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Every Empath's Nightmare- Compassion Fatigue · Millennial Mental Health Channel

0:02
Speaker 1: Welcome to MMHC, your go to mental health podcast.
0:06
Speaker 2: I'm Dikoreo, a licensed professional counselor.
0:08
Speaker 1: And I'm Justin Romano, a Board certified Child an Adolescent psychiatrist.
0:12
Speaker 2: We created MMHC to give listeners evidence based information directly
0:16
Speaker 2: from professionals who work in mental health.
0:18
Speaker 1: We're not influencers, we're not trying to sell you anything.
0:21
Speaker 1: We just want to bring love, empathy, and understanding of
0:24
Speaker 1: mental health into this world.
0:26
Speaker 2: And we really think that learning about mental health should
0:28
Speaker 2: be fun, interesting, and most importantly honest.
0:31
Speaker 1: So thanks for tuning in. This is a show by
0:33
Speaker 1: two millennials, but it is intended to be for everyone.
0:36
Speaker 1: We hope you enjoy the show. Welcome to MMHC, your
0:44
Speaker 1: go to mental health podcast.
0:46
Speaker 2: I'm Dikoreo, a licensed professional counselor.
0:49
Speaker 1: And I'm Justin Romano, a Board certified Child and Adolescent psychiatrist.
0:53
Speaker 2: We created MMHC to give listeners evidence based information directly
0:57
Speaker 2: from professionals who work in mental health.
0:59
Speaker 1: We're not in unswers, we're not trying to sell you anything.
1:02
Speaker 1: We just want to bring love, empathy, and understanding of
1:05
Speaker 1: mental health into this world.
1:06
Speaker 2: And we really think that learning about mental health should
1:08
Speaker 2: be fun, interesting, and most importantly honest.
1:12
Speaker 1: So thanks for tuning in. This is a show by
1:14
Speaker 1: two millennials, but it is intended to be for everyone.
1:17
Speaker 1: We hope you enjoy the show. MMHC is a production
1:22
Speaker 1: of Speaker from iHeartMedia, I Heart so Eddie. It's summer break.
1:30
Speaker 1: You've been off for a couple of weeks. Now what
1:32
Speaker 1: from zero to one hundred? What's your level of compassion
1:35
Speaker 1: fatigue and burnout?
1:39
Speaker 2: Oh? Today's episode is about compassion fatigue, right, And I
1:43
Speaker 2: think when I was writing it up, but we were
1:47
Speaker 2: putting this together, I really had to think to myself,
1:51
Speaker 2: like I think this is I feel like I should
1:54
Speaker 2: have maybe titled it separately. It's less about compassion fatigue
1:57
Speaker 2: when it comes to like my work, and I think
2:00
Speaker 2: it's been more of compassion fatigue towards like regular towards
2:04
Speaker 2: other people. I don't know, does that make sense? Like
2:07
Speaker 2: I just feel like, man, like, so much shit has
2:10
Speaker 2: gone on in six months, and I think it's really
2:13
Speaker 2: put a lot of people on edge. But I and
2:16
Speaker 2: and not to like make us seem like we're these special,
2:19
Speaker 2: like all knowing people. But I feel like it's put
2:21
Speaker 2: like quote helper profession people in like a really tough
2:25
Speaker 2: spot because you not only do you have to care
2:28
Speaker 2: about yourself and like your family and the people you
2:30
Speaker 2: care about and the people around you, but then you
2:32
Speaker 2: have to care about like the people you're serving in
2:35
Speaker 2: your job. That's where I've had a really hard time.
2:37
Speaker 2: Like I feel like I'm at a spot right now.
2:40
Speaker 2: Maybe it is because of the work that I do
2:42
Speaker 2: where I feel like I'm caring about other people less.
2:46
Speaker 2: Does that make sense, Like I just don't have it's
2:49
Speaker 2: it's just a really tough spot. I really don't have
2:52
Speaker 2: a good way to describe it other than to like
2:55
Speaker 2: ramble about it. But yeah, I just figured we should
2:58
Speaker 2: we should talk about compassion for do a little bit,
3:00
Speaker 2: because it's very real. I think it's one of those
3:03
Speaker 2: things that probably gets talked about when you're in school
3:06
Speaker 2: and in training. But like unless like you're you're feeling it,
3:09
Speaker 2: like you don't really know what to do, right. It's
3:12
Speaker 2: just like with burnout too, like unless you're like unless
3:15
Speaker 2: you're actively burnt out, or it's really been drilled into
3:18
Speaker 2: like this is how to avoid burnout, or like these
3:20
Speaker 2: are the things you need to do to take care
3:22
Speaker 2: of yourself. You're not really paying attention to it until
3:25
Speaker 2: like you're really into it. I don't know, unless you're
3:28
Speaker 2: like really experiencing it. So I guess that's really what
3:30
Speaker 2: I wanted to talk about today. I think we try
3:33
Speaker 2: not to be too political. I say that like kind
3:36
Speaker 2: of backhandedly, because I'd be saying the fucked head cruise
3:38
Speaker 2: all the time. But the United States is a tough
3:44
Speaker 2: spot right now. You know, the it's July third, at
3:47
Speaker 2: seven twenty two Pacific standard time, what like nine hours ago,
3:54
Speaker 2: eight hours ago, the quote unquote big beautiful bill just
3:57
Speaker 2: got passed, you know, and people are very happy about it,
4:01
Speaker 2: for me, for Justin, for other helpers, and you know,
4:04
Speaker 2: audience of the show. We understand that it's going to
4:07
Speaker 2: impact a lot of people that we care about and
4:09
Speaker 2: that we work with, and like, I think that part
4:11
Speaker 2: really makes it hard to care about other people that
4:14
Speaker 2: don't understand how much is going to impact the people
4:17
Speaker 2: we work with, you know. So I think that's really
4:20
Speaker 2: what's put me in the spot recently of just like
4:23
Speaker 2: I care so much about my students and my clients
4:25
Speaker 2: and people that I work with, and then it's it's
4:28
Speaker 2: hard to care about others when we're kind of put
4:31
Speaker 2: into the spot. I think the other piece that's really
4:33
Speaker 2: weighed on me has just been how this it's not
4:36
Speaker 2: a surprise, but I think, you know, this administration has
4:39
Speaker 2: really run on tax cuts, tax breaks, and but the
4:42
Speaker 2: other really big piece to it has been increasing or
4:45
Speaker 2: their their quote unquote mass deportation. And you know that
4:48
Speaker 2: really that's something that sists with me a lot, you know,
4:51
Speaker 2: being someone who is Mexican, who is the son of
4:54
Speaker 2: two Mexican immigrants, that's something that I think about a
4:57
Speaker 2: lot when they talk about these mass deportations and trying
5:00
Speaker 2: to really like dehumanize people and like make it seem
5:02
Speaker 2: like we need these people out of our country. Right.
