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Tired In, Not Tired Of

Territorial Social Services Conference - 2015

3/2012

Presenter: Kevin Ellers, D.Min. Territorial Disaster Services Coordinator: Central Territory

Major Karen Hanton: M.F.C.S. Territorial Disaster Training Coordinator

Stress Self Test

The next photo has two identical dolphins in it. It was used in a case study on stress level at St. Mary's Hospital. Look at both dolphins jumping out of the water.

The dolphins are identical. A closely monitored, scientific study of a group revealed that in spite of the fact that the dolphins are identical, a person under stress would find differences in the two dolphins. If there are many differences found between both dolphins, it means that the person is experiencing a great amount of stress.

Stressed?

Why This Course?

• Helping can be rewarding • Helping can destroy you • You can create balance • Only you can take care of you

Slide Handouts

You can get a printout of the entire presentation at the

conference website.

Looking Within

•  What is your primary life calling? •  How do you maintain this calling in an ever

changing world? •  What are your greatest risk areas? •  How have you changed? •  How do your care for yourself? •  How are you connected?

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My Story My Burnout Risks & Faults

What my self-assessment revealed: •  Over commitment •  Tendency to be a workaholic •  Shallow and minimal relationships •  Lack of accountability for self-care

Self Assessment Results

•  Feeling of constant stress due to inability to complete an excessive number of critical projects

•  Constant tension in shoulders •  Frequent tension headaches and stomach problems •  Trembling of hands •  Reluctance to answer the phone, check messages,

and read emails •  Excessive work hours for months •  Difficulty stopping work or shutting off work

related thoughts and planning at home

Self Assessment Results

•  Few boundaries between work and home time •  Inability to relax without activity •  Little personal down time •  Failure to engage in former fun recreational

activities •  Limited hours at home with children and spouse •  Failure to invest in or enjoy close relationships •  Degradation within the marital relationship

Precipitating Factors

•  Marital breakdown •  Father dying of cancer •  Finishing doctoral program •  Constant travel •  Excessive workload •  Lack of sleep •  No play •  Minimal support system

Bringing It Home

This workshop is about you!

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Two Minute Reflection

“Burnout is not a matter of weakness or poor attitude in individual

employees. Rather it is a problem of the social environment in the workplace

caused by "major mismatches" between the nature of the person doing a job and

the nature of the job itself. The greater the mismatch, the greater the potential

for burnout.” Maslach & Leiter

Mission and Calling

•  Identifying your primary life calling

•  Maintaining your calling through transitions

•  An evolving call

•  Finding your passion

“When your passion begins to decline, you already start to die. You were born to burn. Elisha came to the king and said, "Please strike the ground with these arrows." And he struck the ground three times. The prophet became furious at the king and said, "If only you had struck the ground five or six times you would have annihilated the enemy, but now you're only going to have three temporary victories." Because the king did not live out of passion, he couldn't carry the anointing that God wanted to give him, and it cost the nation. When leaders don't have passion, it costs everyone who follows.” Bill Johson

Mission and Calling

•  Overfilling of plate •  Messiah complex •  Failure to utilize full body

of believers •  Can I say no? •  What drives you? •  Am I a religious glutton?

Beware of ministry creep…

“I would rather be ashes than dust! I would rather that my spark should burn out in a brilliant blaze than it should be stifled by dry-rot. I would rather be a superb meteor, every atom of me in magnificent glow, than a sleepy and permanent planet. The function of man is to live, not to exist. I shall not waste my days trying to prolong them. I shall use my time.” Jack London

•  It is a calling for many •  There are few who specialize in helping •  As Christians it is difficult to not respond to

human suffering •  May get personal needs met •  “Savior complex” – no one can do it better

than me

Why do we struggle with self-care?

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Myth and Reality

Common Myth #1 “It is better to burn out than rust out.”

Myth and Reality

Common Myth #1 “It is better to burn out than rust out.”

Reality: Either way you are out!

Myth and Reality

Common Myth #2 •  Dedicated Christians

never say no to ministry opportunities.

Reality: Saying “NO” frees you and someone else to say “YES!”

