Burnout, and Resilience, in Service Providers

What if the key to resilience is practicing together?

This episode fom the Practicing Connection archives features a conversation about burnout and resilience with guests Dr. Charles (Chip) Benight and Nicole Weis from the Lyda Hill Institute for Human Resilience at the University of Colorado in Colorado Springs. 

Their research on human resilience paves the way for therapies that address the needs of trauma survivors, including service providers and others who may suffer secondary trauma. 

Links and resources from this episode:

• Greater Resilience Information Toolkit: https://grit.uccs.edu/ 
• Join our LinkedIn group: https://www.linkedin.com/groups/12879756/ 
• Send us a message: practicingconnection@oneop.org 
• Sign up for our monthly newsletter: https://oneop.aweb.page/practicing-connection-newsletter

Transcript

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Erin Carlson Rivera: Welcome to Practicing Connection! I’m Erin, and today we are diving into our archive to discuss burnout and resilience. This our first episode in our From the Archive series, where we are updating and releasing previously created content that is still relevant and current. Today we’re returning to an interview Jessica and Bob did with Dr. Charles Benight and Nicole Weis on their work with trauma survivors. 

I am excited to share this interview! Here’s what we love about it: 

• Dr. Charles Benight and Nichole Weis bring both research and years of experience to their work. Their methods for how to empower individuals and communities to build mental health resilience are both tested and nuanced. 
• Resilience as something to be practiced rather than an innate skill
• Connections between secondary trauma and burnout

Without further ado, please enjoy this archive episode!

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Bob Bertsch: I'm Bob Bertsch.

Jessica Beckendorf: I'm Jessica Beckendorf. In this episode, we'll be talking about burnout and resilience with our guests, Dr. Charles Benight and Nicole Weis from the Lyda Hill Institute for Human Resilience at the University of Colorado and Colorado Springs. The institute's research on human resilience paves the way for therapies that address the needs of trauma survivors. Their healing division works with a variety of clients, ranging from veterans and first responders to students and community members with a focus on helping individuals and families heal from trauma. Their community training and empowerment division empowers individuals, communities, and organizations with the tools needed to build mental health resiliency.

Bob: Dr. Charles Chip Benight is Executive Director of the Lyda Hill Institute for Human Resilience. He's a professor of psychology, researcher, psychologist, and educator who throughout his career has focused on the intersection of trauma and human resilience. Nicole Weis is the Director of Community Training and Empowerment for the Lyda Hill Institute for Human Human Resilience. She's a licensed professional counselor and licensed addiction counselor. In her role at the institute, Nicole provides peer support training to several organizations in Colorado, teaches the trauma training for professionals online program, manages the GRIT coaching program, and liaisons with the 4th Judicial Veterans Trauma Court. Chip and Nicole, thank you so much for joining us. Welcome to the Practicing Connection Podcast.

Nicole Weis: Thank you for having us.

Charles Benight: Yes, I'm very excited to be here. Thanks, Bob.

Bob: So I'd like to start with getting a sense of what brought you guys to this work. Chip, can you tell us how you got interested in human resilience?

Charles: Sure. I think really it started way back when I was moving to Miami for my postdoctoral fellowship way back in 1992. I happened to get there three days before Hurricane Andrew hit. My wife was five months pregnant. I think that whole experience of having to relocate and establish social connections and a new job and all of that and a new baby and so forth, was really the foundation of moving from- I was studying stress in the heart before that and how heart disease occurs and how people can die from sudden cardiac arrest and emotional factors related to that. I think that whole experience with the hurricane shifted my focus on how people overcome severe adversity like a hurricane or almost anything that's a severe trauma or adversity.

Bob: It's interesting you mentioned having to reconnect with community when you had a baby and your family trying to reconnect. It's something that our audience, that includes military family service providers is very familiar with because with relocation, permanent change of station, our military families are experiencing that all of the time, frequently, much more frequently than many of us are experiencing that. You see that as really important to resilience, that connection to community and network?

Charles: Absolutely. I think the military is an interesting world for that because obviously, they have their own internal connections as military members and connecting to other military providers and service members and so forth. I think that that's been pretty instrumental for them. At the same time, their interconnections to communities shifts and changes quite frequently when they have to move.

I think that's difficult on families specifically and the kids and adapting and obviously with deployments and so forth, it becomes a very challenging process. I think community and something Nicole and I have spent a lot of time thinking about with our GRIT program, which we can talk more about and other programming that we do, is that that interconnection between social network, social fabric in our lives is really instrumental in being resilient and being able to cope effectively.

