Stress, Compassion Fatigue and Dealing with Emotional Clients

  • View

  • Download

Embed Size (px)


Stress, Compassion Fatigue and Dealing with Emotional Clients . Betsy Brandborg 447-2205. How We Know Things. Oliver Sacks, M.D. is a physician, a best-selling author, and a professor of neurology at the NYU School of Medicine. - PowerPoint PPT Presentation

Text of Stress, Compassion Fatigue and Dealing with Emotional Clients

Slide 1

Stress, Compassion Fatigueand Dealing with Emotional Clients

Betsy Brandborg447-2205

1How We Know ThingsOliver Sacks, M.D. is a physician, a best-selling author, and a professor of neurology at the NYU School of Medicine.

He is best known for his collections of neurological case histories, including The Man who Mistook his Wife for a Hat (1985), Seeing Voices (1989),Musicophilia: Tales of Music and the Brain (2007) and The Minds Eye (2010). Awakenings (1973), his book about a group of patients who had survived the great encephalitic lethargica epidemic of the early twentieth century, inspired the 1990 Academy Award-nominated feature film starring Robert De Niro and Robin Williams. The New York Times has referred to him as the poet laureate of medicine.

You can experience all forms and matters, but you cant respond or catalogue to them without naming them.Name your experiences so you can form your response.

2Getting StartedWhy did you become a lawyer?

Sources of satisfaction in your practice

Sources of stress in your practice

Effects of workplace stressWhy?To help people Make $ Have a certain level of control over our lives that so many jobs dont seem to have.

Sources of Satisfaction: The Clients, the $, the autonomy

Sources of Stress: The Clients, the $ (or lack thereof), the lack of control

Lawyers are high achievers.

We often hide our emotions and show a tough exterior or pretend (manipulate with kindness) to maintain professional demeanor.

We cant always be authentic.

3Stress AcuteEpisodic AcuteChronicAcute Traumatic StressThis are a few forms of our subject. Foundation.4Acute stressThe most common form of stress.

It comes from demands and pressures of the recent past and anticipated demands and pressures of the near future.

Acute stress is thrilling and exciting in small doses, but too much is exhausting. A fast run down a challenging ski slope, for example, is exhilarating early in the day. That same ski run late in the day is taxing and wearing. Skiing beyond your limits can lead to falls and broken bones.

Overdoing on short-term stress can lead to psychological distress, tension headaches, upset stomach, and other symptoms.Fortunately, acute stress symptoms are recognized by most people. It's a laundry list of what has gone awry in their lives: the cancelled primary presenter, the auto accident that crumpled the car fender, the loss of an important contract, a deadline they're rushing to meet, their child's occasional problems at school, and on and on.

Because it is short term, acute stress doesn't have enough time to do the extensive damage associated with long-term stress. The most common symptoms are:

emotional distress--some combination of anger or irritability, anxiety, and depression, the three stress emotions;muscular problems including tension headache, back pain, jaw pain, and the muscular tensions that lead to pulled muscles and tendon and ligament problems;stomach, gut and bowel problems such as heartburn, acid stomach, flatulence, diarrhea, constipation, and irritable bowel syndrome;elevation in blood pressure, rapid heartbeat, sweaty palms, heart palpitations, dizziness, migraine headaches, cold hands or feet, shortness of breath, and chest pain.

Acute stress can crop up in anyone's life, and it is highly treatable and manageable.

5Chronic StressWhile acute stress can be thrilling and exciting, chronic stress is not. This is the grinding stress that wears people away day after day, year after year. Chronic stress destroys bodies, minds and lives. It wreaks havoc through long-term attrition. It's the stress of poverty, of dysfunctional families, of being trapped in an unhappy marriage or in a despised job or career.Chronic stress comes when a person never sees a way out of a miserable situation. It's the stress of unrelenting demands and pressures for seemingly interminable periods of time. With no hope, the individual gives up searching for solutions.

The worst aspect of chronic stress is that people get used to it. They forget it's there. People are immediately aware of acute stress because it is new; they ignore chronic stress because it is old, familiar, and sometimes, almost comfortable.

Chronic stress kills through suicide, violence, heart attack, stroke, and, perhaps, even cancer. People wear down to a final, fatal breakdown. Because physical and mental resources are depleted through long-term attrition, the symptoms of chronic stress are difficult to treat and may require extended medical as well as behavioral treatment and stress management.

