Self-Care Primer for Disaster Helpers
© 2005 Babette Rothschild, MSW, LCSW

Download a pdf version of Self-Care Primer

** This primer was created for ALL those helping survivors of the recent hurricanes and other natural and terrorist disasters. Included are mental health professionals, medical professionals, and all rescue and recovery workers. Please feel free to copy and distribute this information, including forwarding it electronically, to anyone you think might find it of use, also those helping in other disaster situations. There are several points covered below, do not expect all of them to apply to you. Please take what is useful for you and disregard what is not. **

Contents:
1) Preventing and Alleviating Compassion Fatigue
2) Preventing and Alleviating Vicarious Trauma

1) PREVENTING AND ALLEVIATING COMPASSION FATIGUE

• First and foremost, you MUST take care of yourselves as much as possible.
  Get adequate sleep
  Eat regular meals
  Take breaks
  Get exercise: run, walk, lift weights
  Talk with family and friends often
  Remember, if you don't take care of your own basic needs, you will not be able to care of others in the long run. If you burnout, who will take your place? Of course in some situations this will be more possible than in others, but you must do the best you can!
  
• Of course in a crisis, many of you are working 7 days a week. However, as soon as possible reduce work week to 4-5 days. What you are doing is so demanding and exhausting, you absolutely need time to rest and take care of basic things.
  
• Carry your resources with you in your mind, and with pictures or small objects that remind you of them. Create comforting images of favorite people, places, and activities. Take mini-breaks frequently to call up these images in as much detail as possible. You need to remember you have a life and pleasures separate from the distressing (albeit valuable) work you are doing.
  
• Accentuate the positive. Rather than focusing most of your thoughts on the tragedy at hand, spend blocks of time thinking about the good you and the other helpers are doing. Pay attention to how many lives you are helping and saving more than how many were lost or destroyed.

2) PREVENTING AND ALLEVIATING VICARIOUS TRAUMATIZATION

When a helper "catches" the trauma of those being helped, vicarious trauma can develop. There are some simple things you can reduce your risk and possibly prevent this altogether.

• Remember that you are not a victim, you are a helper. That means you have strength and resources available to use to assist others who do not have those abilities right now.
  
• Some of you will be feeling "survivor guilt" that you have not suffered as much as those you are assisting. It is critical to remember that if you had, you would not be in a position to help! So actually, it is fantastic that you are not a victim of this tragedy, that makes it possible for you to intervene and help those who are.
  
• When hearing survivor stories, or when reflecting on your work, it is common to consciously or unconsciously create visual, or auditory images of what has happened to the victims, or to try to feel what it was like. This can actually be very harmful to you. Such imagery is a major factor in vicarious trauma because it makes you feel like a victim and/or eye-witness. Where possible, avoid the creation of such images and states. Instead, create other images-neutral or pleasant-to keep up your mood and strength.
  
• If you find that visual and/or auditory images are inevitable, you can learn to control them. Try putting the visual image on a screen and the auditory ones on a tape player in your mind. Then practice manipulating the controls. For visual images, change the size and distance of the screen. Slow down the action and speed it up. Change the color mix to black and white or sepia, etc. For auditory images, speed it up and slow it down, change the pitch, add in other sounds that might not belong, if there are speakers, change their voices. The idea is for you to learn that these are 100% your images and you can control them rather than feeling victimized by them.
  
• As much as possible, avoid over-identifying with the people you are assisting. Internal language like "That could have been me." "What if that happened to my child (parent, sister, etc.)?" "How could I...if..." Etc. will all make your job harder. Remember, the advantage you have as a helper right now is that it did NOT happen to you. Because of that you have resources to help. Over identification could risk sapping those resources.

** Any of you who continue to have difficulty with compassion fatigue or vicarious trauma are welcome to contact me by email or by phone. I will try to do what I can to help or refer you to other resources. **
------------------------------------------------------------------------------------------
Babette Rothschild, MSW, LCSW
PO Box 241778, Los Angeles
California 90024, USA
Tel: (+1) 310 281 9646
Email: babette@trauma.cc
Website: http://www.trauma.cc
Author:
· The Body Remembers: The Psychophysiology of Trauma and Trauma Treatment
· The Body Remembers CASEBOOK: Unifying Methods and Models in the Treatment of Trauma and PTSD
· Help for the Helper:
The Psychophysiology of Compassion Fatigue and Vicarious Trauma
(All published by WW Norton)

http://www.tlcinstitute.org
This information is made available courtesy of The National Institute for Trauma and Loss in Children (TLC), a non-profit 501(c)3 program of Children's Home of Detroit (CHD). If you have questions that you would like to ask our TLC Certified Trauma Specialist on staff, or would like a recommendation for a TLC Certified Trauma Specialist in your area, please call TLC toll-free at 877-306-5256 or email us at steele@tlcinst.org

Download a pdf version of Self-Care Primer

Adobe Reader is needed to open pdf file.