Bob: Nicole, can you share a little bit of what brought you to this topic of resilience?

Nicole: Yes, absolutely. My interest really started with interest in trauma. I grew up in a complicated family. We went through a lot of different things growing up. What really sparked it was my brother joined the United States Air Force right after 9/11 and witnessed a lot of horrific, really difficult things, came home, and really struggled with it. Watching his journey really prompted me to go into psychology. Then I continued on. I came to the University of Colorado Colorado Springs and started working with Dr. Benight Chip in his lab understanding trauma more in-depth, continued to go through some complicated things in my life.

2017, two weeks before my wedding day, I woke up to a fire two feet away from me. I lost most of my house, lost a lot of things, and really learned the journey of resilience from that event. It coincidingly was really hearing from Chip about this dream of the institute and what resilience could really mean for everybody. That really prompted me on this road. I got to work at a crisis center for a while and worked with individuals who were really struggling with thoughts of suicide, thoughts of harming themselves, really significant crisis moments.

I got to see not only how do you help somebody, but how do you walk a journey with somebody and growing and adapting through some of those significant life events. My journey's just been rolling with that ever since and just watching really remarkable people grow and adapt in really hard experiences. I'm still here 10 years later and I really love what we do and being able to just see those sparks in people as they get through, work through what they've been going through.

Jessica: Oh, thank you both so much for sharing that. How do we know when we are approaching or experiencing burnout?

Nicole: In a lot of my trainings, I have this GIF or this little video that I show that it's this girl that's just crawling across the screen. I always say, "If you've ever wondered if you've been burned out, do you ever relate to this picture of just crawling across the floor?" I think burnout can really feel like that of, "I'm here and I'm doing a job that I am invested in and I love, and I'm exhausted. How do I get out of bed? How do I be here? How do I perform the way I want to perform while I'm exhausted?"

To me, that's the image of burnout that comes out. I think burnout is especially relevant for the helping professions, for the people who constantly put other people in front of them. Burnout then feels really complicated because again, "How do I do this job that I love, that I really want to be there and help people, and at the same time, I am broken right now?"

Charles: I do think the fundamental feeling of exhaustion is pretty paramount for burnout. Combined with that sense of the loss of love for whatever it is you're focused on, whether it's your work, whether it's your family, that whole process can affect all of our lives, not just our work environment. I think Nicole was right, that exhaustion and not feeling efficacious anymore in terms of what we're trying to do.

Jessica: When you're noticing that, it feels like, "I've been there before." To me, "It feels like you're already in the middle of it." It isn't until you notice that you're in the middle of it. This has been my experience that you realize, "Oh, my gosh, I'm burned out." It sounds like from your descriptions, that that's the reality of it that you might not realize it until you're in the middle of it. Is that right?

Nicole: Yes. I think as a society, we're pretty good at being reactive to things. I know Chip can talk a lot about this with our medicalized model of trauma and mental health conditions. We're good at being reactive. We're good at saying, "Oh, there's been a problem, now I need to go find a solution." What we're not as great with is being really proactive and self-aware and noticing when there's the first red flags, the signs that something's different, something's changed.

One of the things that we really emphasize with our institute is that proactive approach and just allowing yourself to be curious, "What is different about myself today?" I think if we spent the time to be a little extra self-aware without the stigma, without all of the preconceptions of what might it mean for us to be burned out, if we just acknowledge that this is a human experience, then I think there's so many things we can do to prevent the really impact of burnout, to prevent some of the impact of stress. That piece, I think is something that goes against the norm a little bit. I'll let Chip add to that.

Charles: We've had fun, Nicole and I, really talking through these cycles of how people go from feeling pretty good in their lives into this burnout phase. We've talked about prevention planning for organizations, for individuals, and talked about presilience as a concept that if we can get in front of things, we can then build the shell, if you will, or armament around ourselves that can help us manage these changing environmental conditions. I think the pandemic, we needed something to shine a light on burnout. The pandemic did that for a lot of people and a lot of organizations. I think that's a key for us to look at is, what did that teach us versus, thank God, the pandemic's over which it's really not, but people say that, and then we just move on in our lives. I think there's a lot to learn from that for us around Burnout.

Jessica: When you are at the point where you're crawling across the floor, or you find that you're having a hard time doing things that you love serving people that you love to serve, what should we do when we find that we're crawling across the floor like that [chuckles]?

