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| The Supervisor's Role with Compassion Fatigue |
| Columns - Clinical Supervision | |
| Written by David J. Powell, PhD | |
| Friday, 05 October 2007 | |
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One of the most requested topics for me to present on these days is
care of the caregiver — how to overcome compassion fatigue. The topics
of clinical supervision and compassion fatigue are related, as the
supervisor plays a critical, supportive role with supervises.
In my definition of supervision, there are four functions of a supervisor: administrative, evaluative, clinical/educational and supportive. It is the coaching, mentoring (hopefully not tormentoring) and supportive role of the supervisor, which might be the most important these days, with counselors feeling the strain of too many clients, too little time, too much paperwork, and so many people needing help. Compassion and supervision Compassion is an innate, natural condition of the human heart. One does not have to be a saint to find the grace and transformative power of compassion. By the nature of what we do as caregivers, we are called to be willing to pay attention to others’ (and our) pain and its causes, and to commit ourselves to its end. We are asked to develop the capacity to hold adversity, loss, grief and pain — with love. Counselors, on a daily basis, cultivate and sustain compassion for their clients, for those who cause suffering in the world, for those whom we love in our professional and personal lives, and for ourselves. We must not romanticize or idealize compassion. We are not saints — not yet, anyway. Compassion is born of our willingness to meet pain rather than to run from it. Compassion emerges, hopefully, in the darkest moments of our lives. The Dalai Lama said that if we want to know what compassion is, we need only look deeply into the eyes of a mother as she cradles her sick child in her arms. Compassion is the willingness to engage with pain, and in places where there are no loving human beings, we are asked to be one, crossing the divide that separates “us” and “them.” As clinicians, our inclination is, when we are tired, to separate ourselves from the pain of our clients. When we feel we cannot take another painful story told by a client seeking help, we may withdraw behind the veil of a diagnosis, a treatment plan, a therapeutic modality (all of which are necessary for care and treatment but which can become a way of distancing ourselves from the person before us). We want to try to fix it, to make it better for the client, when, in reality, all we can really do is offer our caring, compassion, and loving presence, without trying to separate ourselves from “them.” We are dedicated doers and fixers. When we encounter pain, we automatically think in terms of finding a solution. After all, that’s what the client is paying us for, right? Yet, there is not always a solution to suffering, but there is always a possible response. When we are willing to turn directly toward pain, receive it, and embrace it with tenderness, we have begun to embody compassion. Compassion is a response of the present. It asks the question “how do you receive the person who is right before you?” Here is where the clinical supervisor enters. Helping the helper find compassion for themselves in those moments is at the forefront of being able to extend compassion without conditions to others, whose rage, fear and confusion may be no different from that of the counselor. If the supervisor can aid the counselor to understand the pain of their own experiences in their own heart and be willing to stay present and intimate with that pain, the counselor will then be able to find the steadfastness and courage to be present for another person tangled in the same pain. Supervisors embody this compassion in how we approach supervisees. For compassion to make a difference it must be embodied, rooted in wisdom. So, supervisors, to help supervisees face their fatigue and desire to avoid pain and suffering, offer in yourself a heart that trembles in response to pain, and offer the capacity to “feel with.” Supervisors, and counselors are transformers, offering another the wisdom of their lives. Your willingness as a supervisor and counselor to be present to another’s pain is the midwife to compassion. When you find yourself tired, be aware that most likely what we are really experiencing is a sense of helplessness and powerlessness, an inability to fix things for the patient in pain, which is exactly how the patient feels, hopeless and helpless. What is asked of us in that moment is to choose to make our home in forgiveness, understanding and kindness. So, supervisors, where do you begin in aiding the tired, rusted out counselor? As Socrates said thousands of years ago, “physician, heal thyself first.” Ask yourself how often you, too, want to withdraw from life, close your eyes and your heart; to numb yourself and resign to the impossibility of finding an end to the suffering you face daily. Remember, you can never make your staff happy; you cannot make their fatigue go away. You can only be present, and in that engagement with the lives of your staff, you are never helpless. Do you embody hope in your relationships with counselors? Do you cultivate a sense of compassion, loving kindness and generosity as much as you can in the present moment? Do you feel compassion for yourself, for your counselors, for your clients? A Chinese proverb says if you keep a green bough in your heart, the singing bird will come. Compassion invites you to keep a green bough in your heart. Storms come in our personal and professional lives — new requirements, more tasks, less resources to help, and what often seems to be declining payoffs. We cannot predict when the storms will end, but the storms of life always do. Remaining committed to ending pain allows the supervisor to help the counselor embrace the pain of this moment rather than looking for the end of the storm. Today, become the supervisor of compassion you long to be.              |
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