Subscribe
Share
Share
Embed
In Therapy Talk, clinical psychologist and co-founder of It's Complicated, Johanne Schwensen, takes you on a captivating journey through the world of therapy.
In conversation with a diverse array of mental health professionals, the various modalities are demystified, and therapy's intersection with society is explored. Whether you're a therapy-seeker or simply psychologically curious, Therapy Talk offers valuable insights and a fresh perspective on the impact of therapy.
Find your Therapist at: https://www.complicated.life
Music by Kadri Arula
Rebekka & compassion fatigue
===
[00:00:00] As I bear witness to some of the worst atrocities carried out in the name of war that I've come across in my 35 years of living. A concept that has lingered in my thoughts is that of secondary trauma and compassion, fatigue. And this episode I'm joined by Rebecca Lehman. Uh, therapist specializing in these very issues. We'll delve into the relevance of her work, especially during times when we extend ourselves to care for others. Whether it's through caregiving. Writing volunteering, activism or teaching. The risk of neglecting our own needs and experiencing burnout is ever present. Rebecca expertise lies in helping those who support others. And in the next 30 minutes, we'll unfold the nuances of her work. And explore methods for maintaining, not pausing our ability to support and stand up for others. Also, if you stick around until the end of the interview, Rebecca will graciously lead us [00:01:00] through meditation. I hope you find it as beneficial as I did.
Track 1: I am so happy to
have you on today, and
rebekka_1_10-26-2023_114049: Thanks for having me
Track 1: I wanted to hear you. If before we really kick off the interview, whether you can give a quick
introduction of yourself to the listeners.
rebekka_1_10-26-2023_114049: Sure. Yeah, my name is Rebecca, I'm a clinical and health psychologist and a trauma therapist. I live and work in Berlin, mostly online. Um, yeah, I'm German. I would say East German, actually, because I was raised by parents who were very much involved in the system. Um, so I think that's always something. interesting to reflect on where we actually come from and what else? I practice yoga, [00:02:00] um, and mindfulness and I think it has a big influence on my work too. And I focus on working with people on and helping professions. Um, that's where my, my passion lies to make sure that those who care for others are also taking good care of themselves.
Track 1: And is that then also the majority of your clients? Like will they be in
different types of helping professions
or is it more diverse than, than that?
rebekka_1_10-26-2023_114049: It's very interesting. I think it's, it's quite diverse Um,
and I've been thinking about why that is, and I think people feel very called in this way. Um, you know, when I say that people in helping professions, They're very focused on other people's needs
instead of their own, and they put their own wellbeing very low on the list of priorities.
And I find that the
clients that come to me, not all of them are in a helping profession, but a lot [00:03:00] of them identify with this that, okay, like I've been putting myself last or very low on, on my list of priorities and I wanna change that right.
Track 1: So they can be carrying a mental load due to other factors than being a nurse or being a therapist or. Or so
on. It can be, you know, that they're caring
For everyone and their family's needs, or
rebekka_1_10-26-2023_114049: For example, or
in their relationships, right, that they put it, put themselves last and always look okay, like, what does my partner
want? ,let's
make sure that you know, everybody's Happy before I, I check in with myself. So, yeah, it's quite diverse and I, I enjoy it.
Track 1: And you mentioned that you're, you're a trauma therapist as well. Um, can you
explain what that entails,
what that is? Trauma therapy.
rebekka_1_10-26-2023_114049: Sure. It basically means that
I'm trained,
um, to be very aware of the role that trauma plays in our lives and, you know, the trauma that we've [00:04:00] been through. Um, how that translates into the present moment, let's say. And, um, I have, I work, let's say with this lens, but also particularly for this demographic of people and helping professions, it's a very useful knowledge and background to have and the skills and, you know, the, the tools that, um, that I have from that, because it's a risk group for what is called secondary trauma, which means That we can become traumatized by only listening to the stories that others tell us. Or by, um, yeah, again, and again hearing the traumatic material as we call it, um, what happened to others. , we can also start to develop, uh, symptoms that are very similar to, to post-Traumatic Stress Disorder, for example. So in this regard, it's very, very useful. Um. that I have this focus.
Track 1: I [00:05:00] actually remember that as something that really struck me when I was a psychology student. Um, understanding secondary trauma and then it showing
up as much as it. Did, um, when I started practicing,
rebekka_1_10-26-2023_114049: Mm-Hmm.
