Compassion Fatigue, Burnout, and What the Pandemic Revealed About Clinician Resilience

Hello and welcome back to Therapist Voices at Reach Length. My name is Jessica. I oversee our network of amazing providers. Today I am joined by not one but two guests. We have Natasha Dark Angelo and Celeste. Amazing. The amazing guest of today. What What kind of canine do we have here? Natasha is a seven-year-old multis poodle. And believe it or not, she is full grown. and she's a certified therapy dog. So, um she's got her own her own certificate to practice. She does therapy dog and we've completed all of our hours of training. And I always say she's a better therapist than I ever will be. And I know that always give it to the assistant. Yes, I I know that. I own it. I am not ashamed in the slightest. She is an absolute doll. How long has she been with you in her practice? Um, so she and I, believe it or not, we did our training in 2020.

We started in January of 2020 and it took us longer than it normally takes. It took us about nine months to complete the course because with so many things shut down with COVID, we couldn't get in all of our hours. U, but we graduated in September of 2020. Um, so she has been a therapy dog since then. We don't do as much in-person stuff now that I am fully virtual, but um she still does come with me when we go to do um like because I do speaking engagements, I do trainings for um you know, organizations for clinicians. And so if it's somewhere in the greater Orlando area, I will offer to have her come with me. Perfect. and she and I are going to be in Gainesville in just a few weeks doing a training for a group of crisis counselors in Elatchua County. Yeah, that's amazing. I am about three hours south of you.

So, if you ever want to make an appearance in my home office, we will Oh, we'll do a follow-up podcast of an inerson with Celeste. There we go. Well, maybe we can even ease into our conversation with what you just mentioned about that training. That really shows. I mean, I've been all over your website. I've been checking you out. I know you've got a lot of trauma background in your career. I mean, and you're a certified compassion fatigue professional, which I really want to ask you about. So, take all of that that I just threw at you, tell me what you're open to telling us, and we want to hear all of it. As uh Julie Andrews would say, let's start at the very beginning. All of this came about as a result of the pandemic, believe it or not. So, back in March, April of 2020, I was watching everything go down and thinking to myself, we are going to end up with a generation of nurses struggling with PTSD in an already broken health care system.

And that's not good. And so, I wanted to help, but didn't know how. Ended up partnering with a dean of nursing at a school down in St. heat and she gave me the platform to do support groups, free support groups for nurses on Saturday mornings. And it felt good, but it didn't feel like I was doing enough. And so I was like, well, obviously I need more training. Um, so I sought out additional training specifically on compassion fatigue and ended up finding Dr. Eric Gentry's work and research and he is an amazing amazing therapist and has been researching compassion fatigue for over 25 years. So I did my initial certification with him. I ended up doing a um nine-month cohort with him where I learned all of his research and um that g that gave me the ability to be able to present his findings uh because his whole goal is to get his message out at a wider level and he knew the most effective way to do that was to train other people in order to tag him in this podcast while we're at it.

Sure. um was to be able to t you know train other people in order to get his research out there. Then I also took a cro a course through the green cross traumatology institute to be a compassion fatigue educator. So what ended up happening, which was not my initial intent, was I learned so much about me as a professional and how much I have struggled with compassion fatigue through the course of my career, which is not something that I had initially thought about when I Right up on you. Yeah. As I was listening to Dr. entry present. I realized, oh my goodness, I have been there. I have experienced these things. I know what this feels like at the cellular level. And so, not to be too cliched about it, but it it really did end up transforming my career. I never anticipated that I was going to be doing public speaking, but it it was such valuable information that I I was like, I have to talk to other clinicians about this and I need to be helping other mental health professionals so that they're not burning out and leaving the field earlier than they really should be because they just don't have the tools that they need to help them be successful and sustainable.

You know, I think sustainability really is the key. This is what you're saying is exactly why I wanted us to talk about this. I feel like there's no shortage of of mental health providers talking about compassion fatigue. But when I saw that you had this credential, I thought, wait a second, she there's there's a little more to this that that you might be able to shed some light on in addition to all your other credentials. By the way, I had to I had to pick just one of them. That's okay. So, how do you incorporate this into into your practice? The big thing that I have found is people don't really understand what compassion fatigue is. I think that people will use compassion fatigue and burnout interchangeably and they are not the same thing and they do not have the same definition. So, I'd like to start with the definition of compassion.

