Good afternoon, everyone, and welcome to today's webinar, hosted by Patagonia Health. Today's webinar topic is on Practicing in a Heart-Heavy Time: An Invitation to Rest. If you aren't familiar with the Zoom webinar platform, take a look at the control panel at the bottom of your screen. Here you can configure your audio settings, send chat messages, and ask any questions that you have.

As a quick background about our awesome special guest:

• Stacey Otto is a therapist at CATA Health, specializing in infant and early childhood mental health for children ages one through five, addressing concerns such as:
  
  
  • Attachment
    
    
  • Anxiety
    
    
  • Depression
    
    
  • Emotional regulation
    
    
  • Adoption
    
    
  • Abuse and neglect
    
    

With over 30 years of experience supporting abused children and families, she holds:

• A master's degree in social psychology from Purdue University
  
  
• A master's degree in social work from the University of Minnesota Twin Cities
  
  
• A Capstone certificate in infant, early childhood, and family mental health from UW–Madison
  
  

Stacey is also:

• A registered child–parent psychotherapy therapist
  
  
• A longstanding mental health consultant with We AIMS Reflective Supervision Learning Collaborative
  
  

Outside of work, she enjoys reading, yoga, cross-country skiing, time with loved ones, and caring for her cats Teddy, Tiggy, and Sarah.

So without further ado, I'm going to go ahead and pass it over to Stacey and we'll get started.

Great. Thank you, Denton, for that warm invitation and welcome. I'm trying to get the screen share on here. Hopefully that's working there.

I want to welcome everyone today and I really hope that our time together will be beneficial and helpful. So here, let's just jump right in.

Denton shared, right, I am working at Catawba Health, and outside of that I do some private work for Nurturing Connections. That is the role I'm in today. I am practicing in Oshkosh, Wisconsin, a little city in northeast Wisconsin named after Chief Oshkosh of the Menominee Nation, and this area is also the ancestral homelands of the Ho-Chunk, in addition to the Menominee people.

Today, I will humbly share what I have learned so far. I ask that my elders who are listening, or community members, please forgive me if I misspeak or leave out any important information. I'm doing my best to share, with heart, sincerity, and good spirit, what I know so far.

Objectives and Roadmap

Our objectives today, we have just three:

1. I want to increase your understanding of resiliency and what the benefits of resilience are.
   
   
2. We are going to explore some coping skills, and we will do some practicing of those today too.
   
   
3. Throughout, I want each of you to be recognized and feel validated for the meaningful work that you are doing.
   
   

If you feel comfortable, I'll ask you to put in the chat now:

• What your role is
  
  
• Where you're practicing (for example, if you are a therapist, if you're in public health)
  
  
• How long you've been doing that
  
  

Again, this is an invitation, not a demand.

A little roadmap of what we're going to be doing today:

• First part: introductions and some concepts with a few slides to get us all on the same page
  
  
• Then we will dive into resilience
  
  
• For the second objective, coping skills, we are going to look at REST, which I see in a way as an abbreviation of resilient
  
  

I picked my favorites:

• R – Reflection
  
  
• E – Expressive arts
  
  
• S – Self-compassion
  
  
• T – Trauma stewardship
  
  

Throughout our time together, we are going to have some experiences to calm and regulate. We will save a little bit of time for questions at the end, and then we will close with a very brief loving-kindness meditation.

Sheltering and Holding Space

I'm going to start with one of my favorite quotes. I have been using this for a long time:

It is in the shelter of each other that people live.

Each of you, in your roles and in your personal life, provides so much shelter to other people. Your work matters, you matter. What I am really hoping for today is that, just for this time together, you can come in from the storm, from all the burdens that you carry with the work that you're doing.

So many of us are always outward-focused, right? Focusing on the other. Today, this is really for you, to kind of get some rest.

The idea for this talk came originally when Patagonia Health reached out to me. We were looking at me doing a talk on early childhood trauma and attachment. Just in talking, it really came up that this is such a stressful time for all of us, and what is it like for professionals to be showing up every day and having to hold so much suffering, when there is such chaos and hard things going on? So that is a little bit of where the talk idea came from.

