carrying out an interview with Pat Fisher in the weeks to come, so come back if you are curious to know more. And if you live near Kingston, do consider enrolling for the course. It will be an extremely valuable two day workshop specifically designed for managers and supervisors.

Now, in terms of what I'm up to today, I'm going to play badminton with kids this afternoon, and then I will likely not be able to resist watching part of the Oscars before falling asleep (those long boring speeches where everyone thanks their lawyer, stylist and publicist, yawn. Why not take this opportunity to advocate for a charitable cause? Maybe one of the winners will do just that tonight and surprise us).

Next week is the Train the Trainer workshop which I am very much looking forward to as it's an opportunity to work for two days with a small group of dedicated helpers from highly varied backgrounds. This time around, there are psychologists, family doctors, nurses, social workers and counsellors from a wide range of agencies such as hospitals, veterans affairs, public health, children's services and other community agencies. If you are interested in this training programme, please note that the June session is already half full.

Hope you have a good week!

Quick post

2009-02-08T12:45:00.004-05:00

This is a quick one as I am about to jump on a train for Brampton, Ontario. I have been asked to go run a series of focus groups for a very forward-thinking large community agency who wish to prepare their managers and supervisors to respond appropriately to staff presenting with concerns surrounding compassion fatigue. I am really looking forward to hearing their thoughts and concerns about this important issue. Then it's Montreal for dinner with my siblings and nieces (always a wonderful treat) and a workshop to the National Parole Board. Then back on the train for a pitstop at home to kiss hubby and kids and change clothes and off to Toronto for a workshop with special needs educational assistants. I will be very happy to sleep in my own bed by the end of the week.

I have had the very rare opportunity to spend part of the weekend completely on my own, sans children and sans partner (they were away visiting relatives) which is very nice but also very odd, for those of you who have had children I'm sure you can relate? So this is what I did with my free time: I went to play badminton with a friend, went for a very long walk around our town, and went to see the movie Slumdog Millionaire last night (very disturbing first part but the rest is very good and worth staying through the difficult stuff, I thought) and then out for wings and beer until the ungodly hour of, gasp 11:30pm. Crazy night out on the town...

I also came across a fun blog for those of you interested in cooking with a crockpot and thereby saving on energy costs and lowering your grocery bills: take a look at www.crockpot365.blogspot.com
Freelance writer Stephanie decided to spend a year cooking with her crockpot and you can find her amusing reflections and recipes on this site.

Ok, off to the races. Wishing you a healthy week.

Preventive Medicine and Healthy eating: Things we know...but are they things we do?

2009-02-01T16:05:00.013-05:00

Photo by Sakurai Midori - Autumn Fruit and Vegetables Japan from wikimedia commons

On the lovely topic of food:

One of my very first memories is watching my Inuit babysitter roll and fry her daily bannock when I was 2 or 3 years old. I can still conjure up the smell and taste of that hot bread now. Fresh deep fried bannock tastes like nothing else you'll ever try, it's just one of those things. You likely have foods like that too from somewhere in your past?

I have always been passionate about food. I'm not sure why, though I recall that when I was young my mother and my aunt used to love planning meals together, poring over recipes and trying new and unusual things. I remember one hilarious day when my mom and I bought one of each of the new tropical fruit that had just arrived in the grocery stores. This was in the early 1980s and we had never seen these strange things before nor did we know how to tell whether they were ripe (they weren't - we ended up feeling like we had fur growing on our tongues and racing for water but laughing our heads off.)

My mother was also always a strong believer in healthy eating and tried to the best of her ability to offer us fresh produce. I am not sure how she managed that during the years that we lived in a place where the ship came only once or twice a year with our groceries but she soldiered on: she made home made yogurt, sprouted beans, granola...

Anyhow, this rather lengthy introduction is to talk about a fascinating radio show I heard on Thursday. If you speak French, you can skip the rest of this post and simply go to www.radio-canada.ca/radio/christiane and look for Christiane Charette's January 29th interview with Dr Richard Béliveau.

Dr Béliveau is a biochemist who works as a research scientist at two Montreal Universities. He is an expert in cancer prevention and is also a gifted communicator who aims to bring his lab findings to our dinner tables.
He has written three books on cancer prevention and nutrition:
Foods to Fight Cancer, Cooking with Foods that Fight Cancer and his most recently released Eating Well, Living Well: Everyday Preventive Medicine which will be available in English in the Fall of 2009. He also writes a weekly column in the Journal de Montréal which you can read online:

Here are some findings:

-Reaching your healthy weight reduces your chance of developing diabetes by 90%
-26% of Canadian children and teens are overweight
-Excess abdominal fat is linked to certain types of cancers (the rates are staggering: 75% of colon cancers are nutrition related).