Myth and Reality

Common Myth #3 I won’t burnout if I’m doing ministry.

Reality: We have consequences for our choices

PACT for Life

What is your PACT for life? In a life of busy schedules and time constraints, it is critical to identify and focus on what is most important to you, the areas that you most enjoy, and where you can have the greatest impact. By determining your PACT for life, you can seek to re-evaluate your activities to direct your energies on that which is your major life focus.

PACT for Life

Assess the following: 1.  Passionate Pursuit

2.  Assessed Action

3.  Commitment to Completion

4.  Time & Transformation

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Defining Terms

•  Caregivers with the suffering walk a fine line between empathy and objectivity. How do you enter the world of the suffering and yet protect yourself from absorbing the pain to the degree that impacts your own life?

•  A failure to walk this fine line can lead to compassion fatigue or hardening oneself to the degree that can impede the helping relationship.

Compassion

Webster defines compassion as:

“feeling of deep sympathy and sorrow for another who is stricken by suffering or misfortune, accompanied by a strong desire to alleviate the pain or remove its cause” Webster, 1989, p. 229.

Compassion Definition

•  When dealing with excessive levels of suffering and not taking care of one’s self one can develop compassion fatigue.

•  Systematic studies of effectiveness of therapy suggest a strong correlation between a strong therapeutic alliance between the client and clinician and an ability to empathize, understand, and help clients.

•  The helper’s ability to express empathy and compassion are critical to the helping relationship.

•  Compassion fatigue and secondary traumatic stress are often used interchangeably.

•  I contend that there is a difference. •  STS symptoms closely mirror PTSD

symptoms.

CF & STS

One Category of STS resulting from trauma work is an indication of

psychological distress or dysfunction. Indicators may include: 1. Distressing emotions (Courtois, 1988; McCann & Pearlman, 1990b;

Scurfield, 1985), including sadness or grief, depression, anxiety, dread and horror, fear, rage, or shame.

2. Intrusive imagery by the trauma worker of the client’s traumatic material (Courtois, 1988; Herman, 1992a; McCann & Pearlman, 1990b), such as nightmares, flooding, and flashbacks of images generated during and following the client’s recounting of traumatic events.

3. Numbing or avoidance of efforts to elicit or work with traumatic material from the client, including dissociation (Courtois, 1988; Herman, 1992b; McCann & Pearlman, 1990b; McCann & Pearlman, 1990b; Silver, 1986).

Indicators of Psychological Distress or Dysfunction (1)

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4. Somatic complaints (Figley, 1986; Herman, 1992b) including sleep

difficulty, headaches, gastrointestinal distress, and heart palpitations.

5. Addictive or compulsive behaviors, including substance abuse, workaholism (Boylin & Briggie, 1987), and compulsive eating.

6. Physiological arousal (McCann & Pearlman, 1990b; Van der Kolk, 1987).

7. Impairment of day-to-day functioning in social and personal roles, such as missed or canceled appointments; decreased use of supervision or cotherapy (Boylin & Briggie, 1987); chronic lateness; a decreased ability to engage in self-care behaviors, including personal therapy; and feelings of isolation, alienation, or lack of appreciation (Boylin & Briggie, 1987).

Indicators of Psychological Distress or Dysfunction (2) Major Burnout Symptoms

Three major things happen in burnout: 1.  You become chronically exhausted. 2.  You become cynical and detached from

your work. 3.  You feel increasingly ineffective on the

job. Maslach & Leiter, The Truth About Burnout 1997, Jossey-Bass Publishers

In a comprehensive review of the empirical research on the symptoms of burnout, Kahill (1988) identified five categories of symptoms. •  1. Physical symptoms (fatigue and physical depletion/exhaustion,

sleep difficulties, specific somatic problems such as headaches, gastrointestinal disturbances, colds, and flu).

•  2. Emotional symptoms (e.g. irritability, anxiety, depression, guilt, sense of helplessness).

•  3. Behavioral symptoms (e.g. aggression, callousness, pessimism, defensiveness, cynicism, substance abuse).

•  4. Work-related symptoms (e.g. quitting the job, poor work performance, absenteeism, tardiness, misuse of work breaks, thefts).

