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Protect Yourself from Compassion Fatigue While Working with Clients in Trauma

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Protect Yourself from Compassion Fatigue While Working with Clients in Trauma

Special care is needed when working with clients in trauma, both to support them and to protect yourself. This session covers the ways to prevent secondary trauma and compassion fatigue when working with clients in trauma, including how to maintain your equilibrium while hearing stories of trauma and tips on self-care during the interview and afterward. We will define the serious consequences that may arise for practitioners working with those in trauma and outline a well-being approach to prevent burnout, secondary traumatic stress, and vicarious trauma. This program will benefit practitioners who work with clients in trauma, including those in criminal law, family law, immigration law, employment law, and all those whose work, including pro bono work, touches on issues of trauma.

Presenters

Katharine Manning
Coach, Consultant, and Author
The Empathetic Workplace

Transcript

Katherine Manning - Hello, my name is Katherine Manning. I'm the author of the book, The Empathetic Workplace: 5 Steps to a Compassionate, Calm, and Confident Response to Trauma On the Job. I'm also a lawyer who has worked for more than 25 years with those in trauma and distress, starting off as a volunteer at a domestic violence shelter and later at Rape Crisis Center, and ultimately ended up at the Justice Department for about 15 years where I was a senior attorney advisor on Crime Victims' Rights and helped guide department policy in that area. I did a lot of training and I also advised on the department's work with victims in cases like Bernie Madoff, the Boston Marathon Bombing, and the Pulse nightclub shooting. I also teach in American university and in the master's in Trauma-Informed Leadership program at Dominican University.

In this session, I'm gonna share with you some information on how the exposure to trauma affects us in our jobs, and also give some advice on ways we can protect ourselves. Just to give you a brief overview of where we're going, I'm gonna start off talking a bit about the prevalence and effect of trauma in our clients and in witnesses, those we interact with. Then I'm gonna talk a bit about trauma and the brain, so how trauma affects the brain, both of the person who is experiencing the trauma and of those who are interacting with them. And then finally, I'll go through some ways that we can protect ourselves from secondary trauma and compassion fatigue.

First off, I'm gonna share with you just a few statistics on the prevalence of trauma among our clients and witnesses, everyone that is participating in the legal system, and then the effect of that. So first off, in our work as attorneys, we often are called upon to interact with those who are in poverty, particularly in our pro bono work, or if we work in any kind of social services, government agencies, nonprofit work. All of it will generally lead to a fair amount of interaction with people in poverty, and one of the things to understand is the significant link between poverty and mental illness, so those who are in poverty are more likely to experience mental illness because of the stresses, the experience through witnessing or experiencing violence, food insecurity, housing insecurity, all the administrative struggles of navigating public assistance, childcare, schooling, budgeting, and everything else that falls upon your shoulders when you're living in poverty, so all of those stresses can lead to greater incidents of mental illness.

And in addition, those struggling with mental illness are more likely to end up in poverty. People who have experience with bipolar disorder, depression, anxiety, other forms of mental illness are more likely to experience poverty themselves, so there is a back-and-forth relationship where poverty tends to lead to mental illness and mental illness tends to lead to poverty. Just to give you a sense of the rates of stress among those who are in poverty, they did a study of people who lived in public housing in Chicago and found that they had rates of worry at six times the national average, and that young people there experienced long-term anxiety and worry at seven times the national average, so for those who are in poverty, the stress levels are really significantly higher than those who are not. And, of course, it isn't only those who are in poverty who have increased levels of stress, anxiety, and mental illness.

I have a few statistics there on the slide for you. 60% of men in prison have symptoms and signs of severe to moderate PTSD. I also saw a statistic that said, among the prison population, the exposure to violence was nearing a hundred percent, so if you do criminal law, if you have clients who are in prison, you are going to be working with people who are experiencing PTSD at pretty high rates. In addition, if you do employment law, those who have experienced discrimination, are 25% more likely to experience psychological distress, to be diagnosed with a mental illness, or to report excessive drug use, so those who maybe your clients or witnesses may be experiencing this kind of psychological distress. In addition, more than 95% of medical malpractice defendants report physical or psychological impact from that case, including grief, anxiety, lethargy, and depression. And in addition, more than half of those who have experienced a workplace injury suffer from PTSD or partial PTSD. I could go on. If you do family law, trust in estates, criminal law, immigration law, towards any kind of discrimination or civil rights, you're likely to be encountering people in trauma. And then on top of that, there's the added trauma of the legal system and it's uncertainties and costs, which adds stress to all those who come into contact with it. So I think it's important to understand that for all of us who are working as attorneys, we are likely to be encountering high levels of stress, trauma, anxiety, among those that we are working with, in our clients, our witnesses, other people that we're interacting with as part of our jobs.

