DQ wk 5

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UNKNOWN Good afternoon everyone. It's my pleasure to introduce my next guest, Dr. Anna Baranowsky, the CEO of Traumatology Institute, Canada, training and development Inc, and is a psychologist who works with trauma survivors in Toronto, Ontario. Dr. Baranowsky's guiding principle has been the development of services to meet the needs of trauma survivors, their families, friends and organizations, and professional seeking personal care and training to advance their knowledge in the field. Dr. Baranowsky received her doctorate in clinical psychology at the University of Ottawa. She is a Green Cross Scholar, Registered Traumatologist and Trainer. She serves on the board of directors of the Academy of Traumatology and is a Board Certified Expert in traumatic stress through the American Academy of Experts in Traumatic Stress and is recognized by The National Center for Crisis Management. Her accomplishments include the co-development of the Accelerated Recovery Program for Compassion Fatigue in the Traumatology Institute Training Curriculum. The trauma Growth Online program and 30 day video stabilizing program. She is also the author of the bestselling, of the best seller Trauma Practice, what is PTSD? Professional and secure online meeting room. She has created an Internationally recognized series of training programs leading to designations in compassion fatigue, Early intervention field of trauma, Clinical Traumatology, community and work places traumatology, TeleMental Health, School Crisis Response, Justice System Certificate. Dr. Baranowsky works with individuals, couples, small businesses and organizations to alleviate emotional distress, reduce blocks to potential, and enhances feelings of wellness. And there are senses, I'm feeling rather unaccomplished having to read all of these titles for everyone. Anyway please join me in welcoming Dr. Anna Baranowsky.

02:20 TRAUMATOLOGY

INSTITUTE

WhatisPTSD.com

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www.TicLearn.com

www.WhatIsPTSD.com

We all struggle sometimes…

First flights after "911" Embedded with the fear of events through media images

You are the ones who show up…

Compassion Fatigue or FLAT OUT EXHAUSTED

Primary & Secondary Trauma

Overwhelmed

Burn-out (demands overwhelm resources)

Nervous system depletion

LINKS & DOCS!

[email protected]