I don't think I was totally clear on that. Please. So, Dr. Charles Figgley, who really was the first one to actually study this as a phenomenon and try to get some solid research like foundational knowledge. Um, he coined the definition back in 1995 and he defines compassion fatigue as a combination of burnout and secondary trauma. So, it's a state of exhaustion and dysfunction biologically, psychologically, and socially as a result of prolonged exposure to compassion, stress, and all that it invokes. So, burnout is more of an environmental thing. Burnout is more of a my job is putting demands on me that I can't possibly meet or I don't have the resources to be able to do what they're asking me to do. Um, and that that's part of it. That's half of the equation. But when we interchange burnout and compassion fatigue, you're missing that secondary trauma piece of things.

So, secondary traumatic stress is what happens when you are sitting with working with suffering and traumatized clients over and over and over again. You're listening to their narratives. You're being exposed to their trauma. And as mental health professionals, that's what we do day in and day out. I mean, that's really, I would argue, like the first bullet point on any of our resumeumés. Even if you're not, like I do specialize in working with clients that have extensive histories of trauma, but even if you're not specializing in trauma work, your clients walk into your office with their trauma weighing on their minds, weighing on their bodies. So, all of us end up working with trauma, whether that's what we specialize in or not. and we hear the worst of the worst. I don't think that there's a week that goes by that I don't hear.

So, I've never told anybody this before, but and you you may be the first person in 40, 50 years that's ever heard this thing that the client is telling you. And because at a baseline, what we do is care for others, that very caring leads us to be more susceptible to symptoms of compassion fatigue. And this is not just mental health professionals. This is anybody that's under the caregiving umbrella. So I'm talking about nurses. I'm talking about mental health professionals, physicians, veterinarians, hospice workers, first responders, educators, educators. Um, and the the thing is is that again in my experience, nobody gets trained in this stuff. I have never worked with a nurse who had ever actually had any kind of training in compassion fatigue. Same thing with the physicians that I've worked with.

Same things with the veterinarians that I've worked with. I've never had an educator that I've worked with that had ever heard of the term compassion fatigue. Even mentally that probably have the burnout though that so they know about all that and are probably thinking what I was thinking of. It's sort of the same thing, but it's not. Yeah, exactly. Even the mental health clinicians, um, because I've presented to groups as big as 300, they have heard of compassion fatigue, but don't really have an understanding of the definitions or the symptomology and definitely not an understanding of how to get to a more resolved place with things. Oftent times what I'll hear is, and this is one of my pet peeves, um they will hear messaging like, "Well, clinician self-care and clinician self-care and clinicians need to do self-care."

And yes, we do need to do self-care. I'm I'm not arguing with that. But you cannot self-care your way out of compassion fatigue. What you're talking about is a a systemwide impact on your nervous system. And so if you're not Sorry, my cat just came in. Um you can head up here. She's she's looking out the window. She'll she'll come and make herself seen here on screen in a moment. Just make sure she comes up on your shoulder. Amazing. I'm actually pretty sure that's my cat, by the way. Don't see mine. So there you go. You got a therapy cat and a therapy dog. This makes you so relatable though, Natasha. Like truly, it makes you a real person. Love it. Love it. All of it. Your kitty cat. Don't That's not nice. That's not nice. There you go. Relax. Um so you let's say that you had the disposable income and you could go get a massage every day, right?

If you're not tackling things at a neuroscience level, if you're not working with your own nervous system, it doesn't matter how many massages you go to get. It doesn't matter if you meditate for an hour a day, it doesn't matter if you're going for a walk every day, right? You need to be tackling things from the nervous system level. So, I think that's what's missing in most conversations when we talk about compassion fatigue. Um, and and quite frankly, I think sometimes it falls into the category of victim blaming. It's like, you know, oh, you're a therapist that's tired. Well, have you thought about going for a walk every day? And it's like, oh, had not even thought about that. What are your write all of my notes? I don't have time to be going for walks, you know? Um, so it's it's not really tackling where the problem lays. and I presented to um the Therapist Resource Network is a fantastic organization.