Dr Béliveau recommends five key strategies to improve your health and reduce the risk of cancer

1) Quit smoking
2) Exercise at least 30 minutes per day
3) Aim to reach and keep your healthy weight
4) Eat a large amount of fruit and vegetables each day
5) Eliminate junk food

Key foods to add to your diet:

-Any vegetable from the cabbage family: broccoli, cauliflower, cabbage...
-Garlic and onions
-Soy products (soybeans, tofu)
-Turmeric (1 tsp per day)
-Green Tea
-Berries
-Omega 3 fatty foods (salmon, walnuts, flax seeds)
-Tomatoes
-Citrus fruit
-1 glass of red wine per day
-Two squares of 70% dark chocolate per day

Of course you know all that already, right? But are you walking the walk?

My children were thrilled when I announced that from now on, desert would have to be chocolate!

Only 5 Spots left - March 2 & 3 Compassion Fatigue Train the Trainer

2009-01-28T14:39:00.005-05:00

with Françoise Mathieu, M.Ed., CCC.
Location: Donald Gordon Conference Centre Kingston, On.

A beautiful location and great food. A nice starting point for a two day intensive retreat to become (or hone your skills as) a compassion fatigue trainer.

Workshop Size
Spaces limited to a maximum of 20 participants.
Certificates of Completion will be provided
Cost (includes lunch and morning and afternoon breaks): $598.00 CND
This fee covers cost of materials including training manuals and handout templates.

Workshop Description
Some past participants of our one day Compassion Fatigue workshop (Walking the Walk) expressed an interest in receiving help in designing a workshop to bring back to their communities and developing skills and knowledge base to deliver compassion fatigue workshops themselves. This train the trainer workshop offers tools, handouts, strategies, training material and marketing strategies to adapt Walking the Walk to your community's specific needs (and to your own presentation style). You do not need to have attended WtheW in the past to benefit from this training.

Because of the small size of the group, we will customize certain aspects of the training to your specific needs. A questionnaire will be sent ahead of time to establish your needs/goals and objectives and aim to fulfill as many of these as possible.

Day one will be experiential (you will participate in a one day CF workshop) and Day two will discuss tools, strategies and techniques to develop and deliver the workshops on your own and become a CF educator and trainer.

What differentiates this workshop from other educational sessions out there is the extra layer of understanding and validation that we hope to convey to our workshop participants. Therefore, the train the trainer workshop is designed to take you deep first, to gain a true and thorough understanding of your own relationship to CF. Then we go into the didactic details (what to teach, how to teach) and finally talk about the mechanics of the whole process (how to customize this for your own work needs/goals etc.). More info: www.compassionfatigue.ca

What's going on

2009-01-28T06:45:00.006-05:00

Photo of Rideau Canal in Ottawa, Canada, from commons.wikimedia.org

Here is what has been going on this week in Kingston Ontario.

If you live in my part of the world, you too will have been enjoying the deep freeze that we have been experiencing during the past week or so. I run outside throughout the the winter and spent the first part of my childhood in the arctic so I am not too fazed by cold weather but when my eyelashes freeze together, I tend to draw the line at outdoor pursuits. I did make one exception to this on Sunday as I was in Ottawa and had the opportunity to skate, for the very first time, on the Rideau Canal which is considered to be the longest natural frozen ice rink in the world, or the second if you are from Winnipeg, who claim to have the world's longest natural frozen ice rink in the world!

Skating on the Rideau was fantastic, and had it not been minus 25 celsius and had I been sans kids, I would have loved to skate the full length of it. I don't know why exactly, but skating outside makes me feel blissfully happy and at peace.

Do you have an activity like that?

I am currently working on the Compassion Fatigue Workbook which is a distillation of my one day compassion fatigue workshop but is designed to be used as a solo or group tool. I have several ongoing projects right now to develop more distance learning materials which are far more affordable than travelling to attend a workshop or bringing a speaker to your community. Let me know if you have any special requests or ideas. Stay warm.

Launching the Compassion Fatigue Solutions Bookstore!

2009-01-16T16:22:00.002-05:00

I am very pleased to announce that after many months of work and a very helpful computer programmer, my bookstore is finally ready. Now, this is a very soft launch as there are only two products in the bookstore at the moment (an ebooklet and a Train the Trainer workbook) but it will grow over the coming months. The goal of this bookstore is to create a web-based resource centre for helpers seeking distance learning resources and workbooks to assist them as individuals and/or as trainers.

Go take a look: www.cfsolutionsbookstore.com

Currently available:

Ebook: Designing and marketing a compassion fatigue workshop in 10 key steps

Contains:
• Self assessment exercises to help you evaluate where you are starting from.
• Strategies to identify and develop your very own workshop style
• Key books and resources in the field
• Marketing and promotion: lessons learned and things you should know and many more tips, ideas and strategies.

Compassion Fatigue Train the Trainer - Workbook

This manual offers tools to help you design your own CF workshops and assist you to become a compassion fatigue trainer. The material included in this manual is based on WHP’s one day workshop Walking the Walk: Creative Tools for Transforming Compassion Fatigue which has been offered across Canada since 2001.

