Karl D. LaRowe M.A., LCSW International Speaker and Author ... · •Stress from challenging situations and events plays a significant role in cardiovascular symptoms and outcome,

Karl D. LaRowe M.A., LCSW

International Speaker and Author

www.compassionfatigueseminars.com

Stress Releasing Exercise

Shoulder rotation with “dynamic tension”

Focus on muscles in neck and shoulders

Tighten/squeeze the muscles

Breathe in and rotate shoulders up and back

Visualize all the tension in neck and shoulders

break into small pieces

Discharge/release all of your stress/tension as

you allow your breath out with a rush of relief!

Check-In (Journal) How was your month?

Overall – how did it go? How did you feel?

How did you apply what you learned last month? What was different this month with clients/coworkers/self?

Releasing/replenishing energy? Did you remember? What did it feel like?

Process of observing yourself What does it feel like? How/what was easy/difficult? What

are you learning about yourself?

Process recordings: What was your experience of doing them?

What You Did Well (Process Rec)

With one other person describe an interaction/counseling session that went very well last month

Describe the context/situation/issue

Describe what you did/said/felt/sensed

Describe this person/client’s response

Describe how this impacted your relationship with this person/client

What personal strengths did you utilize?

How did you feel after this interaction?

The Experience of Focusing on Strengths/Competency What is your experience of focusing on your strengths,

your sense of competence?

Where does your focus of attention go?

What happens to your “intention”

How does it feel in your body/mind – your sense of self?

How can you begin to “transfer” this experience to helping clients focus on their strengths?

What would need to change in your counseling approach, methods, focus?

What would you need to change inside yourself?

“When the frozen energy of Compassion Fatigue is absorbed and internalized one of two things can happen. Either the energy accumulates and exacerbates Compassion Fatigue, or the energy is discharged through conscious breathing and mindful movement, activities that transform “energy residue” into flow and peak performance.”

- Karl D. LaRowe M.A., LCSW: Breath of Relief: Transforming Compassion Fatigue into Flow

The Changing Paradigm

“…therapy needs to consist of helping people to be in their bodies and to understand their bodily sensations. And this is certainly not something that any of the traditional psychotherapies, that we have all been taught, help people to do very well.”

- Bessel van der Kolk, MD

Somatic Awareness

“Mind doesn’t dominate body, it becomes the body. Body and mind are one.”

– Dr. Candice Pert:

“Molecules of Emotion”

Your Body IS Your Subconscious Mind

The changing paradigm

Brain, body and mind

The psychosomatic network

Molecules of emotion

Emotions are in the body

Emotions and information

The body remembers

“The body keeps the score”

Somatic memories

Interview with Dr. Peter Levine Somatic Experiencing

Residual energy

The fight/flight/freeze response

“Corralled” un-discharged, frozen residue of energy in motion

Persists in the body as physical sensation

Split off, dissociated from the self

Can be automatically triggered

Triggers symptoms of trauma

Energy Residue

The Body of the Self The sense of self

Sense of being connected to our bodies

Physical/emotional feeling of presence

The “gut-brain”

Digestive/immune system

Sense/feeling/intuitive

The “heart-brain”

The intelligent heart

Emotional center

Reduce your stress to protect your heart

•A growing body of evidence suggests that psychological factors are — literally — heartfelt, and can contribute to cardiac risk. •Stress from challenging situations and events plays a significant role in cardiovascular symptoms and outcome, particularly heart attack risk. •Depression, anxiety, anger, hostility, and social isolation also affect cardiovascular health. Each of these factors heightens your chances of developing heart problems. But emotional issues are often intertwined: people who have one commonly have another. •Many studies have documented that various forms of stress can take a toll on the heart

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14 © 2008 Institute of HeartMath®

Heart-Brain Communication

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EmWave Biofeedback

Based on new research by Heartmath.org.

