Compassion Fatigue in Foster Care
Compassion Fatigue in Foster Care
Hello to all that read this, I hope you are all well and, in some way, seeing some light shine onto the possibility that we might all be, at least one day relatively soon, free from Covid 19! In this article I explore compassion fatigue in foster care and discuss being aware of it’s presence as well as coping strategies.
Fostering Support Groups to connect with others
We recently held a virtual male foster parents support group which myself and my colleagues not only enjoyed but recognised was an effective means of bringing together people who although do the same noble role might not have an opportunity to share their experiences in an open and engaged manner due to their other commitments.
Our hope is that we can and will continue to offer this space to our male foster parents with the view to ensure that we can all share our knowledge and experiences while offering a sense of community that can manifest some faith in feeling connected to others despite being in Lockdown.
When asked how often we should hold the group, it was explored that due to the current situation with Covid that monthly would be good.
I was slightly taken aback at this initially, as I anticipated that we might be told every 3 months or so. On reflection, I can now see how and why it is so important for people to feel connected to others, especially at heightened times of stress, it is our innate drive to be social beings to feel close to others, it is literally in our DNA!
Being a foster parent is the most noble role that I can think a people can look to undertake, it comes with many challenges that when we first come to the arena of fostering might not be so obvious.
After the “Honeymoon”
Compassion fatigue in foster care is a very real and understandable aspect of caring for very often times traumatised children and young people, who’s very trauma is often related to how they themselves have been treated by other human being in the past. How are these children and young people expected to trust in adults if adults have been their source of danger, fear and trauma?
Simply and understandably, they very often do not.
They may appear to settle in on the surface at least initially when they first come to live with foster parents, but once the infamous honeymoon period is over and the child or young person is able to at least sense that foster parents will not harm them, any more than they have been treated before, they understandably and naturally revert to what is familiar to them.
What is familiar to them is and always will be personal to their experience, but what we can almost guarantee is that rather than this being harmonious, their experience of others has been frightening and traumatic in some way. They will have adapted their behaviour to suit the environment they lived in. These adaptive behaviours that have led to them surviving in often times very complicated and chaotic situations are crucial to their existence, they are consequently important and have been imprinted in their neural pathways within their brain to literally keep them alive.
Now changing the environment in which the child lives does not simply mean that these (essentially protective) neural pathways are able to be adjusted to suit the new environment, they are organically imprinted into the very fabric of the organism. These pathways are set to keep the person alive.
Neuroception, the word devised to describe this according to Stephen Porges, PhD, who researched this offers that “not only does the body remember a traumatic experience, but it can actually get stuck in the trauma response mode”.
So even when the threat is gone, the body still perceives danger and its defences stay engaged.
This has consequences that can be far reaching and complicated to navigate, children who have experienced relationships to be traumatic understandably can keep their distance, they avoid social bonding as this is potentially dangerous. Or they seek out attention constantly when it doesn’t matter to them if this is positive attention or not, they simply seek out to know that they exist.
They have often adapted to know their place in the hierarchy of their family structure. Power based ranking relationships become their norm, this can lead to developing high levels of stress hormones, such as Cortisol, with low levels of serotonin (happy hormone) and Oxytocin (bonding hormone) often leaving high levels of norepinephrine.
The general function of norepinephrine is to mobilize the brain and body for action. Norepinephrine release is lowest during sleep, rises during wakefulness, and reaches much higher levels during situations of stress or danger, in the so-called fight-or-flight response.
In the brain, norepinephrine increases arousal and alertness, promotes vigilance, enhances formation and retrieval of memory, and focuses attention; it also increases restlessness and anxiety.
Children who experience relational trauma tend to (understandably) have learnt to avoid relationships in the normal sense of connecting the I’m OK your OK situation, they are on high alert to avoid connecting on a deep level with others, especially adults, in the past these have likely been the source of danger and discomfort.
The Trauma of the transition to foster care
Even becoming looked after and being brought into the care system is in itself a traumatic experience. Imagine someone coming into your home today and without any clear understanding, you being informed you will no longer be living with your family, in your own home, you will need to go and live with another family who you have (very likely) never met before, they live in a place you have never visited before, but do not worry because they are nice people!? This seems fanciful and odd, but this is what happens to children and young people every day of the year.
Human beings’ main function beyond anything else is to survive, all other concerns are secondary. Because as described, we adapt our behaviour to what is familiar to us, what we can predict and what is consistent becomes favourable to us. This remains the case despite whether something is harming us or not, if we can survive it, then it is deemed acceptable.
