Show Notes

Kayla: Welcome back to the Designer Practice Podcast and I’m your host Kayla Das.

In today’s episode, Natasha D’Arcangelo, Licensed Mental Health Counselor and I are going to discuss compassion fatigue and how to manage it so that compassion fatigue doesn’t prevent you from reaching your private practice dreams.

Hi, Natasha. Welcome to the show. I’m so glad to have you on the show today.

Natasha: Hello, thank you for having me on the show. I’m excited to be here.

Kayla: Oh, and this is such a great topic too. Well, it’s not really a great topic in the sense that we don’t want people to feel compassion fatigue. But it’s such a great topic because it’s something that can really hit any of us at any time as therapists and as healthcare providers and it’s really important topic for us to discuss today.

Introduction

But before we get into it, please introduce yourself, where you’re from, and tell us a little bit about your experiences and really just who you are.

Natasha: Sure. So, my name is Natasha. I use she/her pronouns. And I am a Licensed Mental Health Counselor. I am currently living in Orlando, Florida. I am licensed to see clients in Florida, in Washington State, and in Oregon. I’m a certified clinical trauma professional. I’m a certified compassion fatigue professional. I’m a compassion fatigue educator. And I’m also a certified forward facing professional resilience coach and consultant. So, I talk about compassion fatigue a lot and the further that I got into it and doing more of my training, the more I realized that there were multiple points in my own professional journey where I was struggling with compassion fatigue, but I didn’t actually have a name for it. And so, I get really excited to be able to talk to people about it, bring awareness, help normalize it for folks. And I think most importantly, give them some skills for being able to handle symptoms that they probably don’t even recognize are going on.

So, I was actually an educator once upon a time. My career started with me as a teacher, and looking back on it, I realized that I was struggling with compassion fatigue, but I didn’t know that at the time and ended up doing a career change, now I’m a therapist, can’t see myself doing anything else. But even as fulfilling as this is, I’ve still had points where I’ve struggled.

So, I have worked on an inpatient psychiatric unit. I’ve done community mental health work. I’ve worked in private practice. I’ve worked for some large telehealth companies and currently I am the clinical director of a local behavioral health non-profit here in Orlando. So that’s who I am. I’m also adjuncting for Purdue University Online and I have my own LLC on the side. So that’s me.

Defining Compassion Fatigue

Kayla: You’re a busy woman for sure. So, what is compassion fatigue? And how does compassion fatigue differ or how is it similar to workplace burnout?

Natasha: So, the most commonly used definition of compassion fatigue comes from Dr. Charles Figley. He coined it in 1995. And he defines compassion fatigue as burnout combined with secondary trauma. So, when you do any kind of literature review looking on the topic of compassion fatigue, you’re going to see Dr. Charles Figley’s name. And he was the one that really kicked off, you know, this is something that we should research and we should have numbers on and really take a look at because it can impact professional caregivers. So he further defines it as a “state of exhaustion and dysfunction, biologically, psychologically, and socially, as a result of prolonged exposure to compassion, stress, and all that it invokes” (Figley, 1995).

And so, the reason that it differs from burnout is because burnout is essentially only one half of that equation. In order to meet the definition of compassion fatigue, you need to have those two pieces. The one-piece being burnout, but the other piece being secondary traumatic stress. And I think that we use the word burnout a lot without necessarily having a good idea of what it means. We kind of throw it around a lot. But compassion fatigue goes essentially deeper than that. It’s more pervasive and it’s those of us that are professional caregivers that are susceptible. So, our educators, our nurses, physicians. mental health professionals, first responders, journalists, actually. I did a presentation for some HR folks last year because people go to them with all of this stuff, but they have not done a master’s degree and being able to deal with people who are grieving or need to take time off because they’ve just had a pregnancy loss or something like that. So, anybody that is involved in the work of caring for others can be susceptible to compassion fatigue.