Track 1: And, and seeing for instance that, yeah, they also didn't even many of my clients experiencing secondary trauma without knowing that that was what they were going through, told me they didn't even feel they really had the right to feel such
Pain because, you know, they didn't experience that horrific event. It was their sister, it was their brother, it was their, you know, someone else or, or they were like witnessing it and yeah, figuring out
, That can
be a really isolated position
rebekka_1_10-26-2023_114049: Mm-Hmm.[00:06:00]
Track 1: And the helping professionals not readily, um,
having a focus on the witnesses, on the close witnesses of traumatic events.
I think it's a really
interesting, important phenomenon.
rebekka_1_10-26-2023_114049: Yes. And I think it can
be a very lonely place too. And
I just, I think it's great that you learned about this already in university. 'cause I don't think it's always the case that we, that it's included in our training. So it's great that you came into working with this clients, with this awareness already, right?
That
Track 1: Yeah.
rebekka_1_10-26-2023_114049: it might be an issue.
Track 1: But can I just clarify, so like secondary trauma, it, would you consider it like an umbrella term that both entails the type of trauma experienced? If a person witnesses a car crash for instance, but also the secondary trauma from being in a [00:07:00] helping profession where you're just hearing a lot of these stories day in and day out.
You are hearing about traumatic events and, and so then that leads to. Compassion fatigue?
rebekka_1_10-26-2023_114049: Yeah, I feel the difference is not that big depending on
you know, is this your client who's telling you, or is this your sister-in-law, or you know, whoever. But I think it's more about the more you're exposed, you are, which,
you know, psychologists, social workers, psychiatrists maybe are much more prone to this. Um, is the duration and how often you hear it, how regular it is in your life. Right. If it's a One time event,
like, you know,
you hear something had happened to your sister-in-Law, you will have more time to process, more time, you know, to deal with it. Because it's not like, okay, in an hour the next client will come and [00:08:00] we'll tell them about their, their story.
Right. But you have more time to, to adjust and to let it settle into your body also and to, yeah, to work through it. Um. Yeah. I feel just people in helping professions, they're more at risk because they hear it, you know, constantly, let's say.
Track 1: Yeah, that makes a lot of sense. So it almost sounds like you knew straight away from, from. Learning about secondary trauma and, and doing this training that this was something that you'd bring into your
private practice work or,
rebekka_1_10-26-2023_114049: Um, yes,
Track 1: it take a while?
rebekka_1_10-26-2023_114049: I
think so. There was like
a little bit of a development, um, I got very curious about the topic and I looked, okay, are there a lot of parallels,
um, you know, regarding how much our focus is trained to be, let's say, [00:09:00] outside of ourselves, toward the needs for others, anticipating them, right?
Like. Knowing what others need, even before they maybe say it right before they voice it. Um, and this little regard for our own wellbeing. And I saw there's, there's so much
parallels and I think that really got me, got me interested in, in the topic. And I think this realization that, okay, I love working with people and I see it as something meaningful and something valuable in my life. And I kind of saw my future unfold, and I really didn't like what I saw, right? I didn't wanna have to stop working in my field at one point because I'm, I'm gonna drop out due to burnout or something like that, right? Um, I didn't wanna feel like I'm sacrificing my, myself and my wellbeing for this line of work.
I, you know, I started to look for ways where, yeah,
I can be well and take care of other people at the same time. Um, but [00:10:00] yeah, I actually didn't find a lot of resources back then specifically for our population
like this, you know, population of helpers let's say. Um, and um, yeah, we have a quite unique range of challenges, I think. So, yeah, I decided to eventually to become one of that resources my myself. I felt we do such important work in this world and it's a real problem. That's, um, yeah. How little are we, Are appreciated both by the systems we work in, but also individually. And yeah, I guess learning about all of this kind of killed the fire in me,
Track 1: Yeah. And I guess this, this focus of your work also becomes especially pertinent, especially relevant in, in a world where there are more and more, uh, quick fix solutions to mental health. . Problems which [00:11:00] warrants fast-paced therapists. You know, like the, what you could call like the McDonald's of therapy , but people seldom stop to think about for there to be a quick fix.
They're also often
will have to be a stressed out therapist
rebekka_1_10-26-2023_114049: Mm-Hmm.