Heart/brain communication

Heart rate variability

Heart rhythms

Psycho-physiological coherence

Neuroscience Research Centre: www.nsrcgroup.com Tel: 6336-0035

Dissociation “The process of dissociation involves a partial or total separation of

aspects of the traumatic experience - both narrative components of facts and sequence and also physiological and psychological reactions.” - The Body Remembers

Dis-integration of the sense of self

Mind/body disconnection

Separation from experience

Detachment , depersonalization, derealization

Compartmentalization

SIBAM Model of Dissociation Sensation

Image

Behavior

Meaning

Affect

Sensation

Body awareness

Internal sensation

Senses in present

Physical feelings

Energy awareness

Image/Impression

Concrete memory

Images from past

Symbolic / representational

Symbols

Pictures

Behavior

Posture

Movement

Intentional movements

Facial expression

Breathing

Affect

Emotions

Emotional feelings

Emotional expression

Meaning

Realizations

Understanding

Coherence

(New) Beliefs

Integration

The Felt Sense

As a tool to connect with the self

A “portal” to internal body sensations

Experience the emotions often trapped behind

our sensations

Blends energy, awareness and information

Unbinds and frees energy

The Body as a Resource Utilize your “felt-sense” to identify the body

sensations of “energy residue”

Notice where in the body the sensation of tension/blocked Energy in MOTION

Sense the overall quality and feel of the sensation/feeling/emotion

Breathe energy/awareness into sensation

Feel the emotion of the sensation

Allow the body (part) to release the energy residue of the sensation

Somatic Awareness Exercises

Sense of boundary at skin level

Rubbing surface of skin (not massaging muscles) - with own hand, towel, pillow, against wall.....

Feeling where clothes touch skin; where body meets chair....

"This is me. This is where I start / stop. This is my boundary".

Somatic Awareness Exercises Sense of solidity of bones

Awareness of spine - against wall, sitting, standing.

Tapping bones at elbow, wrist, knee, ankle.

Muscular tension

Tensing parts which feel vulnerable / shaky.

Using hard chair / upright posture.

Muscular resistance in legs, arms, internally.

Compare stretching / tensing.

Grounding Sense of connection with body

Connected, solid, safe, in the body

Body/positional awareness

Connected with external reality

Externally aware/focus, sights, sounds

Here/now orientation

Sympathetic de-activation

Breath: Longer, slower, deeper

Grounding Techniques Pay attention to BODY SENSATIONS - feet on

floor, body weight, posture.

Refocus eyes - move gaze around room.

Reconnect to SIGHTS, SOUNDS, SENSATIONS.

Shift position in chair - sit upright .

Take a deep breath - follow breath in body.

Wriggle toes.

Touch watch, ring, arm of chair, clothing...

Pinch muscle between thumb and forefinger.

Dissociation in Session

Emotional Recharging A basic tool for “re-setting” the ANS

Emotional “re-set” technique

Protects against emotional exhaustion

Somatic awareness, conscious breathing mindful movement, creative visualization

Disengages sympathetic response

Creates calm, safety, connection

Recharges your energy

Emotional Recharging Technique

When you FIRST notice yourself “froze-up & run down”:

Stop!, relax, breathe, regain your balance

Discharge the energy residue

Focus on connecting to your body, allow yourself to calm down

Breathe slowly, deeply, nurture your inner strength/calm

Rotate shoulders/tense relax

Listen/connect/nurture to your “sense of self”

One hand over heart, one hand over stomach

Re-focus your attention on being safe inside your body

Review and Incorporate

What did you learn today?

What new information did you learn?

What did you learn about yourself?

How might this new information change your way of thinking, feeling or behaving?

How will you use it?

How can you put this new information to work for you?

What changes are you willing to make?

What barriers do you anticipate? How will you overcome them?

Homework Please continue process recordings with a client(s) you

are working well with

Focus on your somatic awareness, i.e., your feelings inside yourself, your body sensations, as you engage and connect with clients - the therapeutic relationship

Personal journals

Please continue observing yourself as you go through your day – pay special attention to those times in which you feel “in the flow” and describe them

Remember to replenish your energy!

Discharge and recharge

Next Month The therapeutic relationship

Primary goal of treatment

The “holding environment”

Engagement/encountering the client

Utilizing the ‘felt-sense” in the listening process

Resistance

Transference

Counter-transference