Kayla: That’s interesting that you mentioned that it’s workplace burnout combined with secondary trauma. I actually work with workplace burnout in my private practice, so I’m very familiar. I tend to work with more executives than healthcare professionals, although I’ve had a few healthcare professionals as well. And it’s interesting because it’s that additional layer and I’ve heard really compassion fatigue and workplace burnout be connected together, which they’re similar, but it’s an additional layer. It’s more of an intensified type of burnout in a sense.

Natasha: Yeah, exactly. And the thing with compassion fatigue, when we’re talking about the secondary traumatic stress piece of the equation, part of that is either witnessing or interacting with traumatized or suffering people. So, you’re listening to narratives over and over again.

So, imagine, an emergency room nurse, right? Or a teacher that works in a school district where there’s very little resources and a lot of the kids come from a high trauma background. So, you’re dealing with people that are suffering on a day-to-day basis.

And, and the thing is, is we’re in a really unique position. I have yet to meet a mental health professional who doesn’t care about people, right? And also, it’s the fact that we care so much about people that can lead us into compassion fatigue. But at the same time, we can’t do what we do without caring. So, it’s this interesting paradox to be in.

Compassion Fatigue in Caregivers

Kayla: That’s really interesting and something just came to mind. When we think of people who care about others, could compassion fatigue show up for, say, a caregiver who’s looking after their mother or their partner or someone that they love?

Natasha: Absolutely. Yeah. And in fact, I did a presentation last year for the Myositis Foundation. They had their annual conference here in Orlando, and the session that they asked me to do was on compassion fatigue in caregivers. Because it’s hard when your loved one is struggling with a very intense illness that is causing them to get more and more dependent on you. It’s not uncommon for feelings of resentment to come up. And again, there’s that paradox. You give the example of somebody caring for their mother. Well, yes, you love your mother. You want to care for your mother. You want to ensure she’s getting the best care. And also, it’s hard to do that while also taking care of yourself. And, a lot of times if people are becoming angry or feeling resentful, they’ll beat themselves up and think that there’s something wrong with them. And that’s just not true.

How Compassion Fatigue Shows Up for Private Practitioners

Kayla: So, when we think of compassion fatigue, how does it show up? What are some of the symptoms? And is there anything that private practitioners should watch out for when it comes to monitoring their own potential susceptibility to compassion fatigue?

Natasha: Absolutely. So, great question, and what I would encourage folks to do is look up the work of Dr. Eric Gentry, his name is spelled G E N T R Y. And we can put his website in the show notes as well, but he’s the one that I’ve done the bulk of my compassion fatigue training with. And what he’s done is he has categorized five major essentially subcategories of symptoms:

So, there’s physical symptoms, things like feeling fatigued, sleep disturbance, you’re taking more sick days.

There’s psychological. So maybe you feel numb. That’s a common one I get when I’m doing presentations. Maybe you’re having nightmares about work. Maybe you’re struggling with making decisions.

There’s emotional. So, you’re irritable. You’re feeling overwhelmed. You have this dread. You don’t want to go to work.

There’s the spiritual aspect. So, you’re avoiding your friends and family. You’re feeling hopeless. Maybe you’re finding it difficult to trust people.

And then the fifth category is professional. So maybe you’re struggling with decreased productivity. You can’t leave work at work, right? Maybe you’re thinking about quitting your job.

So those are the five major categories. The physical, the psychological, the emotional, the spiritual, and then the professional. And there is a great tool. Which is a nice objective way for you to be able to measure your symptoms. It is called the ProQOL, which stands for Professional Quality of Life. And it is available to practitioners for free. They’re on the 5th iteration, so right now it’s the ProQOL 5. And whenever I do a CEU presentation, I always recommend that the folks on the Zoom. I present most often virtually. But that they take it. If I’m in person and I have the ability to print it out, then I’ll give it to folks so that they can take it. But it’s a really nice objective way for you to measure your symptoms. It’s hard to know if you are struggling with something if you don’t have kind of a baseline for where you’re at, right?

