Volunteer Pastoral Cares

Workbook

Developed by Ross Wakeley

Effective Pastoral Care and avoiding

Caregiver Burnout

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Devotion – A still, small Voice

Ahab told Jezebel everything Elijah had done and how he had killed all the prophets with the sword. Jezebel sent a messenger to Elijah to say, ‘May the gods deal with me, be it ever so severely, if by this time tomorrow I do not make your life like that of one of them.’ Elijah was afraid and ran for his life. (1 Kings 19:1-3) God met Elijah where he was at emotionally A great and powerful wind tore the mountains apart and shattered the rocks before the Lord, but the Lord was not in the wind. After the wind there was an earthquake, but the Lord was not in the earthquake. After the earthquake came a fire, but the Lord was not in the fire. And after the fire came a gentle whisper. (1 Kings 19:11,12)

A Healthy Emotional System

God has created us to enjoy a life of peace, rather than being burdened by stress. In God’s extraordinary design of our body our nervous system is a vital part of how we absorb and deal with stress issues. The sympathetic nervous system is one of the two main divisions of the autonomic nervous system, the other being the parasympathetic nervous system. The autonomic nervous system functions to regulate the body's unconscious actions. The sympathetic nervous system's primary process is to stimulate the body's fight, flight or freeze response. It is, however, constantly active at a basic level to maintain internal balances. The sympathetic nervous system is complementary to the parasympathetic nervous system which stimulates the body to "rest-and-digest".

“Be still, and know that I am God.” Psalm 46:10

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Stress will come and go. We know that stress is a poor indicator of burnout. We all feel stress. How we feel after the event that has triggered our stress is over will tell us if we are experiencing burnout or we have been reacting to a stressful event.

Not setting realistic expectations sets the stage for more stress, feelings of helplessness, inadequacy or confusion. These negative emotions can be overwhelming and often lead to us feeling anxious or hopelessness. Common indicators that our thinking is going in the wrong direction (it triggers stress) are:

❖ “If only I could please my father or ______.” ❖ “I need to do it, so it will be done correctly.” ❖ “Maybe things will be different this time.” ❖ “It is my responsibility.” ❖ “I need to do things perfectly. I can’t make a mistake because it might cause harm.” What are the specific areas where my thinking triggers stress?

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A definition:

A cumulative process is marked by emotional exhaustion and our withdrawal from people.

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Jesus’ Help With Our Stress

Jesus said, “What I’m trying to do here is get you to relax, not be so preoccupied with getting so you can respond to God’s giving. People who don’t know God and the way he works fuss over these things, but you know God and how he works. Steep yourself in God-reality, God-initiative, God-provisions. You’ll find all your everyday human concerns will be met. Don’t be afraid of missing out. You’re my dearest friends! The Father wants to give you the very kingdom itself.” (Luke 12:29-32)

Help With My Self Talk

Take a step back and sort through our beliefs and feelings about pastoral caring. Ask yourself:

❖ Are my expectations realistic? ❖ Do I have a need to control every aspect of them? ❖ Is there another person that can assist me?

Look at the situation and determine what skills, resources and assistance will be needed. Invite God’s Spirit to give us the wisdom, revelation and insights that will help us.

Solutions for managing expectations might include:

❖ Being wary of “must,” “should,” “have to,” and “if only” self talk statements. ❖ Recognizing what I can and cannot do. ❖ Giving to God the things beyond our control and our everyday life. ❖ Acknowledging our own limitations. ❖ Asking for support and/or help from family, friends, and our community. ❖ Owning our feelings - the good and the bad ❖ Asking God for His wisdom and revelation

What other solutions would help me in managing expectations?

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1. The issues that create stress and the risk of burnout for you. 2. Which ideas will help you in your life and as a pastoral care visitor. 3. What specific help you’ll need. 4. Pray together for each other.

