By Arianna Monge, MusicWorx Intern

“Helpers carry a heavy load, they listen, love, cry, and often go into the depths of others’ pain. They sometimes enter darkness that no person should have to step into: the darkness of the abuse of a child, of mental health, of our cultural propensity to sit back and do nothing about it. They bear this each day.” – Jenn Bruer, Helping Effortlessly: A Book of Inspiration and Healing.

For music therapists, caregivers, teachers, physicians, nurses, social workers, paramedics, psychologists, and child-life specialists, vicarious trauma is a natural consequence of the work we do. Stress and trauma acquired in doing the job, when left unaddressed, results in compassion fatigue. Compassion fatigue is “the profound emotional and physical exhaustion that helping professionals and caregivers can develop over the course of their career as helpers” (Mathieu, 2015). MusicWorx Intern TaylorLyn explored how we can “get through the muck” by leaning into difficult feelings.

As a music therapy intern in an Adult Medical setting, I’ve witnessed joy from the spirit, healing, and progress in my patients. In the same day, I’ll hold space for my patients’ trauma, or family member’s grief and fear. While the work continued to leave me in awe, I found it increasingly harder to cope with the vicarious trauma. My worldview began to shift from working closely with those who have experienced illness, trauma, homelessness, violence and abuse. I noticed myself become fatigued, irritable, anxious and completely off-center. If I continued this trajectory, I’d burnout quick. I knew I couldn’t be the only one who felt this way.

While compassion fatigue and vicarious trauma are specific to helpers, burnout can affect any profession. Excessive and prolonged stress, overdoing things, not being centered, and not listening to yourself or your body are all contributers to burnout. Those on the road to burnout may experience physical, emotional, and mental exhaustion, feeling overwhelmed, hopeless and unmotivated.

Signs and symptoms of burnout:

 Physical:

• Feeling tired and drained most of the time
• Lowered immunity, frequent illnesses
• Frequent headaches or muscle pain
• Change in appetite or sleep habits

 Behavioral:

• Withdrawing from responsibilities
• Isolating yourself from others
• Procrastinating, taking longer to get things done
• Using food, drugs, or alcohol to cope
• Taking out your frustrations on others
• Skipping work or coming in late and leaving early

Emotional:

• Sense of failure and self-doubt
• Feeling helpless, trapped, and defeated
• Detachment, feeling alone in the world
• Loss of motivation
• Increasingly cynical and negative outlook
• Decreased satisfaction and sense of accomplishment

Be Here Now

Whether you recognize the warning signs of impending burnout or you’re already past the breaking point, trying to push through the exhaustion and continuing as you have been will only cause further damage. Overcoming burnout requires the “Three R” approach:

Recognize

• Watch for the warning signs of burnout

Reverse

• Undo the damage by seeking support and managing stress

Resilience

• Build your resilience to stress by taking care of your physical and emotional health

Perhaps you’ve recognized signs of burnout—now what? How does one manage stress and build resilience?

Therapeutic Approach for Wellness

When I first learned about self-care, I was a brand new music therapy student. I didn’t know then how much I would come to lean on the self-care strategies I’d develop over the next few years. You can read more about MusicWorx intern Katie’s guide to self-care here. Self-care is important because it allows us to sustain ourselves in the chaos of our everyday lives. As music therapists, we advocate for the health and well-being of our clients. We must also take the time for treating ourselves with the same attention and kindness we give to our clients.

“Overall, we recommend that therapists do for themselves the self-nurturing, self-building things they would have their clients do. Increasing our awareness of our needs and remaining connected with our bodies, our feelings, and other people will strengthen us as individuals and allow us to choose to continue to do this important work” -L.A. Pearlman (1995, p. 62)

In music therapy, the music therapist will first assess the strengths and needs of their client. Then, they develop objectives that support the treatment goals. Next, the therapist facilitates an intervention and evaluates its outcome. Lastly, they are able to adapt the approach. By applying this music therapy protocol to our lives, we allow time and space to connect with ourselves.

Assess

• Ask yourself what you need in this present moment. Start with the most basic needs: water, food, warmth or rest. You cannot acheive your full potential without your basic needs fulfilled.

Set goals

• Determine 1-3 goals to focus on and keep them visible. Write them down and keep it where you can see it.

Break it down into objectives

• Make it manageable for you.

Intervention

• Create, express, debrief, do what you feel you need.

Evaluate & Adapt

• Self-care is not one-size-fits-all. Find what works for you.

G.R.A.P.E.S.

Another therapeutic technique to help plan self-care is a CBT exercise known as GRAPES. Each letter of the acronym describes a different self-care goal to choose from. Below is an example.

Gentle with self

• Identify negative thoughts and challenge them

Relaxation

• 5-10 minutes of (breathing/yoga/laying down)

Accomplishment

• Clean & do laundry

Pleasure

• Watch netflix

Exercise

• Go for a walk

Socialize

• Call a friend

Sustainability is the goal

Self-care looks different for everyone. What works for one person may not work for the next. We may not fulfill our goals as often as we like. We are human, it happens. What matters is we forgive ourselves and try again. This is how we build resilience while maintaining empathy for our clients. Above all else, self-care reminds us to be kind to ourselves. It is a balance between rest and action. We don’t always have to be in forward motion. The pause is just as necessary and important.

References

• Burnout Prevention and Treatment. Help Guide (2019). Retrieved from https://www.helpguide.org/articles/stress/burnout-prevention-and-recovery.htm
• Harris, A. (2017). How “Self-Care” Went From Radical to Frou-Frou to Radical Once Again.
• Mathieu Françoise. (2015). The compassion fatigue workbook: creative tools for transforming compassion fatigue and vicarious traumatization. New York, NY: Routledge.
• Pearlman, L. A. (1995). Self-care for trauma therapists: Ameliorating vicarious traumatization.
• B.H. Stamm (Ed.) Secondary traumatic stress: Self-care issues for clinicians, researchers, and educators (pp. 51-64). Lutherville, MD: Sidran Press.
• Skovholt, T., & Trotter-Mathison, M. (2011). The resilient practitioner: Burnout prevention and self-care strategies for counselors, therapists, teachers, and health professionals (2nd ed., Counseling and psychotherapy). New York: Routledge.
• Tomlin, J. (2018, December 3). Hierarchy of Needs. Retrieved from https://www.careinnovations.org/resources/hierarchy-needs