Track 1: doing 50 sessions a week. I mean, therapists feel pressured to, take on
that many sessions in order to have a decent wage because yeah. The,
the companies offering this
type of, um, you know, round the clock therapy
will, yeah.
rebekka_1_10-26-2023_114049: Yeah, and I think it's a very important point because like this whole work, it's not only about ourselves, right? It's not about saying, okay, you know, you just have to learn how to take a bubble bath once a week. like this is not it at all. But it also looks at, okay, the systems that I live in, that I work in, how do they maybe [00:12:00] hinder. you know, my own wellbeing. How do they support it? What needs to be done there? You know, is there something to do there or there isn't? And this is what makes me feel so helpless, right? Like it has both these things. Of course.
But this is like one of these important things that, um, you have to also
take into consideration the system you live and work in. in order to find out, you know, what isn't working for me and, and how can I get better?
Track 1: Yeah.
Can I just say one thing to that? Um, which is I, um, finished reading the book. We've had a hundred years of psychotherapy and the world's getting worse by James Hillman and Michael Ventura.
And they're just like having, they're having conversations about
what the title implies. And, and then Hillman, he said,. Look at a [00:13:00] person's schedule. Your schedule is one of your biggest defenses. And I was like, I was reminded of that, that, you know, sometimes, sometimes I think therapy is so focused also on like, just like inner work, that they fail to look at some really concrete things.
rebekka_1_10-26-2023_114049: Mm-Hmm.
Track 1: that make up your daily life, such as, you know, how are you scheduling your time? Like, are there any breaks?
Like, are you
constantly staying busy
rebekka_1_10-26-2023_114049: Mm-Hmm.
Track 1: to avoid what Then, you know, like,
um,
rebekka_1_10-26-2023_114049: Yes.
Track 1: yeah, yeah.
rebekka_1_10-26-2023_114049: I think it's very important, especially
for people who are self-employed, right? Like, what kind of system
do I create for myself? Am I a very harsh
boss to myself, right? Am I compassionate toward myself? Do I um,
Yeah. set up my life in a way that serves my wellbeing or [00:14:00] you know, and I think a lot of people who come, for example, out of employment into self-employment, I heard a lot of stories, and I think I experienced some of it myself as well, that you start to create patterns that are
actually not working. But you know, you start to realize, okay,
actually I have the power to make some of these decisions, so
why not make them
Track 1: Yeah. And I've, I've worked in Berlin like you for seven years, and
I don't know the statistics around this, but it seems to be a mecca of freelancers of self-employed people. So I, I mean, I almost only had clients who were self-employed, so this was such a big topic. But yeah, it just creates for a lot of flexibility. But with that flexibility, the self-employed life or the freelance lifestyle also entails so much
like risk of burnout
rebekka_1_10-26-2023_114049: Mm-Hmm.
Yeah. And I think a lot of confrontation
around how am I treating
myself,
Track 1: Yeah,
rebekka_1_10-26-2023_114049: um, [00:15:00] right. And, and, and topics like this. So
it's a very, I think it's a path on its own to, you know, on your self-employed, you can learn so much about yourself. There's so many mirrors constantly all the time.
Track 1: It's true. It's true. So I also wanna get . Into the nitty gritty of your therapeutic practice because on your profile, it says that you work . Not just trauma informed, but also in a culturally sensitive and, and feminist way. So as I'm curious to, to hear like what this means, and also how it shapes your,
your work,
your therapeutic practice.
rebekka_1_10-26-2023_114049: Sure. So helping
professions, um, especially the ones that are not paid well enough are systematically still women's work, right? Um, I read that around two thirds of the global care workforce, so that's paid and unpaid work, or women and [00:16:00] women actually experience 53% more stress than men, with the
difference being particularly big between The ages of 35 and 45. So also when a lot of people have small kids. Right.
is that your age group?
Track 1: I, I have the worst to come. So it's like now, now hell will begin
the, the hell, the gates to hell are
opening, you know?
rebekka_1_10-26-2023_114049: or the gates to a very special opportunity.
Track 1: Yes, yes, yes.
rebekka_1_10-26-2023_114049: So yeah, the caregiving roles in our
families, you know, taking care of children of maybe elderly, of, of sick, um, family members, the tasks around that are still, um, very much distributed in an unequal way. Um, so we have to be very conscious about creating a fair distribution or relationships and our family. It's like almost still going against the grain of what we've been taught. And, you know, we are talking. Here in countries in Germany and and in [00:17:00] Denmark, where I would think feminism has come quite a way compared to some other countries in this world. And still, it's a constant battle, right? If we're conscious of it.