My responses to the questions:

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Teamwork helps us with Stress

Break into Pairs to Discuss

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This chart is a basic overview showing what is different about stress and burnout. Invite your spouse or a good friend to reflect with you on where you’re at –

Three “Burnout” Questions for Reflection

1. Am I being with God or doing for God? We’re invited to be with God, not do for God. A pastoral care role can deceive us into thinking we’re tending to our relationship with God. We read scripture, pray, and talk about God all the time, but if we only do them because the role requires it, we may be starving ourselves of experiencing God personally.

2. Is God refining some part of my character? We assume any heat or pressure is a bad thing. We need to be able to discern when God is refining us and not be too quick to cry burnout because we’re uncomfortable.

3. Am I creating times for rest and observe ‘rest’? Evaluate our priorities and boundaries as people’s demands for pastoral caring and their issues they have can swamp us. It’s vital we give ourselves permission for rest and rejuvenation.

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4.

Personal Reflection

1. In what ways does this Scriptural insight help you in your daily life?

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2. What process do you make use of to access help from Jesus in the issues that you find are a personal struggle?

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Stress and

Burnout –

Jesus fully

understands

What are some Causes of Caregiver Stress? ❖ Unrealistic expectations of both ourself and the

client/resident about what we can achieve ❖ Taking on ourself the person’s emotional or

spiritual baggage ❖ Allowing our worth to be found in our ministry

so that we overextend ourselves, and then feel guilty when we rest

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Personal Exercise:

Where are you at on each of the two aspects? Mark your self on the graph. Invite your spouse or a good friend to give their view. What is this graph showing you and spend time with Jesus reflecting on those insights.

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Traumatic Stress

Previously we noted what a healthy emotional system looks like > However, if we face a major traumatic event in our life, our reaction can be for our sympathetic nervous system to be stuck at ”on” – we are constantly in fight, flight or freeze mode and we have a range of symptoms.

Or the trauma event can lead to our parasympathetic nervous system being stuck at ”off” – so we are always “chilling out” resulting in a different range of symptoms.

My Response

How does this information help you?

What action steps might be helpful to take?

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Window of Tolerance

We all have a “window of tolerance” – our capacity to stay present and operate with more or less full access to all our internal resources and coping skills. When we are within that window, we function pretty well to great! When we find ourselves outside that window, we have gone beyond our current capacity at that moment to stay present. We often flip into a fight, flight or freeze mode. When we are in that mode, a different part of our brain takes over.

That part of the brain has us focus on our survival: How can I be safe? We may find our self getting defensive (fight), withdrawing (fleeing), or closing down (freezing). When we find ourselves outside our window, our conditioned tendencies have been triggered. We find ourselves tightening, contracting, mobilizing in one way or another rather than being present in the situation as it is unfolding.

Trauma can trigger hyper-arousal (similar to the "fight or flight" response regulated by the sympathetic nervous system. People who are hyper-aroused often experience anxiety, may be hypervigilant, and/or suffer from dysregulated emotions. During hyper-arousal we may shake, run away, fight, feel our heart pounding, experience tension in our body, and have racing thoughts. Extreme hyper-arousal may be experienced as a panic attack.

Trauma can also trigger hypo-arousal is similar to the "freeze" response regulated by the parasympathetic nervous system. During hypo-arousal we may shrink or hide, feel our heart slowing down or a heaviness in our body, feel numb or empty, and "tune out" what is going on around us. Extreme hypo-arousal may be experienced as dissociation from the real world.

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The first goal in working with the window of tolerance is to simply gain awareness. As we become more aware of where we are in or outside our window of tolerance, we can begin to develop strategies to help us stay within our window, or return to our window if we are outside of it. There are different tools we can utilize depending on whether we are hyper-aroused or hypo-aroused.

