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News in Brief
Hamm Elected New President of the ACA; WFC / ACC 2014 Education Conference: Call for Papers; F4CP Recognizes Standard Process as $1 Million Supporter; Texas Chiro. College Begins Search for New President; League of Chiropractic Women Hosts Women's Success Summit.
Are You Guilty of Paternalism in Your Approach to Patient Care?
Einstein is purported to have said, "When a man sits with a pretty girl for an hour, it seems like a minute. But let him sit on a hot stove for a minute and it's longer than any hour. That's relativity." In some way, everything is relative to one's point of view.
Why DCs Need to Understand the Principles of "Inclusive Design"
In the past few columns, I've written about the negative effects of prolonged sitting at work. I've attempted to make the point that prolonged sitting (or prolonged standing) takes a toll on workers. Now let's discuss a related issue: the concept of "inclusive design."
AAAOM – Making Promises They Can't Keep
When the AAAOM first formed in 2007, their mission was clear: to support the profession through education, resources and legislative advocacy. The first years of the organization were filled with promise and hope.
Monoculture of the Mind: Part II
Cases are built within boundaries. Such bounds may be a program, event, activity or individuals. In this instance, a medical case has boundaries that include clinical interactions that are comprised of history, signs, symptoms, diagnoses, treatment plans and treatments.
Leaving a Lasting Legacy: Donna Liewer
For the past 31 years, Donna Liewer has been on a personal mission "to comfort the afflicted and afflict the comfortable." In her role as executive director of the Federation of Chiropractic Licensing Boards, Liewer has accomplished that and much, much more.
Resilience is the New Longevity
Sometimes we must enter a room through one door and not another, even though they both lead into the same space. I am talking now of the recent cachet with the concept of "resilience" regarding health, chronic pain and longevity.
Risk Factors for Heel Problems
Heel pain and gait disability are common occurrences in adults, often the result of thinning heel pads and a lifetime of exposure to heel-strike shock. One condition experienced by many people is plantar fasciitis.
Creating Child-Friendly Clinics with ABT
The Zurich Dojo was scattered with toy ducks, dolls, trains, exercise balls and teddy bears during my recent pediatric workshop.
Stress in the Modern Age: Impact on Homeostasis and What You Can Do (Part 1)
In 1926, Hans Selye first used the word stress in a biological context, referring to the nonspecific response of the body to any demand placed upon it.
Green Tea Catechins Lower PSA, Other Biomarkers in Men With Localized Prostate Cancer
A 2006 study (Cancer Research) was the first human investigation to show that green tea catechins (GTC) are highly effective in reversing premalignant prostate lesions (high-grade prostate intra-epithelial neoplasia), an established precursor to prostate cancer.
Steven Rosenblatt: Birthing A Cross-Cultural Acupuncture Profession
The existence of a cross-cultural acupuncture profession in the United States, one that is legalized, licensed, supported by formalized, academic training and inclusive of non-Asian practitioners, is an important part of the medical landscape in this country and is responsible for improving the lives of hundreds of thousands of Americans.
Chiropractic Prevents ADHD? Research Shows...
Now that I have your attention, let me tell you what the latest study actually states. As you may have noticed, research over the past few years has begun to reveal that acetaminophen (the primary ingredient in Tylenol) is not as safe as once thought.
Epigenetics: The Western Science Supporting Essence
Since the days of Darwin, western medicine has touted that our genes were set in stone, that our genetics were our destiny. We were told that the diseases that ran in our family were likely coming to us as well.
Get That Shoulder to Move: Restoring Internal Rotation
How many times have you mobilized, performed ART, Graston, FAKTR and PIR, and stripped a patient's posterior capsule, yet on re-exam, discovered it was still blocked?
Successful Strategies in Integrating Acupuncture and Shiatsu in a Hospital Oncology Program
Colleagues from the Network of Researchers in Public Health in CAM recently published an article of interest to our Traditional Asian Medicine community.
What is a Discipline in Medicine?
In my now prolonged dialogue with physicians, one question emerges with enough regularity to deserve mention and naming: what is a discipline?
Flexion-Intolerant Lower Back Pain (Pt. 3): Mobilization & Soft-Tissue Treatment
What is the biggest challenge to the chiropractor in treating discogenic pain? You have to completely reframe the purpose of your manipulation. It is rarely about unlocking a stuck segment at the disc involvement level; it is not about putting a joint back in alignment.
The Healing Properties of Light: An Interview With Researcher Anna Cocliovo
This interview is with Anna Cocliovo, a light researcher and Acupuncturist in Arizona. During my own research in light, I came across the article she published for the American Journal of Acupuncture and sought her out as a result.
