Every one of us in a helping profession recognizes that on some level, we are making a difference: for our community, our circle of friends and acquaintances, and the families and individuals we serve. Will they remember everything we provided for them in their moment of need? Maybe not. They may thank us for facilitating the preparation of a funeral, for the kindness we showed when they felt like their lives were falling apart, and if they do reach out, we feel the satisfaction of a job well done. Some won't, and we pass no judgment and carry on. In normal circumstances, we experience death and loss and sadness all the time, and many of us have learned how to strike a balance between work and rest, family and friends.
As soon as the pandemic began, however, we became front-line workers interfacing with families who were reeling from losing a loved one on top of the harsh reality that curtailed traditional rituals like ceremonies and other gatherings to grieve. Showing empathy to our clients has always been a mainstay in our line of work, but this was different, both in intensity and in scope. As we extended ourselves to help our communities find appropriate ways to grieve, we experienced the same fears as the rest of the world. A fear of contagion, fear of carrying the virus to those we love, fear that our community would be unable to cope with the onslaught of illness and overflowing hospitals. We may have also felt concern for co-workers who became sick, and through it all, we had to reinvent the ways we provide support. When so much was expected of us, our hearts became tired, and our stress level increased exponentially.
We had to become experts at juggling our stress while also providing comfort to others. The word "comfort" comes from the Latin – com, meaning "with," and Fortis, meaning "strength." Literally, to provide someone with comfort is to come alongside them with "strength" or "to make someone stronger." And that's what we have been doing this past year. But at what cost? Because we are more than physical beings, depending on the type of traumatic event and the meaning we give to it, our minds and spirits may suffer deep hurt. All of this can lead to Compassion Fatigue, a side effect of the caring, giving, overworked lives we live.
In my field of Disaster Spiritual Care, we concentrate on "devoting presence, attention, and respectful assistance to helping people discern what is the meaning in their lives now, in this new environment of destruction and pain; and how they will seek to live out that meaning as the recovery unfolds." [1] So we start by articulating what we are feeling, thinking, dreading. We have to give a name to what we have been through.
Compassion Fatigue can come on silently, slowing us down and making us feel overwhelmed. It can also hit us like a brick wall: some of us have experienced working at our maximum capacity when, suddenly, we can't go on. No matter how badly we want to. We know that abnormal reactions to abnormal situations, like a pandemic, are normal. This last year can only be described as a mass casualty event – the very definition of abnormal - and no one is immune to its impact. Have you dealt with a family who has had multiple deaths with which to contend? Have you felt the waves of grief, or sadness, or anger if those clients happen to also be friends or family? This is common for many of us working in this field. Those feelings can drive us to work harder than we usually do and can lead to debilitating physical fatigue. While we may not compare to competitive athletes, we would do well to remember the need for rest or recovery time; an opportunity for physical, mental, and spiritual renewal.
We may find that we have a hard time communicating thoughts or instructions or making decisions that would, at other times, be automatic. I have found that I have a limited attention span during times of extreme stress, and I am less able to problem-solve. Many of us react to this increased stress by remaining at work to finish what cannot be accomplished in a typical workday; we may need a nudge or reminder from a co-worker or boss as they gently steer us toward the door. Others of us may leave work feeling like what we have accomplished is just not enough.
Throughout my time with the Red Cross, I have been an ear and shoulder for those in desperate need of respite. Like many others who do this work, we are often the ones who catch the falling when they realize it's ok to let go and share their story; when they realize they need a break or that they can't carry their heavy burdens any longer. Being exposed to the stories – and life is all about stories – from multiple survivors affects a person's empathetic vulnerability to others' suffering. Our hearts may be large, but they are not indestructible, and eventually, what we see, hear, smell, and touch will take its toll.
How do we find our resilience that will enable us to resume our work while protecting ourselves? When life is calm, when we have the leisure to prepare ourselves for upcoming stress, we can map out ways that will work for us; not every solution works for everyone. But self-care is not an option: it is a critical part of the disaster response, as my colleague Rabbi Zahara Davidowitz-Farkas has taught.
It helps to keep in mind the following:
- Know your own strengths and gifts
- Know your own vulnerabilities and triggers
- Don't bite off more than you can chew
- Ask for help, ask for advice, buddy up
Very few organizations have prepared staff for this stress. So, our real challenge is figuring out how we can use what we've learned from this past year by preparing ourselves and our co-workers for whatever the future holds. Tara Hughes, the Northeast Division Disaster Mental Health Advisor for the Red Cross, refers to this preparation as "stress inoculation." She suggests that "preparing responders for the realities of the event will help regulate expectations of the event and themselves, as well as help them predict the intensity of emotion and interpersonal interactions they are likely to experience… Responders need to realize that the goal of effectively dealing with this level of stress is not to get rid of it, but rather to manage it." [2]
Without preparation, when the crisis happens, we're left scrambling for ways to survive. Finding good coping skills to mitigate the trauma we feel takes intention, and it takes work, but these self-protective - not selfish - methods can help restore some of our focus and overall well-being.
- Don't take projected anger personally
- Breathe deeply
- Limit work hours
- Listen to music
- Process emotions with co-workers
- Take brief breaks
- Take longer breaks for rest and relaxation
- Diffuse and debrief
- Stay connected to support system
- Don't forget to eat healthy, drink water and get enough sleep.
Additionally, make use of everything you have at your disposal, including the Virtual Family Assistance Center of the American Red Cross, geared toward supporting those who have suffered a death to COVID-19. Red Cross has brought together resources, both in English and Spanish, with trained volunteers available for Disaster Mental Health and Disaster Spiritual Care to serve both clients and first responders/caregivers. Everything provided by the Red Cross is free and confidential.
To provide others with comfort, whether it is offering condolences, or preparing the bodies with care and respect, or helping a family cope with the enormity of their loss, is helping "to make someone stronger." If we can do that as we comfort our clients and take care of ourselves simultaneously, we will have indeed made a difference in our world and survived to tell the story.
[1] Foster McCurley, 2003
[2] "Stress Inoculation," by Tara Hughes, Northeast Division Disaster Mental Health Advisor
Rabbi Dr. Shira Stern, MHL, DMin, BCJC, is a past president of and certified through the National Association of Jewish Chaplains and currently chairs the Ethics Committee. She has served on the Central Conference of American Rabbis Board of Trustees as the vice president for member services.
She currently has a private pastoral counseling practice in Marlboro, New Jersey, and serves Temple Rodeph Torah of Marlboro, New Jersey, as its educator. Previously, she was the director of community chaplaincy of Middlesex County, New Jersey, and director of the Jewish Institute for Pastoral Care, part of the HealthCare Chaplaincy, providing programs for rabbinic and cantorial students, chaplains, and clergy in the field.
Rabbi Stern was trained by the Red Cross to serve on the SAIR team—Spiritual Air Incident Response Team (now the Critical Incident Response Team)—and worked for four months at the Liberty State Park Family Assistance Center in the aftermath of 9/11.
Her selected works include “Visions of an Alternative Rabbinate,” CCAR Journal, and “Healing Muses: Music as Spiritual Therapy,” Jewish Relational Care A to Z.