5:05
Speaker 2: Just recently, the who I don't want to name was
5:09
Speaker 2: in Florida and they were at this place like out
5:12
Speaker 2: in like the Everglades or whatever, and they're calling it
5:14
Speaker 2: Alligator Alcatraz. Did you hear about this?
5:16
Speaker 1: Yeah?
5:17
Speaker 2: And then a temporary basically deportation center. You know, there's
5:21
Speaker 2: gonna be this many million new people at Alligator Alcatraz.
5:26
Speaker 2: The really shitty part is that the number that they
5:29
Speaker 2: used was the exact same number of Latinos that they
5:32
Speaker 2: are in this country. So essentially what they're saying is
5:34
Speaker 2: we're gonna get all the Latinos out of here, you know.
5:36
Speaker 2: So it's just so much has gone on, you know,
5:39
Speaker 2: the ice raids, the things that are happening in la
5:42
Speaker 2: It's just so much has gone on. It's just like
5:45
Speaker 2: really tiring. But then the hard part too is that
5:46
Speaker 2: we have to also understand that because we are in
5:49
Speaker 2: this like healing profession and we're here to help people,
5:53
Speaker 2: sometimes it feels like we don't necessarily get the choice
5:56
Speaker 2: to like take a break from it and take a
5:58
Speaker 2: step back from it because we are kind of in
5:59
Speaker 2: it our clients and patients, I think, So that part's
6:03
Speaker 2: really hard. You think about what's going on in Palestine
6:07
Speaker 2: and the genocide and war going on there, that's really
6:10
Speaker 2: hard too. I think I've talked to you about it
6:12
Speaker 2: justin where like as a state organization we made a
6:16
Speaker 2: statement to offer up our support for the Palestinians, we're
6:20
Speaker 2: quickly met with like the opposite of like, well this
6:22
Speaker 2: is you know, you're saying this and you're shitting on
6:27
Speaker 2: us and this and that. I'm like okay, so like
6:30
Speaker 2: I guess what I'm trying to go with that of
6:31
Speaker 2: like with that situation is it really made me think
6:33
Speaker 2: of like, Okay, we are in a very different space
6:36
Speaker 2: where it's like we can have these thoughts and these feelings,
6:38
Speaker 2: but then we also have to there's a power, there's
6:40
Speaker 2: a level of power and privilege that comes with these
6:42
Speaker 2: roles that we have where we can always say certain things.
6:45
Speaker 2: And I don't know. All that to say is the
6:48
Speaker 2: empathy levels are are low. I'm tired, not for my kids,
6:53
Speaker 2: not for my students, not for my my clients or anything,
6:56
Speaker 2: but maybe towards the rest of the world. So that's
6:59
Speaker 2: I'll take a break, right and Rent go ahead, just.
7:03
Speaker 1: Well, I feel you. And it does feel like there
7:05
Speaker 1: is so much emotional stuff and there is so much
7:08
Speaker 1: emotional content going on in the media where they are
7:11
Speaker 1: trying to get an emotional reaction out of you that
7:16
Speaker 1: it's working, I know, right, And on the grand scheme
7:21
Speaker 1: of things, I would say like, you're more of an
7:25
Speaker 1: emotional person than your random average man in this country.
7:30
Speaker 1: And I think that's a wonderful thing. I think that's
7:32
Speaker 1: a good thing. I think it's one of the things
7:33
Speaker 1: that makes you such a good therapist and a counselor.
7:36
Speaker 1: Is that you are emotional, you do connect with people,
7:38
Speaker 1: you do want to see people well. But it's hard
7:41
Speaker 1: to see so many terrible things going on in the
7:43
Speaker 1: world and to make it feel like no matter what
7:46
Speaker 1: you're doing, there's just going to be these horrible things
7:48
Speaker 1: going on all around you. Like you do you agree?
7:51
Speaker 1: Do you think that I'm on the right path there?
7:52
Speaker 2: Yeah? Yeah, And I think too, like the you know,
7:56
Speaker 2: I want to feel for these people that are about
7:57
Speaker 2: to lose their insurance medicate things like that happening a
8:02
Speaker 2: lot of people because of like this bill that just
8:05
Speaker 2: got passed, are going to really be impacted negatively, and
8:08
Speaker 2: I know you think about it, and I think about
8:10
Speaker 2: another like helping professionals think about it. But then unfortunately
8:14
Speaker 2: it's the same people that turn around and be like,
8:15
Speaker 2: you know, there's exactly what I voted for. Get the
8:17
Speaker 2: Mexicans out of here. I'm like, well, how am I
8:19
Speaker 2: supposed to feel for you and feel concerned for you?
8:22
Speaker 2: And like this is kind of what you voted for
8:25
Speaker 2: in a roundabout way, you know. And again, not to
8:28
Speaker 2: make it super political, but I think of like, you know,
8:30
Speaker 2: when when all the things were going on about like
8:33
Speaker 2: federal spending or feral federal money being taken away from
8:37
Speaker 2: schools towards like special education and things like that. When
8:40
Speaker 2: you look at the charts and you look at like
8:41
Speaker 2: what states get the most federal funding for these student services,
8:47
Speaker 2: the then diagram of the states that get the student
8:49
Speaker 2: services all this money and that voted for in this
8:52
Speaker 2: direction is essentially a circle, so like, these states are
8:56
Speaker 2: going to be impacted educationally, Like it's it's really hard,
9:01
Speaker 2: you know, And it's hard to to continue to care
9:04
Speaker 2: and feel for people like that and I don't know
9:08
Speaker 2: it almost like being a therapist, you hear the term
9:11
Speaker 2: like jaded a lot. You hear the term like like
9:14
Speaker 2: I don't care anymore, Like I can. You know, it's
9:17
Speaker 2: not a big deal. I've seen worse, and it almost
9:19
Speaker 2: makes you feel like, am I like jaded right now?