Checking In: How Are You Doing?

I'm going to invite you again to check in now and, again, if you feel comfortable, put this in the chat. You do not have to put your number in the chat, but:

• How would you say you're doing?
  
  
• How are you mentally, physically, emotionally?
  
  

Just take some time to pause. And I know this changes, sometimes daily, sometimes within the hour, depending on what sessions you have had or what is happening.

If you are showing up on the higher end of the scale, that is great. I really hope this time will add to your lightness and your energy. If you're noticing, “Oh my gosh, I'm serotonin depleted here, I'm kind of crabby, life is kind of hard,” we will take that number too. We will accept wherever you are at, and again, hope that wherever you're at, this talk recharges you.

Nature, Regulation, and a Brief Body Scan

Throughout our time together, you will be noticing different pictures of nature. In a way, this is coming from some of Deb Dana’s work with the polyvagal theory. Sometimes we cannot be in nature, but even just looking at nature scenes can be regulating.

These pictures are ones that either my husband took or my oldest daughter took and shared. This one is from the Superior Hiking Trail up in Minnesota.

I am going to encourage us to just do a brief body scan now:

• Take a nice, deep, slow breath in
  
  
• And blow it out
  
  

As you're slowing down your breathing, notice:

• Are there any areas of tension?
  
  
• Any stress that you're carrying in different parts of your body?
  
  

Next, deep breath in, and blow it out.

Then on this third breath, let's raise our shoulders up to our ears. I carry so much stress in my shoulders. Bring those up, just hold it for a bit, and then a nice, slow exhale.

Stress, Exhaustion, and the World We’re In

As I was preparing for this talk, I looked at some slides from some presentations I did during the COVID-19 pandemic, and this information is from Forrest Hansen, who is Rick Hansen’s son. He was doing some different talks and brought up how tired everyone was at that time, and the cost of the stress we were under.

He was sharing that the families we are working with are more and more stressed. I think I was starting to notice that with the professionals I'm working with and also my clients. In fact, just a few weeks ago, there was a single mom that I was working with who is raising her little three-year-old, and she just started talking about the state of the world. She did give me permission to share this quote.

She said, feeling the heaviness:

“The world is so uncertain and scary, so much hate.”

She was saying that was really making it harder for her to do her professional job, but also to show up as a mom.

From Bruce Perry’s work, the international presenter and researcher on trauma, again this is from his work on COVID, but I think it relates to this time now: we are also exhausted, dealing with decision fatigue, and we have lost that sense of safety in our world. It has been eroding.

He encourages no blaming, however. No matter how regulated you are, and how many yoga classes you're going to, with prolonged stress activation, we get worn out, tired, and in despair. So what are we going to do?

Rising Stress, Anxiety, and Mental Health Needs

I looked at a study that was done in February of this year by Modern Health. They looked at 1,000 adults ages 18 to 65 and their stress levels:

• Almost half of the people reported that life was easier during the pandemic compared to now
  
  
• They reported surging levels of stress, low moods, and a need for more mental health services
  
  

Anxiety has continued to increase. By 2020, close to half (47%) of people reported having anxiety regularly. That is experiencing anxiety, not necessarily being diagnosed with it. By 2023, this number continued to increase, with anxiety being the most common mental health illness in the world.

For comparison, about one third of adults in the U.S. will report a diagnosis of anxiety. Along with anxiety increasing, rates of depression and suicide have also surged, especially for young adults and marginalized populations.

In the U.S.:

• About one in five adults will experience a mental health illness in a year
  
  
• Almost 50% are not going to receive treatment
  
  

Since 1999, suicide rates have increased about 30%. Some of you may be working in emergency rooms; your clients may be heading there. The emergency rooms are overwhelmed. Homelessness is increasing, especially for those who have untreated mental health issues. This is putting a strain on schools and workplaces.

One study estimated that over 160 million Americans live in areas that are considered to have mental health professional shortages. This is from the Health Resources and Services Administration, 2023.

Impact on Providers and Hope for Regeneration

So then what does this mean for us? How are we doing?