Compassion fatigue or Blocked care occurs specifically in the fostering world when we are constantly faced with attempting to connect with a child who is fearful of connecting to us or is constantly seeking out attention, due to the damage that relationships have caused them in the past. They can block the care being offered to them as a defence mechanism, this is not thought out cognitively, this is a reaction to past traumatic experiences, much like placing our hand in the fire, we are unlikely to do this again if it hurts.
It can also be that the child is so fundamentally anxious around having their needs met that they are literally by your side all the time, seeking out the attachment they never were offered. Both are just as complicated and difficult to navigate.
When children block the care that we are offering and make attempts to keep us at bay by being avoidant or volatile or dismissing, we are likely to suffer from blocked care or compassion fatigue in foster care. Our own brains reactively notice our efforts are being spurned to connect and as a protective factor our brains respond naturally to what it perceives to be a rebuttal. They simply give up trying to connect and do what is simply required to get by, we do the basics we cook, clean and get them off to school on time…. All the while with a sense of having to walk on egg shells in your own home.
The other side whereby we do not seem to have a second to ourselves because the child is so desperately needy can also lead to compassion fatigue, you quite understandably can run out of compassion.
Self-Awareness of Blocked Care or Compassion Fatigue in Foster Care
Noticing we are in blocked care or struggling with compassion fatigue is often the first step in working through this. It can understandably be difficult to recognise when we are struggling in such a manner. We might be too busy to even pay attention to it, we may be hiding from recognising it through a subconscious sense of shame, after all, we did not set out to become foster parents who struggle to care!
Most people come to fostering to be helpful and support children and young people to feel cared for. What is often missed initially is the manner in which trauma impacts children’s capacity to want/need to be cared for. If we look at it from the perspective that children growing up in their biological families can end up being scared of, or reluctant, to trust in adults, it follows that they will be scared of adults or scared they will not have their needs met, this includes well-meaning and committed foster parent adults.
In actual fact in my understanding, the only UK based research on the topic commissioned by Sarah Naish was entitled “No one told us it would be like this”!?
Strategies for Coping
How we move from blocked care or compassion fatigue is in my experience through our understanding of what is actually happening, that the child or young person is protecting themselves from further pain and keeping us at a safe distance, or is seeking out the attention they are drawn to crave.
Once we can comprehend this, usually with the support of our supervising social workers we can begin to focus our attention on changing our attitude towards the child and the situation and offer what is termed an attitude of PACE. (Dan Hughes, Phd)
Playfulness, Acceptance, Curiosity and Empathy are important ingredients that can support us in getting back on track and discombobulating or challenging the child’s brains expectations or preconceptions of adults.
PACE is not a set of strategies but a sense of how we structure our attitude to what we are faced with. It can bolster us to have an idea of how we can navigate things, to be mind minded to think about thinking. To become the viewer so to speak to wonder and question what is actually happening here? What is driving this situation to be the way in which it is?
This can create a sense of safe disconnect from the behaviours, we can so often be faced with, we become the detective, while not taking whatever behaviour is sent our way as personal, although it very often appears as if it is on the surface it is a defence mechanism to great loss and pain from the past.
Playfulness can be a great way in which we can create an air of hopefulness, the part of the brain that is being playful cannot work at the same time as the aspect of the brain that is looking for danger or is upset, they simply do not go together. Playfulness also conveys that enjoyment in one another’s company is possible, that it can be fun etc.
Playfulness is quite possibly the only manner in which children are able to experience connection with others initially, it can however set the blueprint for further trust, leading to being open and engaged to the possibility of relying on others.
Acceptance is very important when thinking about compassion fatigue or blocked care, this doesn’t mean we are accepting of the negative behaviours we may be experiencing but, in the reasons, as to why the child or young person is behaving in such a manner. Offering us an understanding of why we may be faced with the challenging behaviours allows us to be able to be flexible and adjust our strategies to suit the situation. Not taking things personally but taking things instead from the perspective of, “of course you do not trust in me, you have been treated unfairly in the past, but it is my job to convince you that adults are able to be trusted and can be relied upon for support”
Curiosity, while remaining open and engaged and despite any rebuttal we may come up against offers that we are interested, wanting to get to know the child or young person and are attempting to understand their reluctance to want to get to know us, or over reliance on us for them to feel safe. This is very likely something alien to the child or young person and geared toward igniting their own innate but often times dumbed down curiosity into themselves and the world they inhabit. This discombobulates the child or young persons felt sense of who they, dictated to them by the problematic relationships they have experienced as painful in the past.
