Cultivating Compassion: Crisis as an opportunity for transformation

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In this presentation, we explore the integration of compassion-based approaches and expressive arts in programs for promoting resilience and growth in face of shared trauma.

The COVID-19 pandemic caused unprecedented disruptions to our personal, social and professional lives (Slavich, Roos & Zaki, 2022).  Such disruptions are likely to have psychological impacts far-reaching and long-lasting bringing new and unique challenges that had the potential to impact experience of burnout.

Programs that promote resilience and prevent burnout are needed to support the resilience of healthcare practitioners, who are often exposed in such situations to immense psychological strain due to working in high-pressure and emotionally demanding environments. Irrespective of the specific intervention, major components in helping individuals affected by traumatic exposure are safety and stabilizing, processing of the trauma, and reconnection and integration.

The more complex the traumatic experience and its aftermath, the more multicomponent, and multimodal interventions are called for to effectively address the diverse dimensions of the situation. This presentation focuses on the transformative potential of cultivating self compassion in face of trauma.

Promoting Resilience through Cultivating Self Compassion:

Resilience refers to the process of adapting successfully to disturbances (adversity, trauma, pressure, or stress) that threaten an individual’s growth and function. Self-compassion increases individuals’ resilience in the face of such stressors (Slavich, Roos & Zaki, 2022). By treating ourselves with kindness and understanding, we can become more resilient to the challenges life throws our way.. Self compassion reduces isolation, shame proneness, maladaptive perfectionism and over-identification (Neff, 2016; Andel et al, 2021).

Self-compassion is an individual’s tolerance and compassion for himself in suffering (Neff, 2003). Self-compassion consists of six components: self-kindness, self-judgement, common humanity, isolation, mindfulness, and over-identification.

Self-kindness is described as the tendency to be caring and inclusive towards one-self rather than indifference or judgmental. Common humanity refers to seeing one’s experience as a universal experience, rather than seeing one-self as the center of pain that can lead to feelings of isolation. Mindfulness is supposed to be a clear and calm attitude towards the suffering of the moment rather than over identifying with them.

Self-compassion, as an emotional regulation strategy, has been found to mediate between social support and an individual’s post-traumatic responses (Compassion literally means “to suffer with", which implies a basic mutuality in the experience of suffering. Extending compassion towards oneself has been found to reduce burnout and compassion fatigue in caregivers and practitioners (Beaumont, Durkin, Martins, & Carson, 2015).

When we're under pressure, our clinical judgment and decision making can become narrow and rigid; reliance on biases can be excessive, and emotions can influence our beliefs and opinions (Muran & Eubanks, 2020). As a result of a lack of reliable feedback, we may fail to recognize how these factors are affecting us.

 A sense of belonging, compassion, and kindness are important ingredients for fostering resilience, recovery, and growth (Slavich, Roos & Zaki, 2022). A review of the research over the past few years demonstrates how compassion practices can counter compassion fatigue (Bentley, 2021). Practitioners who practiced self compassion during the pandemic reported less fear, more emotional safety, and less burnout (Haeshem & Zeinun, 2021; Kotera., & Van Gordon, 2021).

Shared humanity:

One of the most important elements of self-compassion is the recognition of our shared humanity.

We are all fallible.

Accepting that suffering is part of a larger shared human experience and struggles (i.e.,common humanity) can help reduce perceived stress and increase positive affect (Slavich, Roos & Zaki, 2022). Fears of compassion (for self, for others and from others), on the other hand, have been found to magnify the experience of perceived threat of COVID-19 on mental health.

Compassion involves turning towards and not away from difficulties, including our own. However, developing compassion for oneself can be difficult for many of us.  Recognizing misgivings regarding self-compassion as well as potential barriers to receiving compassion from others is therefore important in improving staff support (Bentley, 2022; Matos et al, 2021). By maintaining humility about our abilities and our approach, we can foster trust and connection in our work.

Patience:

In addition to paying attention with mindful curiosity to what unfolds moment by moment, in times of tension or strain, it is also necessary to zoom out from time to time and look at the big picture. We may become so absorbed in a conflict moment that we fail to notice that we are stuck—in a vicious cycle or self-defeating pattern (Muran & Eubanks, 2020).

We may feel the urge to fix things, soothe an angry patient and smooth over tension when we are in conflict, or defend ourselves when we feel wronged during a conflict. Our sense of helplessness and worthlessness, when things seem stuck, may lead us to do something, anything, to alleviate our sense of helplessness. Recognizing this and seeing what is going on in a broader context is essential (Muran & Eubanks, 2020).