Tune In with your Nervous System

And the first thing that I would recommend to people looking to mitigate symptoms is you have to get really in tune with your own nervous system. That’s where it starts from. So, one of the things that I work with mental health professionals on when I do workshops, that they are never expecting, is I talk about their own nervous systems. And I talk about what is going on with them. Because that’s where it all starts from. What we don’t think about, or maybe we think about it but we don’t talk about it, is that we are whole people when we walk into that counselling room. And consciously or unconsciously, the things that are present within you are going to show up in that counselling room with you.

So, the best example that I can give is this. One thing that I always provide to folks is the ACES, so the Adverse Childhood Experiences Survey. Many of the mental health professionals that I have presented to don’t actually know their own ACES score. And that’s something that I would really encourage you to know about yourself. I’m not saying it has any bearing on your quality of work as a clinician, but that’s something that goes into the room with you just like your intersectional identities.

So, I didn’t do it at the beginning of this presentation, but normally when I present to folks, what I start with is, let’s talk about our intersectional identities. Here are my intersectional identities. For example, I’m first generation American. The fact that I was raised by immigrant parents very much influences my worldview. That comes into the room with me. So, you should know your ACES score. If you haven’t taken it in a while, then that’s something that I would encourage you to do. And what we know about ACEs, any of you that do trauma work, you know that the body keeps the score. We continue to hold those things in our nervous systems.

So, here’s what ends up happening. Let’s say that you have an ACEs score of eight. We’ll make it a pretty high number. And you’re working with a client who also has a pretty high ACEs score. And they are telling you a narrative of growing up and maybe they grew up with a caregiver who had substance abuse issues and often express those issues through yelling and unpredictable behavior. So, you’re sitting in session and the client that you’re working with is telling you this narrative. What’s happening in your nervous system is your nervous system is going into panic, fight or flight mode. Your threat response is being initiated, not because of the client, they’re not being threatening in any way, overtly. But your nervous system. because the body keeps the score, is remembering what happened when you were growing up, potentially with a caregiver who also struggled with substance abuse issues, and express that through a lot of yelling and unpredictability. So unconsciously, your nervous system is now in fight or flight mode, and you’re sitting in session. Ignoring it. So, at some point, your body has tensed up because your nervous system is telling you, get out, you need to fight or flight your way out of this situation. But you cannot, because this client is paying money to see you. And so you’re now in this battle with your own nervous system that’s telling you for your own safety, you need to run away or fight this client. And you’re telling yourself, we can’t do that, we have to be with them for the next 45 minutes or however long your session is, right? So, you now walk away from that session and you are just wiped, you are exhausted. My guess though is that in 15 minutes you have to see another person, if you have a 15-minute break in between sessions. And so, you can see how this gradually accumulates over the day.

So, the best way, the most impactful and effective way to be able to avoid getting yourself neck deep in compassion fatigue is you have to become familiar with what’s going on inside your nervous system. And the most effective way to do that is you have to teach your nervous system, and I know it sounds silly, but you have to teach your nervous system the difference between what is a real threat and what is a perceived threat? Because the truth is, all it takes is one interaction in your life for your nervous system to classify something as a life-threatening danger.

Here’s a good example of that, middle school. Anybody that survived middle school has painful past learning, right? And painful past learning is what leads to our compassion fatigue. So, let’s say on the first day of middle school, you dropped your tray in the middle of the cafeteria, and it was like in those movies, everything stopped, everybody looked at you, you’re now covered in spaghetti sauce, and people probably laughed at you, right? From that moment on, your nervous system registered people looking at you as painful. Now, were you actually in life threatening danger in that moment? No. But the shame and the embarrassment of having your peers laugh at you got registered in the bucket of life-threatening things. Okay, fast forward 15 years, and you are at work. And you just so happen to walk into the break room when somebody told a funny joke, and as you walk in, everybody’s laughing, what’s your nervous system going to do? So, middle school you is going to come to the forefront in your nervous system, and you’re going to do that whole panicky thing. Again, not consciously, but your nervous system in its desperate attempt to keep you alive is going to once again go into that panic fight or flight mode in the presence of your colleagues who just coincidentally happen to be laughing at a joke. And this happens to every single one of us. hundreds of times a day. Sometimes there’s a really obvious connection between that painful past learning and the present-day behavior. For example, I dropped my tray in middle school, now I go into panic, fight or flight mode when I’m perceiving that they’re laughing at me.