Expanding My ‘Window of Tolerance’ Take at least 10-15 minutes on your own for this exercise/reflection. What to do: • Identify a situation in your life where you find yourself triggered “outside your window”. Does

it matter to you? That it matters is critical! If it doesn’t matter to you, if the consequences of your behavior are not significant enough, you probably won’t bring forth the wherewithal to stay with the exercise. So, pick something that matters – where expanding your window of tolerance would make a significant enough difference to make your effort worthwhile.

• Find a place where you can sit undisturbed for 5 minutes or so. I suggest you do this

exercise sitting down. Sit in a comfortable position, feeling your feet on the floor, your buttocks on the chair or couch you are sitting on. Place your hands gently on your thighs. It’s very helpful to have a sense of a strong foundation under you. If you’d like, you can try to do this while you are walking. If you choose to do it that way, begin by feeling your legs and feet under you. Walking makes it a bit more complicated, if you are also trying to navigate your way. But, it’s certainly do-able.

• Now, take a few deep breaths to settle your body.

• Recall in your imagination a memory of a time when you were in touch with a full sense of

your capacity – your intelligence, creativity, ability to respond effective, effectively navigate your circumstances. Let yourself sense into that. What was the situation? What does that feel like in your body? What emotions are present? What images and/or thoughts come to mind? Hang out with that for 30 seconds or so.

• Now, imagine in your mind that you have a dial in front of you. It’s like the dial on a gas

stove that lets you control the intensity of the flame. Imagine turning it up and down to test

A practical exercise in Self care

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out, to make sure you are comfortable using it. You’ll be using it in the next several steps of the exercise.

• Now, recall a time when you experienced finding yourself triggered in the way that you

identified earlier. What was the situation? Where were you? Who was there? What did it feel like? What emotions were present? At this point, check in with yourself. Is it too intense? If so, turn down the flame! Turn it down until you can felt some heat, but it is tolerable. Enough intensity so that there is a level of challenge you can hang out with.

• When you’ve found the right level of intensity, hang out with it. Continue to review the

situation in your mind. What sensations do you feel in your body? What emotions are present for you? Hang out with this for a minute or two, with a focus on continuing to sense into your body.

• Now, return your awareness to the memory of when you were in touch with a full sense

of your resourcefulness. Hang out there for 30 seconds or so.

• Take a few moments to reflect on your experience of the exercise. What was that like

for you? What did you learn? How does it feel in your body?

• When working with this kind of exercise, it is best to repeat it over a period of time, as

this has the effect of “massaging” the edge of your window. It takes repetition over time to relax the edge. Plan on repeating the exercise several times a week for a couple of weeks, or more, depending on the issue.

• Remember to approach the exercise in a spirit of kindness, gentleness, patience and

encouragement toward yourself!

Arch Hart is a clinical psychologist and

Senior Professor of Psychology at Fuller

Theological Seminary in California.

He’s been giving brilliant practical help

to people carers for over forty years and

has published thirty three books to date!

He researched what occurs in us if our

body is constantly “on a high”: we over

produce adrenalin. That’s the thing that

causes heart attacks and stroke. Arch

proved that if we reduce the adrenalin in

our system, we will be a lot healthier.

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Qualities of a Healthy Pastoral Carer (Arch Hart)

1. Understand ourself - who we are, our unfinished business (hangovers from the past) and invite God to bring healing to us

2. Accept who God has made us to be and avoid comparisons to others. 3. Be spontaneous in our actions and feelings. Be aware that we constantly monitor what

impression we are making. We can try to manipulate this impression and when we do, spontaneity is lost.

4. Be transparent - what you see is who we are. Live this at home and in all my relationships.

Check how we are going in being authentic by asking our spouse or close friends as what they say is how we are. That’s the real us.

5. A healthy pastoral carer is not dependant on another’s approval.

• Often we look to our grandstand for approval and affirmation. Our grandstand is the people we have placed there who have power over us in a negative way. They can include spouse, children, parents, work colleagues and teachers.

• Living to our grandstand can result in driveness, insecurity and frustration.