Taking a step back instead of reacting immediately requires patience.Rather than rushing to end it before we understand what is happening, we can be patient to let it unfold. An attitude of patience allows us to be more flexible and open to different solutions and approaches. It can help us see the bigger picture and create better outcomes for ourselves and our clients.

Creativity:

"Constraints are catalytic forces that stimulate exciting new approaches and possibilities. They can make us more than we were, rather than less we could be. In play, we understand that our limitations our favorite game’s rules impose also give that game character, energy, and pleasure.(p.2). Morgan and Barden, 2015, p,2 cited in Selekman, 2021).

Compassion is, by definition, relational. The challenges that the COVID-19 pandemic has posed for practitioners provided transformative opportunities to strengthen their connections with others and find new ways to deal with  longstanding difficulties (Selekman, 2021).

Walsh (2016) differentiates between shared resilience and shared posttraumatic growth, which are differentiable outcomes of adjustment to a shared collective stressor. Shared posttraumatic growth refers to positive effects of a shared traumatic reality on health care providers beyond resilience (Ali et al, 21). Shared posttraumatic growth is a promising area of inquiry but much remains to be learned

As a route to cultivating resilience and growth, the experiential exercises described in this presentation promote self-compassion in medical and mental health settings. The participants in these programs were invited to to co-generate their own novel ideas  for balancing care of self and others in their personal lives as well as the workplace.
The illustrations are based on the MOVING model as presented in the chapter Promoting compassion satisfaction and regeneration (Pardess 2019). The implementaion of these programs is discussed in light of recent models of shared trauma, resilience and growth (Ali et al., 2021).

References

Ali, D. A., Figley, C. R., Tedeschi, R. G., Galarneau, D., & Amara, S. (2021). Shared trauma, resilience, and growth: A roadmap toward transcultural conceptualization. Psychological Trauma: Theory, Research, Practice, and Policy.
Andel, S. A., Shen, W., & Arvan, M. L. (2021). Depending on your own kindness: The moderating role of self -compassion on the within-person consequences of work
loneliness during the COVID 19 pandemic.Journal of Occupational Health Psychology. 26 (4), 276-290.
Andersson, C., Stenfors, C. U. D., Lilliengren, P., Einhorn, S., & Osika, W. (2021). Benevolence–associations with stress, mental health, and self-compassion at the workplace. Frontiers in Psychology,12, 568625
Bentley, P. G. (2022). Compassion practice as an antidote for compassion fatigue in the era of COVID-19. Journal of Humanistic Counseling,1–16.
Calaprice, Alice, ed. (2002). Dear Professor Einstein: Albert Einstein's Letters to and from Children. Amherst, N.Y.: Prometheus Books.
Galili-Weinstock, L., Chen, R., Atzil-Slonim, D., Rafaeli, E., & Peri, T. (2020). Enhancement of self-compassion in psychotherapy: The role of therapists’ interventions. Psychotherapy Research, 30(6), 815–828.
Gates, T. G., Ross, D., Bennett, B., & Jonathan, K. (2021). Teaching mental health and well-being online in a crisis: Fostering love and self-compassion in clinical social
work education. Clinical Social Work Journal
Hashem, Z., & Zeinoun, P. (2020). Self-compassion explains less burnout among healthcare professionals. Mindfulness, 11(11), 2542–2551.
Horesh, D., & Brown, A. D. (2020). Traumatic stress in the age of COVID-19: A call to close critical gaps and adapt to new realities. Psychological Trauma: Theory, Research, Practice, and
Policy, 12(4), 331-335.
Kotera, Y., & Van Gordon, W. (2021). Effects of self-compassion training on workrelated well-being: A systematic review. Frontiers in Psychology, 12, 1142
Latorre, C., Leppma, M., Platt, L. F., Shook, N., & Daniels, J. (2021). The relationship between mindfulness and self-compassion for self-assessed competency and selfefficacy of psychologists-in-training. Training and Education in Professional Psychology, Advance online publication.
Liu A, Wang W, Wu X. Self-compassion and posttraumatic growth mediate the relations between social support, prosocial behavior, and antisocial behavior among adolescents after the Ya'an earthquake. Eur J Psychotraumatol. 2021 Feb 11;12(1)
Matos et al (2021). Fears of compassion magnify the harmful effects of threat of COVID-19 on mental health and social safeness across 21 countries. Clin Psychol Psychother. 2021 Nov;28(6):1317-1333
Matos et al. (2021.a). The role of social connection on the experience of COVID-19 related post-traumatic growth and stress. PLoS One. 16(12).
Muran, J. C., & Eubanks, C. F. (2020). Therapist performance under pressure: Negotiating emotion, difference, and rupture. American Psychological Association
Prudenzi, A., D. Graham, C., Flaxman, P. E., & O’Connor, D. B. (2021). Wellbeing, burnout, and safe practice among healthcare professionals: Predictive influences
of mindfulness, values, and self-compassion. Psychology, Health & Medicine, 0(0), 1–14
Reizer, A. (2019). Bringing self-kindness into the workplace: Exploring the mediating role of self-compassion in the associations between attachment and organizational
outcomes. Frontiers in psychology, 10
Selekman, M. D. (2021). COVID-19 as a Transformative Opportunity for Families and Therapists : Harnessing the Possibilities That Constraints Offer Us. Australian Association of Family Therapy,  70–83.
Serlin, I. A. (2020).  Dance / Movement Therapy : A Whole Person Approach to Working with Trauma and Building Resilience. American Journal of Dance Therapy, November. 42:176–193.
Slavich G.M., Roos L.G, & Zaki J. (2022) Social belonging, compassion, and kindness: Key ingredients for fostering resilience, recovery, and growth from the COVID-19 pandemic. Anxiety Stress Coping Jan;35(1):1-8.