So what is the effect of that? For that, I wanna talk briefly about trauma and the brain, so how is it that trauma affects the brain? I'm not a psychologist, I'm a lawyer, so this is going to be a very high level overview, I don't want to go into a deep discussion of the neurobiology of trauma, but I think it's helpful before we go on for you to have some high level understanding of how trauma affects the brain of those are experiencing the trauma and those who are interacting with them. So the first thing I want you to understand is that we have a part of our brains that is constantly scanning our environments to determine if we are in some kind of danger, it's back in our amygdala, part of the brain stem, the oldest part of our brain, and what it does is if it perceives a danger, so it identifies some threat in our environment, it does a few things automatically. First, it gives us a flood of adrenaline, so we start to experience just a surge in adrenaline coursing through our bodies, our heart rates increase, we start pumping more blood into our extremities, our muscles, we, our oxygen levels increase, we start breathing faster, there's actually parts of our lungs that are normally not activated that open up so that we can get more air in, we actually have increased hearing and vision in those moments, all because of this flood of adrenaline that the amygdala is pushing out because it perceives a threat to us in our environment. The second thing that the amygdala does in that moment is the parts of the brain that are less useful for immediate physical protection, it dials down just a little bit.

Most relevantly, the part of the brain and the prefrontal cortex that is associated with complex thinking and rational decision making, that gets dialed down just a little bit, because I think our amygdala is rightly reasoning. Right now, I don't need to read a spreadsheet, I need to run, so I'm just gonna slow down the parts of the brain that are gonna be less useful to getting me to safety immediately. Now, a few more things to understand about that. This is a response that can kick in instantaneously before we're even consciously aware of the threat, so imagine that I'm walking down the street, it's a perfectly fine day, I'm walking my dog, and suddenly I realize that I have dived behind a car, and I'm not even sure why, and then I look up and I see that down the street there's a person holding a gun. Before I have even consciously registered the gun, my amygdala has kicked in and pushed me to take action, protective action, immediately, so something that can happen right away, instantaneously, like that.

The other thing to understand is, it's something that can develop over time based upon our life experiences. Imagine a woman who is in an abusive relationship and part of the abuse is that her abuser will text her multiple times a day and she has to respond immediately, or there is some kind of consequence. For her, hearing a text alert can trigger that stress response, she can get that same response, that blood of adrenaline, the suppression of complex thinking, just from hearing a text alert. For most people, hearing a text alert doesn't cause that response, but because of her life experience, it does for her.

And then the final thing I want you to understand is that for those who grew up in an environment where they were repeatedly exposed to danger, it can actually affect the way that their brains develop. They are, they may have an enlarged amygdala, so they're more likely to get that stress response, and it'll be triggered more quickly. And the prefrontal cortex, the part associated with complex thinking and rational decision making, will be slightly smaller. This is because of the repeated exposure to danger in their environment as their brains were developing, so this could be people who grew up in a war zone or in abusive household. This is not something that is necessarily permanent, it can be altered through therapy and other kinds of interventions, but I just wanted you to understand that this stress response can be affected by the particular life experiences of the individuals who are exposed to different stimuli. And so, in the same situation, somebody might have a greater stress response than somebody else.

Okay, there is one more piece about how our brains operate that I want you to understand, and for that, I'm gonna need a little help from this guy. Did you smile when you saw him? I find that most people do. In part it's because he is a really cute baby, but in part it is because we are hardwired for empathy. If I'm at a party and I see somebody across the room who's laughing really hard, I might smile or begin to laugh myself, even if I have no idea what the person is laughing about. Similarly, if I'm sitting at home and watching a football game and I see somebody get tackled really hard, I might wince or kind of crouch, adopt a protective stance myself, even though I'm sitting on my couch safe and sound, and nobody is anywhere near me threatening to tackle me. When I see it, boy, I can feel that hit, right. Feelings are contagious. There's actually a part of our brain called mirror neurons that the scientists believe allow us to feel the feelings of those we're interacting with, or even just those we are observing. And so, if I see somebody who's really happy, I might catch just a little lift, a little bit of that feeling myself. There are probably great evolutionary reasons for this. I'm sure it helps us to bond with one another, support one another, probably has a protective mechanism as well. If I see somebody who's scared, I might start to be on alert myself.

But one of the challenges that can arise is when the person that we're interacting with is experiencing that trauma response, because how does it affect us? The same way it affects them. We get that same flood of adrenaline and suppression of complex thinking. Not to the same extent, but just a little bit of it, we catch a little bit of that feeling, and so it'll affect us in the same way, that flood of adrenaline might mean that we are suddenly a little bit fidgety in our seats, playing with our pens, tapping our feet, maybe looking at the door, kind of, trying to figure out, is there a quick exit here? Suppression of complex thinking. It might be harder for us to remember our train of thought, what it was that we were in the middle of discussing, so this stress response, as you can probably already begin to imagine, can really affect our ability to be good warriors, to do our jobs in this moment when we're interacting with somebody in trauma. If I am deposing somebody, interviewing a client, or maybe questioning a witness, and I start to experience this stress response, it can really affect my ability to question them effectively, and also, it can affect how I am perceived by them.