• We need to take people out of our grandstand - only GOD should be there.

Who is in our grandstand?

As we accept and experience deep in our spirit the relentless tenderness of God’s love we discover freedom and security in Christ. We don’t need the approval and affirmation of others.

Father, Son and Holy Spirit are really fond of you.

6. A healthy pastoral carer affirms other people. We may think we don’t have a role to give encouragement as in our culture, affirming is seen as crawling; seeking to be superior or thinking this person is trying to gain some power over us.

7. A healthy pastoral carer is the same on the outside and

inside and we give ourself permission to live an authentic life (not religious or a phony “good” Christian). We have the courage to be imperfect and give up the drive for perfection. Reality is that we all struggle with failure and mistakes. We forgive ourselves. As we reflect on ourself, forgive our mistakes. Forgiveness is giving up the right to hit back at people (including ourself).

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8. Develop a non-anxious presence. This means that we are able to receive criticism without feeling personally threatened; that we can be open to the issue being raised and apologise sincerely as needed. A non-anxious approach enables us to not get tense about differing views. Our peace in the situation will relax the other person(s), which helps the discussion flow easier. When we are anxious this raises the anxiety level of other people; we won’t listen effectively and it inhibits the discussion so that emotion, rather than clarity, govern the discussion. In our society, 1 in10 people will be depressed at any one time and need medication. If we are that place then relax – we haven’t “failed” as a person.

9. A healthy pastoral carer is a person free of neurotic guilt and self punishment.

• What is neurotic guilt? When we punish ourselves for things we believe we have done wrong e.g.: feeling good about doing a task well, yet

feeling Christians shouldn’t praise themselves, or we’ll get a ‘big head’. Neurotic guilt means we won’t allow ourselves any good feelings; that we can’t receive forgiveness; that we punish ourselves.

• We need to challenge our neurotic guilt and accept forgiveness from God in our mind, body and spirit about our neurotic guilt by understanding that it’s not real and refute the lie in our mind (see 2 Corinthians 10:5). Learn to step over our neurotic guilt (that’s been taught to us). Most Christians have a deep sense of neurotic guilt - we want “penance” e.g.: we do extra church work or deny ourself pleasure.

10. A healthy pastoral carer doesn’t react to other people. If we react to other people’s actions towards us then they control us. Jesus alone should direct us - as we grow in our security in Him, so we can choose to act towards people, rather than react (Eph. 5:18).

Expanding my Physical Self-Care

☺ Did I exercise three times this week?

☺ Did I have a day off this week?

☺ Did I eat a balanced diet this week?

☺ Did I have eight hours sleep most nights this week?

WHY?

So I have the energy to grieve and process the stuff I’m dealing with well.

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Expanding my Emotional Self-Care

☺ Have I laughed a few times today? ☺ What % of my self-talk today is positive?

☺ What amount of time this past week did I live in the present?

☺ Did I do something three times this week for relaxation and recreation for emotional release, coffee with spouse/friends and rest. ☺ My suggestions: ___________________________________________________________

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Expanding my Spiritual Self-Care

☺ Have I had time to just be with God this week or

I am always doing work for Him? Why is that?

☺ Am I defining success too narrowly?

☺ Am I caught in a ‘Messiah complex’ trying to go beyond my limits?

☺ What is effective that helps spiritually?

☺ My suggestions ...

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Reducing my Stress Levels

1. Have I done something good for one person in the past week?

2. Am I feeling blessed by God or am I allowing envy to eat away at my spirit?

3. Do I really talk with my spouse/close friend about my feelings every week?

4. What has given me hope and/or a real sense of community this past week?

5. My suggestions: ___________________________________________________________

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My suggestions: ___________________________________________________________

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1. Recreational leave

2. Quality time with family

3. Time alone in reflection/prayer

4. Physical exercise or sport

5. Hobbies/non‐ministry activities

6. Learning to say “no”

7. Retreats/ spiritual formation

8. Music/going to cultural events

Helpful activities for

work/life balance and

my boundaries

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Break into Pairs to Reflect and Discuss

1. What’s been helpful in this section for you.

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2. What changes do you need to make in your life and as a pastoral care visitor?