DR. ANNA BARANOWSKY Hi. I'm really glad to be here, you are exactly the people that I wanna speak with. Umm… and thank you very much for the introduction and for inviting me here, but I will say that, what I want to do is just start by saying I'm coming to talk from the perspective of a human first and not an expert, okay. And I start with that, because I absolutely do exactly what all of you do, I help people and I feel like that has been the mission of my work for as long as I've been talking about Compassion Fatigue and certainly for as long as I've been helping people. Umm… I wanna start by telling you a story and this comes with the "I'm a human being first" package. So, uh… right around "911", umm… you know, we all faced these really awful events, where we were mesmerized by what was going on and very, very deeply concerned about the impact on the people who were uh… harmed directly and indirectly by these events. Now I was scheduled to go on to a plane that day, and instead people started to show up at my office and say that, you know, basically all the flights are closed down and everything is grounded. And I was doing a lot of training and then I started to uh… wind down for the day, because I wasn't gonna go anywhere, but instead of winding down, the calls started to come in from media, umm… and I wasn't going training, so I was going to studios to talk about umm… my perspective of the impact of trauma on individuals and communities. And so, as I arrived at the studio, I don't know, how many people have had this experience, but it's kind of strange, you know, you are right there, and there is this camera looking right at you and they say, you know, don't look to the right or the left, look start ahead, look into the camera or eye or whatever it is. And right on the right and left of me, were two TV screens and the twin towers were going down, the towers were going down, they kept on looping it, they kept on playing it over and over again. You know, the planes going into buildings, over and over again. And I couldn't get away from it, because I was right there, and I was talking about the issues and talking about the impact of trauma and then, when the plane started flying again, within about a week, I was booked to do across Canada, tour to talk about trauma and recovery and compassion fatigue, and all the stuff that I talked about. And so, I get on the plane, huh… and all of a sudden, I am hit with the strongest feelings of anxiety I have ever had in my entire life. And I'm on the plane going, "Oh! My God! I can't bear it", because I am woven in the exact same way that you are, that we all are. So having those images alone, talking about the issues and then being on the plane within the first week after the flights started again, it knocked me to my feet, I was just, I just could barely stand it. And so, what did I have to do, I had to do all the stuff that I tell anybody I work with, I had to do all the stuff to help myself get through those first few minutes, and remember that this is just the wiring of anxiety and stress, and when we are exposed to deeply impactful things, we cannot imagine that there will not be an impact. I was just watching the screens, I mean I was in a position where I was working with some people after the incident, I was in a position where I was talking about the issues related to the incident, but I wasn't there, okay. So being there, experiencing something directly, and being exposed to it secondarily, yeah the impact can be pretty strong and we forget it sometimes, and we let ourselves down by forgetting that more than anything we are human first. So you are all the people that show up, You are doing the good work, you are making a difference in the lives of the people around you, every day, and sometimes that's also very easy to forget the deep work that it really takes, and how important you are, and how important your well being is. But I don't forget it, because I work with individuals all over the world. who have experienced being absolutely flattened by the work that they do. You know, it's… it happens, and it happens to the best of us, and I really want to take this 2 hours to talk about not letting yourself get flattened by what you do, you are too important, and I want you to embed that, because that's probably the most important message that I have to share today. I want you to take that home, because that's about you taking care of yourself. So what I see with compassion fatigue is, that individuals can be exposed to a lot of impact in the course of their work, what I want to say is, don't worry about taking notes or anything like that, uh… Mandy, who is standing there, who is right there. She is waving. Umm… she'll be happy to provide you with a set of links uh… to anything that I talk about, and documents, if you needed and Ush(ph) is right here too, if you need any uh… information after the workshop about some of the stuff that we do, because I'm gonna talk about some of the stuff we do, because it relates to what you are all doing out there as well. So, I don't want you to worry about that. So, you've got a sense of what I think it happened to you, when you were exposed secondarily to trauma. I think this is very important because what I see is that individuals have a (inaudible ) into the work that they do. I come with my own history, I didn't come by this work umm… with uh… no sense of what it's like to experience difficult things, I think everybody who does this work has a sense. And then we carry that into our work, and then that can get ignited when we work with certain clients, it depends of the content, there are certain content, that some of us are more vulnerable to, and that depends on you, who you are, what you've been exposed to in the course of your life, right. we all know what that is. And then, we're exposed to environments, where we lack resources and we start to get depleted over time. But I have been working with individual uh… uh… professionals who help other people, since 1997. And what I have found pretty consistently is it's those people who have their own history that end up coming to see me. And uh… I think that empathy is a huge vehicle of transmission, so it's really you being able to connect with other people and be openhearted that then makes you vulnerable to the impact of the work and the exposure. So that's why I talk about compassion being a double-edged sword, because I don't think I could do the work I do, either umm… training or working individually with clients. And I've worked with a large number of clients every week and most of it is trauma based. Umm… I don't think I could do my work, unless I could be present in the room with all of me. And that means that when we are able to do that, and be present, those people that we work with, they do feel that, part of that big piece, is the connection we have with other people that makes the work possible, right? Because nobody is going to trust you, if you are not in the room with them, right? But it's being in the room with them and really being present for those stories, that creates that double-edged sword. Empathy makes it possible for us to