Burnout is becoming more common and is increasing. In my area, right here in Wisconsin, I'm seeing providers leaving the field. There is more and more stress on us. It can be taking a toll, and there is more and more demand for services. It is really hard to say no when there is so much need.

So what does this mean? Are we going to give up? No.

We want to embrace impermanence. It is so hard to embrace at times, but in this case we are really happy about it. This is not permanent. We will regenerate, we will recover, and our bodies will know what to do.

I am going to lean into a quote from Martin Luther King Jr. This was from a talk or sermon he gave on June 3rd, 1958:

Can we have the ability to lift us from the fatigue of despair to the buoyance of hope?

I hope that we can bring some hope today and, again, that you can share that with your clients and feel that in your life, because hope, we are kind of lost without it.

Nature Break and Simple Regulation

Time for another picture. Here we go. This is from California in the High Sierra range.

I'm going to encourage us to:

• Roll our shoulders forward
  
  
• Take some nice, slow, deep breaths in
  
  
• And blow it out through your mouth
  
  

Roll forward a little bit, and then reverse that a few times.

Take in that beautiful nature.

Objective 1: What Is Resilience and What Are Its Benefits?

Here we are for our first objective: what are the benefits of resilience, and what is resiliency?

The first person to study resilience in an experimental setting was Norman Garmezy back in the 1980s. He noticed certain children who excelled even in difficult situations. He gave one example of a nine-year-old boy whose father was absent and whose mom was struggling with alcoholism. Yet he came to school every day with two slices of bread and nothing in between. He did not want people to feel sorry for him and was trying to protect his mom. He came in with a smile every day with his “bread sandwich.”

Charney, who has done a lot of research on resilience, defines it as:

An adaptive characteristic of an individual to cope with and recover from adversity.

In his research, he was looking at prisoners of war and people who had survived sexual assault. He noticed that some of these individuals did not develop PTSD or other psychiatric disorders and was curious about what was different in these individuals.

A more recent definition can come from Valerie Kaur’s work and her Revolutionary Love Project. She is a civil rights leader in building up community with people of color. For her, resilience is:

Not never feeling harm, but moving through it, dancing through it, and breathing through it.

Another definition from Dr. Thema Bryant:

Bouncing, walking, crawling, leaning back from adversity.

Some of these leaders are saying that if our common definitions are too heroic or too rosy, we are going to miss people and miss what resilience can look like.

For example, during the pandemic:

• Some people were learning new languages or musical instruments
  
  
• For others, being resilient just meant getting out of bed, feeding the kids, and dealing with all the stressors going on
  
  

“If we only recognize resilience when it is shiny, we are going to miss it.”

Another example could be from the Olympics. In Tokyo 2020 (held in 2021), Simone Biles stepped back for her own mental health. Not all parts of society recognized that as resilience, but I see that as her really showing strong resilience.

Dr. Thema also says:

Resiliency can be a radical act for my wellness and care.

We live in a society where authenticity is not always promoted or accepted. As practitioners, especially in mental health and public health, we can feel extra pressure to ignore ourselves and our needs. Our body says we are tired or hungry or want to go outside, and we override it: “No, we have notes to do.” Our worth is often tied to being busy and productive. That can be a challenge.

So again, we can ask: what really is resiliency? Is it a quality, a trait, a skill? Is it taught, genetically determined?

Traits and Signs Related to Resilience

Turning back to Charney’s work, based on his research, resilience is associated with:

• Being extroverted
  
  
• Having the ability to be emotionally regulated
  
  
• Being open to new experiences
  
  
• Being trained in mindfulness and attention
  
  
• Being present and having the ability not to ruminate on the past
  
  

Both Charney and his colleague Southwick have personally been challenged:

• Southwick was diagnosed with cancer
  
  
• Charney was shot in 2016 by a disgruntled co-worker and survived
  
  

From other research, resilient leaders:

• Provide high energy
  
  
• Are motivating
  
  
• Are collaborative
  
  

What it is not:

Teams that were struggling and not showing resilience had:

• More irritability and anger
  
  
• Persistent common illness
  
  
• Poor memory
  
  
• Trouble sleeping
  
  
• Moodiness
  
  
• Reckless behavior
  
  
• Lack of hope
  
  

Other signs of low resilience:

• Low productivity
  
  
• Office conflict
  
  
• Increased sick leave
  
  
• Lack of innovation
  
  
• Lack of problem solving
  
  
• Lack of future planning
  
  

What it boils down to, from my reading, is that we are born with a certain amount of resilience, and the really positive, encouraging news is that we can increase it and we can teach it to ourselves and to the people we are working with.