Nicole: Every few months, every year, I think Chip and I play with a theme of human experience. Lately, the one I've been really thinking about is you have permission to be human. It feels really relevant for a lot of helping profession because again, we tend to put ourselves second or last. Sometimes it's hard to acknowledge the impact, stress and trauma and secondary trauma has on us. We do a lot of work with attorneys and court reporters, health care workers, some of these helping professions. For them to just admit that what they hear is hard, that alone can sometimes feel like a barrier.

I think having this idea that if you hear something that's hard to hold on to, if you hear what somebody else has been through and somebody else's tragedy, you're human, and if it impacts you, you get to say that was hard, I can take a step back, and I can take a moment to absorb and lean on somebody else, power of peer, I'm sure we'll talk about. To me, that's what you do. You give yourself permission to say it was hard, and I'm human, and I get to feel that. It doesn't make me any less amazing at my job.

Bob: Chip, does that secondary trauma that service providers and helping professionals experience, does that impact their risk of burnout?

Chip: It's a very interesting question. Back in about 2008 to 2012, somewhere in that range, we did a major project called Support Net with the Army across the world. In that project, we were able to sample service providers, behavioral health providers across all of the entire globe that were related to the US Army. We learned a lot and we did publish quite a few papers from that project.

One of the things that we learned was that burnout itself actually can create a risk for secondary trauma. It makes sense that you've got this shell that when you're working hard, listening to a lot of difficult issues from people and really putting yourself out there as a helping professional, that if you've become burned out, that information can seep through more. What we see is that actually, if you get more severe burnout, you actually have an increased risk for secondary trauma symptoms. That's really important for us to think about as providers, because often I don't think people put those two things together and understand how they would interact, but that's what our studies show.

I think it's important for the discussion, as we were just talking about that, self-care and other care in the sense of reaching out and getting support from others, as Nicole was describing the power of peer, is pretty crucial. I think a lot of helping professionals assume that they're good, they can handle it, they're used to taking care of other people, but they sometimes don't prioritize themselves very well. That's a pretty crucial piece here or else, you can find yourself on that cascade of, I'm getting burned out, I just noticed it, but I'm also having dreams about my clients and the horrific things that somebody maybe has gone through, and that stuff starts really creeping in more.

Nicole: On the topic of self-care, again, one of the things we've been really thinking about lately is self-care can sometimes have this fluffy feeling. Sometimes when people say, "Oh, you just need self-care," that actually that feels like, oh, that's even more frustrating because now you're saying I need to add one more thing on to my plate or whatever that might feel, it feels fluffy. Especially when talking about health care workers, one of the things we really talked about is self-care is self-preservation, that you really have to be able to take care of yourself even in really basic needs.

Go talk to a health care worker and ask during your shift, how much do you go to the bathroom? When do you stop and eat besides a cube of cheese? The answers are, oh, I go 8, 9, 10 hours. Self-care is the idea of you get to stop and go to the bathroom, you get to stop and eat, you get to stop and take care of yourself. When we do that, it helps us preserve who we are, again, why you got into this field. One of the challenges we've been putting out in a lot of our trainings is to think about it as a way to preserve who you are when you get to stop and take care of yourself, and that it's a pocket of time.

That self-care doesn't have to be, oh, I have to take a day off, or I have to go on a vacation, or I have to do whatever. It's a pocket of time. It's a minute of meditation. It's choosing to go for a walk during your meeting. It's things like that, that really start to add up.

Jessica: You mentioned the pockets of time, and these are some of the ways that service providers can build a little bit of time for themselves. You also mentioned that sometimes if you tell people, "You need to just do some self-care moments." Even when it's little pockets of time, does that start to feel like they have to add these things to their list to check off, or are there strategies to help people build that in without making it feel like another thing that they're supposed to do?

Nicole: One of the things we talk about is we tend to be really good at putting all of these things on our to-do list, like I have to attend this meeting, and then I have to pay this bill and then I have to work on this report. We have a to-do list. What we tend not to do is put the self-care pieces on my to-do list, like I should eat lunch today, make sure I cross that off. I can listen to this podcast today, cross that off. It's less but it's one more thing and more of it's part of your day. Just as important as seeing these clients is me taking care of myself. Those get to live on equal planes, versus when it feels more important than the other.

Jessica: Yes, okay. I love that. That makes a lot of sense. Given the factors leading to burnout, what are some other things that service providers can do to build their resilience up?

Nicole: I'm going to talk about power of peer here. I think, really being able to lean on one another and to share what's been going on, I mentioned one of the things I'm so proud about with our own institute is how much care and respect and longevity we have with each other, and how much respect for work-life experiences we have. One of the things, the trends that we've seen in recent years, and we talk about this in our GRIT Program, is we have a tendency of what I call a drive-by check in, that maybe I come in and it's Monday morning, and I see Chip walking in too and I say, "Chip, how's it going?" Before Chip has had time to answer, I'm already in my office.