You know, if I'm interviewing a client and I really need to understand their story, but I keep tapping my foot or playing with my pen or looking out the door, that's going to signal to them that I don't actually wanna hear their story, and they're gonna clam up and share less information with me, so I'm gonna get less of the information that I need. Again, this is all a normal response. It means we are empathetic humans. It's just not very helpful in this moment. So what we need to do is learn how to protect ourselves a little bit from that stress so that we can continue to do our jobs effectively and also so that we can continue to be good, full, healthy humans and attorneys, so in this next section, I'm gonna talk a little bit more about how this stress impacts us, the ways that it's showing up in our lives and in our work, and then I'm gonna move on to some advice on how we can protect ourselves from it. Let's look now at some of the effects of secondary trauma and compassion fatigue.

So first, what is secondary trauma? Secondary trauma is that effect that I was just talking about, when we are interacting with somebody in trauma and we get that contagion, a little bit of that feeling of the trauma that they're experiencing, that's called secondary trauma. It's defined as the emotional duress that results when an individual hears about the firsthand trauma experiences of another, and it actually does have a measurable effect in numerous studies where you can see that those who are, have not themselves experienced the trauma are nonetheless getting some of the impact of the trauma from those that they are interacting with, from hearing that story of trauma from another, so, for instance, if you are interviewing a client who is talking about his experience with the criminal justice system and he's discussing violence in his life, and maybe he is experiencing a trauma response as he is remembering his past experiences, we can catch a little bit of that trauma response and it can have a measurable effect on us as well.

Next, I wanna talk about compassion fatigue. Compassion fatigue is what can develop over time when we are repeatedly exposed to secondary trauma. So as a lawyer, I interact with a number of people who are experiencing trauma. Each time I catch a little bit of that feeling. Over time, if I do not take any steps to mitigate that, that can lead to compassion fatigue, which is defined as emotional and physical exhaustion, leading to a diminished ability to empathize or feel compassion for others. It's most often recognized in a sense of apathy or shorter temper. We'll talk a little bit more about that later on. As lawyers, it's important to remember that this stress that we experience through our exposure repeatedly to the trauma of others, as well as just the general stress in our profession, can really have an adverse effect on us, so just a few statistics here.

There was a survey of more than 13,000 working lawyers, and they found that 28% suffered with depression, 19% had symptoms of severe anxiety, 21% reported using alcohol in unhealthy ways, and sadly, a little over 11% of lawyers reported that they had had suicidal thoughts in the previous year. All in, lawyers are about 3.6 times as likely to be depressed as people in other jobs. So it's clear that we have a problem in our profession and we need to learn to get better at managing some of the stress that we are experiencing through our work.

One of the things I think is challenging is not only are we repeatedly being exposed to the trauma of others, but compassion fatigue or burnout is something that's really difficult to identify. On this slide, I am setting out some of the possible symptoms or markers of someone who has experienced compassion fatigue, or burnout, somebody who is starting to feel the effects of repeated exposure to stress and secondary trauma. It can be really challenging to identify it, though. You know, there was a guy that I worked with at the Justice Department. He was a prosecutor of child exploitation cases, and he was really just a phenomenal prosecutor, a really gifted attorney as well as very good with the victims and their families. He and I worked together on a project for a few years, and I really enjoyed working with him. He was very professional, kind, funny, easy to work with, reliable. I just really enjoyed the time working with him. And then the project ended and we parted ways and probably maybe about five years went by before we were brought together again on another project. And when I came back together with him, he was like a different person. Suddenly, he was much more short-tempered, angry. He would fly off the handle over just little, kind of, bumps in the road that you hit on any project. He was never impolite to me, he was always very, very kind and polite to me, very professional, but he just had a much shorter temper than he had before. He was more sarcastic and bitter, and I thought, my gosh, what happened to him? He's like a completely different person. And finally, I realized that he was likely suffering from compassion fatigue, that all those years of working child exploitation cases, those really grueling cases, had begun to take effect on him, and it had really affected his mood, his ability to cope with the general burdens and challenges that we all face in our lives.

