Into the Field of Suffering : Finding the Other Side of Burnout

Healthcare providers are constantly confronted with illness and injury, and the challenges of healing. Yet this very work, the relief of suffering, inflicts on healthcare providers suffering of their own that is often crippling. The most common terms for the pain caregivers and healers suffer from are burnout and moral distress. These common terms are, however, often used judgmentally--as if those trying to heal others have failed themselves, their colleagues, and their patients. The net result is that much discussion of burnout and moral distress, and the interventions they underwrite, have served only to worsen the crisis. Into the Field of Suffering: Finding the Other Side of Burnout provides a much-needed reframing of burnout and moral distress. These depleting experiences are approached as trials virtually inevitable in the course of the healer's vocation. The challenge medical professionals and caregivers face is not avoiding them, but meeting them directly with insight into the role of moral distress and burnout in the development of their vocation. Into the Field of Suffering presents a set of analytical frameworks and awareness skills, which have the potential to transform the work of healers and caregivers. There is a growing body of academic literature on these topics, and many memoirs recounting distressing situations and wounding traumas. Into the Field of Suffering takes its place alongside these works, while offering a distinctly different approach that treats as essential the spiritual dimension of the healing vocation. Practices, teachings and dialogues to assist in the cultivation of compassion and gratitude are key components in this presentation. Schenck and Neely address their readers in a direct voice, speaking to the sense of failure and discouragement so many healthcare professionals and caregivers experience on a daily basis. This is a book that carries a mentor's voice and presence, born out of experience with burnout and moral distress, and grounded in hundreds of conversations, de-briefings and interviews with healthcare workers and caregivers, patients and families. "This book is written for people who spend the bulk of their days working with others who are suffering. What I want to offer here is an invitation to conversation: a conversation with me, a conversation within yourself, and a conversation with the people with whom you work. A conversation about what it means to spend your days with people whose lives are disrupted by illness or overwhelmed by brokenness. That can be brokenness in bodies. It can be anything from flu to cancer, from sprains to AIDS. It can be traumatic brain injury, severe mental illness, or debilitating chronic conditions. Or it could be families in neonatal units dealing with children with debilitating genetic defects, struggling to make decisions about if, when, and how to end lives. Or violence on the street, or the devastation of a flood-ravaged community. What is it that we can learn from these situations? I put an emphasis on learning because I do believe that if we don't learn every day, if we don't learn every hour, this work will destroy us. It's important to use a word as strong as "destroy." There are reasons not everyone does this work, and there are limits to how much of this work anyone can do. What we must keep asking ourselves is: Why do we do this work? Why are we drawn to those who suffer? What is it that's good about this? And what not so good? What is it that is admirable, and something that we should show enormous compassion and respect to ourselves for? And what is there in it that is self-destructive, that we should be constantly questioning and challenging? To answer these questions, we must get past the assumption that attending to the suffering is entirely saintly and noble, or that it is a symptom of a deep, perverse drive. Much attention is rightly being focused on people who serve on healthcare's front lines. The framework for these discussions tends most often to be the terms "burnout" and "moral distress." These terms certainly point to very real experiences, very painful experiences. Unfortunately, they also often carry with them judgmental messages: "You are failing." "You must do better." What I want to say to you here is that, while these terms point to realities for those of us who have worked with suffering day-in and day-out, they may not help us move and grow into the deeper ranges of compassion and recognition and attention that are possible, unless we supplement them with other constructs and insights. When I say that I want to encourage a conversation within you, part of what I have in mind is this: We are all multiple selves. And one of the things that happens when we work with people and communities that are suffering and in pain-physical pain, psychological pain, spiritual pain-is that distinct pieces of ourselves often respond quite differently to what is going on in front of us. Many different feelings are stirred. We may be terrified, and at the same time move with great compassion, while being also completely exhausted, and madly energized"-- Provided by publisher Cover Into the Field of Suffering Copyright Dedication Contents Acknowledgments A Note on Sources and Method Invitation: For You Who Do This Work PART I. VOCATION AS PATH Chapter 1. The Healing Vocation Chapter 2. On Depletion and Burnout: Reframing the Darkness Chapter 3. How Breakthrough Happens: The Mutuality of Healing Chapter 4. The Practice of Replenishment and Renewal: Core Exercises Chapter 5. In Conclusion: On Healing Presence and Gratitude PART II. THE DIALOGUES: DEEPENING CAPACITY Dialogue 1. Honing the Exercises Dialogue 2. The Exercises as Spiritual Disciplines Dialogue 3. The Essential Skill of Advocacy Dialogue 4. The Field of Suffering Is the Field of Healing Dialogue 5. The Fulcrum and the Great Compassion Appendix: A Practice Calendar References Index Abstract The five dialogues presented in Part II invite readers to join in the continuous exploration of what healing is and how they can sustain one another as healers. These conversations were held between the author, David Schenck, and his collaborator, Scott Neely. They explore more fully skills involved in finding the other side of burnout, as well as the spiritual dimensions of the healing vocation. Dialogue allows one to practice the skills of attentive listening and apposite sharing. In dialogue, partners accompany one another into ever-evolving, ever-deepening understanding. The dialogues in Part II remind readers that the conversation continues, that learning never ends, and that they are not alone.