We have this very casual, "Oh, how's it going? How are things going for you?" but we rarely stop and listen to the answer and follow up and say, "No, really? How are you doing? How are you coping? I know you went through that hard thing? What's it like for you now?" I think one of the things that we can do for burnout and, again, that self-preservation is truly check in with one another, truly take the time to say, "Really, how are you?"

That can be a 5-minute conversation, 10, 15-minute follow-up conversation, but it's just saying I notice you, I care, I'm invested in what's going on in your life. It gives permission for that other person to really start to share and open up a little bit. We hear all the time about how important social support is when it comes to stress, but I think it goes beyond just checking in with one another and truly asking some of those questions, which is what I love about the GRIT Program is we really break that down. That's what I would say, social support.

Chip: I think the GRIT Program that we want people to recognize this out there and access it, it's free and it's at grit.uccs.edu. It's something that really teaches people and it's interesting, if you're already a service provider, a lot of this information is not going to be like, oh my god, I've never heard that before. It's packaged in a way to think about how to reach out to people that we care and love in our lives and really create that deeper bond and deeper support that we often think is there, but we don't harness it. We don't really cultivate it necessarily. I think some people do, some people are really good at that.

I think helping professionals often are good at doing that for clients, but they're not necessarily good at doing that for themselves. I think the GRIT Program might be something for people to think about with that. This morning, for example, I went for a quick hike with a good dear friend of mine, and we had just a wonderful conversation that was deep and meaningful about our lives and what's happening. We were out for about an hour. I was driving home, and I was thinking that filled me up. It gave me a sense of connection, we hugged each other at the end and there was just a calm, common connection in our lives around somebody cares about me and I care about them. That sounds pretty fundamental, but I think it is fundamental, actually.

Nicole: If you see a colleague coming in and they're in crutches and holding a box and holding a coffee and holding a stack of papers and they're struggling to get through the door, any one of us would say, "Oh, let me help you. Let me grab this for you. Let me help get you into the door." At the same time, I think sometimes we see colleagues coming in and they look upset and they look frustrated, they look flustered and we have this, "Oh, I should respect their privacy moment." We just let them do their thing.

I think if we start really respecting how mental health is health, it's all one body, then we can start respecting how can we reach out in those moments as well. "Hey, I just noticed, are you okay? Is there anything I can do? Can I offer some assistance right now?" Instead, we take this really, "Oh, we'll just leave them in their space." That's what I think about with those moments as well.

Bob: Do you guys have a framework for how you view resilience? We've been talking a lot about social support, and some resilience researchers talk about internal factors, external factors. How does your institute and your work look at the factors for resilience?

Charles: It's a great question. To be candid, we spent six months as a team with several people on the team talking about what resilience is because it's so used in different ways in the literature, but among people as well. What we really came down on is that, unfortunately, a lot of people think resilience is a trait and we really push back against that. I think that's too simplistic. What resilience is is a process. It's a process by which a person is able to adapt and change in an effective manner, a more adaptive manner, utilizing both internal resources, so our own capacity to cope, our efficacy perceptions and so forth, and external resources like social support.

We're able to harness those in a way when we're dealing with a severe adversity that has, in a sense, knocked us down a little bit, and we're having to react to that and come back from it. We utilize our resources in a way that are more effective for us and that enable us to be able to overcome what's happened. So that, I think, is what resilience is. It's a dynamic process that's changing across time and the utilization of resources in an effective way.

Bob: Nicole, can you talk a little bit about the community programs and maybe connecting back to what Chip said, how those programs might be able to help people build those resources that we draw on?

Nicole: Yes. One of the things that we were really conscientious of with GRIT is putting out some easy resources to share. I think one of the wonderful human phenomenons that happens when we experience a community disaster stress is a lot of genuine people do come together and say how can I help? How can I support? Sometimes what ends up holding us back is I don't know what I would say. I don't know what I would share. I don't know how to reach, how to get these people to the next resource.

With GRIT, we really break it down into say these are five exact steps of how do you reach out, how do you make that connection, so we can make it pretty fluid. Then how do you share some resources? There could be some really helpful resources. We encourage people to be aware of what's in your community. Then we also share national resources like the Crisis Center number. 211 is it a phenomenal resource. Some of those sites and apps and things like that so that you do feel equipped to share some of this out.