•  5. Interpersonal symptoms (e.g. perfunctory communication with, inability to concentrate/focus on, withdrawal from clients/coworkers, and then dehumanizing clients).

Burnout

•  1. Burnout is a process (rather then a fixed condition) that begins gradually and becomes progressively worse (Cherniss, 1980; Maslach, 1976, 1982).

•  2. The process includes (a) gradual exposure to job strain (Courage & Williams, 1986), (b) erosion of idealism (Freudenberger, 1986; Pines, Aronson, & Kafry, 1981), and (c) a void of achievement (Pines & Maslach, 1980).

•  3. There is an accumulation of intense contact with clients (Maslach & Jackson, 1981).

Burnout

These three characteristics are the classic antecedents of burnout of those in human service careers: 1. They perform emotionally taxing work. 2. They share certain personality characteristics that made them choose service as a career. 3. They share a client centered orientation.

Ayala Pines, Elliot Aronson, Ditsa Kabry

•  Burnout is “A negative state of physical, emotional, and mental exhaustion that is the end result of a gradual process of disillusionment. It is typically found among highly motivated individuals who work over long periods of time in situations that are emotionally demanding.”

Wilmar B Schaufeli, Christina Maslach and Tadeusz Marek

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Compassion Fatigue

Burnout

•  Preoccupation with absorbing trauma and emotional stresses of others

•  Symptoms similar to burnout, but onset is faster

•  Better opportunity to recover

•  May lead to burnout

•  Subtle, over time, & may lead one to believe he/she is not meant for this type of work

•  Feelings of being ineffective, callous, negative, emotional absent, sarcastic, & “stuck”

Challenges in the Workplace

Burnout Accelerators

•  Long-term work overload •  Lack of variety in duties •  Lack of leadership support •  Lack of peer support •  Poorly defined and embraced sense of

mission and purpose in ministry •  Lack of humor and play in workplace

Burnout Accelerators

•  Ministry population with chronic problems •  Highly distressing emotional content •  Lack of control •  Insufficient personal support system away

from ministry setting •  Poor self-care habits: lack of exercise,

nutrition, sleep

Two Minute Reflection

Are you more prone to compassion fatigue, secondary traumatization,

or burnout in your ministry?

Hold on….I’ll help

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“Humm … maybe this one’s a little too big for me”

“Going to get help… I’ll be right back!”

Remember! Sometimes psychological

first aid may just be keeping them from

falling off the cliff while you call for help.

Knowing Your Limits?

Stress and Strain

•  Dr. Hans Selye, later said he used the wrong term. He should have called it “strain syndrome” vs “stress”

•  Stress is the external pressure

•  Strain is the internal effect

Selye’s 3-stage General Adaptation Syndrome

•  Alarm Reaction

•  Stage of Resistance

•  Stage of Exhaustion

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Sympathetic

•  Motivating •  Protection:

– Fight –  fight

•  Maintaining homeostasis •  Complementary to the parasympathetic

nervous system

Parasympathetic

•  “rest-and-digest” •  “feed and breed” •  Sexual arousal •  Salivation •  Lacrimation (tears) •  Urination & defecation •  Digestion

•  Humans need a moderate amount of strain to remain healthy – Eustress

•  “An optimal plan has you alternating the strains of intense work with periods of detachment, rest, and relaxation. Alternating strain with relaxation sustains your health and increases strength” Selye

Reflection

•  What are your top signs that you are out of balance and have exceeded your limits?

Jesus as a Model for Self-Care

•  Withdrew and sought solitude

•  Changed location of his ministry

•  Engaged in a different activity (e.g. from preaching to healing to prayer)

•  Renewal through time with Heavenly Father

See page 94-95 in your guide

Mark 6:30-34

•  30The apostles gathered around Jesus and reported to him all they had done and taught. 31Then, because so many people were coming and going that they did not even have a chance to eat, he said to them, "Come with me by yourselves to a quiet place and get some rest." 32So they went away by themselves in a boat to a solitary place. 33But many who saw them leaving recognized them and ran on foot from all the towns and got there ahead of them. 34When Jesus landed and saw a large crowd, he had compassion on them, because they were like sheep without a shepherd. So he began teaching them many things.

