31 Jul Easing Caregiving Stress With Mindful Self-Compassion
B. Bartja Wachtel spoke to a packed crowd of caregivers at DSHS’s Giving Care, Taking Care conference. They were there to hear about what some call techniques, skills, or methods for easing on-the-job stress, but Bartja calls them, “ways of being in the moments of suffering.” Wachtel, a Licensed Clinical Social Worker, Mental Health Professional, and Child Mental Health Specialist, and Mindful Self-Compassion Trained Teacher led the group through sometimes moving and deeply effective meditations that can be practiced in moments of difficult feelings or in-the-moment caregiving stress.
Mindfulness Self-Compassion (MSC) practices can be brief or more involved. Do it in 3 minutes or devote your lunch break. To begin, simply settle into a comfortable position. You may have time to do a 2 minute body scan (a check in on you and where you are in the moment) or perhaps you can manage only a few deep slow breaths into the present moment. Put your hand over your heart to bring affection into your awareness if you like then continue. On a difficult day, maybe you can find 7 minutes for a Self-Compassionate Break? If not, Dr. Kristin Neff, researcher, co-developer of MSC curriculum and narrator of the Self-Compassionate Break audio, says, this can be used in the heat of the moment. It’s a portable, powerful and flexible tool for managing the stress of difficult emotions.
If you haven’t meditated before, you may find it challenging to bring it into your life, as Anderson Cooper recently shared, in a 60 minutes segment, below, but persist and you’ll enjoy a new sense of support and strength in your day. Don’t push yourself to learn mindfulness Jon Kabat-Zinn, researcher, clinician, and father of the Mindfulness Based Stress Reduction curriculum advises Cooper, “It’s not a great big should. It’s not like one more thing…now I have to be mindful.” “And if it becomes that?” Cooper asks. “Just don’t do it. Don’t do it. It’s not a doing at all, in fact. It’s a being and being doesn’t take any time.”
The awareness that most people simply don’t have time to cultivate a meditation practice was partly why Mindful Self-Compassion was developed. Formal and informal MSC meditations are built on mindfulness practice, and are not necessarily meant to make everyone formal meditators. They offer specific benefit and support for individuals and their care partners living with illness or emotional challenges. Through practice, caregivers get in touch with feelings and learn to align, in a deeper more authentic way of being, with their core values such as empathy, kindness, and service, . MSC helps meditators transcend the fight-flight-freeze responses of self judgement, expected perfection, over identification with role or emotions and caregiver isolation which cause burnout and stress, as Dr Kristin Neff further explains in the video below. “In the moment, when you just blew it at work, or you had someone reject you or something really bad happens in your life, what happens non-rationally is that we get very ego-centric. We feel like why me? This has somehow happened to me. I’m the only one who is messed up. I’m the only one who is going through that difficult time. We feel cut off from others…When we feel isolated or cut off from others physiologically that’s very frightening.”
Mindfulness Self-Compassion turns the usual self-critical paradigm around and asks the care partner, in the midst of a difficult caregiving moment; become aware of the emotions that arise in the moment and where they reside in your body (Mindfulness), recognize that there are others who suffer in this way (Common Humanity), and then offer yourself what you need in the moment (Self-Kindness). Again, this is not to change the moment of suffering for the person you are caring for or for yourself, but because you are suffering too! In the end this supports both of you in a softer way and provides the circumstances, not necessarily for ‘cure’ but for healing.
“…healing is a transformation of view rather than a cure,” Wachtel said, quoting Full Catastrophe Living, a book by Jon Kabat-Zinn. “It involves recognizing your intrinsic wholeness and, simultaneously, your interconnectedness with everything else. Above all, it involves learning to feel at home and at peace within yourself.”
Contemplative Neuroscience shows us that how we respond to life, i.e. with stress or calm, influences our health profoundly by contributing to which genes turn on and off at any given time, Wachtel explained. Ongoing mindful meditation practice translates to positive health outcomes: reducing stress hormones, increasing blood flow and endorphins, regulating pain and boosting immunity… but that’s not all! “Mindfulness research shows, in study after study, that people who meditate show thickening in the centers of the brain in charge of attention, memory and stress reactivity. With lower stress, our brains function better, more clearly, with more attention, which slows memory loss…Meditators tend to be happier, more optimistic about the future and respond with clarity instead of fight-flight in crisis. There is a feeling of calm and contentedness that shows up, even in trauma and difficulty, for meditators,” Wachtel said.