A lot of times though, those connections are much more subtle. So, take for example, I have a three-year-old nephew and if we go out to breakfast and we’re eating outside, and he gets stung by a bee, and he was eating waffles at the time, his nervous system is now going to register the smell of the maple syrup with that life-threatening danger, air quotes there, of the bee sting. Now, the maple syrup had nothing to do with the pain, but that’s not how it gets registered in your nervous system. But I don’t have any memories of being three. I don’t know how many people do. So that may not be something that you remember when you’re 35. You may just “Ugh, I don’t touch maple syrup, that stuff is gross, like take it away from me.” And it’s because your nervous system remembered when you got stung by a bee when you were three years old.

Checking in with your Body

So, the point of this is not to try to remember what is causing me to perceive threat in this present moment. What is my nervous system responding to? It’s much a better use of your time to recognize that you’re going into threat mode. And you do that by checking in with your body, which is probably something that you tell the clients that you work with to do all the time, but you want to check yourself for muscle tension. That’s how your nervous system is telling you that there’s something in your environment causing your threat response to alert.

So, if you do a body scan, and here’s one that I teach folks when I do presentations or when I’m working with clients individually, Dr. Gentry calls it the wet noodle. It’s always the one that he starts off with, and the way it goes is this. If you do a body scan from head to toe, pretend like you’re standing and looking at yourself, and you’ve got one of those like price scanners that they have at Costco, and you’re just slowly going down from your head to your toes. Become conscious of where your muscles are tense right now. Even as I say this, I recognize that my shoulders are tense, but as I just identified, I am not currently in life threatening danger. I am sitting in my home office, in my home. There is no life-threatening danger going on around me. But my nervous system is picking up on some kind of life-threatening danger. So, I’m going to recognize that right now I’m in a perceived threat. There is no life-threatening danger happening around me.

And I’m going to take 5 seconds and do another body scan. But this time, I’m going to count from 1 to 5. And as I slowly scan from my head to my toes, I’m going to consciously try to soften all of the muscles in my body, not just the muscles that I recognize for tense. And I always invite people, let’s just try it and let’s see what happens for you. And if you feel comfortable closing your eyes, you can. If you’re listening to this while driving, please don’t close your eyes. And then we’ll see what happens for you. So, I count from one, two, three, four, and five. And then I check in with folks and I ask them, were you able to let go of a little bit of tension? Did you go from a hundred level of stress to a 95 level of stress because if you did, then congratulations, you succeeded. What you just did was you interrupted your threat response. That’s the key to unlocking your compassion fatigue.

So now when you’re sitting in a session with a client who’s sharing with you this childhood narrative trauma, you’re recognizing that your muscles are tense, which is not a good or a bad thing. It just means your nervous system is working. So, try to not judge yourself for that. Recognize that it’s a perceived threat. Your client is doing nothing life threatening to you. And take five seconds to soften up those muscles in your body, to relax those muscles. You may need to do it multiple times during that session, and that’s okay. And what’s going to happen is, you’re no longer fighting with your nervous system. You’re letting your nervous system know that you’re here now. You are not five-year-old you, who didn’t have any kind of control in this unsafe environment with your caregivers. And you’re back in present day. And if you do this throughout the day, what you’re going to find happens is you’re not building up all that cortisol and all that adrenaline that is probably what’s causing your sleep disturbance. So yeah, that was a long explanation, but.

Giving Compassion to Your Compassion Fatigue

Kayla: No, but that was fabulous. And something that really hit me, you’re giving compassion to your compassion fatigue in a sense.

Natasha: Yes. Absolutely.