Benefits of resiliency:

• You are going to be more effective
  
  
• More productive
  
  
• More collaborative
  
  

Making Stress More Bearable

Going back to Bruce Perry’s work, he really encourages us to ask:

• Can we make our stress as predictable as possible?
  
  
• Can we moderate the stress so it is not overwhelming and stripping us of our resources?
  
  
• Can we make it more controllable?
  
  

This is easier said than done. Stress in itself is not a bad thing. It is especially more helpful if we can hit those three characteristics.

Simple Brain Gym: Crossing Midline

Time for another chance to regulate. This picture is from Georgia, from the Appalachian Trail.

We are going to do a little brain gym:

• Think of the infinity symbol, or a sideways eight
  
  
• With your right hand, use your pointer finger or whole hand and trace that sideways eight in front of you
  
  
• Make sure you are crossing midline
  
  
• Take some nice, slow, deep breaths
  
  

Then reverse it, drawing it the other way, still crossing midline.

Now switch to your left hand:

• Draw the sideways eight
  
  
• Cross midline
  
  
• Take deep, slow breaths
  
  

Then reverse again.

This is good for our brain, making connections.

Objective 2: Coping Skills – REST

Yay, we are to objective two. We are going to explore a variety of effective coping skills and practice using these stress-reducing techniques.

REST:

• R – Reflection
  
  
• E – Expressive arts
  
  
• S – Self-compassion
  
  
• T – Trauma stewardship
  
  

These are just some of my favorites, and when I think about being resilient and what gets me through hard times, these are things I lean into.

Reflection and Reflective Practice

R being for reflection. I will ask you now, if you feel comfortable, to put in the chat who of you has heard of:

• Reflective practice
  
  
• Reflective supervision
  
  

That is what I am talking about. Reflection can be used in a lot of ways, but I am in particular referring to reflective practice.

What is reflective practice?

• It is relationship-based
  
  
• It creates the space to be authentic and show up as your true self
  
  
• Here you do not need to wear a mask
  
  
• It can be done individually or as a group
  
  
• It really encourages you to slow things down
  
  

Sometimes, when we are back-to-back with meetings, home visits, and productivity demands, it is really hard to slow things down.

This is a different type of supervision:

• It is not clinical supervision focused on treatment plans and diagnoses
  
  
• It is not administrative supervision focused on policies
  
  

Our work can be immensely rewarding and also, at the same time, frustrating, discouraging, and painful. Reflective practice, which is so focused on our relationships, on what we bring and what the client brings, is a different way to look at this.

Use of self is really key. We are the most important tool in our work. So what can we do to support ourselves and increase our awareness of:

• Our reactions
  
  
• Our clients’ reactions
  
  
• Our emotions and motivations
  
  
• Our clients’ emotions and motivations
  
  

Traditionally, the consultant or supervisor is seen as the expert. Not with reflective practice. Instead, we enter into the role of co-observer of our own and our supervisees’ unpredictable inner experience.

We step back, think alongside, and come into relationship rather than over. We wonder and contemplate what has been done, what has not been done, what is behind that, and we listen deeply.

Rebecca Shahmoon-Shanok, again a dear leader in this field, talked about supervision being:

The ability to see deeper, wider, further.

We look for patterns that come up in our work with children and families, with colleagues, and in ourselves. It requires the ability to step outside the work experience and create a safe holding environment where staff can feel secure enough to share:

• Insecurities
  
  
• Mistakes
  
  
• Questions
  
  
• Differences
  
  

And also celebrate successes. We do not want to overlook those.