Enclosed in this manual you will find:

• A description of the 17 Educational and experiential goals of the Walking the Walk course.
• A extensive resource list (books, links to websites, articles, etc.)
• An appendix with handouts that can be used for your training sessions.
• A copy of three articles written by WHP: Low Impact Disclosure , Running on
Empty and Transforming compassion fatigue into compassion satisfaction: top 12 self-care tips for helpers.

The 50 Best Employers to work for...

2009-01-15T13:29:00.007-05:00

Yesterday, (January 14th, 2009), the Globe and Mail published the results from the 5th annual survey of "the best small and medium employers in Canada" by Queen's School of Business.

I was very curious to read more on the key elements that made these companies the best, and my hunch was confirmed: Among the top companies, the focus is on empowering employees, rewarding effort and encouraging growth among staff by supporting ongoing training. Flexible work hours are also encouraged and hierarchy discouraged (some of our hospitals a ways to go on some of these points...)

"At top-ranked Protegra [the company who won best employer award], employees are encouraged to participate in goal setting and decision making at monthly staff meetings. [...] At top companies, not only do employees have a say in setting direction, they are also given wide berth to run with their ideas."

I am fascinated by these findings as they are exactly what we recommend to minimise compassion fatigue and enhance wellness among helping professionals. The top strategies for health care organizations wanting to mitigate the impact of compassion fatigue are related to offering flexible work hours, providing staff with positive feedback, supporting continuing education and genuinely inviting staff to contribute to the direction and manner in which the organization is progressing in the future.

So, I'm sure many of you are wondering who came in the top five? Here they are:

Number 1: Protegra Inc., Winnipeg (IT and business consulting)
Number 2: Miele Canada, Ontario (Appliance maker)
Number 3: Gibraltar Solutions Inc., Mississauga (IT and consulting)
Number 4: ISL Engineering and Land Services Inc. Edmonton (Engineering)
Number 5: Hood Group, Edmonton (Engineering, construction and environmental consulting)

More on this at globeandmail.com/smallbusiness

If you are interested in exploring this issue some more, I would highly recommend that you read the book "Maverick" by Ricardo Semler. Semler owns a large successful manufacturing company in Brazil and this book chronicles how he dismantled the entire corporate structure of his company and reaped the rewards tenfold. He also describes how he obtained the help of his staff to weather through a severe recession in Brazil in the early 90s. It's a highly readable book, I would recommend it to any manager interested in exploring this further.

Making sushi with children

2009-01-13T06:49:00.006-05:00

There are times that are simple yet very precious moments in our lives. I don't know about you, but sometimes I get so task-oriented and "completion-focused" (sadly, strong features of the enneagram 3 for those of you who know about the enneag.) that I lose my sense of humour and fun. This is something that I know about myself and try to keep at bay. Enter children - they are the best people in the world to force you out of your task-oriented focus (as right now, I am writing this but I can hear little feet coming down the stairs, back later).

Ok, I am back. On Sunday, my kids and I decided to make sushi for the first time. Now these are not works of art, I will grant you, but it led to a wonderful conversation about food, culinary traditions and eating with one's hands, something my 8 year old son is very keen to do again - "but you do it every day sweetie" I said, given that using cutlery is an ongoing battle with him at the best of times. So now for the next few Sundays, we are going to explore "foods that are eaten with our hands" from various countries of the world. I am thinking of Ethiopian next week, if I can find Tef flour to make the large, spongy breads that are used as plates and spoon.

I have several exciting announcements coming up later on today or Wednesday, come back and read some more when you have a chance.

Back to work

2009-01-07T07:42:00.000-05:00

This is a photo of two of my nieces rolling in the snow. One of them is 17 years old and still enjoys making snow angels. When was the last time you rolled in the snow? (on purpose, I mean, not wiping out in front of your driveway, as I will likely do this morning as we have received a large amount of snow and ice during the night)

I hope you had a chance to take some time off during the holidays. I was very fortunate in being able to take two full weeks off and I spent them eating (many times per day!), catching up on my sleep and connecting with friends and family. It was a welcome break after such a hectic Fall. I am now fully rested and looking forward to the next chapter in this journey.

News for the start of January 2009

Compassion Fatigue Train the Trainer:
If you are considering attending the March Train the Trainer workshop in Kingston, I encourage you not to delay in registering to avoid disappointment as the workshop is limited to 20 participants. For more information visit the link at www.compassionfatigue.ca

Compassion Fatigue Solutions Bookstore
I am putting the finishing touches on the Compassion Fatigue Solutions Bookstore, where you will be able to purchase workbooks and training materials in the months to come. This site should be going live in a week or so. I will send an announcement when it is ready. At first, there will only be a few products available on the bookstore, but I hope to build on that in the future, to provide more distance learning materials for those of you who are looking for more training opportunities.

Compassion Fatigue News Group
Charles Figley has updated his CF news group and has moved it to a much more user friendly site on Google. Consider joining this community of helpers interested in CF-related topics. To find out more cut and paste this link in your browser: http://groups.google.com/group/compassionfatigue/web/google-alerts-about-compassion-fatigue

I will be posting again in the coming days with more news and views. Here is wishing you a healthy and balanced 2009.