Kayla: And being compassionate with ourselves is something like you said, that we often tell our clients or we encourage our clients to do. But sometimes it’s easier said than done. So being able to have those reminders of we can scan and we can acknowledge that we’re feeling this way without judgment on ourselves.

Natasha: Absolutely. I think another thing that clinicians are not very good at, and I mean this in the gentlest of ways, is giving ourselves that leeway. For example, COVID-19, talk about a global traumatic event, right? And it impacted us too. But what happened was, for me, on a Friday, I was in an office seeing people and by that Monday, I was completely remote. Nobody ever taught me how to do therapy in the middle of a pandemic. And my program didn’t really teach me about teletherapy. I’m maybe aging myself here about when I graduated. But prior to COVID, I only had one client that I was seeing remotely. Everybody else was coming to me in-person. And we all made that pivot, right? And in the meantime, we were also struggling with isolation. We were also fearful of being sick. For me, I live in the United States and so there were lots of things happening politically, George Floyd was murdered and the election of 2020. We deal with a lot of school shootings here in the U. S. unfortunately. And we’re not immune from the effects of those things, but we sit at this really interesting intersection where these global events are impacting us as people, as humans, and also our job is to sit with people as they are processing through, oftentimes, the most difficult periods of their lives.

And yet, unless you do what we do, I don’t think people understand that. Our jobs are very tiring, but in a different way than, I love my husband, he’s a brilliant man, and he sits, from what I can understand, in like eight back-to-back meetings a day. But if I do two heavy trauma sessions, I’m probably going to be more tired than him at the end of the day. But again, if you don’t do what we do, I don’t think that people get that. And I think that clinicians don’t have that compassion for themselves for whatever reason. I know we want to keep going because there’s always more people out there to help. I know we have a hard time turning people away. And we want to keep doing it, but at the same time, we have to take a break. We have to take a step back and understand that we’re human too, and if we’re not taking care of ourselves. How many times have you said this to a client? Then you can’t take care of anybody else.

So, I do think that compassion has to be a huge part of it. And understanding that sometimes you need to say no, and that’s okay, that doesn’t make you a bad clinician. Maybe you need to reduce your caseload. Maybe you need to adjust the population of folks that you’re working with, and that’s okay.

Knowing Your Limits

Kayla: I’m going to actually add a little layer to this too. It’s in private practice, we often think that we need to take more clients, because that’s going to obviously pay for our paycheck because we don’t necessarily get paid per hour, we get paid per session. Even what I heard you say, it’s very relatable. It’s that you can have two sessions that could really drain you by the end of it. And in a typical workplace, someone may go all day in meetings and feel less drained than you might. So, giving yourself that compassion and even that permission to not fill your calendar with seven, eight, or nine sessions a day.

And I will say when I first started out, I started doing seven a day. Well, actually, at one point I did eight and oh, it was bad. But I did do seven a couple times too. And it was draining and I had all these physiological symptoms and impacts connected to that, even the next day I couldn’t even be my full self with my clients. And it’s really understanding, even though the money seems a big part of what we do in private practice, burning yourself out and putting all of these amount of sessions is not going to help.

Natasha: No, and it could very well lead to you being exhausted. And if you end up in the hospital, you’re not making any money on any sessions at that point, you know? Yeah, yeah.

Strategies and Tools to Prevent, Minimize and Recover from Compassion Fatigue

Kayla: And that’s a really good point too, and I think this brings me to my next question, although you did touch on this a little bit in your last scenario. When it comes to compassion fatigue, are there any strategies, tools, or anything that can help therapists and coaches either prevent, minimize, or recover from compassion fatigue?

Natasha: So, the first thing that I would encourage folks to do is a little bit more digging, because I have yet to do a presentation where I ask, what did you learn in grad school about compassion fatigue? And people are like, “Oh, goodness, I learned all of this stuff.” And instead, I get the exact opposite, which is, “Nobody taught me anything.” And so, as clinicians, they’re not training us about compassion fatigue. So, if this is intriguing to you, I would encourage you to do a little bit of research. Check out Dr. Gentry’s site and resources. Just educate yourself a little bit more because we tend to stigmatize ourselves as our first response instead of understanding that there is a term for what you’re going through. It doesn’t mean that you’re a bad clinician. It doesn’t mean that there’s something wrong with you. So, I would start there.

