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Week 7 – Trauma & Empathic Distress

This week we focus on trauma, empathic distress fatigue and emotional exhaustion. How do you nourish yourself and look after yourself in times of stress or difficulty, particularly when working in emergency services (or when many people around us are experiencing high levels of stress and psychological distress). What self-care techniques do you practice to decompress, regulate and return to your window of tolerance? How do you show empathy for others but ensure you don’t take on too much of other peoples’ energy, stress or trauma?

WISE Recap

  • Mindfulness can help us to overcome emotional exhaustion and vicarious trauma. Mindfulness is a useful tool for regulating emotions by increasing awareness and developing flexibility and adaptability in responding to our own emotional experiences. Mindfulness encourages acceptance rather than avoidance of our experiences and decreases rumination about past and future events that can exhaust our energy. When we are mindful and accept sensations and thoughts that arise, we likely reduce our emotional numbing.
  • Empathy is the ability to understand and share someone else’s feelings. Emotional empathy enriches our relationships with others, but it becomes a problem when we are overwhelmed by our emotional response to other people’s distress. This can sometimes lead to empathic distress fatigue or vicarious (secondary) trauma.
  • Our capacity to hold space for own our suffering and pain, directly correlates to our capacity to hold space for other’s pain. It is likely that many people have empathy tanks that are full (i.e. they have reached their own capacity for empathy). Empathic distress is common after what we have all experienced collectively in the world.
  • The skill we have learnt this week is responding mindfully to others’ pain by dialing down the empathy. We are working towards maintaining equanimity (inner balance), whilst also learning how to respond with kindness, compassion, respect and care.
  • Kindness is good for our physiological wellbeing. It produces oxytocin which fills our heart with blood, dilates our blood vessels and lowers our blood pressure. Make your kindness acts this week unconditional (you don’t need anything back).
  • Remember the hand model we did at the start of the workshop (the hand opened with acceptance, allowing and compassion. The hand tightened with resistance and forcing a particular state to occur). There is often intelligence in the trauma response and ‘shutting down/closing off’ to protect and stay safe. This is a survival mechanism and response. However,  when we communicate to ourselves and others with warmth, care, respect, kindness, love and compassion it helps move through these states and difficulties with more mindfulness, grace and composure.

What is Empathy?

Empathy is the ability to understand and share someone else’s feelings, to the extent of imagining what the other person is thinking or feeling, and responding with care. It is an emotional response. Therefore, we can regulate and modulate the sensations in our body just like we practiced in week three with emotions.

 

Minimising the Impact of Secondary Trauma

Trauma is defined as a physical and/or emotional wound or shock that creates substantial, lasting damage to a person’s psychological development. Vicarious trauma (otherwise known as secondary trauma) refers to an individual’s own psycho-emotional reactions due to his or her exposure to others’ traumatic experiences. For police officers who work with traumatised or challenging populations, vicarious trauma becomes a much more serious issue because it can potentially compromise the individuals’ health and well-being.

Mindfulness can help us to overcome emotional exhaustion and vicarious trauma. We can learn effective self-directed techniques and tools to maintain equanimity in the face of danger and human suffering, thereby reducing the incidence of secondary or vicarious trauma, PTSD or other stress-related health concerns.

Studies measuring stress in health care professionals and individuals working in emergency services/ trauma-related professions found an eight week mindfulness meditation program resulted in a significant decline in emotional exhaustion and empathy fatigue.

Mindfulness is a useful tool for regulating emotions by increasing awareness and developing flexibility and adaptability in responding to our own emotional experiences. Mindfulness encourages acceptance rather than avoidance of our experiences and decreases rumination about past and future events that can exhaust our energy. When we are mindful and accept sensations and thoughts that arise, we likely reduce our emotional numbing.

Firstly, let’s revise the window of tolerance so we can identify the early warning signs of trauma and dysregulation.

Window of Tolerance Chart

Know the Signs

Before we can respond to trauma, we first need to recognise it. It is important to notice the nonverbal cues that someone is struggling with traumatic stress. We can assess trauma through direct conversation (i.e. reading facial expressions and noticing nonverbal cues) as well as paying attention to the following basic internal and external signals that suggest someone may be experiencing trauma and outside of their window of tolerance:

  • Muscle tone extremely slack (collapsed, noticeably flat affect)
  • Muscle tone extremely rigid
  • Noticeably pale skin tone
  • Hyperventilation
  • Exaggerated startle response
  • Excessive sweating
  • Noticeable dissociation (person appears highly disconnected from their body)
  • Person reports feeling they are a long way away
  • Person cannot hear our voice and/or constantly asks others to repeat questions
  • Person is staring off into space without blinking and not responding to any questions
  • Person loses sense of time and cannot remember what happened previously
  • Consciousness appears to fluctuate—you notice the person “isn’t there” or seems preoccupied with internal distraction
  • Person cannot maintain a continuity of story or experience in conversation (e.g., jumping from topic to topic)
  • In conversation with the individual who is experiencing trauma, you yourself may begin to feel foggy, confused, or like you’re floating. This can be a sign that the person you’re connected with is dissociating
  • Emotional volatility (enraged, excessive crying, terror)
  • Disorganised speech or slurring words
  • Reports of blurred vision
  • Inability to make eye contact during interviews/interactions
  • Reports of flashbacks, nightmares, or intrusive thoughts

 

Early Warning Signs of Emotional Exhaustion/ Empathy Fatigue

  • Feeling emotionally exhausted and drained (unable to perform basic tasks)
  • Depression, guilt
  • Increased negative thought patterns
  • Sense of hopelessness
  • Reduced ability to feel empathy towards other individuals, including clients, employees or family/friends
  • A sense of resentment towards demands being put on you at work and at home/ decreased job satisfaction
  • Feeling unappreciated
  • Difficulty concentrating or focusing
  • Change in appetite or sleep habits
  • Frequent headaches or muscle pain
  • Lowered immunity, frequent illnesses
  • Increased conflict in relationships
  • Withdrawal from friends/ family emotionally
  • Feeling trapped and defeated
  • Detachment, feeling alone in the world
  • Loss of motivation, passion or drive

Dialing Down the Empathy

Emotional empathy can also distract us from having an accurate judgment of what the other person really needs. Our capacity to perceive and resonate with others’ suffering allows us to feel and understand their pain. This skill in responding mindfully to others’ pain results in us remaining equanimous whilst also motivating us to respond with compassion.

The ability to demonstrate kindness to ourselves and others and express a deep understanding of what they are experiencing or going through is a wonderful skill. We must however, take steps to ensure ongoing feelings of empathy, stress and/or trauma to others doesn’t tip us over the edge where we come out of our window of tolerance. Although empathy is an important skill in social connection, leadership, as well as career success it is important to find a balance. This is where mindfulness can help.

The practice below will help you to dial down the impact that stress, emotional exhaustion, empathic distress or secondary trauma is having on you (particularly if you are around others who are experiencing suffering, or you are working in a job where you are working in a heightened state of hyperarousal or hypervigilance).

***Be mindful that this practice may bring up feelings that are contrary to what we are actually working towards. This is perfectly normal.  For example, you may notice feelings that seem counterintuitive, for example like you’re not caring enough by reducing your empathy. This is where kindness is important. Kindness produces chemicals and positive emotions in our brain and sending this kindness outwards can help us to remain balanced on the inside. The inner process of turning down the empathy dial is a skill and a practice that must be practiced regularly to help us remain balanced emotionally and healthy throughout our career. Demonstrating kindness to others can often help us strike that sweet spot and find balance.

WEEKLY PRACTICE TASKS

INFORMAL PRACTICE-  Unconditional Kindness

The informal practice this week is to do something kind for someone else. This is a RANDOM ACT OF UNCONDITIONAL KINDNESS which means that you are not doing this to get anything in return. Be creative- e.g. pay for someones coffee behind you in the drive-through, buy a parking ticket for someone and place it on their windscreen, cook a meal for an elderly neighbour, leave a note for someone expressing your gratitude about something they did well, write a letter to a colleague letting them know you appreciate them being a positive pillar in the office, brighten someones day who appears to be having a bad day by leaving lollies or chocolate on their desk, leave flowers on a neighbours door-step, make a cup of tea or coffee for a  colleague. The possibilities are endless be creative!

Have fun with this activity and see if you can do something kind EVERY DAY.

FORMAL PRACTICE- Dialing Down the Empathy

Practice this week Dialing Down the Empathy. This is a mindfulness practice to help us cultivate kindness, care and respect for ourselves. Although emotional empathy enriches our relationships it is important to find a perfect balance between kindness and empathy. Mindfulness can help us to decompress and nourish ourselves, regulate our emotions and avoid vicarious (secondary trauma), compassion fatigue or other stress-related health concerns such as PTSD or burnout. Movement practice is also important here. You may like to stretch the body or perform the decompression practices that we went through in the session. Experiment with having different anchors of attention to support your window and help with grounding. This could be focusing on the soles of your feet, your palms, the back of your body, the sense of smell, sounds, sights around you (i.e naming objects internally (e.g., “couch; the color blue”) or placing a hand on an object that feels stabilising to touch such as a solid object or the floor.

Week 7 : Dialing Down the Empathy