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Personality Type

•  Extraversion – Live in the outer world – Refueled by being with others

•  Introversion – Live in the inner world – Refueled by being alone or with a few

Extraversion

•  The energy of extraverts is outward, towards people and things.

•  They need a lot of stimulation and often express emotions.

•  They get their motivation from other people. •  They often want to change the world (rather than

think about it). •  Extraverts like variety, action and achievement.

They do well at school but may find University more difficult.

Extraversion

•  Their attitude is often relaxed and confident. •  They are understandable and accessible. •  They tend to act first and think later. •  At work, they seeks variety and action and like

working with other people. They prefer work that has breadth rather than depth.

•  Introverts may see them as being shallow and pushy.

Introversion

•  The energy of introverts is inward toward concepts and ideas.

•  They need little external stimulation - and in fact they can easily be over-stimulated. it is possible that they focus more on their inner worlds because they suffer from sensory overload if they spend too much time outside and focusing on other people.

•  They thus bottle up their own emotions, which can explode if pushed too far.

•  Rather than trying to change the world, they just want to understand it. They think deeply about things and often do better at University than they did at school.

Introversion

•  Their attitude is reserved and questioning and they can seem subtle and impenetrable. They tend to think before they act.

•  At work they like to work alone and often seek quiet for concentration. They tend to prefer work that has depth rather than breadth.

•  Extraverts may see them as egocentric and passive. •  There is a view that introverts may act as they do because

they are more easily overwhelmed by external stimuli, as opposed to extraverts who have a higher basic stimulation threshold and need the more visceral external stimulation to avoid boredom.

•  In dealing with those who are undergoing great suffering, if you feel "burnout" setting in, if you feel demoralized and exhausted, it is best, for the sake of everyone, to withdraw and restore yourself. The point is to have a long-term perspective. - Dalai Lama

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Self-Care and Renewal Spiritually

Emotionally

Mentally Physically

Relationally

Self Care

Is your load too heavy?

Carry each other’s burdens…

Each one should carry his own load

Do not grow weary

Let us do good to all people

Galatians 6:2-5

Supporting Each Other

Ex. 17:11-13 So it came about when

Moses held his hand up, that Israel prevailed, and when

he let his hand down, Amalek prevailed. But

Moses’ hands were heavy. Then they took a stone and put it under him, and he sat on it; and Aaron and Hur

supported his hands, one on one side and one on the

other. Thus his hands were steady until the sun set. So

Joshua overwhelmed Amalek and his people with

the edge of the sword.

“I have a prescription for boosting your resistance to burnout: Get outside yourself, and do something that has nothing to do with your normal day's work... Do other things. Do things for other people, if you can. Do whatever you must to get the focus off your own problems. You need to have a diversion, particularly when times are difficult.”

Ben Carson, pediatric neurosurgeon

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Organizational Remedies for Tedium and Burnout

1.  Reduced ration (number of people for whom care is provided)

2.  Availability of times out 3.  Limited hours of stressful work 4.  Organizational flexibility 5.  Training 6.  Positive work conditions 7.  Work significance

Anayal M. Pines, Elliot Aronson and Ditsa Kafry

Self Management Techniques

1.  Good nutritional habits 2.  Good exercise habits 3.  Self-awareness 4.  Letting-go techniques 5.  Personal planning

J. D. Adams

Individual Coping

What can one person do about burnout? 1.  Setting realistic goals 2.  Doing the things differently 3.  Working smarter instead of harder 4.  Taking things less personally

Christina Maslach

Doing your part in having a healthy staff – Officer/Supervisor

•  Understanding officer/supervisor •  Really listen •  Don’t discount feelings of staff •  Acknowledge and validate feelings and

concerns. •  Encourage staff with words, notes, and

other forms of encouragement. (i.e. know your staff’s favorite drink or candy)

Doing your part

•  Be attentive to what’s happening in your office.

•  Be aware of if your staff have dealt with difficult clients, other staff members. Etc.

•  Don’t assume you know what problem is affecting your staff member.

•  Don’t assume you know what caused a rough day. It could be YOU!