connect. And then, it is that openheartedness, that leaves us open to the wounding potentially. So really, Figley was at the root of a lot of this and you know, he started to write about these issues in 1983. Compassion fatigue, the actual term came from a paper that was written for a nursing journal, but Figley really picked it up. Now, in 1997 I went to study with Figley, and started to write, think about compassion fatigue and develop this accelerated recovery program for compassion fatigue, both working with larger groups and individuals as well. But, you know the reality is that, we are all hard wired to remember stories. So, if comes and they tell us something, or we see something and it gets embedded in our brains, we then start repeating it to our self, that's why I was on the plane, I was in this highly charged state of anxiety, because it got woven, embedded into my nervous system, and I then started to tell myself stories about how difficult and dangerous that it was to be on that plane, when really in reality, there was nothing going on in the moment. So, we do this to keep safe, we ruminate, we tell ourselves stories… I tell you stories. And then, if I tell you a bad story, may be I'm saying, you need to watch out, umm… don't go to that ATM at night, and then you started thinking about the ATM, right? We all do this. So, from the perspective of evolutionary psychology that makes absolute, perfect sense, because it's how we keep ourselves safe, but it really works much, much better when we are running away from a saber tooth tiger, who is at one watering hole and we know to stay away from that watering hole, but when it comes to our modern world. When I keep repeating dangerous stories, over and over and over again, what I do is create a highly reactive nervous system, because it's not just the one event that upset me, now it's all the reminders and the triggers and the queues and anything that links in with that thing that I think I should be worried about. So, then I get exhausted, and we all get exhausted when things like that happen, because your mind is a story telling machine, that will terrify you. We all know what that's like, right? I certainly do. And the problem is that, we have these hormones that actually galvanize all of our resources and help us get away from danger, so adrenaline gets released in our body, and it's like umm… If you have ever seen somebody throw gasoline on a fire, that's how adrenaline works in your system, so it's like a bash! a big explosion of energy, that helps you runaway. And that's wonderful. And then it burns out. And then cortisol comes in and it keeps you activated long, long after. So if you get a lower level event, something that gets you agitated, you can have the same level of reactivity, the same big anxious feeling for a lower level event. This is really important stuff, because if this keeps happening over and over again, like it did for me with the aeroplane. I started to wire in my brain, being on this plane is dangerous. Not only dangerous but it's going to kill me, so I'm on the plane going like, "Oh! My God! I'm gripping my seat, I'm going to die here", right? Because what happens in the brain is, as we think about something, repeatedly, over and over again, it becomes hard wired like a very strong steel cable, very difficult to break. And so, we can have thoughts and believes from earlier in our life, that have been following us around forever, and it takes a lot of work to get that to disengage, because that's the way the brain helps us. But it's pretty tough stuff, so we have to think about the things we need to do to break that, I'm gonna talk about that later. So compassion fatigue and secondary traumatic stress and PTSD are, and interwoven terms, just keep that in mind. My trauma becomes your trauma, you clients trauma can become your trauma, these things can happen before you even recognize what's going on and it can leave you feeling very vulnerable. But as I said before, one of the things that I'm very interested in is what came before? So when a client comes to see me, if somebody calls me up and say's, you know, umm… I do some kind of helping work. And I work with a lot of uh… doctors and lawyers, and veterinarians, and emergency responders, and clinicians, therapist, and often they may call and say, you know, I am experiencing uh… helper burn out or compassion fatigue and what we do is we recognize that there are some injurious points along the way, things that they were exposed to in the course of their work. And then we peel back another layer, and we realize that underneath that is latent vulnerability. So what came before? What were the injuries that laid the foundation, for where this individual is right now? And a lot of what I'm talking about is what I want you to be thinking about as well for yourself. What came before the really strong feelings of stress? You know, either for you or somebody you know, or somebody you work with, because we all have our own stories. And some other things to be aware of in terms of compassion fatigue, is that the symptoms are the same as PTSD. I don't really differentiate that much. I just know that when I work with professionals, I want to be highly respectful, because these are people who are out there trying to help and make a difference. And sometimes have found them selves overwhelmed because of the exposure to their difficult work. So intrusion avoidance, negative beliefs and arousals, we see these things in PTSD, and we also see them in compassion fatigue. And we also see a lot of symptoms in burnout, which is that other piece of the puzzle, that we need to keep in mind, because this is the kind of impact that these things can have on your emotions, your body, how you interact with people avoiding work, feeling like somehow your relationships are not what you want them to be. And just one thing to keep in mind with burnout, that it is different than compassion fatigue as a whole, because with compassion fatigue, what I usually hear is that there was one pivotal or a serious of pivotal events at the work place that led to this unravelling. With the uh… burnout, what we are really doing is looking at umm… feeling like that there are not enough resources in your environment to be able to tolerate the demands. And it happens overtime, and in general, people stop feeling like they are achieving. So the other piece of it, that's very important is, this notion of disrespect. So if you find yourself in a work environment, and don't feel valued or feel disrespected, there is likely to be a greater sense uh… of burnout. Now this is interesting, because this is part of the reason that I often think about burnout is perceived resources. Because if one of the resources is feeling respected and valued, part of that is a, attitudinal shift in the work place, and that's a resource. A lot of people by the time I see them, they understand that they went through a long period of time without understanding what was going on for them or why they were feeling so bad, why they weren't coping or thriving. And here is just a whole list of things that we see umm… and you may notice that some of