9:22
Speaker 2: Like do I not care about people? I know it's
9:24
Speaker 2: not true because I still care, you know, and I
9:26
Speaker 2: still hurt for these people. But yeah, it's a tough
9:29
Speaker 2: spot to be in. So I think when it comes
9:32
Speaker 2: to our jobs and our roles and the work that
9:36
Speaker 2: we do, I think capassion fatigue is a very real thing,
9:40
Speaker 2: and I think it's something that we kind of sweep
9:43
Speaker 2: under the rug a lot, you know, don't. We don't
9:45
Speaker 2: talk about it enough, and yeah, so I think that's
9:48
Speaker 2: that's why I wanted to talk about it today.
9:51
Speaker 1: Yeah, me too, And I feel it sometimes as well.
9:53
Speaker 1: The compassion fatigue where end of a long day, after
9:56
Speaker 1: a long week, after a long year, I'm like I
9:59
Speaker 1: get into with my last visit of the day and
10:02
Speaker 1: I'm like, oh, I am just having a hard time
10:05
Speaker 1: sitting here and being compassionate with this patient that I
10:08
Speaker 1: know I should be, but it's just like it's hard.
10:11
Speaker 1: So we want to give you a specific definition of
10:14
Speaker 1: compassion fatigue, and it is the physical, emotional, and psychological
10:19
Speaker 1: impact of helping others, especially those experiencing stress or trauma,
10:25
Speaker 1: that can lead to exhaustion and reduced ability to empathize
10:28
Speaker 1: or feel compassion. So pretty self explanatory name, but always
10:32
Speaker 1: nice to have an elaborated definition.
10:35
Speaker 2: Yeah, we do also want to talk about how compassion
10:38
Speaker 2: fatigue is different than burnout. I've used both words already
10:41
Speaker 2: in our first ten minutes of the episode. Burnout is
10:44
Speaker 2: essentially like systematic work stress, so because of things like
10:48
Speaker 2: workload or lack of control, micromanagement from upper level management
10:53
Speaker 2: people things like that, whereas compassion fatigue is that empathetic overload,
10:57
Speaker 2: like the it's basically the emotional cost of care, like
11:00
Speaker 2: the feeling depleted to the point where like you don't
11:04
Speaker 2: care anymore. I guess it's like the easiest way to
11:06
Speaker 2: say it. Why this is important is it's just people
11:10
Speaker 2: like us, justin are just at a higher risk for it. Therapists, nurses, doctors,
11:15
Speaker 2: social workers, first responders, we're just at a higher risk
11:18
Speaker 2: of developing something like compassion fatigue, which is really hard
11:21
Speaker 2: because our job is to care. I don't know if
11:24
Speaker 2: you've ever had it, but I've had kids tell me
11:26
Speaker 2: in the past, like you only care because this is
11:28
Speaker 2: your job, and it's like, yes, my job is to care.
11:32
Speaker 2: But if I didn't care, I would do something else,
11:34
Speaker 2: man Like I would figure something else out to do
11:37
Speaker 2: as a job. I would not be in this field
11:39
Speaker 2: their career if I didn't care. We're paid to care,
11:42
Speaker 2: we have to care, we want to care, and then
11:44
Speaker 2: sometimes it's just really hard to care. So I think
11:48
Speaker 2: because of that it oftentimes it gets overlooked in our jobs.
11:51
Speaker 1: I wanted to throw in teachers in there too, Yeah,
11:56
Speaker 1: damn it, Yes, you know, I love teachers. Man, Sorry,
12:01
Speaker 1: he works in the school and he's not.
12:08
Speaker 2: That's my bad. I'll take that. I'll take that.
12:11
Speaker 1: So for some of you listening out there, this may
12:14
Speaker 1: be the first time you've heard this term of compassion fatigue.
12:18
Speaker 1: So we want to give you a list of some
12:20
Speaker 1: of the symptoms to watch out for. So, some of
12:23
Speaker 1: the emotional symptoms would be numbness or detachment, irritability or
12:28
Speaker 1: mood swings, or decreased sense of accomplishment.
12:32
Speaker 2: Some physical things you might see or things like fatigue, headache,
12:35
Speaker 2: sleep issues. For sure, I think I've started to notice
12:39
Speaker 2: when I get like headaches more often, or when I
12:41
Speaker 2: just start to like feel kind of iffy. If I
12:44
Speaker 2: think back and realize I think I'm just a little stressed,
12:46
Speaker 2: and I start to think about that and process that
12:48
Speaker 2: a little bit, it's almost like the symptoms go away
12:51
Speaker 2: a little bit when I start to really be like, no, no, no,
12:54
Speaker 2: I don't think anything's wrong. I think I'm just stressed.
12:56
Speaker 2: I need to take care of that.
12:57
Speaker 1: And then some professional symptoms of compassion fatigue could be
13:01
Speaker 1: dreading client or patient interactions, difficulty concentrating, feeling cynical, jaded,
13:07
Speaker 1: or hopeless.
13:08
Speaker 2: As much as we like to ramble here and like
13:11
Speaker 2: to just say whatever comes out, we do want to
13:13
Speaker 2: have some stats because that's important in the age of misinformation.
13:17
Speaker 2: We do want to have some stats in fact. So
13:19
Speaker 2: here's what we got for you. The first one is
13:21
Speaker 2: that up to seventy eight percent of mental health professionals
13:23
Speaker 2: report moderate to high levels of compassion fatigue at some
13:27
Speaker 2: point in their careers, and that's from the National Institutes
13:30
Speaker 2: of Health from twenty twenty. A twenty twenty three survey
13:33
Speaker 2: of nurses found that fifty two percent experience symptoms of
13:36
Speaker 2: compassion fatigue, with many citing emotional exhaustion as the top
13:40
Speaker 2: factor affecting their care quality. And this is from the
13:43
Speaker 2: American Journal of Nursing in twenty twenty three. During COVID
13:47
Speaker 2: COVID nineteen the pandemic the big c rates of compassion
13:50
Speaker 2: fatigue among healthcare workers increased by over thirty percent compared
13:54
Speaker 2: to pre pandemic levels. This is from the Journal of
13:56
Speaker 2: Clinical Nursing in twenty twenty two, which I think makes
13:59
Speaker 2: total sense. Life and work and everything was already hard
14:02
Speaker 2: and then you throw in COVID fuck man exponentially harder.
