One of the well-known ironies of working in the field of human services is that while many are motivated by our desire to help other people, we sometimes miss providing ourselves with that same level of help and care. If we go for too long without taking care of ourselves, we risk damaging our own mental and physical health, as well as our relationships with others.

Have you listened to the safety speech that is given by flight attendants on most commercial airline flights? One part of that speech advises passengers to “put on your own oxygen mask first before assisting others.” In other words, be sure that you are able to breathe and function fully before you take on helping your child or neighboring passenger. In human services, we strive to take care of ourselves, so that we are our best selves when we help others.

In this section, we will talk about common stresses that human services professionals face and strategies that can be used to keep your metaphorical oxygen mask securely fastened, as well as developing overall well-being, while you help others.

12.6.1 Overall Well-Being

Before we discuss the various types of stress that human services workers encounter, let’s look at what overall well-being looks like. We’ll use a biopsychosocial model developed specifically for child welfare workers as shown in figure 12.4, but that we will use for all human services professionals.

Figure 12.4. Human services workers must pay attention to their own physical, social, and psychological well-being even while working and caring for other people.

Physical well-being consists of caring for a worker’s overall health and well-being. This means tending to general physical health concerns such as sleep disturbances, headaches, or respiratory infections. It also means ensuring workplace safety where workers are protected from workplace violence, verbal or physical threats and secondary traumatic stress. Psychological well-being includes job satisfaction, psychological safety, and feeling able to show one’s self without negative consequences to self-image, career, or status. It also includes avoiding job burnout, engaging in one’s work, and feeling included. Social well-being includes social support and work-life effectiveness. These dimensions work together within the framework to make up the workplace well-being of a human services professional.

12.6.2 Compassion Fatigue

Human services work can be very satisfying, but it can also take its toll on you in the form of compassion fatigue. Research indicates that compassion fatigue is made up of two main components: burnout and secondary traumatic stress (Huggard et al.,2013). When experiencing burnout, you may feel exhausted and overwhelmed, like nothing you do will help make the situation better.

For some practitioners, the negative effects of this work can make them feel like the trauma of the people they are helping is happening to them or the people they love. This is called secondary traumatic stress. When these feelings go on for a long time, they can develop into vicarious trauma. This type of trauma is rare but can be so distressing that the way a person views the world changes for the worse. It is important to be aware of secondary trauma so that you can avoid developing a longer-term trauma response.

It is important to acknowledge the limitations of your skills and your own personal risks (such as a history of trauma) and other negative aspects of helping people deal with complicated life problems so that you recognize how they may be affecting your feelings as well as your behavior.

12.6.2.1 Signs of Compassion Fatigue

You may experience several of the following signs of burnout and the more serious component of compassion fatigue, secondary traumatic stress. Remember, not everyone experiences all of these symptoms in the same way as others. This list includes some of the signs of compassion fatigue:

• discouragement, as if nothing you can do will help
• tiredness—even exhaustion—and overwhelm
• feelings of failure, as though you are not doing your job well
• frustration
• cynicism
• disconnection from others, lack of feelings, indifference
• depression
• Coping with the use of alcohol or other mind-altering substances

Signs of secondary traumatic stress, a more serious component of compassion fatigue, may include the following:

• fear in situations that others would not think were frightening
• excessive worry that something bad will happen to you, your loved ones, or colleagues
• anxiety, easily startled, feeling “jumpy” or “on guard” all of the time
• wariness of every situation, expecting a traumatic outcome
• racing heart, shortness of breath, and increased tension headaches
• sense of being haunted by the troubles you see and hear from others and not being able to make them go away
• the feeling that others’ trauma is yours

If you are experiencing any of these signs of stress, talk with a friend or colleague, seek wise counsel from a trusted mentor, or ask your supervisor to help you determine a course of action. You may also consider seeking help from a qualified mental health professional.

12.6.2.2 Addressing Compassion Fatigue

Traditionally human services workers have focused on helping others solve their problems, but with the adaptation of the strengths-based approach, it is helpful to focus on identifying resilience, fostering strengths, and encouraging self-care, actions you take to improve or preserve your own health. Just as you assist others in this process, you can apply this approach to yourself on a routine basis—whether at work or at home—to avoid compassion fatigue. By focusing on building your strengths and carrying out self-care activities, you are contributing to your behavioral, cognitive, physical, spiritual, and emotional resilience. The following strategies can help you do just that:

• Focus on the four core components of resilience: adequate sleep, good nutrition, regular physical activity, and active relaxation (e.g., yoga or meditation).
• Complete basic hygiene tasks: As obvious as this may seem, don’t forget self-maintenance: comb your hair, brush your teeth, bathe, and change your clothes. Wearing clean clothes can make you feel better.
• Wash away the day: Try to wash up, even just your hands and face, after you leave your work shift. Take a walk, even if it is only for five minutes. Think of it as a symbolic “washing away” of the hardness of the day.
• Cultivate relationships: Make time to learn about the people with whom you work. Taking time for conversations will help foster feelings of positive regard toward yourself and others. Engage with your fellow workers to celebrate successes and mourn sorrows as a group. Cultivate the relationship with yourself by taking alone so you can think, meditate, or rest.
• Create and Recreate: utilize journaling, art, or other expressive means. Take time away from work on a regular basis. Practice your spiritual beliefs.

When combined, the self-care practices mentioned above can help prevent the development of compassion fatigue. Once you begin to routinely practice these healthy habits, they become part of your overall prevention plan. Not only do healthy habits strengthen your ability to cope while in the moment, they can help your body remember how to bounce back to a healthier state. Establish these habits now so that they become part of your preparedness plan.

12.6.3 Compassion Satisfaction

Compassion satisfaction refers to the sense of fulfillment you feel for the work you do. It can be a source of hope, strength, and ultimately resilience. This satisfaction with your work is also what allows you to face another day, another client, another challenging set of circumstances. It is the quiet knowledge that what you do makes a difference, and that you possess the same strengths you see and support in the clients with whom you work. Appreciating each encounter with a client can add to your compassion satisfaction and help protect you from compassion fatigue. Even when things do not go as well as you had hoped, you can try to appreciate these encounters, knowing that you did the very best that you could do to help someone solve life’s problems. In these ways, compassion satisfaction can serve as a natural, protective tool against the negative aspects of disaster response work. By noticing, acknowledging, and appreciating the work you do, you can build compassion satisfaction in yourself and encourage it in your colleagues.

12.6.4 Overload and Spillover

Overload, the experience of having excessive stress, workload, or other burdens, is another kind of stress that human services professionals experience. Spillover, when stress from one part of life overlaps or “spills over” into another part of life, is especially prevalent when one is experiencing overload.

For example, if you have a disagreement with your partner, and the plumbing in your kitchen backs up you might start feeling overloaded about your home life. If you have multiple deadlines at work and a client who is having a severe traumatic response you could feel overloaded at work. In either situation, it’s possible for that overloaded feeling to spillover into the other environment, perhaps by overreacting to another difficulty that arises.

Understanding what it means to be overloaded and what spillover looks like can help you to identify this when you experience it. In this next section we will talk about self-care strategies that help you to recognize and cope with these feelings.

12.6.5 Self-Care Strategies and Reflection

The same strategies that help prevent and deal with compassion fatigue can be used to cope with overload and spillover. These are basic self-care strategies, but they bear repeating:

• Get enough sleep or at least rest: This is of great importance, as it affects all other aspects of your work—your physical strength, your decision-making, your temperament.
• Drink enough fluids and eat well: Stay hydrated, and eat the best quality food that you can access.

This next activity will help you to identify an aspect of self-care that you can target for increased self-care.

12.6.7 Developing a Self-Care Mindset

While it is important to align your behaviors and actions with self-care skills, it is even more critical that professionals adopt a self-care mindset that keeps one centered and aware of both what is happening around them and of themselves. In this section we will discuss two concepts: mindfulness and trauma stewardship. Each of these ways of thinking can be used separately, but most powerfully, together.

12.6.7.1 Mindfulness

Mindfulness encompasses several ideas:

• being aware of our feelings, thoughts, and bodily sensations, and accepting them
• staying in the present moment
• being non-judgemental, curious, gentle, and kind

A similar concept is meditation, but mindfulness is different from meditation in that it is a state of mind that can be applied at any time, any place, doing anything. Meditation is a more formal practice, in which one uses a technique to focus the mind on a particular thought or object. This focus helps train the mind to be attentive and aware, and achieve a clear and stable emotional state (Walsh & Shapiro, 2006).

Mindfulness also helps one maintain a clear and stable emotional state, but it is a quality of mind rather than a scheduled practice. Meditations may be focused on learning mindfulness, but there are many other kinds of meditations as well. And mindfulness can be adopted without using the practice of meditation.

