Cycles versus Spirals- Developing the skill of sustainable compassion

Third in a series of five posts

Compassion provides us the breathing room we need to keep on keeping on.
Laura Van Dernoot Lipsky, trauma social worker and educator

How can we learn to cultivate the skill of sustainable compassion as we engage in caregiving work? In the rest of this series of posts, I suggest ways to attend to this vital aspect of caregiving by becoming aware of what I call cycles and spirals through the lens of body, heart and mind.

A cycle moves from one phase to another around a point of balance. There’s the respiratory cycle, for example. We breathe in and out, keeping ourselves in equilibrium. There is the sleep wake cycle. In a holistic sense, life itself can be understood as an interdependent web of cycles. There are also social cycles. Some are as simple as: I say hello to you, and you respond to me, saying hello in return. Or as complex as: I recognize you as separate from me, and you recognize me in turn. Humans tune in to social cycles readily, noticing with some tension if a greeting is not returned in kind. We evaluate the quality and equality of social exchanges with close attention, even if not on a conscious level. Significant and complex imbalances in the social cycles are the stuff of conversations with close friends, letters to the advice columnists and the subject of many hours in therapy. We seek to understand what went wrong, and to achieve a new equilibrium.

A spiral is a trajectory that spins away from equilibrium. We talk of spiralling into depression, for example, or a situation spiralling out of control. We watch with uneasy fascination as an Olympic skier loses their center of gravity and falls in a sickening spiral down the mountain.
Caregiver burnout, or compassion fatigue, takes the form of a spiral. There’s the loss of a center of gravity. There may be a focus on how systems frustrate our mission, making it seem hopeless or overwhelming. We may focus on perceived deficits in our clients or in ourselves. Over time, what once was a cycle of effort made and satisfaction achieved becomes a spiral of increasing withdrawal and decreasing satisfaction.

Recognising spirals of fatigue in body, heart and mind

We learn compassion through awareness of the body, the mind and the heart. Consider these three aspects of being in addressing spirals that lead to burnout.

In the body we may feel:
-Exhaustion
-Fatigue
-Tearfulness
-Pain
-Tension
-Tinnitus
-Blurriness
-Changes in appetite or sleep
-Inertia – coming home from work and collapsing on the couch
-What a friend calls “going feral”- pop tarts for dinner, for example, only washing the top layer of dishes in the sink, dressing from the pile of laundry on the chair
-Feeling rundown
-Getting sick more easily and staying sick longer

A physical example of a burnout spiral might be inertia and poor eating leading to achiness and thus to more inertia and more poor eating. Darryl heads home very tired from working as an administrator of a nonprofit. They skip shopping for groceries, skip going to the gym and sit on the couch eating pizza and drinking diet soda. They feel tired and achy the next day too, and discouraged by having made that choice, but work is exhausting again, and they find themselves again choosing to eat pizza and veg out. After a couple weeks of this, it is harder than ever to get to the gym after work.

In the mind we may notice:

-Negative self talk
-Difficulty focussing, planning, initiating and or decision making
-Feeling overwhelmed
-Feeling irritable
-Difficulty seeing a way back into real engagement with the work, or a way to get out of work that is damaging us
-Holding grudges against yourself or other people
-Feeling too tired to say no to requests

If you have read this far, you may have enough experience with burnout to draw your own spiral, but here’s one; Jerome feels overwhelmed by the volume of patients at the clinic where he works as a nurse. He is asked to take on some administrative tasks. He feels too tired to negotiate the process of declining this request from his overworked boss, and then feels more overwhelmed at the prospect of these extra duties.

In the heart we may notice:
-Heartache
-Indifference
-Discouragement
-Resignation
-Grief
-Guilt
-Despair
-Decline in imagination, creativity, sense of humor, spontaneity
-Difficulty caring
-Withdrawal

A spiral may be one of withdrawal leading to guilt and to more withdrawal. Joanne decides that she won’t go home for the holidays because she’s so worn out from her work as a doctor at a hospice. She feels guilty about it, and stops telling her sisters as much about her worries when they call, reasoning that, “I wasn’t there for them, why should they be there for me?”