14:08
Speaker 2: Last couple of stats we have is in a twenty
14:10
Speaker 2: twenty two study of social workers, nearly seventy five percent
14:14
Speaker 2: reported moderate to high risk of compassion fatigue, with higher
14:17
Speaker 2: risk in those working in trauma trauma heavy settings, so
14:21
Speaker 2: things like childware, welfare, hospice, emergency care. And this is
14:26
Speaker 2: from the Social Work and Healthcare Journal in twenty twenty two.
14:29
Speaker 2: And then finally, only forty percent of healthcare professionals said
14:32
Speaker 2: their organization provided adequate resources or training to manage compassion fatigue,
14:38
Speaker 2: and that is from the American Psychological Association in twenty
14:41
Speaker 2: twenty one. Yeah, so, I mean we're not alone obviously,
14:45
Speaker 2: as much as sometimes it feels like we're not alone.
14:48
Speaker 2: A lot of us deal with this. A lot of
14:50
Speaker 2: us go into these professionals because we care and we
14:52
Speaker 2: want to help people, but sometimes we don't think about
14:54
Speaker 2: like that other piece to it. It's like, this is
14:56
Speaker 2: a very real risk that comes with the work that
15:00
Speaker 2: we do, and I think it's just hard in the
15:02
Speaker 2: jobs that we do. My job is to help. So
15:05
Speaker 2: to admit that I'm having a hard time, does that
15:07
Speaker 2: make me shitty at my job? If I'm not able
15:10
Speaker 2: to help myself, how can I help other people. I
15:12
Speaker 2: think that's I think that's where a lot of us
15:14
Speaker 2: get stuck. I think it's hard for us to admit
15:17
Speaker 2: that something's wrong. I think as helpers, healers, whatever term
15:20
Speaker 2: you want to use, we just we carry this weight
15:23
Speaker 2: of feeling like we need to have our shit together
15:25
Speaker 2: all the time in order to help others. I know,
15:27
Speaker 2: especially for me early on in my career as a
15:29
Speaker 2: therapist working with teens, trying to stress the importance of
15:32
Speaker 2: like good sleep, good diet, exercise, all this stuff, and
15:37
Speaker 2: then just not doing any of that was like a
15:39
Speaker 2: hard thing for me to manage. Now I do a
15:42
Speaker 2: much better job with all of that, but I think, yeah,
15:43
Speaker 2: I think that was a hard thing for me to
15:45
Speaker 2: pay attention to or to know that was going on.
15:48
Speaker 2: But yeah, I think I think it's hard for us
15:49
Speaker 2: to feel like, how can I help others if I
15:52
Speaker 2: don't know how to help myself or I don't have
15:54
Speaker 2: my shit together. I think it's also feeling like maybe
15:56
Speaker 2: we're not good enough in our job if we admit
15:58
Speaker 2: that something's wrong. Right, we just I talked, I said it, right,
16:02
Speaker 2: But yeah, it feels like I am inadequate if I
16:05
Speaker 2: don't know how to help myself or if I'm struggling,
16:08
Speaker 2: how can I how can I possibly help other people.
16:10
Speaker 2: I know it's not the case, but I think it's
16:12
Speaker 2: a thought that a lot of us have at some point.
16:15
Speaker 1: Totally. We always want to be superman. We want to
16:18
Speaker 1: be the one who can take it all. We want
16:19
Speaker 1: to be the one who doesn't get jaded, who can
16:22
Speaker 1: just be powering through it and doing well. But I
16:26
Speaker 1: think it's even more important and it shows more strength
16:29
Speaker 1: to be able to recognize it and work on it
16:32
Speaker 1: instead of just ignoring it and trying to move forward.
16:35
Speaker 1: Because this is I would say this is probably the
16:38
Speaker 1: thing I preach the most clinically with my patients that
16:43
Speaker 1: like the number one topic is that you can't just
16:46
Speaker 1: ignore your problems and pretend like they don't exist. You
16:50
Speaker 1: have to be mindful of it, recognize it's happening, and
16:54
Speaker 1: then work on trying to actually make it better. So
16:57
Speaker 1: I think it's a cool thing that we're talking about
16:59
Speaker 1: it to be able to try and understand these things
17:02
Speaker 1: and ourselves better so that we can be better at
17:05
Speaker 1: treating it. So that if you do start to feel
17:07
Speaker 1: some compassion fatigue, there can be some different things that
17:12
Speaker 1: you can do to work on it to make yourself
17:14
Speaker 1: feel better, and if things work for you in the past,
17:16
Speaker 1: you can go back to that well and continue to
17:19
Speaker 1: use those those same things to help you feel better
17:22
Speaker 1: and get through the compassion fatigue instead of just saying like,
17:25
Speaker 1: I'm fine, I'm fine, I can do this, it's okay.
17:28
Speaker 1: I'm feeling this. How do I recharge my batteries? How
17:31
Speaker 1: do I get my mojo back?
17:33
Speaker 2: The hard part, too, is that when we try to
17:35
Speaker 2: tell ourselves that we're fine and things are okay, people
17:38
Speaker 2: around us understand that things are not okay. People can
17:41
Speaker 2: just see it. So I think you might as well
17:43
Speaker 2: help yourself. I tell kids all the time when they're like, no,
17:45
Speaker 2: I don't want to tell my parents, like I don't
17:47
Speaker 2: want them to worry about me. News flash, buddy, they
17:51
Speaker 2: are ready. They're worried. They know something's going on. I
17:56
Speaker 2: tell kids this all the time, like, I just don't
17:58
Speaker 2: want them to I don't want to be a burden.