A MODEL OF SHARED RESILIENCE & GROWTH

 

A MODEL OF SHARED RESILIENCE & GROWTH

Self-Compassion Guided Practices and Exercises from Dr. Kristin Neff

A human being is part of the whole, called by us ‘universe,’ a part limited in time and space. He experiences himself, his thoughts and feelings, as something separate from the rest — a kind of optical delusion of consciousness. This delusion is a kind of prison for us, restricting us to our personal desires and to affection for a few persons nearest to us. Our task must be to free ourselves from this prison by widening our circle of compassion to embrace all living creatures and the whole of nature in its beauty-  Albert Einstein

COVID-19 as a Transformative Opportunity for Cultivating Compassionate Care

Posted by & filed under .

"At a time when COVID-19 has pushed collective and shared mental health toward the borderless consideration it requires, we must address the well-being and efficacy of a vulnerable population that has always existed. Its intrinsic nature is tied to the future of global mental health care, training, and development of the transnational solutions we need now more than ever". (Ali et al, 21)

This presentation explores mental health challenges faced by healthcare workers during covid-19 pandemic and new ways of facilitating resilience and growth.

Compassion has been described as a valuable resource, in addition to serving as an  antidote for compassion fatigue in the era of COVID-19 (Bentley, 2022). This will be discussed in light of recent models of shared trauma and shared resilience and growth  (Ali et al, 21). The transcultural conceptualization proposed by  Diab Ali, Charles Figley, Richard G. Tedeschi, David Galarneau, and Shilpa Amara opens the door to a more nuanced understanding of compassionate care.

Integrating such models offers new ways for supporting practitioners navigating the massive life changes and coping with the uncertainty and disruption associated with the pandemic around the globe.

Illustrations are offered of the implementation of online individual family and group interventions informed by these models for strengthening resilience through cultivating self-compassion in these challenging times.

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References
Ali, D. A., Figley, C. R., Tedeschi, R. G., Galarneau, D., & Amara, S. (2021). Shared trauma, resilience, and growth: A roadmap toward transcultural conceptualization. Psychological Trauma: Theory, Research, Practice, and Policy.
Bentley, P. G. (2022). Compassion practice as an antidote for compassion fatigue in the era of COVID-19. Journal of Humanistic Counseling,1–16.
Matos et al. (2021). The role of social connection on the experience of COVID-19 related post-traumatic growth and stress. PLoS One. 16(12).
Serlin, I. A. (2020).  Dance / Movement Therapy : A Whole Person Approach to Working with Trauma and Building Resilience. American Journal of Dance Therapy, November. 42:176–193.
Slavich G.M., Roos L.G, & Zaki J. (2022) Social belonging, compassion, and kindness: Key ingredients for fostering resilience, recovery, and growth from the COVID-19 pandemic. Anxiety Stress Coping Jan;35(1):1-8.
APPENDIX

A MODEL OF SHARED TRAUMA

A MODEL OF SHARED RESILIENCE & GROWTH

Ali, D. A., Figley, C. R., Tedeschi, R. G., Galarneau, D., & Amara, S. (2021). Shared trauma, resilience, and growth: A roadmap toward transcultural conceptualization. Psychological Trauma: Theory, Research, Practice, and Policy. Advance online publication. http://dx.doi.org/10.1037/tra0001044