these things that I put up on this list from Showalter, 2010, looks a lot like umm… depression, anxiety disorder and PTSD all come together. People may recognize Malala. We realized the importance of our voice when we are silenced. One other things that I came to realize, when I was talking about compassion fatigue was there is this issue around silencing. And that there was some research that was done quite a few years ago with psychiatrist, who are meeting with Holocaust survivors and this was very interesting, because what the research was showing, was that the psychiatrist didn't want to hear about the Holocaust survivors stories, because they felt that the content was umm… it was either too unbelievable or not something they could tolerate hearing. I mean you people deal with this every single day, you listen to stories. You are exposed to stories that are unbelievable. But with the silencing response what happens is there is a subtle shift away from the content, the trauma content, because it is overwhelming, and that to me is a cue that something is going on, and we did some research around 1997 originally in which we looked at umm… what was happening with a bank robbery debriefers and then would be go to the bank umm… to the banks after the robbery. So, I used to do this a number of years ago. Umm… you go right in and talk to the staff and you do a debriefing and what the research showed was that compassion fatigue, feeling overwhelmed by the exposure to trauma and silencing response were related, very strongly related with a very high p, a very low p value, which was showing us that we had uh… individuals who over a large umm… scope after a while, that they started to feel overwhelmed, they stopped listening. And we looked at the assumptions, and you know, some of the assumptions I found really interesting that if we discuss it, the individual is going to be overwhelmed. I'm going to be overwhelmed. It won't help. It's too terrible to be true that links backs to some of the earlier research. And we just found that's some of the umm… most interesting things came in some of our soft conversations. People would start to change the subject, avoid the topic, give pat answers. Uh… one individual said that the way they dealt with their feelings was to fake listening, all right. Which is an amazing thing when you think of the role, that we… think Many of us have here in the room. So I want to talk about a couple of examples. Umm… I want to talk about Nancy, who is working with cancer survivors and she is umm… feeling really… like she is struggling, because she was working on one umm… with one individual, a women who was very much like her, similar age, had children and this women died. And she was just completely blown away by it. She didn't expect it, because she'd been working in the field and other people had died, I mean when you're working in cancer services this is what happens. And then, Jeffry who is in bereavement and he was helping a family after a child drowning, and he found himself feeling furious at the family. So our reactions can be so strong. And then the final one is Peter, who is a paramedic, and Peter was at an "Officer Down" call, and ended up at emergency with the officer. And initially felt okay, but then started to notice some symptoms, went to the movies and all of a sudden he had this massive panic attack and he didn't know what was going on, and he went to the emerge and they told him it was a panic attack. They ruled out everything else. And now he is humiliated and feels overwhelmed, but his symptoms had been growing, we're going to come back to Peter. With many, many people in a lot of different environments is that, we know what works. We know that when we're working to get better or stronger that there are things that help, uh… education helps, talking about it, like we‘re talking about it here today. Umm… One study with the 169 umm… educators, now this is an important study, because this was a very difficult research piece, because Mercy umm… worked in a very high conflict school district, so there were a lot of acts of violence, death, murder. I mean it was very tough place to be an educator, because you can imagine the impact on the kids and the staff, when they are many, many events. And the next one was with Flarity, Gentry, Mesnikoff, and what they found was educational programs helped them, you know, things that were helping people with specific activities, and encouraging to do this. Now what do we have a quite time, daily prayer, relaxation reading, exercise, hobbies, counseling, bla… bla… bla… we know we all this stuff right? Is there anybody here? Sorry, anybody here who wouldn't think of these things? Is this not something you already know? Right? Exercise, breath, meditate, do yoga, do stuff, right? Stop smoking, start laughing, stop hating, I mean, we know this right? But I've been talking to people since 1997, about compassion fatigue, and what I really want to know is why we fail ourselves? Because isn't that really the issue? Don't we all fail ourselves on some level? We do not do these things that we need to do, to care for ourselves. And if we can't care for ourselves, if we keep walking away, or turning our backs on ourselves, this self betrayal is the piece that then leads to this unbelievable struggle. So one of my markers, and one of the things I had to teach myself to do umm… was after a long day, and sometimes I have very long days, umm… I, you know, people call and, you know, I'm home after a long day and the phones is ringing and all sorts of stuff is going on, so… After a long day, how many people want to answer the phone? You've been, you've been at the office or doing your thing, it's been a long day, the phone's ringing you're going like huh… Pick up your hand if you really want to answer the phone after a long day. Nobody wants to answer the phone. Nobody wants to answer the phone. Okay, how many people do it anyways, right? Because, we, we all find ourselves saying yes, when what we really mean is no. And so why are we vulnerable to saying yes, when we mean no, and the yes doesn't have to necessarily be answering the phone. What I would like to do is just pause for one short break, because I want all of you in your small groups to ask you that question. I want you to ask yourself what it is, that creates this capacity to say yes, when you mean no? What it is that keeps you from doing the things you know will help you, and instead not following through? Even when you know what those things are, and we all do it and I'm guilty of this as well. So this is the conversation that is so essential to have. So, what I'm going to do is, for about 7 minutes, and I'm gonna count it, okay, I'm gonna track it, I'm gonna have you in your small groups. Just talk about that issue, and I'm going to ask you to have a spokesperson for each table. I would like to have a couple of hands from tables that would like to just tell us in briefly why is it that we are failing ourselves? Why it is we are not doing the things that we know? Why we say yes, when we mean no? Yes, so do you want to go to the podium, so people can hear you? Yes thank you.