18:00
Speaker 2: Don't worry. They've known something's wrongast two weeks, man, Like,
18:04
Speaker 2: let's just this is actually gonna make them feel better,
18:07
Speaker 2: And in a similar way, this is going to make
18:09
Speaker 2: ourselves feel better if we can acknowledge and understand that
18:13
Speaker 2: if something's wrong, it's okay, let's try to let's try
18:16
Speaker 2: to fix it. But one thing I wanted to cover
18:18
Speaker 2: is something that we can just ignore in the spirit
18:21
Speaker 2: of acknowledging and before we get to like, what can
18:23
Speaker 2: we do to make this better? You know why are
18:25
Speaker 2: helping professions at risk for developing compassion fatigue? I think
18:28
Speaker 2: it's it's it's d all of the above. The first
18:33
Speaker 2: thing is long hours understaffing. I think of all the
18:37
Speaker 2: therapists and the clinical mental health or community mental health
18:41
Speaker 2: clinic I can I can assume the same for doctors
18:44
Speaker 2: and nurses in some kind of like or social workers,
18:48
Speaker 2: and then some kind of community healthcare clinic. There's a
18:50
Speaker 2: high emotional emotional demand that comes from the work. Other
18:54
Speaker 2: things could be personally a personal history of trauma or
18:56
Speaker 2: unresolved grief. If you have an empathetic personality, tend to
19:00
Speaker 2: be someone who kind of just absorbs other people's pains.
19:03
Speaker 2: That's why people come to you because they know if
19:05
Speaker 2: I speak with you, or if I check in with you,
19:07
Speaker 2: if I meet with you, I'll feel better because you
19:09
Speaker 2: help me kind of deal with it and the big
19:11
Speaker 2: thing that's really shifted in the last five years I
19:13
Speaker 2: mentioned earlier, but the big sea, I mean, COVID really
19:15
Speaker 2: fucked a lot of things. And it's this is not
19:18
Speaker 2: going to be a thing that goes away quickly. It's
19:21
Speaker 2: it's been I don't want to say, it's been five
19:23
Speaker 2: years and it's gone. It's been five years since everything
19:25
Speaker 2: started and things it's hard to fix things and get
19:29
Speaker 2: back to where they were before. Not that we were
19:31
Speaker 2: really living in a great way before if we really
19:34
Speaker 2: are on it. But anyway, let's let's get to the
19:37
Speaker 2: positive parts. How do we how do we fix this?
19:39
Speaker 2: How do we work on this stuff?
19:41
Speaker 1: So some ways that you can prevent compassion fatigue include
19:47
Speaker 1: things like setting boundaries, learning to say no, not taking
19:51
Speaker 1: work home. Mentally, this is something that I've really had
19:55
Speaker 1: to work on too. Just to give you a little
19:57
Speaker 1: personal story, Sometimes people at the hospital will you'll like
20:00
Speaker 1: text me or call me at all hours of the
20:03
Speaker 1: day and night and be like, hey, I got a
20:05
Speaker 1: patient for you to see, and yeah, I want to
20:07
Speaker 1: be superman. I want to jump in and say like, yeah, sure,
20:10
Speaker 1: what do you need, Let me help, let me come
20:11
Speaker 1: into the hospital. But I realized that when I do that,
20:14
Speaker 1: I just stretch myself too thin and I am just
20:16
Speaker 1: on a path for compassion fatigue. So I had to
20:19
Speaker 1: learn how to say like no, like my hours are
20:22
Speaker 1: this time to this time, Like I would love to
20:24
Speaker 1: help you. I'll get them into the clinic, but I
20:26
Speaker 1: can't come and come in the middle of the night
20:30
Speaker 1: to see patients, because like in the mental health and
20:33
Speaker 1: psychiatry world, that's just brutal, especially after like already putting
20:36
Speaker 1: in a ten hour day and then you get a
20:38
Speaker 1: call from the hospital saying like come into the emergency room.
20:40
Speaker 1: I'm like, ah, I can't, Like I just I can't
20:43
Speaker 1: force myself to do it.
20:44
Speaker 2: The other piece of that, too, is that like if
20:46
Speaker 2: you do start to say yes and then finally you're
20:49
Speaker 2: like trying to say no, there's the guilt of like,
20:52
Speaker 2: well you used to like you're shitting now, you know.
20:55
Speaker 2: So it's better to try to have those those firm boundaries.
20:58
Speaker 1: Especially because I'm the only try out psychiatrists who is
21:01
Speaker 1: practicing in Southeast Wyoming. Like, if I give an inch,
21:05
Speaker 1: people will take a mile, and I don't blame them.
21:07
Speaker 1: Everyone needs help, and there is just such a lack
21:11
Speaker 1: of care from child psychiatrists. But if I don't protect myself,
21:15
Speaker 1: no one will.
21:16
Speaker 2: Some other stuff for prevention, I mean supervision and consultation.
21:19
Speaker 2: It's a good way to vent and to process what's
21:22
Speaker 2: going on. You can do some of the stuff yourself too,
21:24
Speaker 2: some self awareness, some check ins, asking yourself how you
21:27
Speaker 2: feel after a certain client, after a certain shift. I
21:30
Speaker 2: think those are important. I think your point earlier of
21:33
Speaker 2: not taking work home mentally, I do this a lot
21:37
Speaker 2: less now, but I know I've definitely had it. I've
21:39
Speaker 2: had points where sometimes I'll just drive home in silence
21:43
Speaker 2: day and I just need to. I need to this.
21:46
Speaker 2: This drive home is going to be my way of
21:48
Speaker 2: being able to separate work from the house. And if
21:51
Speaker 2: I can drive in silence and I get home, I
21:54
Speaker 2: could pick up where I left off the next day.
21:56
Speaker 2: That helps a lot.
21:57
Speaker 1: Doing things like mindfulness and grounding practices. Sometimes that can
22:01
Speaker 1: be writing home in silence right your giving your emotions
22:06
Speaker 1: and feeling some time some you know you don't have
22:09
Speaker 1: any distractions, You're just kind of sitting in how you feel,
22:12
Speaker 1: letting it happen, letting the wave wash over you and
22:15
Speaker 1: then leave. I think that's a really important thing, and
22:18
Speaker 1: it's so funny. I do the exact same thing. I'll
22:21
Speaker 1: drive home in silence. Man, Sometimes sometimes I might cry
22:24
Speaker 1: a little bit, you know, sometimes I might scream a
22:27
Speaker 1: little bit, and just if I've got a lot of frustration,
22:29
Speaker 1: I'll just grab the steering wheel and ah, get it out,
22:34
Speaker 1: address it instead of trying to just shove it all down.