They're a nonprofit based out of North Carolina, but what they do is they support clinicians that are going through a hard time and might need financial assistance. So if they have lived through um a n a natural disaster, if they are undergoing cancer treatment for example and are just really struggling to help make ends meet, the therapist resource network this year is doing a free workshop for clinicians uh every month and I'm happy to provide you the information on that. We're gonna let's link this at the end. Love it. Awesome. Um she so I did a presentation for them a few weeks ago and one of the clinicians that was in that presentation was talking about how you know the other big contributing factor is we really are living through unprecedented times that they did not prepare us for in grad school.

Um you know there's a lot going on. Things feel very heavy right now. And when you're a clinician, you sit at the intersection of being inhuman, watching these things happen and being horrified by what's going on. And I think that as mental health professionals, we tend to feel things more deeply. I like caring is what we do. Empathy is what we do, right? Um and so we have that ourselves as humans. Like here in Central Florida, there have been ice spottings and I look the way that I do and I am worried about my own safety and I hold that as a fear for myself as a human. Like how do I explain to my toddler why I disappeared and didn't pick her up from school? And at the same time, I have clients coming to session that are very, very worried about their loved ones and we're making safety plans for what happens if they get detained, right?

So, it's almost like you're holding the weight of the double impact. And we didn't get training on that in grad school. Like, none of us learned about how to do those things. We learned about how to do group therapy and we learned about different approaches and we learned about assessments. we didn't learn about doing all of this and so in a way we're also breaking new ground. So it's hard to be a clinician right now which is why it's really really important that we are taking care of ourselves and doing more than just taking the occasional bubble bath. Like that's not going to dig you out of the pit of compassion fatigue. The lavender isn't going to do it. It's not going to cut it. The essential oils are not going to cut it. Sorry, friends. Sorry. So, one of the things that I like to do education on is helping people understand what some of the symptoms are of compassion fatigue.

Symptoms fall into five major categories is how Dr. Jed breaks them down. So, there's physical symptoms, so like being tired, having impacts on your sleep. Um, there's psychological, so feeling numb. Hello. Now, now you're in front of my computer. I can't see anything. Um, having difficulty making decisions. Maybe you're having nightmares about work. Emotional symptoms. So, you might be feeling irritable. You might be feeling overwhelmed. Spiritual is another category. So, finding it difficult to trust. Maybe you're avoiding your friends and family. And then professionally, you might be having decreased productivity. Um, you might feel like quitting your job. Maybe there's uh things about the stories that your clients are telling you that are popping up in your brain when you're just trying to unwind at the end of the day.

And so that's something that we don't talk about as clinicians is there are negative aspects, there are negative impacts to the work that we do, but I think that we oftent times just isolate. I think we feel ashamed and we are scared to admit to our peers that this is what's going on with us. I do also think that because there is so much teaalth work going on as a field we have become more isolated. It used to be that if you were you know in person in a private practice oftentimes you were sharing office space with other people or you were in a building with other clinicians. There was there was more of an opportunity to have other people around you. You could knock on the door. Exactly. Exactly. More opportunity for case consultation even if it was just a brief we're passing in the hallway kind of thing.

But now that so many clinicians are teleaalth I mean I'm here in my home office. um it has become a little bit easier to be isolated and it is a little bit harder to seek out those opportunities for pure connection and pure support which is so important when we're talking about compassion fatigue. That's something that we need to have in order to be able to get ourselves to a more resolved place. Um so another tool that I want folks to be aware of is there is an objective way for you to measure symptoms. Um it's called the proqual. So, it's the professional quality of life scale. So, P R O Q. They're on the fifth iteration. So, right now it's the ProQL 5. It's free and I like things that are free. Um, so if folks go to proquall.org, pol.org, you can take it right online on the website. It doesn't take more than 10 minutes.

Um, like I do this in session with clients and we go over their results and we talk about the impacts and what it means. But just like how we talk to clients about how if you're not willing to admit that there's a problem, then there's not really anything that we can work on. The same is true for ourselves. So, a really good place to get started is to do an objective measurement of what your symptoms are looking like presently. It's going to ask how you've been feeling for the last 30 days and it's a lyker scale from one to five. So, you know, not at all to very much and you can kind of see where your scores are at and get an objective measurement of how you're presenting so that you at least have a baseline to start with. So I think the education and understanding what the definition of compassion fatigue is, getting a better understanding of what symptoms are, being able to measure symptoms, and then finally moving into, okay, what do I do to get myself to a more resolved place?

