Suffering & death quiz 1

Nouwen's understanding of the wounded healer: what does being wounded have to do with being a healer? how is this related to his Christian understanding of Jesus?

-"The great illusion... is to think that people can be led out of the desert by someone who has never been there." -Story from the talmud: "how shall I know him?" "He is sitting among the poor covered with wounds." -Making one's wounds a source of healing... does not call for a sharing of superficial personal pains but for a constant willingness to see one's own pain and suffering as rising from the depth of the human condition which we all... share."

healthcare professional as explorer vs. as detective (Causton)

-Detectives listen to facts like location, severity, and quality of someone's physical pain. They want the answers they're looking for and are often cutting people off when they wander from the facts. -Explorers throw out everything they know about the person and learn from the person talking. Often surprised by the journey.

"dispassionate Witness"- definition; what the "dispassionate Witness" helps us to accomplish and how (Dass & Gorman); how this witness differs from Kahn and Steeves' witness in last week's Ferrell/Coyle reading.

-Dispassionate witness helps us accomplish listening to people and being compassionate -It helps us notice our reactivity allowing our natural compassion to come more into play -Process of witnessing is dispassionate, does not commit one result or another, it's open to everything

Nouwen's understanding of healing as hospitality: know the two kinds of hospitality as well as the link between healing and self-car and why Nouwen uses the term hospitality:

-Hospitality as concentration: paying attention to the wounded one- us! Paying attention to the wounded one- the other once we are comfortable with our own wounds we can let in other people's suffering -hospitality as community -Practicing self-care can put you into that place that support who you wish to be both as sufferer and healer. As a wounded healer. What are "the anchor places" of faith or spirituality in your life that can further strengthen and stabilize you as a wounded healer?

The 2-part rejection or stigmatization among the mentally ill:

-Social and familial rejection of those in the community -Internal rejection with loneliness and inner turmoil as the experience of the self-rejection

the emerging Catholic view of God and the diversity of religious traditions (Johnson)

-different religions an be seen as God's handiwork, as God bestowed his divine love on every culture. Important to engage each other with critical respect and affection, learn about the religion of others while sharing beliefs respectfully. Tolerate differences to cooperate for common good, "encountering multiple religious traditions widens the horizon wherein we watch God's loving plentitude" and a glimpse of God emerges -God is shown in every culture

nurse as witness: the four roles according to Kahn and Steeves

1. Firsthand observations. Nurses closest to the patient have the opportunity to inform others about what has been observed. 2. Ceremonial role occurs when nurses reduce suffering by supporting or participating in rituals of transition or "rites of passage" that require witnesses to substantiate them. 3. An expert witness is one who testifies or speaks in public forums about the special knowledge his or her expertise brings to a public issue. Nurses have spoken out in their own institutions and, increasingly, in public forums about issues such as unrelieved pain, grief, and loss. 4. Visionary: in which nursing's collective vision develops as each nurse speaks out about the suffering he or she encounters, how best to respond to it, and the need for a future in which suffering is not ignored. Visionary nurses are currently challenging the care provided in settings such as neonatal ICU (NICU), homeless communities, and psychiatric care.

Brene Brown's strategies of invulnerability:

1. Numb ourselves to our vulnerabilities 2. Perfect ourselves and our live Then we won't feel we're not good enough. Then we won't be rejected. Then we won't be ashamed.

hinduism four goals of life on the paths of desire and renunciation; what stands in the way of moving to the final goal of life; the possibility of hope and meaning in Hinduism for those who suffer (Gaudino)

1. Pleasure (path of desire) pitfall-addictions, self-absorption 2. Worldly success (path of desire) Path of renunciation: giving up what has not satisfied and seeking something more than what one has found thus far Samsara: the cycle of rebirth, re-death, re-suffering into infinity, unless we find a way out of this cycle 3. Duty to community We want infinite being (sat), awareness (chit), and joy (ananda) The fourth and ultimate goal: liberation (moksha) Freedom from samsara and all its suffering and re-suffering. Freedom to oneness with God: the experience and reality of infinite being, consciousness, and bliss. The challenge: the "infinite center of every life" lies beneath all the layers of our surface self, "buried under the almost impenetrable mass of distractions, false assumptions, and self-regarding instincts that comprise our surface selves"