Evaluate

I would also encourage folks to take the ProQOL5 and I’m happy to provide that resource. It’s ProQOL.org. You can take it for free and just get an idea of what your baseline is at. And then finally, Dr. Gentry has some really great resources out there. If you take a look at some of his site, I have a website I’m happy to provide as well. A lot of it is in the moment and this is one of the reasons I really like his stuff because it’s so quick and you don’t need to be an expert on it. You’re just getting to know your nervous system better. It’s recognizing, “Oh, my muscles are tense right now, but in the absence of a life-threatening danger. So, this is not a real threat. Whatever is happening right now is a perceived threat. So, I need to take five seconds, get myself into a relaxed body so that I can interrupt my threat response.” And the combination of recognizing that you’re not in life threatening danger, and then taking those five seconds to relax the muscles of your body. That is self-regulation. And self-regulation is the key, the secret to making sure that you are not remaining neck deep in compassion fatigue.

And in fact, Dr. Gentry actually has five ingredients, if we want to call it that, to immunize yourself against compassion fatigue.

Self-Regulation

The first one being self-regulation. The ability to immediately interrupt your threat response and recognize that you’re not right now in life threatening danger. Even if you’re stuck in traffic and in Florida people forget how to drive in the rain and maybe people are driving too quickly, but until and unless another car is actually coming towards me, I’m not in life threatening danger. All of us do this every single day, hundreds of times a day. We perceive a threat where there is none. And so, recognizing that really is the beginning of everything.

Intentionality

He also talks about intentionality. And for a lot of us that have been doing this for a while, we sometimes forget why we got into this. And so, reconnecting with your why. Why did you get into this work to begin with? Why did you decide you wanted to take on this huge task of caring for other people in their most vulnerable and in many instances painful moments? So, reconnecting with that, reconnecting with your purpose is a huge one that most folks have not visited and that’s a resource that I can provide to people.

Perceptual Maturation

Also, he describes, the term he uses is perceptual maturation. And that’s the concept of understanding that your integrity is worth more than your reputation. And I didn’t know this at the time, but I learned this in community mental health. I was working for an agency that was asking me to do essentially insurance fraud. And those are not the words that they use, but that’s really what it equated to. And it made me really uncomfortable. Financially, I was not in a position to say, I’m not doing that, I quit and walk out the door. I would have loved to have done that, but I have a mortgage to pay. And I now know that I was trying to make myself fit into the box that the community mental health agency was telling me would make me a quote unquote good therapist by billing for unnecessary services, and those are not my core values. And so, a lot of it is identifying for yourself what those core values are, but also understanding that’s more important than anything you’re ever going to get on a performance evaluation. And that was a hard concept for me to understand.

So, I actually recently made a career shift. I recently started at the behavioral health treatment center where I’m at now. And I left my previous company because the caseload was too high. I knew that I was not going to be sustainable. And I knew that I was getting back into compassion fatigue. And so I came to the conclusion, and this was the first time this has ever happened for me professionally, that I was not going to be able to remain at that company because what they were doing was not aligned with my core values. I do not believe that I become a better therapist when I see more clients. That’s just not a value that I hold. And so, I made the decision that I needed to find a company more aligned with my personal values. And so, for the first time in my professional career, there was no angst or crying or anger or I think we’re all familiar with, “Oh, I can’t believe what they made me do this. They’re going to miss me. They’re going to regret it.” I didn’t have that happen this time. I was sad because I did really enjoy the clients that I was working with. And those were some tough conversations to have but I knew deep in my soul, this was what I describe as soul deep knowledge, that I could not remain at that company. And now my work is challenging, I am busy from 9am to 5pm, but I feel so fulfilled because the mission of the non-profit that I’m working for is aligned with my core values. And so, I leave every day, like, “Oh, man, I did good work today. I feel good about what I did.” And I would want that for every person that’s listening to this podcast. And that’s the concept of perceptual maturation.