The biggest one is being able to recognize that the work that you do impacts your nervous system. Not because consciously that's something that you're trying to do, but because you can't help it. Um, every single one of us has traumagenesis. We have essentially faulty learning in our nervous systems that occurred at some point on our trips around the sun. It's not always a conscious memory that you have. So, the one that people most often relate to is every single one of us survived middle school, right? Um, did we did we though? I don't know if I Well, maybe not fully emotionally intact, but you [snorts] know, let's say on the first day of middle school, you're in the cafeteria, you have your tray, and you slip on something and your tray goes flying and you're now covered in, I don't know, spaghetti sauce, right? and everything comes to a stop and everybody stops and stares at you and then somebody starts laughing now and the entire cafeteria is laughing at you.

That now becomes you're the person who spilled spaghetti on them the first day of middle school. There's probably going to be some really mean nicknames that come out of it. So, let's fast forward now 20 25 years and you wonder why when you walk into a room to give a presentation, your whole system freezes up. It's because your nervous system is going back to that first day of middle school where everybody stopped and stared at you and laughed at you. Now, in that moment, you were not in immediate life-threatening danger. However, your nervous system registered that feeling of embarrassment and shame as a life-threatening danger. So, what happened was your nervous system learned when people stop, stare at you, and laugh, you're going to die. And I know objectively you can tell me that you're not going to die, but when you're up in front of a a group of people and you're expecting to give a presentation, your nervous the reason you forget what you're supposed to say is because your nervous system thinks that you're going to die and and it's trying to to get you the heck out of that situation, right?

And so the way that I describe it to clients is you essentially have two filing cabinets inside your brain. There's the filing cabinet of things that will kill you and there's the filing cabinet of things that won't kill you. But every single one of us has things in a filing cabinet of things that will kill you that won't actually kill you. getting up in front of a group of people to give a presentation. Even if you forget everything that you were supposed to say, that's still a little life-threatening danger, right? And what ends up happening for all of us is because of our traumagenesis, because of this faulty messaging that we receive at some point along the line, we go through our days, especially when we're working with clients or when we're working with patients and their trauma histories might mirror some of what we lived through.

So, our nervous system is getting activated. And until you learn how to regulate your own nervous system and acknowledge the fact that the clients that you work with are activating your nervous system, you're going to continue to essentially retraumatize yourself in every session that you have with a client. in every patient that you encounter in an emergency room, in every, you know, child that you have in your class that is not making progress that the state says that they're supposed to be making, right? And I, and those examples could go on and on. So, what you have to do is you have to learn how to work with your nervous system. Recognize that even if a client is recounting a traumatic story to you from their childhood that is like identical to something that you lived through, you are not in that moment in active life-threatening danger.

You are safe. You're in your office. The client's not doing anything actively to harm you. And you have to learn how to regulate your nervous system. And that's a lot of work that I do with clients is let's get you into a regulated nervous system. And what ends up happening is it doesn't just benefit your professional relationships, right? If you're in a regulated nervous system with a client and you're listening to we hear the worst stories. I I mean that's what we do. I worked on an impatient unit for a year and a half. Like I heard really really bad horror stories of what the things that people had lived through. And you can't you can't not acknowledge that those things are brutal and they're having some kind of impact on you. Which is why it's so important that you learn to self-regulate that otherwise every session that you sit in, you're retraumatizing yourself or you're traumatizing yourself.

And there's no way you're going to be sustainable doing this work if that's what's happening in session after session after session. The other thing that happens is if you learn how to regulate your nervous system, you're going to have a better relationship with your romantic partner. You're also going to have a better relationship with your children. Um, so I think I mentioned I'm the the mom of a toddler and right now she is very much in her independent I do it stage. So everything takes us about three times as long as we need it to. Yeah. But she wants to do it. And I and I want her to be able to even if she gets frustrated. She's working on zippers right now. So even if she gets frustrated, I want her to have the opportunity to try it. And even if she gets, you know, frustrated or she fails at it, she's attempted it, right?