So this can be seen also on a very personal level, like to ask ourselves like, who was the caregiver in the family I grew up in? What was taught to me about the role, about my role in this world as a woman, for example, when it came to taking care of others or as a man as well, right? Um, where was my, my mother on a list of her priorities?
Where am I on my list of my own priorities? So I think there's still like an immense pressure on women until this day, like we're very much encouraged to ignore our own boundaries. To please everyone around us to make sure everybody's taken care of. You know, only when everyone is happy, then we get to rest if ever So I think that's very harmful, um, not only to ourselves, but also, [00:18:00] um, I think there's a risk of becoming resentful toward others and for also for other people to not be able to step in and step up into roles that maybe, you know, they would enjoy as well. So. we really have to look at the system around us, how it supports us. Um,
yes, and maybe similarly, you know, connected to the feminism is also, um, becoming aware of the culture we grew up in, right? Like, how patriarchal is it? How much is the machismo present? How do they influence our stress level, let's say, um. How do the structures around us affect our wellbeing? Maybe
contribute to, to burnout. So yeah, as a therapist, I'm very aware of that. This all still differs depending on which country you come from, which culture you grew up in, right? The expectations that were put on you by your family, by your peers, society, religion will be very different, right? For everyone. [00:19:00] Very, it's very individual and. I also have,
you know, the lived experience of having lived abroad for, for many years in different places. So I think that's very helpful when I speak to my clients who come from different backgrounds. Um, so just being mindful about
all this, how it influences us, I think it's just very important.
Track 1: And what about,, this connection between the mind and the body and the way that you think of this and, and how it informs your therapeutic work, um, and how it
can Yeah. Benefit individuals
seeking help.
rebekka_1_10-26-2023_114049: Yeah, so, well, I think by now it's quite well known that that stress and particularly chronic
stress, often settles in, in the body. For example, there are areas that we consider even typical when, when it's about stress, right? Like people often have tense shoulders or they get headaches when there's stress or digestive issues, back pain, [00:20:00] high blood pressure, stuff like this. Um, but of course it can be very individual as well. So it's very, I think
telling, there's a lot of information. Like how our bodies react to the stressors in our lives, right? Like it can really much inform us to learn how the stressors affect us. So in my work specifically, that could look like identifying the areas of tension in your body, right? To look at. Okay. When do these bo bodily reactions pop up? Like in reaction to a certain stressor, for example, or what? What is this reaction your body trying to tell you? if it's maybe pointing toward a need that isn't met. Um, things like this. And I felt quite helpful for my clients because they can create an awareness about this connection, what's happening like on the outside and what's happening on the inside.
And their body is great. Grasp a pole in this way. I'd say they can observe how their bodies respond in [00:21:00] different situations, and we can then talk about those, those situations more specifically and try to diffuse those, those stressors. And I mean, there's a very Practical level of course as well, how you can work on it.
Track 1: And, and when you said that you do a lot of mindfulness and yoga, do you also bring that into your practice room or is that for yourself? Like, do you, you know, do a lot of guided meditation with your clients, for instance, and would you even like sometimes do something somatic, like more body oriented?
rebekka_1_10-26-2023_114049: Mm-Hmm. . So to answer that. Maybe part of the question, I practice it myself very religiously, I would say, uh, it's kind of my anchor in the day, my, my morning yoga practice. Um, and in my work with, with clients, of course, it depends very much on their needs. I don't believe that everybody has to do yoga to be well, of course. Like we all have to find what, what [00:22:00] works for us. But if they're interested in it. Um, I could, could bring it in, but the mindfulness part is definitely something that is, um, I bring in more often. That is very helpful. Helpful tool. Um, yeah. When it comes to this connection between body and mind, um, so let's say for yoga for example, we could start working with the body on a practical level if that's something the client is interested in.
