I recently attended the 2nd Annual Peer Support Conference hosted by the student unions from the University of Alberta and Grant McEwan Community College, and this week I continue with some of the highlights from that conference.
Burnout: coping with it & keeping empathy – Angela Gour, Edmonton Distress Line
People who choose to work with clients in mental or emotional distress are generally highly motivated and committed people who are sensitive and compassionate. Such workers, however, are at high risk of burnout and compassion fatigue. Not only do they experience physical and emotional exhaustion, they may lose their spirit and start to decline in the ability to feel empathy and care for others.
This is caused by a variety of factors. As sensitive, compassionate and giving personalities, they have high expectations of themselves and feel the need to be strong while giving repeatedly to others. The work itself is emotionally exhausting, always dealing with negative topics. It is hard to value oneself, since outcomes and successes are generally not seen. You do your best to help a client in distress, but you generally have no way of knowing what happens once you hang up the phone or they leave your office. In many non-profit agencies there are insufficient resources to provide adequate support for volunteers, and they often are expected to deal with crisis after crisis with little respite or opportunity to debrief. In some organizations employees and volunteers are afraid to show weakness in front of their peers – too much debriefing can be taken as an indicator of weakness and an inability to do the job.
Signs of burnout are often noticed by others first, and each person has different manifestations. There are physical reactions; headache, sleep disturbance, loss of concentration, feeling drained, are common – as mentioned last week, one hour of intense grief equals eight hours of hard labour, and both clients and helpers can become exhausted. Interpersonal relationships suffer; the person under stress may take it out on family and friends, or withdraw and isolate themselves. Boundaries blur as you become over-involved with work and the problems of others. Emotional responses include helplessness, sadness, depression, anger, becoming desensitized, and a loss of empathy.
The best cure for burnout is prevention. It is very important to put yourself first – you can’t take care of others if you don’t take care of yourself! Caregivers need to find a balance, learn to delegate, reassess values, let go of things, and never hesitate to take time off when needed. Focus on the positives, rather than the negatives – what good things did you do on a call? People come to distress centres or call distress/help lines because no one else in their life is listening. You have provided something important for them even if you don’t see the result. Have clear boundaries; burnout occurs when you accept responsibility for others, so it is essential to understand the limits of your responsibility – you are not responsible for the actions of others. One of the most important preventative factors is being able to debrief with a manager or co-worker.
Preventing burnout requires reliance on internal resources (doing things for yourself), and external resources (family and friends). Constant giving is exhausting, and volunteers and workers need to have a portion of their life where they are receiving, not giving. One of the most important ways to cope with negative stress is to be happy.
Figley’s Compassion Fatigue Self-Test for Helpers is a useful tool to help determine whether one is at risk for burnout and compassion fatigue.
Sexuality and Gender Issues – Darrin Hagen
Darrin is a charismatic storyteller: a consummate actor who holds the stage compellingly whether he is doing an interview on Access Help TV or dressed as his alter-ego Gloria (Edmonton Queen: Not a Riverboat Story). He began his discussion by reading a personal essay, using highly effective wordplay to set the mood. The essay described how it felt to walk down a school hallway past bullies who were ready to beat him up for being “different.”
Darrin gave a brief description of what it was like growing up in small town Alberta – as an outsider who recognized that he was gay early on; subject to verbal abuse from peers. Right after high school graduation Darrin caught the bus to Edmonton and immersed himself in the drag scene at Flashbacks (a former gay bar). Soon he had used his talent and confidence to become head drag queen, and within a short time had forged himself an unusual and successful acting career.
After speaking for a short time, Darrin opened the floor to questions and discussion. Each question from the audience gave him a chance to share his outspoken viewpoint of gender issues, and tell yet another fascinating story of his experiences as a gay man and cross-dresser. According to Darrin, gender constructs are flawed and should be removed. He made a convincing argument that homophobia affects straight men more than gay men – since straight men tend to get very upset at any inference that they may not be completely heterosexual. He also made the observation that school is the only time you are in forced association with a peer group. Young people struggling with gender identity issues or bullying would be more likely to make it successfully through those difficult years if they could realize that the school years represent a relatively short segment of one’s life span.
For many, university is the first time they are away from home, and it is an environment that is often conducive to “coming out,” adding to the stress many university students are under. Peer support can be very effective for students struggling with gender issues. Darrin also addressed the topic of women who dress as men, referring to Joan of Arc, who was burned at the stake not for leading a rebellion, but because she “tried to be a man.” According to Darrin, there is evidence that Joan of Arc may have been a hermaphrodite. He added a commentary on children born with ambiguous sex organs who are forced into a male or female gender role that may not fit with who they are (further support for the idea of removing gender constructs).