Have you ever heard the saying about not being able to control other people’s behavior but being able to control your own response? Well, mindfulness can help with that. When a stressful situation occurs, whether it is a personal one, such as having an argument with your partner, or a work-related one, such as working with a client who has not been able to find a home, being mindful can help you to listen better, be less judgemental, and focus on what is happening in that moment. It’s not so much about controlling your response. It’s about training yourself to listen more closely to your own feelings and thoughts as well as listening to others’ experiences and viewpoints. Here’s another way to look at it: “Mindfulness is awareness, cultivated by paying attention in a sustained and particular way on purpose, in the present moment, and non-judgmentally” (Kabat-Zinn, 2016).

Think about a stormy day near the ocean. You’re watching big waves form and then crash on each other far out at sea. You can see the storm clouds and the possibility of rain. Now imagine deep deep into the ocean, 30 or 40 feet below the surface, where it is quiet and still, with gentle oscillations of waves, water, plants, and fish. Mindfulness is about accessing that part of your brain that is deep and can sway gently as the storm nearby unleashes its turbulence. You observe the storm, you think about the storm, you have feelings about the storm, but you don’t want you or your mind to become the storm.

Mindfulness helps human services professionals handle the varied and unpredictable work that is characteristic of serving other human beings. It also helps us to handle being exposed to the trauma that our clients face, and that we may face in our own lives. It lowers our stress response and stress levels. It strengthens our resilience. Developing mindfulness is one of the best things we can do for ourselves and the people we serve.

12.6.7.2 Trauma Stewardship

Trauma stewardship recognizes that trauma has impacts that can be named and managed, and it acknowledges that the person who is helping someone who is suffering from trauma may also suffer. In other words, this concept acknowledges the secondary trauma and that helpers experience, and helps us to identify ways to manage the trauma for ourselves. This definition comes from the founder and director of The Trauma Stewardship Institute:

A daily practice through which individuals, organizations, and societies tend to the hardship, pain, or trauma experienced by humans, other living beings, or our planet itself. By developing the deep sense of awareness needed to care for ourselves while caring for others and the world around us, we can greatly enhance our potential to work for change, ethically and with integrity, for generations to come. (van Dernoot Lipsky, 2017)

Within this model, which draws its thinking from multiple walks of life, cultural traditions, and spiritual practices, multiple kinds of trauma are acknowledged. Trauma stewardship can be applied to

• working with people in crisis-oriented settings such as emergency rooms, domestic violence shelters, or homeless shelters;
• caregiving to someone who is disabled, has a chronic illness or is in pain;
• working to dismantle systems of oppression such as ageism, racism, sexism, and others;
• being on the frontlines of environmental movements, working to combat climate change; or
• caring for animals in veterinary offices and rescue centers, or working with wildlife as scientists. (van Dernoot Lipsky and Burk, 2009)

As you can see from this list, this view of trauma pays attention to the ways that oppression and power limit individuals and in fact, views trauma stewardship within the context of power, oppression,and liberation.

Trauma stewardship begins with the idea of being present and practicing mindfulness. This involves paying attention to whatever is unfolding in our clients’ lives and around us. Like mindfulness, trauma stewardship involves recognizing our response to trauma rather than trying to push traumatic thoughts away. Abundant thinking and feeling helps foster our compassion, which we need, as we do this work.

As trauma stewards, we must first “do no harm.” In order to care for and with others experiencing trauma, we must be able to respond to humans, animals, and the earth in a sustainable way, in other words, being able to sustain ourselves well enough to continue to work and care. This handy little poster from the Trauma Stewardship Institute helps summarize some strategies to help us achieve these goals. It is important that we not assume others’ problems as our own, at the same time recognizing the effects that these problems have on us. All of these actions help us to be true stewards and not add to our clients’ problems.

12.6.9 References

Huggard, P., Stamm, B. H., & Pearlman, L. A. (2013). Physician stress: Compassion satisfaction, compassion fatigue and vicarious traumatization. In C. Figley, P. Huggard, & C. E. Rees (Eds.), First do no self-harm: Understanding and promoting physician stress resilience (pp. 127–145). Oxford University Press. https://doi.org/10.1093/acprof:oso/9780195383263.003.0007

Kabat-Zinn, J. (2016). Mindfulness for beginners: Reclaiming the present moment – and your life. Sound True.

Lipsky, L. van D., & Burk, C. (2009). Trauma stewardship: An everyday guide to caring for self while caring for others (1st ed). Berrett-Koehler Publishers.

Lipsky, Laura van Dernoot (2017). The Five Directions. https://www.cosa.k12.or.us/sites/default/files/images/tsi_handout_-_5_directions.pdf

Walsh, R., & Shapiro, S. L. (2006). The meeting of meditative disciplines and western psychology: A mutually enriching dialogue. American Psychologist, 61(3), 227–239. https://doi.org/10.1037/0003-066X.61.3.227