The thing is, I think I would not have recognized it if I had not been apart from him for those five years or so. I think if I had worked with him every day, I probably wouldn't have seen it because it really does creep up slowly over time, so it's very, very difficult to recognize it when you are interacting with somebody every day, or certainly in ourselves, so for that reason, that's why I wanted to give you these ideas for things that can be signs that you are starting to suffer from compassion fatigue. Very commonly, it's something like apathy or numbness. Like, you'll read something in the news or some new challenge will come up in a case and you'll think, oh God, of course, here's another thing. It can also show up in anger, being more quick to anger, flying off the handle. Sometimes, other people will point it out to us like, wow, you seem really prickly lately, so accept that, understand that as the gift it is that maybe there's a sign that something's going on with you. It can also manifest in things like helplessness. You know, there's just nothing that I can do, nothing I do matters, it doesn't help at all. Sense of hyper vigilance, a sense that there is danger all around you, that you can't ever let down your guard. Rigid thinking means an inability to be flexible, that if something comes up at the last minute, you struggle to alter your course, or let go of a plan that you have. It can also, similarly, give us a sense of isolation.

You know, that's, to me, similar to the rigid thinking and the helplessness, that there's, I'm all alone in this, there's, nobody can ever help me. It can also show up in a sense of guilt that I, why do I have so much when so many others have so little, anxiety, sadness, and it can also show up in physical symptoms, so insomnia, trouble getting out of bed in the morning, feeling tired all the time, or getting sick a lot. That was something that happened to me when I was at the Justice Department working on victim issues. For many years, it was, like, every winter, I would get sick for about six weeks, and it was like clockwork every single year. And I realize now that it was probably that I was suffering from compassion fatigue, and so my immune system was really run down and it meant that I was likely to pick up any illness that came along. So, I would encourage you to think about whether you are seeing, or have seen at other points in your life, any of these signs of exposure to compassion fatigue, or burnout, things that are starting to wear on you, to really take a toll on you, and maybe just jot yourself some notes. You can write a little note to yourself on your phone, or send yourself an email or something for just some things to be mindful of, for what are the ways that it shows up for you. Are you somebody who tends to get a little bit more short-tempered, or are you somebody who gets sick a lot? Just try to make notes for yourself, because as I said, it can be really difficult to identify when we are starting to experience compassion fatigue.

All right, I wanted to make just a quick note that while, of course, taking care of ourselves is important in its own right, it's also perhaps worthwhile to note that self-care is implicated in our work as well. It's implicated in a few of the rules of professional conduct, both on competence and diligence. If we are suffering from compassion fatigue, if we are experiencing that rigid thinking, helplessness, inability to focus, that's going to affect our competent representation of our clients, our ability to exercise the legal knowledge, skill, thoroughness, and preparation that are reasonably necessary for the representation, and our ability to act with reasonable diligence and promptness in representing a client. As the report of the National Task Force on Lawyer Well-Being noted, to be a good lawyer, one has to be a healthy lawyer.

So if you are not able to convince yourself that taking care of yourself is important just for your own health and wellbeing, remember that this is also part of being a good lawyer as well. Now we've noted that as lawyers are encountering a lot of stress among our clients and others that we interact with in our jobs, and that that stress, along with the general stress of our profession, can take a toll on us, so next, I wanna talk about what we can do, and in this next section, I'm gonna share some advice. First, I wanna talk about what you can do during the interaction with someone in trauma to protect yourself. As I mentioned earlier, I've worked with crime victims for more than 25 years, so this is something that I have really had to build up in myself, some tools to help me protect myself during the interview or interaction with somebody who's having a stress response.

First off, I wanna note that, or I guess, reiterate, that it is not a bad thing for us to be having an emotional response when we are interacting with somebody who is recounting a story of trauma or stress. It means that we are empathetic human beings, and we, that's who we want doing this work. We don't want people doing the work of supporting people who are having a traumatic experience. We don't want the people doing that work to be people who don't have emotions and care and compassion, so it's not a bad thing to have an emotional response when you're interacting with someone in trauma. The challenge is that we, of course, need to make sure that we can stay present for the person who is talking about their experience, and also, that we can continue to do our job. We have to be able to keep an eye on things like, are we getting the information that we need, are we closing the loop on our line of questioning, are we making sure that we have all of the evidence we need to prove up our case? So we do have a lot that we are keeping track of during our interactions sometimes, and for that reason, it's important that we manage the emotional response.

What I wanna encourage you to try to avoid though, is simply squelching the emotional response. That's really common thing that we can do. When we start to have an emotional response, we just think, well, I can't have that right now. Like, right now, if I feel really sad or I feel really angry, that's going to impede my ability to be a lawyer in this moment, so I'm just going to squelch that feeling, I'm not gonna have it. The problem with that is twofold. One is, it's not healthy for us. That's the, that exact action that we are taking and denying our feelings is the thing that leads to all of the negative mental health outcomes that we talked about earlier. It leads to increased depression, stress, anxiety, probably to increases in substance abuse, so it's not good for us to just bottle up those feelings.