UNKNOWN Good afternoon everyone. It's my pleasu

re to introduce my next guest, Dr.

Anna Baranowsky, the CEO of Traumatology Institute, Canada, training and development

Inc, and is a psychologist who works with trauma survivors in Toronto, Ontario. Dr.

Baranowsky's guiding principle has been the developm

ent of services to meet the needs of

trauma survivors, their families, friends and organizations, and professional seeking personal

care and training to advance their knowledge in the field. Dr. Baranowsky received her

doctorate in clinical psychology at t

he University of Ottawa. She is a Green Cross Scholar,

Registered Traumatologist and Trainer. She serves on the board of directors of the Academy

of Traumatology and is a Board Certified Expert in traumatic stress through the American

Academy of Experts in

Traumatic Stress and is recognized by The National Center for Crisis

Management. Her accomplishments include the co

development of the Accelerated

Recovery Program for Compassion Fatigue in the Traumatology Institute Training

Curriculum. The trauma Growth

Online program and 30 day video stabilizing program. She is

also the author of the bestselling, of the best seller Trauma Practice, what is PTSD?

Professional and secure online meeting room. She has created an Internationally recognized

series of training

programs leading to designations in compassion fatigue, Early intervention

field of trauma, Clinical Traumatology, community and work places traumatology, TeleMental

Health, School Crisis Response, Justice System Certificate. Dr. Baranowsky works with

ind

ividuals, couples, small businesses and organizations to alleviate emotional distress,

reduce blocks to potential, and enhances feelings of wellness. And there are senses, I'm

feeling rather unaccomplished having to read all of these titles for everyone. A

nyway please

join me in welcoming Dr. Anna Baranowsky.