You're not taking that opportunity away from her, right? But sometimes we have to be someplace at a certain time. And so, and I and I swear those days are the days that she moves about as quickly as molasses on in the middle of a blizzard. Uh, so what I have learned to do is I have to regulate my nervous system. Time is not a concept to her. That's not a her problem. That's a me problem. She doesn't care that we have to be at whatever place it is at 9:00. She doesn't know what 9:00 means, right? It is my responsibility as her parent to make sure that I'm getting up in time and getting her up in enough time to get her dressed and brush her teeth and do the whole thing. And I have to stay in a regulated nervous system because if I start doing, come on, come on, we have to go. We have to go. We have to go move faster, move faster, move faster.

I'm that's my anxiety is now becoming her anxiety. And I'm not making her move faster. I'm making her anxious. and probably putting her into fight orflight mode and we're not going to get anywhere, you know. Instead, it's a I appreciate that you're trying to do this for yourself. We have to get in the car right now. I also try to use timers with her um so she has a visual to see how much time she has left. So, you can try it again tomorrow, but for today, mama needs to do it for you because we have to get in the car. We have to be at the doctor's or whatever it is. Um, but if if I approach her in in a nervous system that's on fire, her nervous system is now picking up on my anxiety and it's not making the situation any better, right? Um, the same thing is true for when we get into conflict with our romantic partners.

That's going to happen. But if you take a look at it objectively and the the conversation I always have with clients because it's it's like the stupidest hypothetical. Let's say somebody makes themselves a peanut butter and jelly sandwich and they leave a mess all over the counter. There's breadcrumbs and they've left the peanut butter crusted knife out on the counter. And this is what you walk into at the end of the day. Do you want to approach your partner in a nervous system that's on fire? Like, what's wrong with you? I'm not your mate. I'm not your mother. You expect me to clean up after you. You do this all the time. Blah blah blah blah blah. Do you want that to be the conversation? Or do you want to get yourself into a regulated nervous system and say, you know, I came home after a really long day of work and when I walked into the kitchen and that was the first thing that I saw, it was really upsetting to me.

Can we work together to try to figure out some kind of solution making for this because it it was not pleasant for me to walk into at the end of the day. All right, two very different conversations. you're going to have two very different outcomes. But that all comes from what's happening inside your own nervous system, which is also something that you're able to control. Even when you're living through unprecedented historical events, you still have the ability to control what's happening inside your nervous system. And that is going to help you with whatever else it is that you're tackling during the day. So that's like my big message that I try to get across. It's a it's a great example because it's obviously relatable relatable to everyone. Darn knife. Um that that is so in that moment what if you if you are not able to regulate have you screwed everything up?

Have you put all this onto your daughter? I'm reliving a lot from drop off at school this morning. So, the what what attachment theory tells us is um it it's not it's not a realistic goal to try to be a parent that's never going to mess up, right? That's not true. I've lost my cool with my child. Um the the goal is that you're repairing it, right? So, you know, mama yelled at you this morning and I apologize for that. I should not have yelled at you. That's not your fault. Mama was feeling angry. Mama was feeling frustrated. mama was feeling whatever my poor child is the child of a therapist. So, we talk a lot about feelings and emotions, right? Um, you know, it's not your fault. You are not responsible for how mama feels. Mama is responsible for how mama feels and mama should have done a better job of handling her anger, right?

Um, so that's the important part is what are you doing to go back and repair that relationship? That is way way more important than trying to be a parent who never messes up because our children need to see that I get angry too. I get frustrated too. I get anxious too. What do I do with those emotions? And the most important thing that we can teach them is that even if they get angry, we still love them. Even if they break something, you know, at some point they're gonna spill a half gallon of orange juice all over the kitchen floor, right? This is messy and this is sticky. Come on, we're going to work together to clean this up, right? You're modeling those things for them. And your dialogue to them ends up being their inner dialogue of how they refer to themselves. So like one thing I do with my child is we do affirmations every night.