In addition, what happens in that interview or that interaction with the client or the other individual is that we slip into what I call law robot mode, like, we just become, we become automatons, we are no longer humans, we are simply there with our line of questioning and we move down to the next question on our list without acknowledging that this person is having an emotional response, we just completely shut down our own emotions, and that is very obvious to the person that we're interacting with. So if I'm interviewing a client, again, imagine I'm interviewing a client and I want this person to open up about a workplace accident, and maybe it was pretty horrific, maybe they saw a coworker experience some sort of really awful accident, and I want this person to explain exactly what happened, and as he's talking, it's really awful and gruesome, and I think, oh, my gosh, I just, I don't wanna be having an emotional reaction to what he's telling me, so I'm just gonna, again, shut down those feelings, and I become almost monotonous in my phrasing, my face shuts down, I'm no longer actually looking at him like a human, that will be very, very clear to him, and he will be less likely to open up to me about what he saw. He will feel less comfortable with me. He'll feel like, oh, this person isn't actually listening, they don't actually care about what I'm saying, and so he will share less information with me. He won't be as forthcoming as he would be if he felt like I actually cared and was listening to him.

So for that reason, again, while it is normal to have an emotional response, and, of course, we don't want it to interfere with our work, it's important that we are able to manage the emotional response in a healthy way in the moment so that we can both protect ourselves and our physical and mental health, and also so that we can continue to do our jobs effectively, so that the person with whom we're interacting feel supported, understood, and he is more willing to open up to us and share with us the information that we really need to do our jobs. So for that reason, I'm gonna go through with you just a few things to help you manage your emotions in a healthy way during that interaction with somebody in trauma.

All right, step one, and this probably won't be a surprise to you, is to breathe. Just a deep, slow breath, in through the nose, out through the mouth is truly magical. It increases our brain function, slows down our nervous system response. It will help so much. Often if I am doing an interview that I think might be challenging, I will write at the top of my notebook, breathe, just as a little reminder to myself to, because we forget when we're having that stress response, it's very common to forget to breathe, so just take a deep breath. It'll slow down your heart rate and help you stay more present.

The next thing is, name your feelings. Just acknowledge how you are feeling. Again, we might have an impulse to just squelch the feeling, just deny that it's happening. I want you to go the other way and just check in with yourself, see how you're feeling and name it. Are you feeling sad, are you feeling angry, are you feeling frustrated about everything this person has been through? There's a common phrase, name it to tame it. Really, just naming our feelings can help us feel so much more in control of them, and it really does just help so much, so just check in with yourself and name your feeling.

The next tip is to engage one of your senses. This is what's called a grounding technique. It's really something that I learned way back when I was doing hotline work in college and it has served me so well over the decades of work in this area with people in trauma, so engaging one of your senses. For instance, look across the room and count the number of pictures on the wall, put your hand on the desk in front of you and note whether it feels smooth or rough, take a sip of your coffee and notice whether it's warm or hot, or maybe it's gotten cool. Just engage one of your senses. What we're doing when we do that is pretty cool, so remember we have that amygdala that's pumping out adrenaline, and it does that because it perceives danger and that perception is likely sort of empathetic response that it's, we're experiencing secondary trauma of the person that we're interacting with. Now, wouldn't it be convenient if we could just say to our amygdala, don't worry, you're fine, you're safe, you don't need to be pumping out the adrenaline right now? Sadly, we cannot simply reason with it. What we can do though is show it that we are safe, and so when I put my hand on the desk in front of me, I am communicating to my brain, I'm safe right now, I'm not being chased, there's not somebody with a gun to down the street, I'm okay and you can calm down. It helps calm our nervous system.

And then the final tip is that it's always okay to take a break when you need it. Very, very easy, it doesn't have to be a big deal. You can just say, thanks for sharing that. I'm gonna get a quick drink of water. Would you like one? And then walk out of the room. It's a good idea to get that drink of water. If you can, walk outside, look at the sky, breathe fresh air. If you can't get outside, opening a window, just doing something you can to sort of breathe fresh air will be really helpful. If you can't get to fresh air, I would suggest pulling up your phone and looking at pictures of your dog or your kids or the beach, just whatever it is that will help you truly calm down. Take a real break before you walk back in that room.

All right, now we've talked some about how you can manage your stress in the interaction with a person who's experiencing trauma, a few tips for you to just try to remember and hold onto for when you're in a deposition or a client interview, where there starts to be a stress response, but as with so many things, the best defense is a good offense, so we wanna make sure that not just that we are protecting ourselves in the interview, but that we're also building up our strength on a daily basis so that we have a good, solid foundation to manage any of the challenges that are coming our way. So in this next section, I'm gonna talk about how we can manage our stress every day to protect ourselves from secondary trauma and compassion fatigue.

