The 'Joy - Pain Spectrum' in helping: mitigating risk and finding support (Part 5/5)

20 July 2022

This five-part blog series of the 'Joy-Pain Spectrum' has explored the opportunities for growth, hope and positive change that help to protect us and mitigate the risks associated with the challenges of helping others at the other end: burnout, vicarious trauma, compassion fatigue (empathic strain) moral injury and secondary traumatic stress. So how do we protect ourselves? How do we maintain our healthy selves in relation to helping work? The answer lies in the need for cultural, political and organisational shifts, as well as the need for BOTH individual and collective supports.

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A health and education workforce in strife

It is no secret that our healthcare and education workers are under enormous pressure. Every day there are new articles highlighting the strain under which these systems have been, and continue to operate. And the toll on our workers is showing in high levels of burnout, high rates of suicide and worker shortages.

This is a cultural and political issue. As discussed in the blog, 'The Misnomer of Self Care', systemic problems cannot be solved with individual responses.

What can organisations do to better support workers?

This is a whole blog in itself, but some of the basics include:

  • Better pay
  • Reasonable caseloads
  • Leadership in terms of workplace boundaries
  • Supportive, authentic leaders

Further, we know from the research discussed in the second blog in this 'Joy-Pain Spectrum' series on compassion satisfaction that the following mechanisms and support structures are essential components for a healthy workplace:

  • Ongoing and specialised training and education
  • Trauma-informed clinical supervision
  • Meaningful recognition within the workplace
  • Authentic, supportive and stable leadership
  • Peer support
  • An ability to have clear boundaries between work and home
  • Adequate self care strategies
  • Authentic connections to clients / patients / students
  • Varied caseload
  • Access to external supervision

When there's a sense of severed belonging, of disconnection, it undermines hope. It cuts us off from that field of possibility. Reconnecting with presence is a process that gives us hope.

Tara Brach

What can we do as communities?

The key is awareness, presence, connection and collective care.

As Lou Cozolino says: "We are not the survival of the fittest, we are the survival of the nurtured."

We need each other to survive and flourish. There is a reason that teachers, nurses, therapists, doctors, pharmacists and every other health profession rely on their teams for support: no one else gets it quite like they do.

When healthy, our teams really are our best resource for coping as they bring us:

  • understanding
  • collegial support
  • emotional debriefing
  • humour and fun.

But family, friends and community play a huge part as they support us:

  • to connect with loved ones,
  • to continue to enjoy interests outside of work and,
  • through looking out for us, being kind and caring when we need it most.

Given that helping professionals seem to struggle with reaching out for support, the role that family, friends and colleagues play is significant.

So how do we move from being stuck in a stress response?

Here is one way that we can begin to notice, sit with and express our response to stress.

Remember each moment of stress is like a wave:

  • meet the wave,
  • surf it
  • know it will pass.

Let's explore how:

  1. Notice your energy or nervous feeling state. Are you hot and bothered? Wanting to hide? Feeling sleepy? Feeling stuck?
  2. Notice is happening in your body, your physical sensations, OR if you don’t notice anything bring kindness and observe this.
  3. Sit with it
  4. What is the need? Do you need to talk to someone? Move your body? Take some quiet reflective time? Laugh? Cry? How can you meet it in the moment or later? Is there someone who may be of support? How can you express this need or stress?

What can we do to support ourselves individually?

We know from understandings of vicarious resilience and compassion satisfaction that being aware of, acknowledging and connecting with the positive aspects of our work are protective. Given the inevitable stress load in helping roles, we understand that absence of quality support and self awareness are risk factors.

As discussed previously, we are very good in this western capitalist society at tuning out of our bodies and felt experiences, and living in our heads: pushing through the need to stop and rest; pushing past feelings and shelving them for 'later'.

However, if we are to truly understand and address the stress we are experiencing, we need to go underneath our thoughts and words, and into our feelings and bodies; we need to identify and move through what Emily and Amelia Nagosky call the 'stress response cycle'.

This can be challenging at the best of times, but especially when we are so practised in the art of disconnecting from ourselves.

The good news that we can practise noticing the positives, sparkle moments or what Deb Dana calls 'glimmers'. These are the small moments of joy that occur through the day - from the big break throughs, to small, seemingly insignificant moments.

One example of a glimmer is that when catching the bus I notice that every time, most people thank the bus driver, with a smile and wave. A small gesture perhaps, but every time I notice I smile and reflect on the warmth in this exchange. This warmth can stay with me, or return to my felt experience whenever I remind myself.

Noticing our physical sensations when experiencing or remembering glimmers or sparkle moments are a great way to begin to pay attention to what is happening in your body.

Stress is not bad for you; being stuck is bad for you.

Emily & Amelia Nagoski

It is inevitable that helpers will be impacted by the work they do.

Policies and systems need to change to ensure better mental health outcomes for health and education professionals. In the meantime we, as communities of colleagues, friends and families need to band together to look after our helpers.

On a personal level, reconnecting to ourselves and our needs - maintaining one foot in our experience and one foot in that of our clients, students and patients - is essential in knowing where we are within the 'Joy-Pain Spectrum'.

This takes practice, especially when most of us are very good at ignoring our needs. So go gently, be kind to yourself and take one step at a time.

If you are interested in learning more and immersing yourself and your team in these concepts, please be in touch here to discuss training programs on offer.

Related Resources

Header image: Pete F