One of our favorite stories, and we share this one a lot, is when we first launched GRIT out, which, by the way we launched [unintelligible 00:25:20] the pandemic really rolled around March 14th, March 16th-ish, we rolled our first GRIT class out in April. We were able to really get this out quickly. In the beginning, when we were doing this, we did what we called GRIT together, which is where we welcomed people who took the training to come back and share experiences and feedback.

Somebody said that, I reached out to a friend that I-- She was just on my mind. I don't know why. I hadn't talked to her in several months, but she was on my mind. I reached out and I checked in and I did the GRIT steps. While they were talking and communicating, the friend revealed that she was actually in a really dark place and having a lot of really hard thoughts and experiences. The GRIT coach, the person who just took our training had literally just went through the module where we talk about some of those resources and had the crisis number right there in her mind because she had just gone through that.

She was able to share the crisis number, get her friend connected to some support. Her friend was really able to get some help that very night. One of the things I'm so proud of is just that ability to share those resources. We hear crisis number, we hear about 211, we hear about some of these things, but we sometimes forget it in the moment when we're overwhelmed with what we're going through. For a friend or someone, a loved one to reach out and say, "Hey, here is this resource, here is this thing," can be really, really helpful and beneficial.

One of the things we were really excited about is we're releasing our app, GRIT E app in the next month or so, which will be able to push out a lot of those resources in real-time. We're really excited to be able to share those.

Charles: I also think it's important for us to think about, if you're a behavioral health provider, for example, and you're working in the military, you understand resources, you understand at least some of those resources that you're typically utilizing for your clients and so forth. I think what we learned from the Support Net project that I mentioned before, what we did with the Army, was that having an interconnection with a peer coach, somebody who is willing to stand by you, around your own sense of wellness and your goals for your own wellness as a way to either help you if you are burned out or prevents you from getting burned out and that the coaching process with that really helped people to be able to make some strides in their lives towards feeling more whole, feeling more efficacious again, you're making strides in your own health, which can make you feel better at your own work.

I think thinking about how to prioritize those goals for yourself and bring some other people one or more into your goal setting and what you're trying to accomplish can just really, really be helpful. I think that's important for service providers in that context to think about as a way to help themselves manage it.

Nicole: Could you share a personal practice that you use to help build your own resilience?

Charles: For me, the fundamental things that keep me going include exercise. I really spend a lot of time outside as much as I can because being out in nature for me and moving is really, really healing for me and it fills me up emotionally, spiritually, and so forth. Having that time outside and to be exercising is really vital for me. I've made that a priority in my life for a long time. I know I need that, and I also have very strong social connections.

One person in particular in my life, a man that I've known for most of my life now, we've been bicycling every Friday afternoon for 30 years and it's just a routine. It's a process in my life that I count on every Friday as a way to decompress. It's a person who knows me extremely well and that's just a wonderful, wonderful thing to have. I think, again, that's that combination of some of it's individual for me just personally to be outside and building myself up physically and then also socially having somebody who loves me and I love him. Just having that social connection is really vital for me. Of course, my family and all of that is vital for my own resilience, that's for sure.

Nicole: I think similarly, I really like to start and end my day with walks was something I picked up when I worked at a crisis center. Whenever I have worked with someone who was just heavy on my heart, I would immediately go for a walk afterwards. That was my big thing. That really got pretty ingrained in me. I really like to start with similar and then nature being out in light. Then family for me as well, I've been with my partner, my husband, for 16 years.

He's been through his own whirlwind of experiences and so being able to lean on one another. Then I have a two-year-old and just watching her just learn life has been really exciting. One of my former colleagues, one of the questions she would like to ask is what brought you joy today and that's something that I really try to think about every day too, it's just what brought a smile to my face, and usually it's her little goofy self. Those are my two big ones.

Bob: Chip and Nicole, thank you so much for the work you're doing, and for joining us today on the podcast.

Charles: My pleasure. I've enjoyed it very much. Thank you, Jessica. Thank you, Bob.

Nicole: Absolutely, thank you for having us and allowing us to share what gets us excited.

Bob: Please check out the GRIT program. You can find it at grit.uccs.edu and Lyda Hill Institute for Human Resilience website at Cto learn more about the great work that Chip, Nicole and all their colleagues are doing.

Erin: That’s it for this episode, thanks for joining us.  If you enjoyed this episode, click the share button in your podcast app to share it with a friend. 

We'll be back next week. Until then, keep practicing.

CREDITS: The Practicing Connection Podcast is a production of One-Op and is supported by the National Institute of Food and Agriculture, US Department of Agriculture and the Office of Military Family Readiness Policy, US Department of Defense under award number 2 0 2 3 4 8 7 74 3 3.