Compassion fatigue and the yetzer hara

Compassion fatigue is a real thing. It is devastating and results in many good people giving up. We forget to take time for ourselves to heal. We give and give and give until we have nothing left for ourselves. We feel that our work is never done.

This is the work of the yetzer hara, the Jewish idea of the “evil inclination”. It says that we have to do it all and save everybody. It says that if we lose one, we’ve failed completely. It says why even try if we can’t fix everybody?

But we don’t fix anybody. We are there to help, and they have to want it. They have to do the real work.

The longstanding idea is that a person has to hit rock bottom to get help, and that they have to ask for it. They have to bring themselves to treatment – it can’t be forced on them.

In a way, this is frustrating. We don’t wait to do CPR on a person who has a heart attack. We don’t ask a drowning person if they want to be rescued. We just do it. We don’t stop first and get them to sign a consent form.

But mental health, often intermingled with substance abuse, is different. To be truly mentally healthy requires not just a change in mindset, but a change in lifestyle. Everything has to shift to keep the process going correctly.

Thus it isn’t up to the caregiver or the facilitator or the mental health provider to “make” the person well. It is up to her or him to keep the ball rolling. The caregiver shows the path – the client has to walk on it.

They have to take their medicine. They have to go to their doctor’s appointments. They have to reduce stress. They have to eat well. They have to exercise daily. They have to get enough sleep. They have to do all the little things that add up to the big thing, the only thing – being stable and sober and well. Balance is hard to achieve. It takes a lot of work.

Getting mentally healthy isn’t like buying a new car. You want to get to “health” and you are tired of walking there. So you want to make a quick change and get there the fast way. You buy a new car and fill it up with gas. But when you get there that way, you still don’t know how to really get there on your own.

It is more like buying a piece of the car, a day at a time. Every day you work closer to the goal. Eventually you have enough pieces that you are able to learn how to put it together. Then you have to get lessons on how to drive it. Then you practice. Finally, you can do it.

It takes years, but all that hard work means that you know how to do this on your own. It means that when the car breaks down, you know how to put it back together. It means you know where the pieces come from. You learn that you have to maintain that car every day or it will break down.

You can’t be driven to mental health. You have to get there on your own.

It should be the goal of the mental health provider to show the client what pieces will work, how to maintain them, and how to use them. They aren’t there to drive the client but to teach them how to drive themselves.

Thus – don’t feel guilty if a person seems stuck on the road. They have to do the work. They have to want to get better. It seems frustrating to watch them struggle, but that struggle is what forces them to make a decision. Work on getting healthy, or go the easy route and stay sick? Pain is a strong motivator to make better decisions.

It is like a baby bird. If you help it get out of its shell, it won’t have built up the muscles to survive. It can’t get help flying either – it has to be strong enough to fly on its own. If you cheat it of the work, it will fail.

Meanwhile, as a caregiver, you have to take extra care of yourself. Don’t get pulled under by the drowning people. Take extra time for yourself. Focus on what you can do, not what you can’t. Focus on your successes. And remember, sometimes you can’t see results right away. Sometimes the result, the reward, of your hard work will “bloom” later, in a way you’ll never see. Trust the process.

Happiness is a front

A Volkswagen bug is a car that brings smiles to people. People smile when they see it. I notice this every time I go for a drive. I think it brings back good memories from their childhood. I also think there’s something special about the shape – all curves and no angles – that is soothing to see.

But the new Volkswagen bug is very difficult to repair. It isn’t as easy as the original ones were. Apparently you have to take almost the entire engine apart in order to fix anything. The designers who created it didn’t think that it would ever break down, so they didn’t make it easy to repair. This means it costs hundreds of dollars in labor every time I have to take this thing in.

So behind the smile there’s a lot of pain for me. The bystanders don’t know this.

This is very true for a lot of happy people. They aren’t happy because nothing bad has happened to them. They’re happy because bad things have happened to them and they’ve grown through them and because of them. The bad things made them stronger. Other people see their happiness and it spreads to them. Meanwhile, they don’t know how much work was required to get to that point.

Poem – thanks for the hard teachers

I am thankful for all my hard teachers.

All the mean people
all the hard times
all the disappointments
all the loss
all the grief.

I’m thankful for all that I did not get
and when I got something
unexpected,
unwanted.

I am thankful,
for these are trials,
tests,
especially tailored
to teach me,
to strengthen me.

I know that I am being called
to learn how to

hear
what cannot be heard

see
what cannot be seen.

Know what cannot be known.

I am thankful.

Love everything. Really?

“And God said “Love your enemy,” and I obeyed Him and loved myself.” – Khalil Gibran

Yup. It means love everybody and everything. Love the ugly bits about yourself. Love the bad situation, too. Don’t resist, and don’t fight it. Love it all, all the time, because it is all from God.

Easier said than done.

I keep reminding myself of this. I keep reminding myself that God is in charge, and everything, even the stuff that I think is bad and terrible and crazy, is from God. I keep reminding myself to be thankful about everything.