The less chronic stress you have in your life, the more acute stress you can handle when it occurs.

6Episodic Acute StressThere are those, however, who suffer acute stress frequently, whose lives are so disordered that they are studies in chaos and crisis. They're always in a rush, but always late. If something can go wrong, it does. They take on too much, have too many irons in the fire, and can't organize the slew of self-inflicted demands and pressures clamoring for their attention. They seem perpetually in the clutches of acute stress.The symptoms of episodic acute stress are the symptoms of extended over arousal: persistent tension headaches, migraines, hypertension, chest pain, and heart disease. Treating episodic acute stress requires intervention on a number of levels, generally requiring professional help, which may take many months.

Often, lifestyle and personality issues are so ingrained and habitual with these individuals that they see nothing wrong with the way they conduct their lives. They blame their woes on other people and external events. Frequently, they see their lifestyle, their patterns of interacting with others, and their ways of perceiving the world as part and parcel of who and what they are.

Sufferers can be fiercely resistant to change. Only the promise of relief from pain and discomfort of their symptoms can keep them in treatment and on track in their recovery program.

7Stress Warning Signs and SymptomsCognitive SymptomsEmotional SymptomsMemory problemsInability to concentratePoor judgmentSeeing only the negativeAnxious or racing thoughtsConstant worrying

Moodiness Irritability or short temperAgitation, inability to relaxFeeling overwhelmedSense of loneliness and isolationDepression or general unhappiness Physical SymptomsBehavioral SymptomsAches and painsDiarrhea or constipationNausea, dizzinessChest pain, rapid heartbeatLoss of sex drive Frequent colds Eating more or lessSleeping too much or too littleIsolating yourself from othersProcrastinating or neglecting responsibilitiesUsing alcohol, cigarettes, or drugs to relaxNervous habits (e.g. nail biting, pacing) Weve all had some of these at one time or another.

But keep in mind that the signs and symptoms can also be caused by other psychological and medical problems. Check in with your doctor.8Flooding

Our modern brains continue to respond to stressful circumstances (change) as threats / dangers you must protect against.

Stress is a normal physical response to events that make you feel threatened or upset your balance in some way. When you sense danger whether its real or imagined the body's defenses kick into high gear in a rapid, automatic process known as the fight-or-flight reaction, or the stress response.

The stress response is the bodys way of protecting you. When working properly, it helps you stay focused, energetic, and alert. In emergency situations, stress can save your life giving you extra strength to defend yourself, for example, or spurring you to slam on the brakes to avoid an accident.

The stress response also helps you rise to meet challenges. Stress is what keeps you on your toes during a presentation at work, sharpens your concentration when youre attempting the game-winning free throw, or drives you to study for an exam when you'd rather be watching TV.

9Dr. John GottmanAdrenaline and cortisol are secreted in such large doses that it triggers a fight or flight stress reaction coupled with intense fear or anxiety. Brain is effectively impaired by stress; cant think; cant process information or communicate effectively.Everyone has had this happen. You become completely blocked. You cant think. You cant process information and youre certainly not communicating effectively.

This is the emotional client but it also happens to us.10What HappensCauses people to go blank; their brain is simply not registering; they cant hear you.The information never registers. If you ask them an hour later what you told them, they wont know. Theyve paid you for advice, but dont seem to take it.This happens with many litigations:Bankruptcy/foreclosuresit may be the reason they stopped functioning in the first placeFamily law and divorceCriminal lawCivilEmploymentBusiness disputesmoney, debt divisionEstates

Emotions run high. People have histories with each other. Theyll come in ready to flood. Pre-loaded. Its contagious (which Ill talk about in a minute).

Since theyre unable to take in information, theyll answer the question in a deposition with the wrong informationtheyll talk but not in sequence.Thinking is scrambled, the words are broken, their memory lapses, they cant describe events in sequence.Youre giving advice, theyre paying for it. They seem to listen, then leave and do something completely different than you agreed theyd do.Theyll go blank on the witness stand. They answer questions in interviews with I dont know or what do you think?Theyll talk too much in depositions. If theyre nervous, they cant shut up. Theyll argue with the judge.

Want to keep the client functioning so they can help you with