Doing your part

•  Allow healthy ventilation – do not provide answers

•  Ask staff for their input on problem solving situations

•  Promote healthy habits •  Ask how you might be able to help with

their current level of stress.

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Officers/supervisor stress

•  Have a life outside the Army – Yes I did say that!!

•  Say NO!!!! •  Find a way to rejuvenate •  Develop a support system where you are… •  Take care of yourself – •  Don’t assume leadership will take care of

you.

Officer/Supervisor

•  Find an accountability partner or some type of accountability.

•  Be mentored or provide mentoring •  Be involved in your children’s life •  The piles on your desk will be there tomorrow. •  Take your vacation time •  Delegate •  Ask for help

Officer/Supervisor

•  Use the wellness program •  Seek support from your peers •  Don’t be married to the Army •  Most importantly – Make sure your

Spiritual life is in order. Find a way to be fed…..

Lessons Learned

•  If your staff knows you care about them, they will care back and work hard.

•  We need to take care of our staff and officers.

“I would rather be ashes than dust! I would rather that my spark should burn out in a brilliant blaze than it should be stifled by dry-rot. I would rather be a superb meteor, every atom of me in magnificent glow, than a sleepy and permanent planet. The function of man is to live, not to exist. I shall not waste my days trying to prolong them. I shall use my time.” Jack London

John 15:1-8

“I am the true vine, and my Father is the gardener. 2 He cuts off every branch in me that bears no fruit, while every branch that does bear fruit he prunes so that it will be even more fruitful. 3 You are already clean because of the word I have spoken to you. 4 Remain in me, and I will remain in you. No branch can bear fruit by itself; it must remain in the vine. Neither can you bear fruit unless you remain in me. 5 “I am the vine; you are the branches. If a man remains in me and I in him, he will bear much fruit; apart from me you can do nothing. 6 If anyone does not remain in me, he is like a branch that is thrown away and withers; such branches are picked up, thrown into the fire and burned. 7 If you remain in me and my words remain in you, ask whatever you wish, and it will be given you. 8 This is to my Father’s glory, that you bear much fruit, showing yourselves to be my disciples.

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John 15:9-17

9 “As the Father has loved me, so have I loved you. Now remain in my love. 10 If you obey my commands, you will remain in my love, just as I have obeyed my Father’s commands and remain in his love. 11 I have told you this so that my joy may be in you and that your joy may be complete. 12 My command is this: Love each other as I have loved you. 13 Greater love has no one than this, that he lay down his life for his friends. 14 You are my friends if you do what I command. 15 I no longer call you servants, because a servant does not know his master’s business. Instead, I have called you friends, for everything that I learned from my Father I have made known to you. 16 You did not choose me, but I chose you and appointed you to go and bear fruit—fruit that will last. Then the Father will give you whatever you ask in my name. 17 This is my command: Love each other.

New International Version

Bringing It Home! This workshop is about you!

Just Do It!

Bringing It Home

This workshop is about you!

Lessons Learned

•  I can’t help everyone. •  I should focus on my calling. •  I am responsible to take care of myself. •  I need to be in healthy, connected

relationships. •  Work and personal life have mutual impact. •  Adversity can produce growth or kill me. •  I need to be connected to the source. •  I need accountability!

Personal Self-Care Strategies

•  Cherish time with those I love •  Schedule lazy weekends •  Exercise throughout day •  Take brief breaks •  Bought a motorcycle •  Put up a hammock •  Use my vacation •  Mini vacations •  Find a hobby

DROP-IT A post-deployment out processing model for

emergency services personnel and disaster relief workers (Ellers, K.L., 2005)

D Describe their role and duties in the deployment. R Recall significant experiences, images thoughts and feelings. O Orientation to present status through self assessment. P Predict and prepare for post deployment challenges I Identify the most difficult and positive elements of the deployment T Transition plan for reintegration, self-care, and follow up

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Taking the best care possible of ourselves and our co-workers will, ultimately, have a positive impact on how survivors cope with stress and recover from the effects of the disaster.

Slide Handouts

You can get a printout of the entire presentation by clicking on the resource tab at the conference website.