Um, the tension in the shoulders, for example, that I mentioned, right. Um, we
can see how incorporating like a movement practice as part of their self-care can be helpful for them and look at exercises specifically targeted for this area of their body. I'm also trained in trauma sensitive yoga, which is, you know, specifically helpful. Um, as we
said for people, people who work with traumatized populations, um, and the mindfulness, it's in and of itself already a part of the yoga
practice. Um, [00:23:00] and I think the very, yeah, like a gold nugget there is in the mindfulness that it's so non-judgmental. It's such a non-judgmental way of exploring and experiencing how we, you know, the situations we find ourselves in to stay with our feelings also to, to learn to observe them instead of trying to push them away. Like it really gives us a chance to, to pause and reflect before, before reacting. And this is something You know, as you mentioned with the guided practices, I often bring, if it's something that resonates with my clients, um, I often bring like guided practices either in the sessions we try it and I might send them a recording to do between the sessions.
Um, things like this. And yeah, I feel the mindfulness is definitely helpful when
we're very much affected by the suffering of, of other people when this touches us very deeply. Um. But yeah, of course, also helpful when you're in conflict with somebody, right? Your colleagues [00:24:00] or your boss or anybody else in the system around you, it can really help you. Pause.
Johanne: We wrote about whether you'd be up for doing, uh, a mindfulness meditation, and I actually don't remember whether, whether you said yes and, you know, how, how much time we'd then, um,
rebekka_1_10-26-2023_114049: I brought something,
um, I think it would take maybe around seven minutes without making promises, but Yeah, if you'd like, we can
Track 1: love that. I'd really love that. Do you wanna start?
rebekka_1_10-26-2023_114049: Welcome to the self compassion practice, inspired by the three center check in from the Center for Mindful Self Compassion. This practice is a way to include mindfulness into a challenging day or situation. It gives you the chance to pause and reflect, and regulate yourself instead of simply [00:25:00] reacting.
This makes it much easier to break down a moment of stress or overwhelm into its parts, your bodily sensations, your thoughts, and your feelings. To begin, come to a comfortable seat in which you can let your breath flow naturally. Perhaps you'd like to sit up a bit more instead of leaning back. Place your feet on the ground if you're on a chair.
Or simply shift around until you find a seat in which you can breathe in deeply. I'll give you a moment to get settled in.
If you wish, you can close your eyes. And if that doesn't feel safe today, simply find a place to focus your gaze on, softly, in front of you, past your nose.[00:26:00]
Take a deep breath in,
and out.
Inhale deeply,
and exhale completely. One more time, inhale all the way,
and exhale.
Let your breath return to a natural rhythm, as you slowly arrive in the present moment, in this space we're creating here together.
And I invite you to just take a moment to notice how you are here today. How you're really doing right now.
Begin by asking yourself, how's my body?[00:27:00]
Is it tired or awake? Tense or relaxed?
What bodily sensations do you notice?
Perhaps you can observe physical sensations in your body like temperature, vibration or tingling.
It's also common to notice areas of tension in your body for example your jaw, your shoulders or your abdomen. But it may be a different area for you.
Just be curious about what's there.
If you can't notice anything, that's completely okay too.[00:28:00]
If you observe any tension in your body, invite it to gently relax, to soften, to soothe,
and perhaps let go of it a little as you exhale.
Next, ask yourself, How is my mind right now?
Is it busy or calm? Curious or judgmental. Again, observe whatever arises with an openness and curiosity.[00:29:00]
Consider the idea that you are not your thoughts, but so much more.
Notice that you are able to observe your thoughts as if from the outside, which means that you can be free from them too. And
lastly, ask yourself, How am I on an emotional level? How is my heart?
Are there any emotions present right now that you can name?
Remember, there's no need to judge. How do you really feel?[00:30:00]
And notice if the feelings that come up perhaps connect to a sensation in your body.
Often, when we notice how we feel, we can observe our body becoming tense. If that's the case, invite your body to relax and soften again the next time you exhale.
And lastly, invite your attention to land on your breath once again. Notice how it feels to inhale.
Notice how it feels to exhale.[00:31:00]
Without your active doing, your body breathes for you. In. And out.
Simply notice what it's like to be aware of this present moment.
If you like, you can give to yourself a moment of kindness. Perhaps by putting a hand on your heart or touching any other place in your body that wants to be held right now.
Or you could simply tell yourself some words of kindness. May I be kind to myself.
May I be free from all suffering.[00:32:00]
May I be at peace.
Or whatever else arises.
Whenever you're ready, take a deep breath in and out. To slowly come back to the space. Remember that you can return to this practice whenever you need it. Open your eyes if they were closed to let the outer world enter once again.
Thank you so much for joining me and for making time to tend to yourself today. May this practice be of benefit to you and everyone around you.