Personal Reflection
This topic of trauma is rather personal to me in that early after graduating high school; I worked as a clerk in a local trauma center emergency room. Being the only trauma center in a 50 mile radius along the northeast corridor (Interstate 95, DC to New York) makes for a busy center. I would be presented with trauma on a daily basis, everything from farming accidents, automobile accidents, crime, rape and child abuse. Often as a clerk, my job entailed not only witnessing the state of the victim, but talking with the family present to gather information for their chart. My job required me to focus on getting data, not on helping with the emotion. I had to be very clinical. As one would imagine, I also witnessed the immediate effects of death on family members. Sometimes, knowing that a family member had passed before they knew, I had to gather information for their chart. I did this job for nearly 10 years and while I did it well, it took a toll on my skills in empathy and compassion. I became clinical and numb in many parts of my life and while intellectually and logically, I was able to process emotion, I didn’t feel it – this contributed to a number of life changing events (another story). Flash forward to Colloquium 1 in VA, Fall 2008. One week of constant mock group, individual and family therapy where I connect with a group of 12 classmates. I feel empathy for the first time and cry for make believe client! This was new ground for me. I hadn’t done this, before…. Ever! Flash forward to Track II , Summer 2009, another week with a new group of classmates with more intensity than I’ve had in my life. I cried like a baby all week and loved it! I have come to embrace empathy as something precious and only hope I don’t over expose myself in a traumatic crisis.
In reading Figley’s article on compassion fatigue, I am thoughtful about applying these methods in my own career and I am particularly thoughtful about my current stance on empathy. The methods of insight that will likely serve me best seem to be the emphasis on a having open discussions with colleagues and facilitating self care. Currently my work under supervision allows m e the immediate venue on keeping empathy and compassion in check. I discuss any transference with my supervisor and have even approached a client role at times disclosing some personal experience during these sessions. Being thoughtful about maintaining this professionally therapeutic session beyond my internship and licensure period will be important. Becoming over confident in my ability to maintain on my own is not likely a good plan. Also, identifying methods to facilitate self care will be critical in my effort to be an effective therapist. Finding ways to detach from the compassion and empathy long enough to recharge will be my likely initial steps. If further steps are needed seeking a colleague for guidance and objectivity will be a thorough follow-up.
So I’m thoughtful about how I might have helped me 15 years ago, had I worked as a trauma counselor in the hospital during one of the many crises that happened during my tenure there. Using Figley’s process, I might have begun by educating the 25 year old me about my compassion fatigue and working to identify the way it was impacting me and my life. I believe the next step would be to have provided a safe place to begin working on allowing the feelings to be expressed, perhaps with people other than co-workers. With this safe group acting out and processing some of these circumstances in a “controlled” manner would be the goal. Figley comments on this exposure dosage writing, “Utilizing the right therapeutic dosage of exposure is challenging.” (Figley, 2002, p.1439) He further writes that combining these controlled dosages with techniques that help process those such as relaxation can be effective. (Figley, 2002) Facilitating this therapeutic exposure, while helping the participants build a support circle of peers seems to be the most effective approach.
Adam T
References
Figley, C. R. (2002). Compassion Fatigue: Psychotherapists’ Chronic Lack of Self Care[SUP 1]. Journal of Clinical Psychology, 58(11), 1433-1441. Retrieved from EBSCOhost.