And one of the things that she really likes to do that I hope she doesn't grow out of is she really likes to help. And so one of her affirmations is I am a helper. And she is starting to have that become part of her identity by like this weekend I was doing laundry and she's mama I help you. And I'm like okay sure you can help me. So she's like looking for opportunities to be able to help. Right? They are sponges. They are watching everything that you do. And you may not think that they're listening to you, they're listening to you. Even if they're 13, they're listening to you. Um, and and so the things that we model for them and the way that we speak to them ends up becoming the way that they speak to themselves. And I would much rather have her inner dialogue be that I'm a helper because she helped to clean up something that she broke or something that she spilled rather than she's a bad kid because she spilled something.

I'm an adult. I'm clumsy. I spill things all the time, right? Um and so I don't want her to feel like she's now a bad person because she spilled something. That's just not accurate. At the beginning when you said, you know, there is this this large difference, I was thinking how big how big can it be? But truly, that's I think where a lot of people's education on compassion fatigue ends. Yes. And it's not well, okay, so what do I do? Did I screw my kid up? How much did this impact? Oh, it's not too late. I can I can fix this? Absolutely. Absolutely. And again, the older your child is, the more you're able to have those conversations. Listen, I'm not proud of how I handled that. I I really messed that up and I'm sorry. I sorry I'm sorry I spoke to you that way that you did not earn that. You did not deserve that.

That was my stuff. I had a really bad day at work. That's not your fault. And I'm going to try my best to not do that again. Right? That's a much more valuable conversation. And the thing is is that if you have those open, honest conversations, like as a clinician, I've worked with parents over the years um trying to get a better relationship with their kids, but you want to be the person that they come to when things are hard. And you can't you can't be that person if you're constantly in a disregulated nervous system. Children will take on responsibility for things that are not their responsibility. Divorce is a good example. Especially when there's a contentious divorce, children will oftent times think and and it doesn't have to make sense, right? It can be, you know, I was upset that I didn't get the scooter for Christmas and that's why mom and dad are getting divorced, right?

So, it doesn't have to make sense, but you want to be the person that they come to when things like that are happening. And and [snorts] that starts in those conversations that we have with them when they're five and and the ice cream store ran out of their favorite flavor. Are you going to tell them to shut up and stop crying because it's not that big of a deal? Or are you going to crouch down, get down to their level, and say, "I'm really sorry. I did not know that the ice cream store was going to be out of your favorite flavor. I would be really sad if they were out of my favorite flavor, too. Here's what I can offer you. We can try again tomorrow, or do you want to get a different flavor since we're here at the ice cream store right now? And that seems like such a little like nonsense situation, but what they're learning in that moment is how they feel is important to you.

It doesn't have to be big to you or important to you. They just need to see that you see them and hear them and care about the stuff that's important to them. How many times have you heard mama watch my child this morning? Mama watch. Mama watch. Cuz she has on a skirt and so she was doing the twirling thing. This jump is going to be different than that one I just did. Trust me. Exactly. So ideally when she's 13 [snorts] and her friends start doing all kinds of crazy stuff on social media and she might not feel comfortable with it. I want her to come to me and be like, "My friends are making these videos and I don't really want to make these videos. What should I do? I want to be the one that she's having that conversation with." But it starts when they're four or five in the ice cream shop and they've run out of their favorite flavor.

Right. But as parents, we have to do the work of being in a regulated nervous system so that we can be that safe place for them to come back to. Yeah. Um the other thing is is so Dr. Gentry has first of all he's he's got videos available on YouTube that are free that I highly recommend people like he's not a gatekeeper so and that folks look up his stuff but he has like a five it's like a f fivepronged immunity um against compassion fatigue and we've talked about several of the points so the first one is being able to regulate your nervous system recognizing the difference between is it a real threat or Is it a perceived threat? Right? That's one of those things. Another one of those things is the stuff that we talk to clients about all the time. Like we tell clients they need to eat well.

We t tell clients they need to sleep well. We tell clients that they need to exercise. Those are things that we need to do as clinicians too in order to take care of ourselves. The other one is connection. Right? If this message is resonating with you, if you're thinking, "Woo, am I maybe struggling with compassion fatigue, talk to a colleague who's somebody that you know and trust that does this work?" Because nobody is going to get it like somebody else that does the work that you do and say, "I listen to this thing on compassion fatigue." And here are my takeaways. Can you be the person that just kind of watches me and lets me know if you think that I am slipping into compassion fatigue? I'm probably going to be angry. I'm probably going to get defensive. Um, but it is really important that you call me out.