The first thing is that it's important to be proactive in protecting ourselves by making self-care a daily habit. I like to think of it as a daily reset, just something thing that you do every day to feed yourself. It could be a morning walk, or playing the piano after dinner, a prayer before bed, or whatever helps you reconnect with yourself. Many people find it helpful to do something in the category of exercise or art or mindfulness. So exercise, again, it could be you go for run, or you play basketball, kickboxing, art. You know, there's a guy I know who at the end of every workday plays the guitar for 30 minutes, and that's his signal to himself that the workday is done, which can be particularly important for those of us who spend a lot of time working from home, just to have some way of signaling to yourself that the workday is done and now we are entering a different phase. You don't have to be a great artist. Doodling also counts, dancing in the kitchen while you're making dinner, anything like that, that just connects you with that sense of art. In addition, experiencing the art of others, so one thing I like to do is fill up my Instagram feed with artists that I really like because just seeing that artwork every day can feed me.

 And then the final, mindfulness or meditation or prayer. It doesn't have to be a very rigorous, lengthy process, it can be very, very quick, so there's one woman I know who has a calendar notice every day at noon to do a one-minute breathing exercise, so literally just a minute. Something like that can be really easy. Another woman I know, every morning while her coffee is brewing, that is her minute of mindfulness, so it can be nice if you have something that reminds you to do it. Tether it to something you know you're gonna do, like you're gonna make your coffee every day, or a calendar notice, something that will pop up and remind you to take that minute for yourself. For me, what I do is I do yoga and meditate for 10 minutes every morning. It doesn't have to be a lengthy thing, as I've said, sometimes I don't even make the 10 minutes, but just a little reset every morning at the beginning of the workday helps give me a solid foundation to carry me through the day.  So think for a minute about whatever it is for you that could be something that you could commit to doing every day. The key is more the consistency than the length, so I'd much rather have you do a minute of mindfulness every day than try to commit to meditating for an hour a day, right, so whatever it is that you think you can actually commit to and maintain continuously is something that would good. And again, don't be overly ambitious, so if you think what you could do is commit to a 30-minute run every day, maybe just commit to a 15-minute run every day to start, and then if you can do more, great, but you won't get frustrated with yourself if you can't make it every single day.

The next thing is, we have to get better at talking about the things that are weighing on us. There was a study of lawyers and mental health professionals who were working in family and criminal court cases, and they surveyed those participants in the system to find out about their rates of secondary trauma and burnout, and it was found that the lawyers had higher rates of secondary trauma and burnout than the mental health professionals, so even though the mental health professionals were there specifically to support people in their challenges around their mental health, and so were likely getting much deeper into discussion of really challenging issues and emotional responses that people were having than the lawyers were. The lawyers were the ones who had higher rates of secondary trauma and burnout. Ultimately, the authors of the study concluded that this was due at least partly to the fact that the mental health professionals had an expectation of discussing with their colleagues the effects of secondary trauma while the lawyers did not. I'm sure this is very familiar to you, lawyers do not have a culture of discussing the things that are hard. We want to believe that there is not an impact on us, that we can just continually take on more stress, more burdens, hear about more horrific things, and it will never have an effect on us. This is, of course, not true, as we see through the rates of alcoholism, depression, suicide in our profession, so it's just not true that we are not experiencing the effects of the stress and the exposure to secondary trauma, so we have to get better at talking about what it is that we are dealing with on a daily basis. Now, of course, attorney-client privilege has to be maintained, but we can still talk about how what we're seeing affects us.

So if I, for instance, say to a colleague or to my spouse, I just had a difficult conversation today with somebody who is dealing with quite a lot, and I'm not sure I gave him great advice, and I don't know that there's a good answer for him, and I'm feeling really guilty that I can't do more and frustrated at everything he's going through. Now, none of that violates attorney-client privilege. I'm not giving any details about what the person is experiencing, or his name, or any identifying information, but I am opening up about my own feelings. Now, I will tell you, I am somebody for a long time who thought it wasn't helpful to talk about things. You know, ah, I'm just not a therapy person. It's just not, it's not how I operate. I don't really process things by talking them out. But, it was a lie. I will tell you that once I started to try this, I just that, I thought, well, let me just try, because I was experiencing so much stress all the time, and I finally said, okay, well, everybody says talking about it helps, so let me give it a shot. Turns out it did help. I did experience less stress, it did help me to be able to share my burdens with others, so I just wanna caution you, if you are somebody who is hearing this and thinking, well, that doesn't really apply to me, I want you to give it a shot, just try it for a little while. You can talk about things with your colleagues, obviously, and be able to maintain some sense of attorney-client privilege if it's within your team, but in addition, you can talk at a more high level about the impact on you with your friends, family members. Never underestimate the benefits of therapy.

And then another thing that has served me well over the years is writing in a journal, Just being able to dump out my feelings, what I'm seeing, the things that are weighing on me on the written page can really help, so what I've done for many years, and I know other people have done with a lot of success as well, is just try to start every morning with writing out a page or two in a journal that is just for me, and it doesn't have to be anything really well-written, it's just a way to get out the kind of mucky thoughts and emotions that I'm carrying around with you.