One and Done: Keeping Patients From Vanishing After Just One Appointment
What happened to my 3:30 p.m. ROF? They may have rescheduled, but there are two common answers no one wants to hear: 1) "She called to cancel. I tried to get her to reschedule, but she refused." 2) "She no-showed.
Collaboration for a Cause
The Patient Protection and Affordable Care Act strongly encourages the formation of multidisciplinary practitioner teams called Patient Centered Medical Homes (PCMHs) and Accountable Care Organizations (ACOs).
June, 2011, Vol. 11, Issue 06
Caring too Much
By Ann Catlin, LMT, NCTMB, OTR
Years ago, while sitting in a restaurant with a colleague, I learned something about myself. We each worked as massage therapists in eldercare facilities and it was really nice to talk to someone who "got it." Our conversation took an unexpected turn.We candidly admitted seemingly unhealthy responses to our work — and they were quite similar: distancing more than we thought we should and feeling irritated with other caregivers. There was one thing that stands out. We each were avoiding our work by putting off seeing clients and rushing through sessions. This caught our attention because we both love our work. So, why were we avoiding it? It just didn't make sense. We had a good laugh at ourselves, got some relief and I'm grateful for it even years later (thanks, Jeff).
I now realize that we might each have experienced compassion fatigue. As it turns out, we aren't alone. Anyone in a "helping profession" is vulnerable. Nurses, doctors, counselors, veterinarians, social workers, chaplains, emergency response workers and people caring for aging parents can also experience this. Massage therapists are on the list, too. I think those of us who specialize in working with frail elders and people living with terminal illness are especially vulnerable. Choosing to serve this special population means we are sensitive people to begin with — not a bad quality to have, but maybe it means we need to check in with ourselves from time to time to avoid the toll of compassion fatigue.
Compassion fatigue is a relatively new term. Dr. Charles Figley, an expert on the subject, describes it as, "a state experienced by those helping people in distress; it is an extreme state of tension and preoccupation with the suffering of those being helped to the degree that it is traumatizing for the helper." He goes on to say that, "the capacity for compassion and empathy seems to be at the core of our ability to do the work and at the core of our ability to be wounded by the work."
Compassion fatigue results from the cumulative impact of taking care of people living with serious illness, trauma, abuse or severe conditions. It's different than job burnout, which is dissatisfaction with our employment situation, not necessarily the work itself.
Wanting Others To Be Happy
Compassion is our feelings and thoughts when we witness the suffering of another and the unconditional desire to alleviate that suffering. The Dalai Lama describes compassion as the "wish for another being to be free from suffering and wanting them to be happy." He also tells us that sometimes we confuse compassion with attachment, which is our own personal investment in the outcome of the situation. In other words, when we think we are feeling compassion, we actually are wrapped up in our own emotional needs rather than simply being open to the needs of the other person. Perhaps it's attachment that leads to compassion fatigue, not compassion itself. In my experience, when I truly feel compassion, I'm uplifted and it does my heart good. I feel love.
A perfect illustration of this happened just yesterday to a massage therapist named Jane in a workshop taking place in a long-term care facility. When Jane walked into the elder's room, she was stunned when she took in what she saw — an extremely thin, emaciated woman with severe bruising and discoloration on her arms and legs sitting in her wheelchair, alone. Jane described her first reaction as fear, which turned to sadness for this woman's condition and knowing that she really couldn't do anything to change it. But she conjured up the courage to stay present and focused her attention on this woman rather than the outer condition. The fear softened. She gently massaged the woman's shoulders and neck and she told Jane, "that feels good." Jane shared that following the session, instead of fear she felt good knowing she had made a difference by connecting with this woman. She was able to drop the attachment to the fear and sadness which allowed her to be present and both she and the elder were uplifted in the process.
Knowing the Signs
How can you recognize compassionate fatigue? Some of the symptoms might seem like "normal" stress responses and you might associate them with your work. After all, we live in a pretty stressful world these days. Some characteristics of compassion fatigue include:
Recognizing our vulnerability to these symptoms is important. How can we avoid this reaction or ease them when they happen? The answer lies in holistic self-care. Advice about self care typically includes physical support like regular exercise, getting enough sleep and good nutrition. However, we shouldn't stop there. Nancy Jo Bush, an oncology nurse, says that holistic self-care also includes setting empathetic boundaries; self awareness and self forgiveness; being in tune with one's spirituality and finding hope. The experts agree that reaching out to others and developing a support system is critical. Who would you turn to if you needed the support of an understanding friend? I personally like the advice from a practitioner working in hospice who says, "lighten up and don't forget to laugh."
That reminds me of an old Joni Mitchell lyric, "laughing and crying, you know it's the same release." Thanks, Joni. We'll all try to remember that!
Click here for more information about Ann Catlin, LMT, NCTMB, OTR.
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