It can be seen as a set of caring conversations where you know that:

I accept you and all that you tell me.

Through this, connections are deepened between:

• Colleagues
  
  
• Worker and family members
  
  
• Parent and child
  
  

There is that parallel process: what is happening in one relationship will be mirrored in the others. Connections to ourselves are also deepened.

Reflective practice allows us to wonder about what these experiences mean, what they tell us about the child, the family, and ourselves. We explore both positive and negative emotions about our experiences with families. A foundation of honesty and trust is really needed.

Jerry Paul, one of the founding mothers of the field of infant and early childhood mental health, said:

How you are is as important as what you do.

Reflective practice allows us to really show up how we want to show up.

The FAN and Mindful Self-Regulation

I'm going to share a few slides about the FAN. Some of you may be familiar with this. It is a concept coming out of infant–early childhood mental health, but it can be used in all areas of practice. Please look up either Linda Gilkerson’s name or the Erikson Institute, located in Chicago.

The FAN, as you see in this visual, has different wedges. We are not going to get into all of them. I just want to highlight MSR, which is mindful self-regulation.

Mindful self-regulation means:

• Before we enter a session, we ground ourselves
  
  
• Maybe drinking some water, taking some deep breaths, having a snack
  
  
• Asking ourselves: what am I arriving with today?
  
  
  • How did I sleep last night?
    
    
  • Am I having a conflict with my partner, with my children, with a friend?
    
    

Can we put that baggage aside? Can we do some breathing?

Also during the session, can we have that awareness and give ourselves permission to pause and be deliberate about being present? This is difficult work. Reading the news, hearing what clients share, there is a lot going on. We can get thrown off.

Again, I invite you, if you feel comfortable, to put into the chat some different things that you use to ground yourself and help regulate when you are in the middle of a session.

Inner Talk and Self-Awareness

I wanted to share this quote:

Be careful how you are talking to yourself because you are listening.

That also connects with the August Patagonia Behavioral Health newsletter, which had the quote of the month:

Your body hears everything your mind says. – Naomi Judd

We are listening. Things are getting in.

If any of you have questions about reflective practice or would like more information, you could reach out to me. My contact information will be available. Also, WE AIMS, the Wisconsin Alliance for Infant Mental Health, are really the founders of this practice in Wisconsin.

Brief Movement Break

Here we have a beautiful shot from South Africa. Again, let it give you a pause to take this in and catch your breath.

If you have the energy, I am going to encourage you to do some heel raises:

• Standing up increases our oxygen
  
  
• You can also stay in your chair and just lift your heels
  
  

I'm going to stand behind my chair and let's do ten:

• Raise up on your toes and down
  
  
• Up and down
  
  
• Up and down
  
  

A few more. This is very grounding, very regulating, helping stimulate that vagus nerve.

Maybe you can imagine yourself on this coast, looking out.

Expressive Arts

E is for expressive arts.

I love this quote:

The arts are a way of speaking the unspeakable.

Some things we do not have the language for or do not want to say. Previously in my practice, I worked a lot with a music therapist, and it was amazing to see what she could do with instruments and music. It encouraged me to look for ways to use:

• Art
  
  
• Writing
  
  
• Movement
  
  
• Poetry
  
  

in our sessions.

We are kind of limited since we are just in a Zoom webinar right now, but I'm going to try to put in some expressive elements.

This picture of waves is one I used a lot during COVID, with wave after wave. I feel that now when I get brave and open up the news. It is one thing after another:

• Political chaos
  
  
• Wars
  
  
• Climate and ice changes
  
  
• Natural disasters
  
  

It can feel unending. I think this picture, in a way, represents that more than words.

Literature and Poetry for Reflection

Some of you may recognize this from high school. This is from A Tale of Two Cities by Charles Dickens. This was written in 1859, and think about how relevant it feels now:

It was the best of times, it was the worst of times.
It was the age of wisdom, it was the age of foolishness.
It was the season of light, it was the season of darkness.
It was the spring of hope, it was the winter of despair.
We had everything before us, we had nothing before us.