22:37
Speaker 2: One of the things for me is, I think because
22:41
Speaker 2: of what's going on in the country, for me, it
22:44
Speaker 2: feels like it ties so much into my work that
22:47
Speaker 2: I feel like I have to know what's happening or
22:50
Speaker 2: have to have an idea of what's going on. And
22:52
Speaker 2: sometimes for me, the boundary is I just won't listen
22:54
Speaker 2: to the news for a little bit. Yes, I have
22:57
Speaker 2: a few news podcasts that I listened to that keep
22:59
Speaker 2: me up to date on things, and sometimes I just
23:03
Speaker 2: take a break from them. Sometimes I just won't listen
23:05
Speaker 2: to them just because it's like I need to I
23:07
Speaker 2: need to listen to something else and not listened to
23:09
Speaker 2: anything at all. So it's another way.
23:11
Speaker 1: Yeah, it's nice to have that mindless stuff. Not I
23:14
Speaker 1: have to just be bombarded with bad news from the
23:17
Speaker 1: news all the time.
23:18
Speaker 2: Sometimes Big Booty Mix twenty is all I need.
23:23
Speaker 1: Two Friends, Big Booty.
23:26
Speaker 2: Look at number twenty is the one, man. I think
23:29
Speaker 2: that's the one, you guys, the very first one you
23:31
Speaker 2: sent me in that that was a life changer.
23:34
Speaker 1: If people have not listened to Two Friends Big Booty Mix,
23:38
Speaker 1: it is some of the most fun music you will
23:40
Speaker 1: ever listen to.
23:41
Speaker 2: But did I tell you that?
23:42
Speaker 1: We went to Two Friends and they're Big Booty Mix
23:44
Speaker 1: at Red Rocks like in April.
23:47
Speaker 2: I know, what the fuck? That's tight?
23:49
Speaker 1: I know, I forgot to tell you. So we went,
23:52
Speaker 1: but it was pouring rain at Red Rocks outdoors, and
23:56
Speaker 1: so we're just like in the rain, just shaking and shivering.
24:00
Speaker 1: It was like forty degrees the freezing, right, We're just
24:03
Speaker 1: trying to dance and get ourselves warm. But it was
24:06
Speaker 1: it was totally worth it.
24:07
Speaker 2: But we were wrenched. It was. It was a party.
24:12
Speaker 2: So do yourself a favor. If you haven't yet, look up,
24:15
Speaker 2: look up Big Big Booty Mix Two Friends. They do
24:18
Speaker 2: some great sets. It's awesome. It's awesome music to listen
24:21
Speaker 2: to in the background.
24:22
Speaker 1: And if Two Friends, everyone wants to collab with us,
24:24
Speaker 1: you know, slide into Eddie's DMS. Ben and eli we
24:30
Speaker 1: are ready for you.
24:32
Speaker 2: Yes. In terms of management with something like compassionate fatigue,
24:37
Speaker 2: I think debriefing with your peers. I think I've worked
24:40
Speaker 2: in enough settings where just having coworkers that understand what
24:44
Speaker 2: you're doing helps a ton, helps to just kind of
24:47
Speaker 2: get it out. Prioritizing rest of recovery, I mean justin
24:51
Speaker 2: talks about it. A lot of sleep is important. I
24:53
Speaker 2: know sleep is important. Breaks, vacation and like a real break,
24:57
Speaker 2: not just like I'm gonna get lunch at my desk
24:58
Speaker 2: while I read three emails, like go take a walk
25:01
Speaker 2: or something if you haven't already. Therapy is great, peer
25:04
Speaker 2: support groups, professional support groups, and then just normalizing self compassion.
25:09
Speaker 2: I think a lot of the times when I work
25:13
Speaker 2: with kids and teens, they'll tell me that they prioritize
25:16
Speaker 2: other people because they don't want to them, They don't
25:19
Speaker 2: want to be a burden on other people with this,
25:20
Speaker 2: and that I think we end up doing the same thing.
25:22
Speaker 2: We prioritize the people around us. We prioritize our clients,
25:25
Speaker 2: our patients, and sometimes we need to talk to ourselves
25:28
Speaker 2: the way that we would to a client or patient.
25:31
Speaker 2: We need to give ourselves some self love too, So yeah,
25:35
Speaker 2: so what I got. So compassion fatigue is real. We're
25:39
Speaker 2: still gonna chug along and make the difference we.
25:41
Speaker 1: Can big booty mix slaps.
25:44
Speaker 2: Big and it's okay if sometimes it's hard to give
25:49
Speaker 2: a shit about other people because of the way things are,
25:52
Speaker 2: just if you can give a shit about yourself, I
25:54
Speaker 2: think that's that's a good enough start.
25:56
Speaker 1: You gotta love yourself if you can love someone else.
25:59
Speaker 1: So I like that advice. You know, some other discussion
26:02
Speaker 1: questions that we wanted to bring up, just talking about
26:04
Speaker 1: our own personal experiences. When did you first start seeing
26:07
Speaker 1: a little compassion fatigue in yourself?
26:09
Speaker 2: What do you think at some point between when I
26:13
Speaker 2: graduated with my masters and now just doing the work,
26:17
Speaker 2: and actually probably before when I was doing internship, at
26:20
Speaker 2: some point just understanding that it is it's really it
26:24
Speaker 2: can be really tough to help other people. It's rewarding, fulfilling, great,
26:28
Speaker 2: wouldn't want it any other way, But sometimes it could
26:30
Speaker 2: be really hard.
26:31
Speaker 1: I noticed that earlier in my career, like right when
26:34
Speaker 1: I started working with kids, and even like the first
26:38
Speaker 1: year of working as an attending it was hard, and
26:42
Speaker 1: there were a lot of those days where at the
26:43
Speaker 1: end of the day, I was just drained and I
26:46
Speaker 1: was having a silent car rides home or crying on
26:49
Speaker 1: the ride home. It's gotten better with time, and I'm
26:52
Speaker 1: grateful for that, just because I think you get a
26:55
Speaker 1: little resilient over time to it. I think it does
26:58
Speaker 1: get better. But boy, when you're first starting out and
27:02
Speaker 1: trying to manage all the emotions of working with kids
27:05
Speaker 1: who have been through a lot of significant traumas, it's hard.
27:08
Speaker 2: Yeah. I think for this next question you probably have
27:10
Speaker 2: an interesting perspective too with like med school, But do
27:14
Speaker 2: you think there's a pressure in our field to power
27:16
Speaker 2: through rather than to admit that we're overwhelmed? And I
27:19
Speaker 2: bring up med school because I hear that so much,
27:22
Speaker 2: whether it's on social media, TikTok, YouTube, whatever, of just
27:25
Speaker 2: this like competition. Everyone's competitive, everyone wants to be the best.