Compassion fatigue prevention (Braband)

Being: empathetic, understanding, supportive, warm, caring, kind, loving Doing: care for self, be your best friend, help others, act kindly Practices: prayer, meditation, guided imagery, gratitude, time in nature, art, story telling, humor, 3 gs (gratitude, grace, and grit)

compassion fatigue vs vicarious trauma vs burnout

Compassion Fatigue (CF) is when someone who regularly hears/witnesses very difficult and traumatic stories begins to lose their ability to feel empathy for their clients, loved ones and co-workers. Vicarious trauma (VT) means that you have not been the direct victim of a trauma, but you have experienced it second hand through your client's stories and may be experiencing post traumatic stress symptoms similar to the person who experienced it. Burnout is the extreme end of Compassion Fatigue. Both compassion fatigue and vicarious trauma can lead to burnout. It means that symptoms have been happening on a regular basis for a long time and longer term support will likely be necessary to recover.

Camus' existentialism: its basic tenets; Camus' understanding of the existential hero Sisyphus; what suffering means; the possibility of hope and courage in his existentialism for those who suffer (return)

Existentialism: we can't stand outside life to understand its meaning. We are swept along by life. There is no meaning in life, sacred or secular, scientific or religious. There is only life itself. Human progress, like science and technology, causes suffering. It objectifies and dehumanizes. It isolates us more. It enslaves us as we are compelled to conform. Sisyphus was the hero who was punished by having to roll the rock up the hill and back down everyday.

Trauma-informed care:

Four Rs: key goals for trauma-informed care -Realization -Recognition -Response -Resist re-traumatization TIC: -offers a safe space for providers and survivors -strengths-based approach -grounded in understanding and responsiveness to trauma -goals: help rebuild control, healing, empowerment, and resilience

GRACE for cultivating compassion (Braband)

Gathering attention Recalling intention Attuning to self/other Considering Engaging

healing (as defined by Rachel Remen in Causton's article)

Healing is something that happens when a person feels that they have been "seen and heard and validated", meaning healing can happen even when a cure is no longer possible. Listening is one of the oldest and most powerful tools of healing.

Common strategies for responding to suffering while keeping it at a distance (Dass & Gorman)

M: be mindful that these reactions have not only been rooted in fear but in the denial of fear. A: simply acknowledge our reactiveness to pain. P: we can use pity to allow some of the person's pain into us, but not enough to threaten our own self-control. P: professional warmth is a stance to keep our distance.

Self-Compassion vs. Self-Esteem

Self-esteem: -Global evaluation of self-worth -Marker of emotional health -Feel special and above average -Contingent on success, achievement, appearance, and other variables -Involves judgment by self and others- good or bad, popular or not, fun or boring Self-compassion: -No judgment -Accepting yourself as you are -Relating to yourself kindly and positively just as you strive to treat your good friends -Relies on you to take the first step

Eric Cassell's definition of suffering

Suffering is experienced by persons. Not merely by bodies, and has its source in challenges that threaten the intactness of the person as a complex social and psychologic entity. Suffering may include pain but is not limited to it. The relief of suffering is an obligation of medicine.

the dangers of labeling someone: that person's "ideological address" or spirituality

by having labels, it creates assumptions from others such as their religion and spirituality.

Self-reflection practices:

journaling meditation centering prayer daily examen Sacred Holding contemplative art and music conversation with a wise friend or spiritual guide poetry writing walking the labyrinth

protest atheism vs atheism of indifference- look

look

vulnerability (braband)

threats of suffering: reverberations with the past expectations guilt vulnerability high cost of empathy inflicting pain silence healer's spiritual needs