So whatever it is that you are, that you choose to, as a way to process the challenges that you're dealing with, try to make an affirmative effort to share those things that are weighing on you. You do not have to carry this all alone. And then the final thing is, try to get better at recognizing your own warning signs, and by that, I mean your warning signs that you're beginning to suffer from compassion fatigue or burnout. As I mentioned earlier, compassion fatigue can develop slowly over time, so we have to do what we can to try to recognize the signs that we're at risk for it. You might wanna take a look back at that slide that I showed earlier that had some of the common symptoms of compassion fatigue and burnout, and really think about what are the signs that are specific to you, it affects different people differently, so what are the things that are unique to you. Again, when we get in this mindset of, I'm the only one who can manage things, there's, it doesn't do any good to ask for help, it can be really, really difficult to recognize that we are, that that is itself a symptom of compassion fatigue and that it's not true, and that it really is okay to ask for help and to get some support in the things that we're doing.

You know, I spoke with a lawyer a little while ago, who, she said, you know, I thought I was fine. She said, I knew I was dealing with a lot. I knew that there was a lot of stress and I was carrying a lot, but I really thought I was doing fine, and I was managing it all really, really well, she said, and then there was a day where I was on a conference call with my team and I just started screaming at them. She said, I just lost it. I was screaming, I was swearing, I just, she said, I don't know, she said, that is not me, I don't know who that was, and she said, I just, and so she came to me and she said, what are some of the things I should be doing to help me recognize that I'm starting to suffer from compassion fatigue, and what I told her is it is really unique to each person, so we have to recognize it for ourselves, but we wanna try to recognize it before it gets to that point. Often I find that when there is something that is off for us, something we're struggling with, it speaks in whispers first, and then it gets louder and louder, so for her, there probably were subtler signs first before she kind of lost it on this call with her colleagues, so if you ignore those quieter signs, they will get louder, they will make themselves known to you, so what you wanna try to do is get better at recognizing those warning signs when they are quieter before we do something that we regret, before we start yelling at people and maybe end up really sick, or doing other sorts of behaviors or actions that can be really destructive in our lives, so, again, take a look at that slide that has some signs that might be an indication, things like insomnia, sense of helplessness, apathy, rigid thinking, hyper vigilance, getting sick a lot, those can all be signs, and there can also be subtler signs, so one of the signs that I try to keep an eye on is when things that I normally enjoy start to feel like a burden. So, for instance, I am somebody who really loves to throw dinner parties. I love cooking, I love having friends around a table and talking over a long evening, so if I am throwing a dinner party this weekend, and all I can think is, ugh, what a pain, I have to shop, I have to clean the house, that is a sign that I am probably starting to suffer some burnout and I need to keep an eye on that.

Other signs might be that sense of frustration all the time. For some people, if you're swearing a lot more than normal, that can be a sign. A very common sign is that you want to drop your daily reset, so whatever it is that you've committed to doing every day, you suddenly start to think, ah, I just don't have time for that today, or, I'll do it tomorrow, I just can't fit it in, I'm just gonna skip it today. That's usually a really early warning sign that you're starting to suffer from some sort of burnout. There's a famous Buddhist proverb that says, every day, you should sit in meditation for 30 minutes. Unless you're too busy, then you should sit for an hour. So that desire to skip your reset is often one of the first signs that you really need to double down on it. And that's really what you should do.

So after you have taken the time to think about what are your warning signs that are particular to you, that's an indication that you need to double down on the talking about the hard stuff and on your daily reset or your daily self-care routine. Oh, and one more thing I wanna mention is, if you are somebody who struggles with an addiction, a very common warning sign is when that starts to make itself much more prevalent in your life, so whatever it is for you, start to take those steps to identify what your specific warning signs are, and just keep an eye on them so that you can take steps to protect yourself before things start to get more out of hand in your life. For this next part of the presentation, I'm gonna ask you to get out a piece of paper or open up a new document on your computer or a note on your phone. If you aren't already taking notes, I want you to find a way to do that now, because for this next piece, I'm gonna ask you a few questions and I want you to take some notes so that you can refer back to them later. All right, you ready?

Question number one, what self-care routine or reset can you commit to doing? What's something that would work for you realistically in your life as it is currently organized? What is something that you could commit to doing? Remember, we talked about different categories of things that work for different people, so something like art, it could be listening to music, drawing or painting, some sort of engagement with art is something that works for a lot of people. Another could be exercise. Maybe you commit to going for a walk after dinner every night. Or you commit to 30 minutes on the rowing machine every morning. Something that is realistic for you. It also could be something involving mindfulness. Maybe what you could commit to is a mindful minute once or twice a day. If you are interested in learning more about mindfulness, there are some phenomenal apps out there, like Calm and Insight Timer, or you can just go online. There are a million really wonderful resources out there to help you learn meditation and mindfulness. So right now, just take a second and write down what is a reset that you could commit to doing every day, say, for the next three weeks. Okay, you got it?