Your job is always going to ask more of you than you’re able to give. Always. Jobs are designed to keep you in a constant stress cycle, even in private practice, but you have more power than you realize that you have, and so that’s the perceptual maturation shift. So, it wasn’t “This organization is horrible and I hate them” and it was like, “You know what? This is no longer aligned with my values. I need to go elsewhere.” And so, I did. So, I hope that makes sense for people.

Kayla: I love that because I actually come from an ACT perspective. So, values is something I talk about on the podcast frequently because that comes from the framework that I work from. Even hearing you say that alignment, and I think that that’s important with everything we do, whether it’s private practice, the businesses that we set up, whether it’s the clients we work with, whether it’s the organizations we decide to work in. But I also want to put it to the other side where you mentioned of sometimes the money, we don’t always have the privilege to be able to say, “Hey this doesn’t align with me, so I can’t do this.” But you work towards getting there. And I think that’s the key. Once you even know what your values are, what your vision is, what your mission is, even if you currently are not at a place where you’re like, “I can’t do this.” Whether it’s you want to go into private practice, whether it’s adding something into your private practice, whether it’s something totally different. But it’s knowing that the vision, the values are your North Star, and they are going to guide you there, and as you start moving towards them, there will be a day when you can say, “Hey, you know what, now I’m going to move on.”

Natasha: Exactly. Yes. And having that knowledge that you’re not going to be staying there forever is incredibly empowering. Believe me, I get it. I have felt stuck in jobs before and stayed probably longer than I should have. And also, now knowing what I know that even in my every day, I still have the ability to control what’s happening inside my nervous system. And even if the higher ups in the organization are making decisions that I don’t agree with, I still get to decide how I’m approaching my day. I still get to decide how I’m doing the work with the clients that I’m speaking with. So, you do still have power. And I think that’s where people really get themselves lost is they get sucked down into this, “I’m down at the bottom. There’s nothing I can do. I’m going to be stuck here forever.”

Immunization

And which leads me to the next piece of this immunization, which is connection. You have to have other professionals that do this work that you’re able to talk to. Nobody gets it the way that other mental health professionals get it. And so, talk to somebody, say, “Hey, I listened to this podcast. They talked about this compassion fatigue thing. Did you know about this?” They probably will say no. And then you can tell them here are some of the symptoms that I heard about. And you can say to them, if you notice this stuff happening with me, I’m going to give you permission to call me out on it. I may not be happy about it, but I’ll do the same thing for you.

And also, let’s say you have a really heavy trauma day and you just need to get it off your chest. Call up that person, ask permission, and say, “Hey, I just had a really heavy day and I just need to sit with somebody. Do you have the energy? Do you have the spoons to do that for me today?” And if they say yes, it’s great if they say no, then you can talk to the next person in line, but you should have a connection, especially in private practice, it’s so isolating. So, I would definitely encourage you if you don’t already have a network of professionals or some kind of consultation group, connect yourself to other people, especially if you’re working fully virtually. Really important.

Self-Care and Revitalization

And then the final piece of that immunization is self-care and revitalization. That’s the stuff that you tell clients to do all the time. You tell them to eat well. You tell them to sleep well. You tell them to exercise. Well, you need to do those things for yourself too. Think about it from a physiological perspective. If you’re spending all this time in threat mode, you have all this adrenaline and cortisol pumping through your body. Well, that excess energy doesn’t just magically disappear. The best way for you to get rid of it is through regular aerobic exercise. Flush all of that out of your system and you’ll feel better for it. So those are the five ingredients to this immunization.