The audience was quite happy to continue asking questions and listen to much more of Darrin’s fascinating discourse, but the conference organizers finally decided it was long past time to break for lunch and brought the session to an end. Darrin left us with one important thought, “don’t let other people dictate who you are.”
Schizophrenia – Florence Miller
Florence acknowledged that Darrin was a hard act to follow. However she, and her companion Bruce, did an admirable job of raising our consciousness regarding both schizophrenia and bipolar disorder. Bruce is disabled by schizophrenia, but manages to function almost normally with the help of medication. Florence suffers bipolar disorder (her father had schizophrenia), and considers herself fortunate to have her disease completely under control with the help of medication as well. It was not always that way for either of them. Both were misdiagnosed for years, self-medicating through alcohol and drug abuse, repeatedly hospitalized and institutionalized. Florence recounted some of her manic episodes, episodes that were bizarre and frightening both to her and observers. Yet she is able to look back now with a sense of humour, and she uses her own experience as a tool to educate others.
Schizophrenia, according to Bruce, affects one out of every one hundred people. It strikes between the ages of 16-30, with men experiencing earlier onset (18-25 yrs) than women (26-45 yrs). There may be a genetic predisposition for the disease, but it usually requires a stressor to bring on active symptoms. These symptoms may be positive: hallucinations, hearing voices, delusions, paranoia; or negative: alogia (speech poverty), affective flattening, loss of pleasure, apathy.
Schizophrenia is not caused by poor parenting, childhood trauma, drug use, or a domineering mother, yet at some point in the history of the disease it has been associated with each of these causal factors. Much is still unknown about what causes the disease, although a genetic component seems likely. It is theorized to be related to a biochemical imbalance in the brain, and has been successfully treated with antipsychotics/neuroleptics.
Outcomes are improving for those with the disease, but the prognosis is still not great. Twenty-five percent recover after an episode and can live a normal life. Another twenty-five percent are functional on medication and can lead reasonably normal lives, with some restrictions. A third twenty-five percent are improved with medication, but need to live in group-homes or under supervision. Of the final twenty-five percent, fifteen percent are confined to a hospital, unimproved or catatonic, and the last ten percent are dead – usually as a result of suicide. The risk of suicide is disproportionately high among those with schizophrenia, with a 40% attempt rate. Although the prognosis for schizophrenia is poor, it is important to diagnose it early, since earlier intervention to stabilize has a better outcome rate.
Listening to Bruce and Florence gave me a new perspective on how it feels to deal with mental illness. Both have had huge struggles in their lives, yet both have managed to find a measure of contentment and peace. Rather than being angry at their illness and using it as an excuse to manipulate others, complain or be miserable, both have worked hard to improve their lives. They have managed to turn their fight with schizophrenia and bipolar disorder into a positive experience that educates others and helps remove the stigma of mental illness.
The conference was an excellent learning experience, and I was left with much to think about. Athabasca University students also face issues of gender identity, mental illness and addictions, and we are more isolated than campus-based students. Many of us are under extreme stress, in difficult family situations, dealing with loss or having suicidal feelings, and may be experiencing emotional, mental or financial distress. There are excellent support services available through the AUs counselling department, and I would encourage any student in need to take advantage of their compassionate expertise. Hopefully at some point in the near future we will be able to supplement this with a peer support network as well!
References:
Student Distress Centre, University of Alberta Students’ Union
http://www.su.ualberta.ca/sdc
Peer Support, Grant MacEwan Students’ Association
http://www.macewan.ca/sa
Distress Line Volunteer Burnout/The Support Network
http://www.thesupportnetwork.com
Figley (1995). Compassion Fatigue Self-Test for Helpers
http://www.response-kit.com/csftest.htm
Access TV
http://www.accesslearning.com/helptv/
Darrin Hagen
http://www.accesslearning.com/helptv/darrin.shtml
Darrin’s Rant’s
http://www.accesslearning.com/helptv/therant.cfm
Darrin Hagen: Edmonton Queen (Not a Riverboat story). Slipstream Books.
http://www.canoe.ca/JamBooksFeatures/hagen_darrin.html
Schizophrenia Society of Edmonton
http://www.ssa-edmonton.com/
Schizophrenia Society of Canada
http://www.schizophrenia.ca/
Debbie is a native Edmontonian, and a single parent with four daughters. She has worked as a professional musician for most of her life, and has enjoyed a rich variety of life experiences – with many more to come! Debbie is working towards an eventual doctorate in psychology, and currently serves as the president of the Athabasca University Students’ Union.