And what I promise to do for you is if I notice things going on with you, I'll call them out in you. Right? We have to have that connection. And that this is why I encourage folks regardless of how long you're licensed, do you have a group of clinicians that you can talk to to do consultation or even just to like talk to, right? Um, another thing that is really really important is that we reconnect to our reason for doing this work. Those of us that are caregivers, I think the longer that we're in it, the easier it is to slip away from the original reason that we got into this work to begin with. And so it's important for you to reconnect to that. Why did you decide to become a therapist? Why did you decide to become an educator? Why did you decide to become a nurse? Reconnect to that purpose.

Because a lot of times the demands of the job, the administration in the place where you're working will have you drifting farther and farther away from that message. And it's important that you reconnect to it. And then finally the last prong I guess um is uh this concept of really understanding yourself and your north star. So Dr. Gentry defines that as um or the term that he uses for it is perceptual maturation which is he has a mission statement exercise and this is part of what I did when I was in the the cohort with him where you write down and you have to do it on pen and paper. Um your and you identify your core values. You write your own mission statement. And my favorite sentence in my current version of my mission statement because I redo it every so often is my purpose here on this planet is to help others.

I know that like I I at a cellular level I know that. And any day that I've done that I've succeeded. And that is true regardless of what my performance review says, regardless of what Google says about me, regardless of what my boss might have to say about me. Now, [snorts] I have the most amazing boss I've ever had, so she wouldn't say that about me, but um you know, I know that I helped somebody today. And because I've helped somebody today, I have succeeded. I am now measuring my own success because I know what my core values are and that's something that was really really important for me to be able to identify um because it really transformed the work that I was doing with clients. You know, I've worked in community mental health before where the way that my performance was being measured was how many sessions I did in a month or how much I was billing for the department that I was working in.

And I didn't become a therapist to be billing a certain amount every month um for the company that I was working for. But I lost sight of that because the demands come down from management. And you know, thankfully I'm at the place in my career where I've been able to make some jumps and make some really crucial decisions so that now I'm at a place where my personal values also line up with the mission of the organization that I'm working for. And I I have hard days and there are days that I'm stressed out. There are days when I feel like there's not enough hours in the day. But at the end of the day, I know that I've done my best. I know that my CEO supports me and values me as a human regardless of how many sessions I did that day and that's been hugely important in my ability to sustain myself.

How often would you recommend that for example a therapist revisits? I know you said you revisit that every so often. I know it's probably not going to look the same for everybody. How often would you recommend? So [snorts] the mission statement exercise itself I try to do about once a year and then the core and and yeah the core values is all wrapped up in that too. It's like one document that Dr. Gentry has and it it just really it there's something super impactful about seeing it written down on paper and just having it as a reference pulling into as [snorts] like here's who I am and here's why I do this work. And some of the education that I do with clients is um the external versus the internal locus of control. Oftentimes we're seeking some sort of external validation. We're we're waiting for the hospital administrator to realize how hard we work.

We're waiting for um you know the supervisor of the department to recognize how much overtime we've put in. But then we're constantly chasing somebody else's approval and we're losing sight of all the good work that we're doing in the meantime, right? And it just feels like you're on this hamster wheel that you can never get off of. So instead, you want to shift to where you're doing it for yourself because of your own core values. I feel it at a cellular level. I I have sat in my car before and and parked in the parking lot and been like, you have to go into the building. Yeah. You can't sit in your car all day. You have a mortgage to pay. Like I've been there. I know what that. And in that moment, it feels like, no, I've got to I I have to stay here. Okay. So, Dr. Gentry literally wrote the book on compassion fatigue.

Wow. Now, this one obviously is not a free um resource, but he does have a lot of stuff available for free, which I really respect. Um and we thank you, Dr. Gentry, Natasha, obviously, but but truly for bringing his work to us and what you've learned. Um I'm going to make sure I link all of this. I would also love to link your contact info if if that's okay. Um, I know I'll be I'll be reaching out to you. Um, thank you so much for being here. You've so happy to be here. You've opened it all up and we got to meet your family. So, next time we've got a the 5-year-old's got to make the appearance.