I think Jesus had it easy. He died before things got really hard. He died before he had to deal with in-laws, and nursing homes, and do not resuscitate orders, and probate.

Actually, it would be easier if I was handling all of this, because I’ve done it before. I know how to detach myself from the situation and just do it. But I’ve intentionally separated myself from all this because these aren’t my parents. I believe that it is the job of the adult child to take care of their parents, not the wife.

I’m trying not to micromanage. I’m trying to stay out of it. It isn’t easy. It is like watching a baby bird – will it fly? Will it crash?

And there is nothing I can do except watch.

And then I think about the guy I know whose wife died from cancer. He’s faking it, and not really taking care of himself. I want him to do well, but he has to do it on his own. If I make food for him, or remind him to eat, or tell him that he needs to eat more vegetables and exercise and stop drinking caffeine and skip all sugar if he wants to stay balanced – I’m not letting him stand on his own.

He could crash. He could sink into depression. He could kill himself.

These are very real things.

And both of these stories affect me. I live with one, and work with one. If they crash, I have to pick up the pieces. That leaves more for me to do. It isn’t really empathy. It is self-preservation.

I’m trying to remember that God is in charge. I’m trying to remember that people need to ask for help first. Unsolicited advice is never heeded. Jesus didn’t make a habit of going up to people and healing them without them asking for it first.

Jonah gave thanks in the belly of the whale too.

This has to be what it is like to watch a child learn to walk. You want to catch them when they stumble, to prevent them from falling and hitting their heads. You don’t want them to get hurt. But pain is an awesome teacher. And we get stronger if we do things ourselves.

I have to trust that this feeling I’m having is part of God’s plan too. I don’t know how it will be used, but I have to trust.

Because the alternative isn’t very healthy.

still point

Being calm is like being in a small rowboat on a large lake. The motorboats speed by. The waves hit the boat. They threaten to overwhelm it.

The energy from unhappy people is exactly the same. You can choose how it affects you. Do you stand up in your boat and jump up and down, angry that they disturbed your peaceful morning? Doing that only upsets it more.

You can choose to affect them by your actions as well. You can be a force for good by remaining calm. You aren’t adding to the ripples.

When a child falls, he will often look to his parents to see what to do. If they freak out, so will he. If they handle it calmly, so will he. Sick people need to see how to deal with bad situations by watching healthy people deal with them well.

The more peaceful I get, the crazier the world seems to get. It doesn’t seem fair. They should get peaceful along with me. Maybe with time. Meanwhile, I’m trying not to let them rock my boat too much.

This is the same as becoming sober. You don’t notice everybody is drunk until you stop being drunk. Then they are annoying. You don’t notice how everybody reeks of cigarette smoke until you quit smoking.

The trick is to stay calm. Stay sober. Stay peaceful.

Answer the anger with a smile. Don’t yield to it. To yield to it, to agree with it, to follow it is to feed it, to give it energy.

The feeling of anger can be like a bell, calling us to prayer. It can be a reminder to still ourselves and find our center. In this way, a bad situation is sanctified. In this way, pain is a teacher and a friend.

You neutralize a flame with wind or water.

I’m trying to be a calm presence at work, where most of the unbalanced people are. There is still a lot of griping, even though the unhealthy managers are gone. I’m starting to realize that some people aren’t happy unless they are unhappy. Being miserable is their normal. Happiness scares them.

But boy are they harshing my mellow.

On process and pain – chewing the steak.

We all have problems. Don’t identify with your problem.

You aren’t an addict. You aren’t an abuse survivor. You aren’t a cancer patient.

With the new guidelines for talking about children with disabilities, we are supposed to talk about the child first, and the disability second. He isn’t an autistic child. He is a child with autism. He is a person first. He isn’t defined by his diagnosis.

Apply the same rules to yourself. You are a person first. The diagnosis is second. It isn’t you. It isn’t who you are. It affects you, certainly. But you are so much more.

When you define yourself by your diagnosis, you are giving it power, and you are diminishing your own.

Now, you also aren’t going to win any friends if you are constantly talking about your terrible childhood or your abusive husband or your sciatica or how you have to take care of your Mom with Alzheimer’s.

We all have problems. We all have something we have struggled with. Sometimes we have overcome it. Sometimes not. Sometimes it seems we can’t ever catch a break. But if you only talk about this, you are going to be lonely. The only companion you will have will be your problems.

Buddhism has a story that speaks to this. A lady’s child had died, and she was unable to accept it. She carried her dead child around the village, going to every house asking for medicine. They were all horrified. One kind person suggested she go to the teacher and sent her to Buddha. Buddha told her to go to each house and ask if they had experienced a death in the family. If nobody had died in that family, she was to get a mustard seed from them. She was to collect all the mustard seeds and bring them back to Buddha, who would then make a medicine for her.