02:20 TRAUMATOLOGY

INSTITUTE

WhatisPTSD.com

TicLearn.com

Inform Inspire Uplift

www.TicLearn.com

www.WhatIsPTSD.com

We all struggle sometimes…

First flights after "911" Embedded with the fear of events through media images

You are the ones who show up…

Compassion Fatigue or FLAT OUT EXHAUSTED

Primary & Secondary Trauma

Overwhelmed

Burn

out (demands overwhelm resources)

Nervous system depletion

NKS & DOCS!

[email protected]

DR. ANNA BARANOWSKY Hi. I'm really glad to be here, you are exactly the people that I

wanna speak with. Umm… and thank you very much for the introduction and for inviting me

here, but I will say that, what I want to do is jus

t start by saying I'm coming to talk from the

perspective of a human first and not an expert, okay. And I start with that, because I

absolutely do exactly what all of you do, I help people and I feel like that has been the

mission of my work for as long as

I've been talking about Compassion Fatigue and certainly

for as long as I've been helping people. Umm… I wanna start by telling you a story and this

comes with the "I'm a human being first" package. So, uh… right around "911", umm… you

UNKNOWN Good afternoon everyone. It's my pleasure to introduce my next guest, Dr.

Anna Baranowsky, the CEO of Traumatology Institute, Canada, training and development

Inc, and is a psychologist who works with trauma survivors in Toronto, Ontario. Dr.

Baranowsky's guiding principle has been the development of services to meet the needs of

trauma survivors, their families, friends and organizations, and professional seeking personal

care and training to advance their knowledge in the field. Dr. Baranowsky received her

doctorate in clinical psychology at the University of Ottawa. She is a Green Cross Scholar,

Registered Traumatologist and Trainer. She serves on the board of directors of the Academy

of Traumatology and is a Board Certified Expert in traumatic stress through the American

Academy of Experts in Traumatic Stress and is recognized by The National Center for Crisis

Management. Her accomplishments include the co-development of the Accelerated

Recovery Program for Compassion Fatigue in the Traumatology Institute Training

Curriculum. The trauma Growth Online program and 30 day video stabilizing program. She is

also the author of the bestselling, of the best seller Trauma Practice, what is PTSD?

Professional and secure online meeting room. She has created an Internationally recognized

series of training programs leading to designations in compassion fatigue, Early intervention

field of trauma, Clinical Traumatology, community and work places traumatology, TeleMental

Health, School Crisis Response, Justice System Certificate. Dr. Baranowsky works with

individuals, couples, small businesses and organizations to alleviate emotional distress,

reduce blocks to potential, and enhances feelings of wellness. And there are senses, I'm

feeling rather unaccomplished having to read all of these titles for everyone. Anyway please

join me in welcoming Dr. Anna Baranowsky.

02:20 TRAUMATOLOGY

INSTITUTE

WhatisPTSD.com

TicLearn.com

Inform Inspire Uplift

www.TicLearn.com

www.WhatIsPTSD.com

We all struggle sometimes…

First flights after "911" Embedded with the fear of events through media images

You are the ones who show up…

Compassion Fatigue or FLAT OUT EXHAUSTED

Primary & Secondary Trauma

Overwhelmed

Burn-out (demands overwhelm resources)

Nervous system depletion

LINKS & DOCS!

[email protected]

DR. ANNA BARANOWSKY Hi. I'm really glad to be here, you are exactly the people that I

wanna speak with. Umm… and thank you very much for the introduction and for inviting me

here, but I will say that, what I want to do is just start by saying I'm coming to talk from the

perspective of a human first and not an expert, okay. And I start with that, because I

absolutely do exactly what all of you do, I help people and I feel like that has been the

mission of my work for as long as I've been talking about Compassion Fatigue and certainly

for as long as I've been helping people. Umm… I wanna start by telling you a story and this

comes with the "I'm a human being first" package. So, uh… right around "911", umm… you