| I recently came across a term I hadn't heard before, "crisis fatigue" Crisis fatigue occurs when our ability to be resilient (or "bounce back") is flooded with an ongoing series of intense, energy-consuming or traumatic experiences. As best as I can tell, it's a form of burnout. Crisis fatigue, like burnout, is a response to ongoing and intense stress, like that faced by people trying to survive war or armed conflict, economic or financially stressful conditions, political instability, natural disasters, or - yes - a pandemic. Based on what I'm hearing from my colleagues and patients, many of us are facing crisis fatigue. |  Photo Credit: Nataliya Vaitkevich, from: https://www.pexels.com/photo/matchsticks-on-pink-surface-6837623/ |
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One of my relatively new responsibilities in my job is helping people with insomnia. I use a modality called "CBT-I" or cognitive behavioral therapy for insomnia for the most part, but occasionally I get to work with people on dreams, especially when they're trauma-related. I love doing this work as it tends to be rich, satisfying, and full of meaning for the people I work with. For nightmares, we use a technique called "image rehearsal therapy," which Marsha Lineman summarized in her "Nightmare Protocol" in the Emotion Regulation section of 2nd edition DBT. The basic idea is that you pick a nightmare with a recurring story or theme, and write it down in as much detail as you can muster. You then write an alternate ending to the dream, one in which you deliberately pick an ending that either leaves you in control, overcoming the fear or problem, or trumping over the fear. You then rehearse the dream with the new ending every day, and practice relaxation strategies and stress management techniques both before the rehearsal and after. With enough practice and time, your subconscious integrates the new information and you ideally both change the narrative of the dream and reduce the hold that fear or trauma has over you.  Photo credit: Engin_Akyurt, from: https://pixabay.com/photos/under-water-fashion-woman-1819586/
Let's be honest - No one wants a "new normal." I was working with the idea of "new normal" long before the pandemic hit, but since the beginning of the COVID pandemic, the idea of adjusting to a "new normal" has become more universal. Since I moved to Boise, I've been working with neurological injuries and conditions, and one important aspect of coming to terms with these conditions is adjusting to changes brought on by illness or injury. These injuries and conditions turn peoples' lives inside out and upside down, and adjusting to the changes is an ongoing process. No matter what caused the injury or condition, the adjustment process seems to have some stages in common, similar to a grief process. We are seeing a similar process in people who have survived COVID and societally in our cultural reaction to the pandemic.  Photo by Kindel Media: https://www.pexels.com/photo/woman-in-white-v-neck-t-shirt-smiling-7298391/
 For the past two years, I've been working in nursing homes, offering counseling to seniors dealing with adjustment issues, depression, anxiety and a host of other mental health concerns. During that time, I've learned that there are people who are polite, and people who are just flat-out mean. I recently had the pleasure of trying to interview a gentleman who could not get over the idea that I was fat, and was very obnoxious about it. Factually, he is right - I am fat. I'm not upset about that - it's the judgment and cruelty in deciding that I am less of a human being because of it that was hurtful.
We'll call him "Mr. Jones" for simplicity. When I went into Mr. Jones' room to introduce myself, he immediately said, "Well, you've put on weight, haven't you?" Not hello, not "how are you," - just an immediate comment on my body. I ignored it and introduced myself and told him I was here to talk with him. He, however, could not get past my appearance. I went to sit down, and he said, "You can't sit on the furniture. You'll break it." I let him know, gently and politely, that I had been sitting on the furniture for over two years without a problem, and that I had a job to do. He said, "you're too fat." At that point, even my patience was shot. I said, "Mr. Jones, I am here as a professional and your comments are out of line. My body is not under discussion. I'll come back again on Friday, and maybe we can try this again." So, after you take action, how will you know it's working? The most obvious answer, of course, "I did what I set out to do." Chances are, though, that you'll want to keep track of your progress, and when you reach your goal, want to know what worked to help you achieve it. If you were unable to reach it, figuring out what got in the way can help you when you begin planning again. So, evaluation of both progress and the process are pretty important, and can help you celebrate successes, sharpen your strategies, plan for predictable obstacles, and debrief after your hard work.
So, you’ve planned, you’ve made commitments, you know what you want and how you’ll get it. What next? As Nike famously said, “Just DO it!” This takes courage – it’s new and unknown. And, you’ve worked hard for this. DO it – you can and you will. Look at your task lists – what do you do first? Start going down your list and work your way through them. It sounds simple – and when life goes perfectly, it is. However…  From: http://www.freeimages.com/photo/mousetrap-3-1309124
There are certain ways to maximize your chances of achieving your goal:
So, interestingly enough, I fell off the wagon in regard to blogging. It’s ironic that just as I was talking about goals and achieving them, I did not achieve mine! This is a great opportunity, though, to emphasize the action planning and commitment needed. How DO we create an action plan that is realistic and achievable? After you’ve identified and come up with strategies (your “coulds”), your next step is categorize them. I recommend keeping it simple, so I use three basic piles:
 Petr Kratochvil, Hand Holding Laptop, http://www.publicdomainpictures.net/view-image.php?image=1820&picture=hand-holding-laptop&large=1 |
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