Next question, how will you make sure you do it? We all have great plans. I mean, I'm sure you've seen the statistics on how poorly we all do on our new year's resolutions. We can have wonderful, wonderful plans, but the key is we have to make sure we follow through on them. So what are some things you can do to bolster your success at following through on this daily commitment? Maybe you wanna put it on your calendar. Just have something that pops up for you at four o'clock every day that reminds you that you said you were gonna walk the dog at that time. Maybe you can tie it to something you know you'll do, so maybe every after you brush your teeth, you will play the guitar for a little while. Another thing that works for some people is to find a commitment buddy, some, a friend, or your spouse, somebody in your life who could hold you accountable, maybe even commit to doing it with you, so if you have a friend or a colleague who agrees to go for a walk with you every day at lunch, that's gonna make it more likely that you'll follow through on it. I also really like habit trackers. I don't know if there's just something in me. It's like a way of getting that A, right, you're getting the positive feedback, it's almost like a sticker chart, but it's just some place that you check off, yes, I did this every day. Maybe on a physical calendar, you can do it on your online calendar, you can even download an app for that, there are a lot of habit tracker apps, but when you start to see that string of success, it makes it more likely you will continue on that path. So whatever it is for you, can you write down one or two things that will help you commit to carrying through with this reset that you wanna do every day? All right.

Third question. We talked earlier about the importance of getting more comfortable talking about the hard things that we're experiencing. So what I want you to do now is write down five people who you could turn to when you're having a hard time, when you're feeling low, or when you're really angry or frustrated, who are some people that you can lean on in that moment? These can be friends or family members, they can be colleagues. It doesn't even have to be a person, so if you wanted to, you could write down your journal. Writing it out in a journal is a great solution. Maybe you talk it out with your dog. Just make sure you have, aim for five places that you can go to vent when you need to.

Question four, what are your warning signs for burnout? What are the signs that indicate to you that you are really just getting too low in your energy tanks, that you are starting to suffer from burnout or compassion fatigue? Try to list at least three. Remember, we talked about some warning signs could be maybe that things that are normally fun start to feel like a burden, or maybe you develop a short temper. You suddenly, things that seem pretty mild at really setting you off. Maybe it's that you're feeling apathetic, that you just can't care about things at all, that's a very common one, or helpless. You know, there's, nothing I do matters at all. That's a very common sign of burnout. Perhaps you are somebody who tends to get physical symptoms, like you're getting sick a lot, you are having trouble sleeping, you're developing insomnia, you have trouble falling asleep, or maybe you wake up in the middle of the night and can't get back to sleep. Again, addiction. If addiction is something that you deal with in your life, this could be another sign that you are starting to experience burnout is when that starts to make itself known to you, so just write down right now three things that could be warning signs for you that you are beginning to experience compassion fatigue.

And then last question, what are three things you can do when you notice that warning sign? We've talked about a few, doubling down on your daily reset, reaching out to a friend, so what are some things you could do? Maybe that's a sign that you need to take a day off of work, or go for a walk in the woods. What's something that could be a bigger reset for you when you start to notice that warning sign? Remember, our aim here is to write three different things. Okay, I want you to hold on to this document or paper wherever you have it and just pull it out periodically. Right now, you've made a commitment to doing something for three weeks. I want you to pull this out again after that three weeks and just take a look at it and remind yourself about what you've committed to and what resources you have available to you. It's a good thing to take a look at regularly. You could pull it out on a monthly basis, or just try to have it someplace accessible, maybe on your desktop, or someplace easy to find on your phone, so that you can remember these issues because, as I said before, compassion fatigue is a really tricky thing, it'll sneak up on you, and it's something that by the time you notice it, it's already upon you, so doing what we can to head that off is really the best route for our long-term health and happiness.

I wanna thank you for joining me today for this program. On this slide, you'll see some information on me and how to stay in touch with me. As you see, my name is Katherine Manning. There are a lot of different social medias that I'm on, so whatever is the form that you like to engage with, I hope that you will get in touch with me through that. If these topics that I've been talking about interest you, and you'd like to learn more about them, please check out my book, The Empathetic Workplace: 5 Steps to a Compassionate, Calm, and Confident Response to Trauma On the Job. It goes into a lot more detail about the stress and trauma that we encounter in our work and how it affects us and how we can better support ourselves and those around us. It's available on Amazon and Barnes & Noble's, really any place that you buy books, and there's also a really great audio book version if you like those. I really would love to stay in touch, so please do connect with me on whatever platform you prefer. I wanna thank you again for spending this time with me and for all the things that you're doing every day to take care of yourself and those around you. Thank you.

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