It really reflects our time. At the end of the book, it actually ends with a sense of optimism, not crushing defeat. Maybe I encourage you to go back and read it for some more hope.

Next I want to share one of my favorite poems from a friend: The Peace of Wild Things by Wendell Berry.

When despair for the world grows in me
And I wake in the night at the least sound
In fear of what my life and my children’s lives may be,
I go and lie down where the wood drake
Rests in his beauty on the water, and the great heron feeds.
I come into the peace of wild things
Who do not tax their lives with forethought of grief.
I come into the presence of still water.
And I feel above me the day-blind stars
Waiting with their light. For a time
I rest in the grace of the world, and am free.

Another Regulation Moment

Here is another picture of nature for us. This is from the Boundary Waters in northern Minnesota.

Another way to regulate is to squeeze both fists:

• Squeeze your fists and arms tight with a deep breath in
  
  
• Then relax
  
  

Let’s do that two more times:

• Deep breath in, squeeze as hard as you can
  
  
• And relax
  
  

And one more deep breath in, and blow it out.

Self-Compassion

We are on to S: self-compassion. This is one of my favorites of all time. How important it is for myself and for the work I am doing with my clients.

How can we respond to the suffering we are exposed to? So many moments are really hard to bear. Yet can we still try to help if we can?

I found this helpful from the work of Gregory and Long. They shared that everyone is on their own life journey. Some mantras they offered:

• “I am not the cause of this person’s suffering, nor is it entirely within my power to make it go away, even if I wish I could.”
  
  

The practice:

• On the inhale, breathe in compassion for yourself, to soothe yourself. We need to be soothed.
  
  
• On the exhale, breathe out compassion for the other.
  
  

It is a beautiful balance, not just focusing on the other’s needs. We have needs too. And we remind ourselves:

• We did not cause the suffering
  
  
• We alone cannot cure it
  
  

From Sharon Salzberg’s work, self-compassion is an important ingredient for resilience. It helps when things are hard.

Can we learn to stay here more and more of the time? We are going to get dysregulated, we are going to get off course. We can start over and give ourselves grace. We can come back. We are going to lose it, we are going to lash out, but then we will notice we get to come back sooner and sooner the more we practice this.

We are encouraged and raised to have compassion for others. How important it is to nourish ourselves, or it is really hard to give to other people. Trust that we are enough. I'm going to say that again:

Trust that we are enough.

No comparing to other people or other practices.

Compassion is when we are really touched by suffering in the world. Self-compassion is when we are touched by and holding our own suffering. Can we hold our own pain with love and understanding, bringing in care, kindness, and tenderness?

A lot of this is from Kristin Neff’s amazing work. Can we be our own best friend? Be there for ourselves?

Components and Benefits of Self-Compassion

According to Neff, the three main components of self-compassion are:

• Mindfulness
  
  
• Kindness
  
  
• Common humanity
  
  

Mindfulness:

• Telling ourselves, “This is hard.”
  
  
• Trying not to get lost in the pain.
  
  
• Recognizing, “This is a moment of suffering.”
  
  

Kindness:

• “May I be kind.”
  
  
• Saying to ourselves, “I am sorry this is so hard.”
  
  
• Asking, “What do I need now?”
  
  
• Giving ourselves permission to feel this pain.
  
  
• Letting go of self-judgment.
  
  

Common humanity:

• “I am not alone in this.”
  
  
• “I am not the only person.”
  
  
• Suffering is universal: 10,000 joys, 10,000 sufferings.
  
  
• We are all in the same boat. We are connected.
  
  

Neff gives an example of being at the park. Her son is autistic, and she started to feel sorry for herself seeing other parents whose children appeared not to have special needs. She was able to reframe it as: all parents struggle.

Benefits of self-compassion:

• Increases happiness, hope, optimism, and self-confidence
  
  
• Decreases:
  
  
  • Stress
    
    
  • Anxiety
    
    
  • Depression
    
    
  • Perfectionism
    
    
  • Shame
    
    
  • Disordered eating
    
    
  • Suicidal ideation
    
    

This is like a superpower. There have been over 3,500 studies done on this.