Kayla: Well, I think that that’s really great. And it helps us understand how we can align ourselves with our business, with our practice, with our clients. And then of course, to help prevent and even recover from compassion fatigue when we’re experiencing it. And when you were talking about the immunization, I was labeling it in my head in a different way. I was thinking, the first is aligning with your values. The second is having that self-accountability, so having someone that can help you to be accountable to yourself. And then the third, self-care, implementing those strategies. Is that a right kind of synopsis of what you’ve said?

Natasha: Yeah, and the only thing is I would encourage you to build it on a foundation of self-regulation, because even if you go for a massage every month. If you’re laying on that massage table and your nervous system is in threat mode, you could be on that massage table for three hours and walk out more tense than when you walked in, right? So, self-care is great if you’re building it on a foundation of self-regulation. So, you got to get your nervous system to recognize that you’re not about to die and then approach whatever the self-care thing is. So yeah, yeah.

Connecting with Natasha

Kayla: Such a great point. And I really appreciate that. That makes complete sense. I know there might be some listeners thinking like, wow, I’d really like to talk to Natasha, she really knows what she’s talking about. And I also know you do continuing education trainings as well. So, if listeners are interested in learning more about compassion fatigue, your services or just to reach out and have a chat. How can they reach you?

Natasha: So there’s two ways. You can definitely check out my website. I am at Natasha, which is my first name, N A T A S H A L M H C, Licensed Mental Health Counselor, dot com. So, all together it’s NatashaLMHC.com. There is a link on that site to be able to email me, but if for whatever reason you just want to go ahead and just email me you can email me at Natasha@NatashaLMHC.com. So probably the easiest way to get a hold of me. And I know sometimes folks will listen to a podcast or attend a presentation and just have follow up questions or you mentioned a resource and it went by too fast. I didn’t grab it. I’m happy to send folks links to things and just clarify what I was speaking about for sure.

Kayla: Fabulous, and do you have a free resource?

Natasha: I do, yeah, so if folks email me, I am happy to connect you to a bunch, like, I’ll send you the ProQOL, I’ll send you a framework for being able to identify your mission statement, I can send you a link to Dr. Gentry’s most recent publication all about professional resilience, if that’s a book that you’re interested in purchasing. I don’t get paid for saying that. You know, Dr. Gentry’s work really transformed my life. I would not be able to be a therapist until I choose to retire had it not been for him. And so, I always want to make sure that I’m connecting other folks to his work as well.

The truth is, is we need clinicians and mental health professionals now more than ever. And so, I really want to help folks be sustainable in the field. Another real passion of mine is the American Counseling Association last year came out with a statistic that only about 30% of licensed professional counselors identify under the BIPOC umbrella, under black indigenous or people of color. And so BIPOC professionals, especially, we need them in the field. So, anything I can do to help you be sustainable, please reach out, please reach out.

Kayla: And I know that you do continuing education credits. Do you work with Canadians and people in the U. S. for continuing education?

Natasha: So that depends on the organization. I don’t hold the ability to offer CEs as an individual. But the way that I’ve done it before is the organization holds that power. If, for example, you’re affiliated with the National Board of Certified Counselors, I meet the criteria as a qualified presenter and you’re able to offer NBCC credits. We would be able to do it that way. I’ve presented multiple times in the state of Florida, so I definitely meet Florida state requirements. But if you’re interested in having me speak to your organization, I’ve got my whole bio and objectives and all of that stuff put together, so feel free to reach out. And if your organization offers CE credits, I very likely meet the qualifications as a speaker and I have all of that documentation that I can provide and in fact that I need to provide in order for you to prove that the CE is valid. So, yeah.

Kayla: Fabulous. Natasha, thank you so much for joining us today on the podcast and sharing such valuable information with how to identify but as well as manage compassion fatigue specifically in private practice.

Natasha: Thank you so much for having me. This was fantastic.

Kayla: Thank you everyone for tuning into today’s episode and I hope you join me again soon on the Designer Practice Podcast.

Until next time, bye for now!

Credits & Disclaimers

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Reference

Figley CR. Compassion fatigue: coping with secondary traumatic stress disorder in those who treat the traumatized. New York: Brunner/Mazel; 1995