As he did at the Giving Care, Taking Care conference, Bartja shared a short exercise specifically for readers of the blog:
Imagine for a moment that you are in the worst caregiving situation you have ever been in, feeling helpless. Now, imagine approaching that situation with clenched fists. If you are reading this blog, do that—-imagine a difficulty and clench your fists as hard as you can. What does that feel like? Not very good I would imagine… in the moment of suffering we don’t have to white-knuckle it.
So the antidote to being in a moment of suffering is to bring love and kindness into the moment, while it is happening, but toward yourself, as the caregiver. To recognize in any moment of suffering, moment to moment, that we have a choice–to engage our flight-flight-freeze response or to engage our own innate caregiving response–toward ourselves. We have to remember who we are in the moment. This act of compassion is a part what makes us human when we fall short. It is what we are capable of, to be kind to ourselves.
Now imagine this same difficulty, but this time open your hands wide. What does this feel like? Hopefully more open and aware. So this is a representation of holding a moment of suffering with mindfulness, having awareness of the emotions (like fear) and where you feel them most in your body (maybe in your chest).
Again, imagine the same situation and hold your hands in front of you, reaching out. What does that feel like? Hopefully it feels a little more connected. This is a representation of common humanity, holding the knowledge that you are not alone, that there are other caregivers suffering in this way.
Now, one last time, still thinking of that difficult caregiving situation, bring both hands gently to your heart. What does that feel like? Hopefully there is a sense of loving-connectedness with yourself.
See, caregivers embrace Compassionate ideals– empathy and love. When your internal resources are tapped out you may feel like you have compassion fatigue but you’re actually experiencing empathy fatigue. You need to fill your own tank with more love to support empathy, so you have more to bring with you into the caregiving experience. How do you do that? Ask yourself, What is the kindest thing I can do for myself in this moment? What does this emotion I am feeling NOW need? Then, with or without hands to your heart think about what it would feel like to send yourself love in that moment. Imagine an image of love or send yourself the compassionate message: May I be loving toward myself in this moment of suffering.
Your caregiving spirit will be refreshed and more available as you work at balancing your own needs with that of your client, friend or family member. Mindfulness Self-Compassion meditations may help. If you’re interested in accessing more free MSC meditations or further learning about Mindful Self-Compassion visit Dr Christopher Gerner’s website, The Center for Mindful Self Compassion or Dr. Kristin Neff’s Website.
Bartja works as a clinical social worker at the Virginia Mason Neuroscience Institute providing social work services to people living with various forms of dementia, ALS, MS and Parkinson’s disease. He has nearly ten years of experience helping people and their care partners who live with chronic conditions. He is also a trained teacher in Mindful Self-Compassion. He runs seminars and workshops for caregivers and organizations focused on neurological conditions. As such he’s a featured speaker at the August retreat for the American Parkinson’s Disease Association (APDA Optimism Retreat) and will hold 2 mindfulness seminars at the Washington State Division of Vocational Rehab Conference in November. Listen to Bartja address Parkinson’s individuals and their families in this April 2015 at the Lunchtime Laboratory Webinar.
This blog was created with generous information sharing, clarification, and editing assistance from Bartja Wachtel. Here are some selections from his reading list.
For people living with chronic disease and their caregivers specific to a mindfulness orientation toward suffering and empathy fatigue:
Ten Thousand Joys & Ten Thousand Sorrows: A Couples Journey through Alzheimer’s – Olivia Ames Hoblitzelle
How to Be Sick: A Buddhist-Inspired Guide for the Chronically Ill and Their Caregivers – Toni Bernhard
Four books I recommend for anyone interested in cultivating well-being from a contemplative neuroscience approach:
Self-Compassion: The Proven Power of Being Kind to Yourself – Kristin Neff’s, PhD
The Mindful Path to Self-Compassion – Chris Germer, PhD
Full Catastrophe Living – Jon Kabat-Zinn, MD
Flourish: A Visionary New Understanding of Happiness & Well-Being – Martin E. P. Seligman, PhD