There are two sides of self-compassion:

• Tender side:
  
  
  • Warmth, care, nurturing
    
    
• Fierce side:
  
  
  • Mama bear
    
    
  • “How can I learn from this?”
    
    
  • Self-protection
    
    
  • Saying no
    
    
  • Rising up, being brave
    
    
  • “I need to change something.”
    
    

Neff says you need both sides. If you only have the fierce side, that can lead to aggression, and we do not need any more aggression in our society.

Touch and a Self-Compassion Practice

Self-compassion can also be supported with physical touch, from others or ourselves. Physical touch releases oxytocin, which:

• Increases feelings of trust, calm, and safety
  
  
• Reduces cortisol
  
  
• Calms cardiovascular stress
  
  

I am going to invite you now to try a very short loving-kindness practice from Jack Kornfield. If you feel comfortable:

• Place a hand on your heart
  
  
• Or on your legs
  
  
• Or hold your face or body gently
  
  

Just see how this lands.

Repeat silently:

May I be filled with compassion for myself and others.
May I hold myself with care and respect.
May I treasure my life.
May I be filled with kindness.

Notice how that was for you, taking that little self-compassion, loving-kindness break.

Nature and Gentle Movement

Here we have embedded another nature picture. Again, just take a breath, some nice, slow, deep breaths in.

If you feel comfortable, you can raise your hands above your head with a deep breath in, and exhale bringing your hands down.

• Deep inhale up
  
  
• Exhale down

Trauma Stewardship

And to our last part here: T for trauma stewardship. We are in the home stretch.

The book Trauma Stewardship is one I highly recommend. If you are not familiar with it, I encourage you to look into it. It is helpful for all fields:

• Mental health practitioners
  
  
• Nursing and medical
  
  
• Environmentalists
  
  
• Anyone working with others
  
  

Some brief definitions:

• Burnout:
  
  

  • Can happen in any profession
    
    
  • Stress and frustration caused by your workplace
    
    
  • Usually takes a longer time to develop
    
    
  • If you leave your job, this will often go away
    
    

• Compassion fatigue:
  
  

  • Deep emotional and physical wearing down
    
    
  • When you are unable to refuel and renew
    
    
  • Your heart gets tired
    
    

• Secondary traumatic stress:
  
  

  • Can come on very quickly
    
    
  • Trauma experienced as a result of exposure to a client’s trauma and reactions
    
    
  • Charles Figley says this is a natural consequence of doing this work
    
    
  • It does not mean there is something wrong with you; it shows how powerful trauma is
    
    

Factors that contribute to secondary traumatic stress:

• Empathy
  
  
• Recovery time being too short
  
  
• Feeling isolated or not valued
  
  
• Lack of systemic resources
  
  
• Hearing similar stories over and over
  
  

We can tolerate stress more, Bruce Perry says, if we:

• Feel valued and respected
  
  
• Are practicing resilience
  
  

From the NCTSN, other vulnerabilities include:

• Content: working with young children, intense stories
  
  
• Use of self in our work
  
  
• Ambiguous successes: not always knowing how things turn out
  
  
• Non-reciprocal giving and attentiveness
  
  

Back to Charles Figley:

It is unethical not to attend to your self-care as a practitioner because self-care prevents harming those we serve.

Trauma Stewardship: Questions and Awareness

Through our work, we absorb the traumas our families have experienced. We need to process these in a safe and reliable environment. Back to reflective practice again.

Trauma Stewardship talks about our trauma exposure response: how we are affected by the suffering of others. This is universal.

We can ask ourselves:

• How did I arrive on this path to do this work?
  
  
• How am I affected by this work?
  
  
• How do I make sense of this work?
  
  
• How do I learn from this?
  
  

It is truly an honor to do this work, and yet it carries big responsibility.

The closer connection we have to this work, probably from previous experiences, the greater gifts we bring, and that also increases the likelihood of this work impacting us in hard ways.