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3. What specific help you’ll need.

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4. Pray together for each other.

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Managing Compassion Fatigue

What types of cases contribute to your stress level increasing your vulnerability to compassion fatigue? Events or situation that causes us to experience an unusually strong reaction and often overpowers our usual coping mechanisms.

Are you aware of any of these issues or contributing factors in your life/work? If so, you could be at risk of compassion fatigue. How does it affect us? ➢ Ability to function is interfered with or altered.

➢ Situation or incident does not seem “typical or ordinary”, it feels traumatic.

➢ “Compassion stress” impacts all of our life or breaks through normal boundaries

➢ Regularly waking up tired in the morning and struggling to get to work?

➢ Feeling as if you are working harder but accomplishing less?

➢ Becoming frustrated/irritated easily?

➢ Losing compassion for some people while becoming over involved in others?

➢ Routinely feeling bored or disgusted?

➢ Experiencing illness, aches and pains?

My Reflection on where I am at - ________________________________________________________________________

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Compassion Fatigue

What may be Happening for Me Internally

"Compassion Fatigue is a state experienced by those helping people in distress; it is an extreme state of tension and preoccupation with the suffering of those being helped to the degree that it can create a secondary traumatic stress for the helper." Dr. Charles Figley

Have you experienced compassion fatigue?

How has it impacted you?

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Reflection:

1. As you look at this model, do you find yourself in any of the boxes?

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2. What insights does this model provide to your situation?

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3. What steps will you take to get help?

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“I myself will be the shepherd of my sheep, and I will find them a place to rest. I, the Sovereign Lord, have spoken. I will look for those that are lost, bring back those that wander off, bandage those that are hurt, and heal those that are sick.” Ezekiel 34:15,16

Ggg

The Lord is my shepherd; I have everything I need. He lets me rest in fields of green grass and leads me to quiet pools of fresh water. He gives me new strength. He guides me in the right paths, as he has promised. Even if I go through the deepest darkness, I will not be afraid, Lord, for you are with me. Your shepherd's rod and staff protect me. You prepare a banquet for me, where all my enemies can see me; you welcome me as an honoured guest and fill my cup to the brim. I know that your goodness and love will be with me all my life; and your house will be my home as long as I live. Psalm 23:1-6

There is great value for us in reducing our stress or our compassion fatigue if we give ourselves time to: ➢ Allow God to love us. To experience His love

for us at heart level, not intellectually. Rest in Him. Enjoy the relentless tenderness of God’s love.

➢ Enjoy worship songs – like Keith Green’s The Lord is My Shepherd and many other songs that have an anointing from God – wash over us and let God’s Spirit minister to us deeply in our body, mind and spirit.

➢ Get away and invite the Holy Spirit to take

Scriptures and bring them as a revelation to our spirit that brings release, rather than information.

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A Final Reflection

1. Three most helpful things for me were…?

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2. I need specific prayer for ____________________________________________________

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A Blessing for Caregivers – Susan Sullivan

May we see with tender eyes The wounds of those before us. May we hear with well-tuned ears The unspoken needs of those whose voices are muted. May we hold with gentle hands The bodies and the spirits of those we care for. May their beauty of soul, Strength of spirit, Wholeness of being Lead us, inspire us And invite us to know our own Beauty of soul Strength of spirit, Wholeness of being. May we know that, As we care for others, God cares for us, sees us, Holds us tenderly. Amen

Acknowledgements

This Unit has been developed by Ross Wakeley with lots of revelation from God and input from God’s Word, Arch Hart, Cliff Powell, David Seamands, Grace Versace and Rose Weir.