She went all over the village and wasn’t able to find a single family that had not experienced death. She came to realize that her experience wasn’t unique or special. She came to realize that death was part of life, and to hold onto it and identify with it was causing her more problems than the death itself.

Simply going to each person’s house, she created her own medicine. Buddha taught her to look outside of herself, and to not identify herself with her suffering.

How often do we hold on to our pains and sufferings, just like that lady carried around her dead child? How often do we think we are alone in our suffering, that we have it worse than anybody else?

We all suffer. That is just part of life. Holding onto it makes it worse. Accept your loss and your pain, but don’t identify with it. Accept it, because to not accept it means to not process it.

Pain, like a big steak, needs to be chewed thoroughly to be digested. Choke it down and you’ll get sick. Spit it out and you’ll miss the lessons it has to teach you.

Pain teaches us about holding on and letting go. It teaches us about what we think we have to have in our lives and what we really need. It teaches us to accept, and live in the now, rather than in the past or the future.

The past never was as awesome as we think it was. Even in the past we were looking back to “the good old days” and thinking about how great things will be “if only I get…if only I can have…when I finish…” In the future we will do the same thing.

The only island is now. When we aren’t on that island, we are drowning in the sea, stuck away from the solid stability of that island. The past isn’t real. The future isn’t real. The more we live there, the more we are missing out on the only real thing that is, and that is now.

How to get back to now? Start looking at it. Start being thankful for it. Make a gratitude list. Notice what you have, right now, and be thankful.

Pain teaches us about ourselves.

Once we are through chewing on it, we need to swallow it, and then digest it. Then it does its work and then we have to let it go. Holding into pain is just like holding onto poop. We get sick if we can’t eliminate our toxins. But it still has to go through us, all the way. Resist it, fight against it, and you’ll only hurt yourself. Just like a tree in a strong wind, if you don’t bend, you’ll break.

“I’m sorry” – on forgiveness.

There is a difference in saying

“I’m sorry.”
or

“I’d like to apologize for…”
or

“I’m sorry that you felt hurt when I….”

They reflect different degrees of admitting responsibility. They reflect different degrees of accepting how the other person has been hurt by your actions.

There is the true sincere apology statement, and then there is the one where the person understands the social obligation of at least acting sorry. One is real, the other is fake. Don’t be mislead. Even saying “I’d like to apologize for” doesn’t mean anything. The person would like to apologize, but isn’t actually doing so.

And worse, saying sorry doesn’t really even mean anything. If you hammer nails into a tree, and then pull them out, there are still holes there.

Expecting the victim to forgive can actually revictimize her. It puts the burden on her, instead of the abuser. It minimizes her feelings. It glosses over the reality of her pain and loss.

If there has been no apology, no restitution, then there is no closure or healing. Even if there has been an apology or restitution, then is no guarantee that closure or healing has taken place. Once a person has been harmed by another person, sometimes saying “sorry” won’t fix it, and the damage is permanent, especially if the offender has a habit of repeatedly hurting people.

It isn’t fair to the victim to expect her to forgive at all.

Sure, Buddha says that holding on to anger is like drinking poison and hoping the other person will die. Sometimes you have to forgive so you can go on with your life. But forgiveness comes when it comes, and no sooner.

Saying “Aren’t you over that by now?” isn’t kind, or helpful.

Saying “But have you forgiven him in your heart?” makes no sense. What about the liver? Is it OK to still hold some resentment there?

It is the same as getting frustrated with someone who is grieving. Grief takes time, and there isn’t a fixed amount. It takes as long as it takes.

I think people are nervous around grief, or unforgiveness, or anger, because it frightens them. They want to rush right ahead to the happy bit, where all is good and everybody is loving and kind. That Hollywood ending isn’t real. That’s why it is in the movies.

Movies don’t show reality. Sadly, a lot of us have used movies as our role models. This is why a lot of us are in pain. A lot. Our reality never matches up to that reality, and we feel like we are doing something wrong.

Working through feelings is a long process, and our society doesn’t give a lot of help along the way. You have to process your pain, just like how a cow chews its cud. You have to work on it, and wait, and work on it a little more, and wait. You have to transform it into something else. Cows transform grass into energy for their muscles, and then milk.

There is a sort of alchemy here.

Trying to take shortcuts on the process only results in it not really being processed. It will come out half way, unfinished, lumpy. It will come out sideways, if it comes out at all. Sometimes it will get stuck inside, with little jagged bits poking into your soft parts, just causing more pain.

Take as long as you need.

You don’t have to forgive to the extent that you let the abuser hurt you again. You don’t have to forget.

It helps if you can move on, where this rock of grief and pain doesn’t define you, doesn’t limit you, doesn’t keep you stuck in one place.

Work on it. Chew on it. Draw. Paint. Write. Go for a walk. Take your anger with you.

You aren’t running away from your anger and pain and loss, you’re using it as fuel. You’re transforming it into something useful and necessary. It takes a while. It takes as long as it needs to take.