Laura van Dernoot Lipsky’s recommendations include:

• Stay present, no matter what
  
  
• Pay attention: how am I different now than last week, last month, a few years ago?
  
  
• Seek balance between feeling suffering and feeling joy
  
  

She writes:

The more we protect ourselves by not being fully present to what is unfolding in our lives, the more we feel the effects of trauma exposure.

She says we can sustain our work with trauma only if we:

• Combine our capacity for empathy
  
  
• With a dedication to personal insight and mindfulness
  
  

We ask:

• Who am I?
  
  
• What is my own history of hardship and suffering?
  
  
• How do I look for joy and build that in?
  
  

We cannot shut down pain without also shutting down joy.

She encourages an honest assessment of exposure to trauma and how it influences our feelings and behaviors.

Jack Kornfield likes to use the phrase “this too.” When something hard happens, instead of shutting down, we stay open and say, “This too.”

We are training ourselves to open our hearts to everything that comes through the door.

It is challenging to feel; it is worse not to feel.

It can be tempting to put on a hard shell, to dissociate when it gets too hard. How do we balance that?

She says:

The more deeply we can connect with ourselves, the more likely we are to find what we need to do our work joyfully and well.

This takes courage and practice, and practicing compassion every step of the way.

I will be sending out a handout from the Trauma Stewardship Institute called “Map for Managing One’s Life,” which I think will be helpful.

Here we go. We just have a few more slides left.

One more picture. This is from California, High Sierra.

Let’s do a neck stretch:

• Right ear to right shoulder, hold it
  
  
• If you want, stretch your left hand out
  
  
• Take a deep breath in and blow it out
  
  

Bring your chin up.

Now:

• Left ear down to left shoulder
  
  
• Stretch your right hand out if you want
  
  
• Deep breath in, and blow it out
  
  

Bring your chin back to center, and:

• Bring your chin down to your chest
  
  
• Deep breath in
  
  
• Blow it out
  
  
• Feel that stretch along the back
  
  

Small Changes and Organizational Care

Going back to Bruce Perry, I really want to highlight:

• Think of ways you can bring more predictability into your life
  
  
• Think of ways to moderate your stress
  
  
• Think of ways to make stress more controllable
  
  

Even small things, as you look for hope and health:

• Can you agree to do lunch outside once a week?
  
  
• Can you limit how much Zoom you have?
  
  

Ironically, we are on Zoom right now, but Zoom taxes our neurobiology, so we just need to be aware and again come with compassion.

Perry encourages:

• More time to process, to think, to reflect
  
  
• Organizational care models, where agencies and organizations step up to share this
  
  

I already mentioned WE AIMS as an example.

Check-Out and Gratitude

We are getting close to the end here.

Here is our check-in again, or in a way, our check-out. I know this has been less than an hour, but:

• Take a breath
  
  
• Notice: has your number changed at all?
  
  

Hopefully it increased. Hopefully it did not go back down the scale.

Again, if you feel comfortable, put that in the chat, but only if you want to.

As I see it, we are all just walking each other home.

I am really grateful for your time today. I am also grateful and thankful for the work that you are doing, no matter what field you are in. We need to be connected.

Pulling it all together, if you feel comfortable, please share in the chat one thing that you want to hold on to or remember from this time together.

And it is time for questions.

Q&A

If anybody has questions, you can come off mute or put them in the chat. Hopefully, Denton, you can help me here if there are any questions that come up.

Denton:
Any questions can definitely go in the chat. Yeah, it looks like we don't have any right now, but I do want to personally thank you. I think you've provided some really great grounding strategies for me.

We have a comment from Heather Brady Chanel, she likes the book recommendations.

But yeah, just generally I think these are some great strategies for me personally. So thank you for your time today. This was an amazing presentation. Did you have anything else to add to that, Stacey?

Stacey:
Sure, well just one last picture and one last… let's end with the loving-kindness meditation, and these wishes that I have for each of you.

Denton:
Absolutely. I think that would be great.

My wishes for each of you:

May you be happy and content.
May you be healthy.
May you be safe and protected.
May you dwell in peace.

Thank you.