Feeling connected to others is fundamental to being human, we are social mammals who rely on others to exist in a potentially dangerous and hostile world. When we learn to be curious with ourselves and the world, this opens up opportunities to being fully emersed in the complicated but hugely rewarding process of being part of society, to feeling connected on a deep and meaningful level to others.
Empathy is the route to determining that connection, to feel understood at an emotional level is one of the greatest aspects of being human, storytelling, music and art are open expressions of empathic connection. To look at a beautiful painting or listen to a heart-warming song is connecting with the artist and their expressions.
When we connect, when we understand one another, when we feel held or heard it is at the very core of how far we have come as a species.
Being able to feel trust with others, to learn to rely on them, that our needs can be acceptable and can importantly be met is fundamental to supporting children and young people to thrive, and indeed it is fundamental to foster parents in feeling understood regarding the complex and difficult nature of compassion fatigue.
Compassion Fatigue symptoms
Compassion Fatigue symptoms to be aware of which we might be best positioned to speak with our supervising social worker about.
(Sourced from Nurse and Midwife support)
Recognising the signs and symptoms of compassion fatigue include:
- exhaustion, absence of energy, feeling constantly mentally and physically tired
- apathy, sadness, no longer finding pleasure in activities
- questioning meaning and purpose of life
- difficulty in concentrating and functioning
- isolation from others both at work and/or socially
- difficulty in maintaining inter-professional relationships
- feeling detached from others
- reoccurrence of nightmares and flashbacks to a traumatic event
- unrelenting thoughts and concerns
- receiving an unusual amount of complaints from others
- chronic physical ailments such as gastrointestinal problems, chronic pain and headaches
- reduced motivation to maintain your own hygiene and appearance
- increased pessimism and suspicion
- increasingly blaming and judgmental of others’ actions
- irritability and anger, or
- poor self-esteem.
Taking time for ourselves, being aware that we must care for ourselves to enable us to care for others is such an important aspect of dealing with compassion fatigue or blocked care.
Self-care strategies include: (Sourced from Nurse and Midwife support website)
- joining healthy activities such as exercise, massage, yoga, and meditation
- eating a healthy and balanced diet
- drinking plenty of water
- ensuring you get sufficient rest and sleep
- remaining engaged in family and personal relationships
- organising your life so you become proactive as opposed to reactive, or
- participating in leisure and recreational activities. Difficult at present but there are some wonderful on-line activities that can be sourced.
- Using supervision effectively, not being scared to open up about how we might be feeling. Respite/overnight stays although can feel as if we are in some way abandoning a child can be helpful to ensure some rest and relaxation. Remember it is better to feel refreshed and able to carry on than face the sadness of not being able to care for the child or younger person longer term.
Responsibility of Self-Care
If you are concerned, or others are raising concerns, taking no action will make you vulnerable to physical, emotional and psychological health problems. You have a responsibility to care for your own health needs and it is important to be proactive in maintaining your own health and seek support.
In summary, if you recognise that you might be now or have in the past suffered with compassion fatigue/blocked care, I would highly recommend that you speak with your supervising social worker or another trusted support person.
You will find other blog post that I have uploaded in the past that may be of some assistance to you regarding self-help, mindfulness and breathing exercises.
Thank you for taking the time to read this blog and I wish you all the very best now and into the future. Take good care of yourselves
Information regarding the signs and symptoms of compassion fatigue sourced from https://www.nmsupport.org.au/workplace/compassion-and-compassion-fatigue
Therapeutic Parenting Lead at Regional Foster Families
I am the fostering agency Therapeutic Parenting Lead (DDP informed) and started my counselling training in 2011 becoming fully qualified in 2016. I have worked for the agency for the last 13 years.
My qualifications in respect of therapy are an advanced diploma in integrative counselling which is accredited by the British Association of Counselling and Psychotherapy (BACP) whom I remain a registered member with.
I spent three and a half years volunteering at Personal Recovery Services as part of my training, an organisation that specialised in working with historic sexual abuse, working with both adults and teenagers.
I have consequently gone on and trained in Level 1 and 2 of Dyadic Developmental Psychotherapy (DDP).
I have worked in various roles in the social care field specifically with looked after children for the past 20 years. I was a deputy team manager of a specialist (children’s) outreach team dealing with crisis interventions, a deputy residential home manager, an NVQ assessor (up to level 4 management), a trainer in dealing with challenging behaviour, drug awareness and therapeutic parenting.
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