27:30
Speaker 2: You're studying hours on it, Like it's just it's like
27:33
Speaker 2: the hunger games in med schools. What it sounds like. So,
27:37
Speaker 2: what's been your experience with the power in through, whether
27:40
Speaker 2: professionally or while you're still a student.
27:42
Speaker 1: It kind of depends on the field you're going into.
27:44
Speaker 1: Like to give you a very basic example, surgeons are
27:47
Speaker 1: very much a power through shut up, don't complain. Yeah,
27:52
Speaker 1: but I noticed that a lot of the psychiatrists that
27:54
Speaker 1: I was working with, they were very much more compassionate.
27:58
Speaker 1: They wanted to know how you were feel They wanted
28:00
Speaker 1: to make sure you weren't overloaded. I even remember, like
28:04
Speaker 1: some of the psychiatrists working I was working with in
28:06
Speaker 1: medical school, they were like, you know, the tests at
28:08
Speaker 1: the end doesn't matter because usually in most rotations, like
28:12
Speaker 1: the test you take at the end is huge. If
28:14
Speaker 1: you fail, you got to like redo the whole rotation, YadA, YadA, YadA.
28:17
Speaker 1: But in psychiatry they're like, it's past fail, you just
28:20
Speaker 1: have to pass it. We want to make sure that
28:22
Speaker 1: you learn. We want to make sure that you like
28:24
Speaker 1: maintain your personhood throughout this rotation.
28:27
Speaker 2: Yeah.
28:27
Speaker 1: And it just seemed like such a complete different focus
28:30
Speaker 1: than the entire rest of medicine. And I thought, this
28:34
Speaker 1: is a breath of fresh air. This is something that
28:37
Speaker 1: I want to gravitate towards. And I appreciate that people
28:40
Speaker 1: are doing this in mental health and psychiatry, and it
28:43
Speaker 1: was a big reason why I went into mental health.
28:45
Speaker 2: And this is just my experience, but I think like
28:48
Speaker 2: my internship supervisor and my supervisor towards licensure were amazing. Great,
28:55
Speaker 2: this has nothing to do with them, so we can
28:56
Speaker 2: take them out of it, Sandra TONI don't worry about it.
28:59
Speaker 2: This hasn't I do with you. I'm more looking like
29:02
Speaker 2: system wides because they took care of me, and I
29:03
Speaker 2: think just having them was so helpful and I'll be
29:06
Speaker 2: forever grateful Systematically, though, I feel like, I don't know,
29:12
Speaker 2: it always felt like when they talked about self care
29:15
Speaker 2: and boundaries, it was just this canned like, yeah, take
29:19
Speaker 2: care of yourself. Here's ten new clients, see them all
29:24
Speaker 2: next week, right, like, yeah, self care, let's write down
29:28
Speaker 2: and no bullshit, we did this write down on this
29:30
Speaker 2: post to note what you can do for self care. Eddie,
29:33
Speaker 2: I need you to do three new assessments this week,
29:35
Speaker 2: like fuck man. Like, I don't know. Maybe it was
29:39
Speaker 2: just the settings I worked at, and I think I
29:41
Speaker 2: can't really speak to it in my current setting. I
29:44
Speaker 2: don't really think it's I'm so one of one in
29:47
Speaker 2: my job that I just take care of myself and
29:49
Speaker 2: I'm cool. I'm all good. My last job at the hospital,
29:52
Speaker 2: my manager sucked so I can totally see that there
29:55
Speaker 2: wasn't really a take care of yourself kind of thing.
29:57
Speaker 2: And then in my first job, yeah, I felt like
29:59
Speaker 2: a so much of what we were told was so
30:01
Speaker 2: canned and like felt like bs that I just I
30:05
Speaker 2: don't know, but I'm glad you had a good.
30:10
Speaker 1: And if you can try and gravitate more towards those
30:14
Speaker 1: jobs that are more compassionate are wanting to give you
30:18
Speaker 1: that time. But because I mean in America, we're production based, right, Like,
30:22
Speaker 1: if you're not seeing patients, you're not making money, you're
30:24
Speaker 1: a drag on the system. I feel incredibly lucky that
30:29
Speaker 1: right now in my current job, they let me see
30:32
Speaker 1: like forty minute follow ups, which is kind of like
30:33
Speaker 1: unheard of in the psychiatry world. It's usually like twenty
30:37
Speaker 1: maybe thirty minute follow ups, and it's like shit, So
30:40
Speaker 1: I actually get to have one on one time with patients,
30:44
Speaker 1: ask them how they're doing, really get to like connect
30:47
Speaker 1: with people, and A boy, am I so grateful for
30:50
Speaker 1: that And I think that helps me a lot with
30:52
Speaker 1: the compassion fatigue, because if I had twenty minute visits,
30:55
Speaker 1: I would be so worried about staying on time and
30:57
Speaker 1: not getting behind that I would be the least compassionate
31:00
Speaker 1: provider anyone's ever seen.
31:02
Speaker 2: I don't prescribe medication or do any type of psychiatry,
31:05
Speaker 2: so I'm just I'm just doing my best. Guess. But
31:07
Speaker 2: how am I supposed to check in with a patient,
31:09
Speaker 2: get an idea of how they've been, check in with
31:12
Speaker 2: whatever vital signs, or whatever else you gotta do. How
31:14
Speaker 2: am I supposed to do all that while also trying
31:15
Speaker 2: to come up with some type of treatment plan or
31:18
Speaker 2: or next step in twenty minutes.
31:20
Speaker 1: Yeah it's brutal.
