“We know there will come a point when this current storm is over. We are making decisions about who we want to be on the other side when it comes,” said trainer and consultant Carla Cheatham, MA, MDiv, PhD, TRT, at the closing general session of PALTC2021, the Virtual Annual Conference of AMDA – The Society for Post-Acute and Long-Term Care Medicine. Talking about “More Than Survival: Thriving Toward Post-Traumatic Growth,” she noted, “We know we will be changed, but how?”
When Compassion Fatigue Creeps In
To move past the pandemic, practitioners and others need to acknowledge and address their own feelings about what they’ve been through. Specifically, Dr. Cheatham said, “Compassion fatigue happens when we are giving and giving and not taking in. This can be acute or chronic. The question is how we notice those moments of compassion fatigue and attend to them so they’re more the exception than the norm.”
Right now, said Dr. Cheatham, “We’re all just trying to get by by the skin of our teeth.” However, she noted that people often are hesitant to admit that they’re hurting or that they need help. “We tend to compare our insides with others’ outsides,” she said. The problem with this is that others are often putting on a false façade so we don’t see their pain or struggles.”
It is essential to find ways to cope with stress, anxiety, and compassion fatigue. Dr. Cheatham said, “If we don’t have coping strategies, we are at greater risk. If we are so driven to care for others, we get into trouble when we don’t care for ourselves.”
The Signs of Trouble
Even if you’re too busy to attend to your needs or in denial, there are too many signs of trouble to ignore them all. These include anger/blame, apathy, chronic lateness, cynicism, depression, displaced anger, exhaustion, existential struggles, gastrointestinal complaints, headaches, unrealistic expectations, hopelessness, inefficacy, irritability, low self-esteem, nightmares, sleep disturbances, and workaholism.
Dr. Cheatham said, “We are facing unprecedented challenges. If you are struggling, you are having a normal human reaction. Struggling doesn’t mean there is anything wrong with you.” In fact, she suggested, people feel like they’re not allowed to be human if those around them seem to be unaffected and refuse to acknowledge their own struggles.
According to Dr. Cheatham, “Research shows that our best hope is to be mindfully self-aware, to believe we can take action on our own behalf, and to have an adequate social support system.” She added, “There are things we can do to take action to garner support and set our sights on coming out on the other side thriving. A safety net lets us be adaptable and creative.”
The key is resilience, Dr. Cheatham offered. “The more flexible we are, the more likely we are able to make it through.” Specifically, resilience involves being able to evolve beyond adversity to a greater level of practice wisdom, while maintaining a capacity for compassion. The most resilient individuals are able to confront a crisis, see it for what it is, and focus on resourceful ways to overcome the challenges facing them.
Resilience involves several protective factors, including learned optimism, internalized locus of control, connections and community, adaptability/flexibility/coping, gratitude and hope, and self-care.
Emotional intelligence is also important for resilience. This means having the ability to manage disruptive emotions in the face of trauma, crisis, and change while maintaining empathy for self and others. Dr. Cheatham stressed, “Fear gets to have a voice, but it doesn’t get to have a vote. We want to stay mindfully aware and nonjudgmental.”
Self-care isn’t one-size-fits-all, and it’s not a one-and-done effort. It needs to be sustained over time and personalized to your own needs and feelings. Importantly, Dr. Cheatham said, self-care should not be confused with selfishness. Selfishness involves doing for yourself at the expense of others. Self-care means taking care of yourself so that you can bring your best self to others. Dr. Cheatham said, “Self-care includes having boundaries with yourself and others. It’s not just something to think about. We need to put it into action.”
As important as it is, self-care isn’t always easy. Dr. Cheatham said, “Our brains are trained to focus on the negative. We have to train our brains to see what is good.” Even then, she suggested, sometimes people need to “hit the decompression value” when they find themselves overcome by negativity. “You need to stop and ask, ‘How can I respond more positively to this?’”
Dr. Cheatham noted, “People often tell me that barriers to good self-care are time, energy, and money. I call bull on this. I think the bigger issue is that we don’t think we’re worth it.” She added, “Consider that maybe self-care isn’t about finding time to take a class or money for yoga pants. It’s about taking the things we do and doing them more mindfully.”
What Can You Change?
It’s important to focus on what you can change and let go of those things that are out of your control. Then determine what steps you can take over time -- in the next day, week, and month.
Ultimately, Dr. Cheatham suggested, it is important to make a commitment to be there for others while taking care of yourself. However, she urged, “Find a sense of compassion for the voice struggling inside your head instead of shaming and blaming yourself.” She suggested, “Let all of the events of the day wash off you so you go into the next interaction clean.”
Senior contributing writer Joanne Kaldy is a freelance writer in Harrisburg, PA, and a communications consultant for the Society and other organizations.