31:22
Speaker 2: Yeah, well, I mean shit that. Our next question is
31:25
Speaker 2: what system changes do you wish employers or organizations would
31:28
Speaker 2: make it the better? Did well be longer appointment slots,
31:35
Speaker 2: not be soap production based, actually care about the well
31:38
Speaker 2: being of And I mean you always got to like
31:41
Speaker 2: take it. I don't even I don't understand the whole
31:44
Speaker 2: taking with a grain of salt, but I'll just say
31:45
Speaker 2: you got to dig it with a grain of salt
31:48
Speaker 2: because it's like you're more likely to hear about the
31:50
Speaker 2: negative experiences, right you go to look at like a
31:52
Speaker 2: review of like a restaurant, like, yeah, there's gonna be
31:55
Speaker 2: people that just yeah, a five star five star, but
31:57
Speaker 2: like the longer reviews, people want to give the negative
32:01
Speaker 2: kind of feedback more willingly. So you know, I've talked
32:05
Speaker 2: about my shitty experiences. It's not to say that's the
32:07
Speaker 2: experience everywhere. But I would say if organizations just kind
32:10
Speaker 2: of operated with those kind of typical things that they
32:14
Speaker 2: would provide, I think would be in a much better
32:17
Speaker 2: space for providers.
32:18
Speaker 1: So if you could go back and give your younger
32:21
Speaker 1: more handsome self, more handsome I mean less handsome, some
32:28
Speaker 1: like the new to the field self advice about compassion fatigue,
32:32
Speaker 1: What would you say.
32:33
Speaker 2: It's really important that you take care of yourself. I
32:36
Speaker 2: think that's yeah, yeah, yeah, because I think you kind
32:41
Speaker 2: of touched on it too, like you always want to
32:43
Speaker 2: be I think you've probably felt it too, but you
32:45
Speaker 2: kind of want to be known as like I'm always
32:48
Speaker 2: ready to help, I'm always helpful, I can always do it.
32:51
Speaker 2: But sometimes you can still do that, but you got
32:54
Speaker 2: to take care of yourself. I think I can, you
32:56
Speaker 2: can still be the go to, but you got to
32:59
Speaker 2: take care of yourself, I think is the biggest thing. Yeah,
33:03
Speaker 2: I wrote this up, or maybe you wrote up the question.
33:06
Speaker 2: I don't know, but I've known about the question, and
33:08
Speaker 2: I feel like I should have a better answer, but
33:10
Speaker 2: I think it's really just you got to take care
33:12
Speaker 2: of yourself. And I think that's what I really enjoyed
33:14
Speaker 2: about teaching. And actually, this upcoming fall, I'm going to
33:18
Speaker 2: get to teach practicum seminar, which is specifically for students
33:23
Speaker 2: that are in their internship year, and I get to
33:24
Speaker 2: be with them for the whole year. And I'll get
33:26
Speaker 2: a group of you know, six to eight students of
33:28
Speaker 2: my own to just meet with and supervise for a
33:31
Speaker 2: whole year, which I'm really excited about. But that's why
33:33
Speaker 2: I like teaching so much and working with therapists and training.
33:37
Speaker 2: I can tell them the things that I wish I
33:38
Speaker 2: would have known or the things I fucked up on
33:40
Speaker 2: so they don't have to fuck up on. So I'm
33:42
Speaker 2: sure I have some better thoughts, but would just do
33:44
Speaker 2: that one? You gotta take care of yourself, Yeah, what
33:47
Speaker 2: about you?
33:48
Speaker 1: I think I said something similar on the Burnout episode
33:50
Speaker 1: a while back, but use all of your time off,
33:55
Speaker 1: Like in America, we're terrible at taking all of our
33:58
Speaker 1: time off. Most Americans don't use all of their time
34:01
Speaker 1: off like it's looked down upon other countries like take
34:04
Speaker 1: pride at how much time they can take off and
34:07
Speaker 1: go explore life and go spend time in nature. But
34:09
Speaker 1: the Americans were just work, work, work, work, work. But
34:13
Speaker 1: your compassion is like a battery, and the more you
34:16
Speaker 1: do it, the more it drains.
34:17
Speaker 2: More.
34:17
Speaker 1: It drains more, it drains time off, and the things
34:20
Speaker 1: that you love that refill that battery help you be
34:24
Speaker 1: a better clinician, help you be a better doctor. And
34:27
Speaker 1: so don't fall into the American trap mindset. Take your
34:32
Speaker 1: time off.
34:35
Speaker 2: Did you know every year there's about two billion dollars
34:37
Speaker 2: worth of time off that people don't use. I believe
34:42
Speaker 2: it totally, like I made that up, but it sounds believable.
34:50
Speaker 1: All right, Well, now I got a look. I see
34:52
Speaker 1: Google I as an answer for me.
34:54
Speaker 2: What's Google? Gentlemen?
34:55
Speaker 1: I got oh American workers forfeit and estimated six six billion,
35:01
Speaker 1: oh shit benefits each year by not using all of
35:05
Speaker 1: their allotted vacation time.
35:08
Speaker 2: I believe no I had a supervisor or a manager
35:12
Speaker 2: years ago, who I think because I was talking about
35:17
Speaker 2: my pay and be like, bro, I gotta get paid more.
35:19
Speaker 2: I do so much more shit than other people in here,
35:21
Speaker 2: and he's like, oh, I just you know how part
35:24
Speaker 2: of the benefit is the time off, and like, you know,
35:26
Speaker 2: I'm really hoping that when I because I don't take
35:29
Speaker 2: time off, and I'm just hoping that by the time
35:31
Speaker 2: I retire, you know, they're going to have to pay
35:33
Speaker 2: me out all this money. And now looking back, that's
35:35
Speaker 2: fucking sad man taking time off. What the fuck you
35:41
Speaker 2: need it? It's good for you, man. You best believe
35:45
Speaker 2: I'm taking my other days off of every year, So
35:49
Speaker 2: take your time, damn it.
35:51
Speaker 1: Yes, it's healthy doctor's orders.
35:53
Speaker 2: That's right. Oh can you write that up for me
35:55
Speaker 2: on one of those fancy prescription pads. Sure, nice, I'll
35:59
Speaker 2: take it that.
36:00
Speaker 1: You might get laughed at if you take it to
36:02
Speaker 1: a pharmacy, but you know that's why.
36:07
Speaker 2: Well, justin thank you my friend for letting me. Uh,
36:10
Speaker 2: this might have been more for me, just event for
36:12
Speaker 2: a little bit, but I appreciate you being there for me.
36:14
Speaker 2: I appreciate our listeners being here. You know where to
36:18
Speaker 2: find this Apple podcast Spotify. Leave us a five star review,
36:21
Speaker 2: leave us a comment. We'd love to see it on
36:23
Speaker 2: social media at Millennial MHC and our website millennia IMH