- Developing Men and Women for Others: Inegration of Wellness Exercises to Prevent Secondary Traumatic Stress
- Exploring Cura Personalis with Daily Mindfulness Practice in and Advanced Counseling Skills Course
Developing Men and Women for Others: Inegration of Wellness Exercises to Prevent Secondary Traumatic Stress
Rhonda Norman, Ph.D.
Mentor: Shelly Webb
COUN 671-01 Clinical Mental Health Internship is the final clinical practice class that engages the community with clientele from local agencies and organizations.
This experiential course is designed as an integrative field experience. Students are expected to engage in on-site counseling program activities with clientele that allow application of the Clinical Mental Health (CMH) Counseling program curriculum.
During the clinical mental health internship class counselor trainees (CT) are treating some of the most severely traumatized clientele who reside in lower socioeconomic communities. While treating trauma survivors with few resources, counselor trainees are susceptible to compassion fatigue and secondary traumatic stress. Compassion fatigue is when we find it difficult to be compassionate with our clientele, and secondary trauma occurs when our client’s trauma narratives impact us in a way that we begin to experience trauma symptoms related to their stories.
Individual CTs have varying levels of resiliency when experiencing compassion fatigue or secondary trauma. Resiliency equates to having the ability to experience the trauma narratives of clients and remain empathetic, compassionate and caring. Developing resiliency as a CT is helpful in developing compassion satisfaction. If a CT has not developed resiliency there can be major consequences if left unattended; therefore a primary reason to integrate Ignatian principles is in the promotion of compassionate care for clientele and self.
Incorporation of Ignatian Pedagogy
The Ignatian principle of Men and Women for others speaks to the CT’s ability to care for the clientele they are serving, hear their trauma stories and advocate on behalf of the client within the context of their environment. Pedro Arrupe initially profiled students as Men and Women for others in his address to alumni of the Jesuit schools in Europe in 1973. While Peter-Hans Kolvenbach emphasized consideration of how our decisions could impact the marginalized groups of our communities.
Developing CT’s as Men and Women for others, self-care and wellness are important aspects to examine in graduate education and professional practice. Therefore, as a result of the mentoring experience through Mission and Identity the integration of wellness and experiential exercises were implemented in the Clinical Mental Health Internship Seminar Class as a means to promote professional resiliency , compassionate practice and advocacy. The Clinical Mental Health Seminar class is the final clinical practice class where many CTs’ become employed after graduation. This class assists with making an efficient transition from graduate student to professional counselor.
The integration of Ignatian pedagogy is emphasized in three student centered learning objectives with the guiding principle: Men and Women for Others/Whole Persons of Solidarity for the Real World.
In conclusion, the students in the internship class are evaluated through in-class assignments and evaluations from the site-supervisor. Students who have assessed the wellness component have commented that they appreciated the focus on wellness and the whole person in the clinical internship class. In the future I will continue to explore how the integration of wellness and self-care impacts compassion satisfaction within the internship practice.
Traub, G. W. (2008). Jesuit education reader. Chicago, IL: Loyola Press.
Valent, P. (2002). Diagnosis and treatment of helper stresses, traumas, and illnesses. In C.
Figley (Ed.), Treating compassion fatigue (pp. 17-37). New York, NY: Brunner-Routledge.
Michelle Flaum Hall, Ed.D.
Mentor: Leslie Ann Prosak-Beres, Ph.D. (Education)
The term cura personalis, which is Latin for care of the whole, individual person, is an Ignatian value that is woven into the very fabric of the counseling profession. Counselors are passionate about caring for and valuing others. They are trained to be skillful listeners, experts in the change process, and advocates for mental and emotional wellbeing. Because counselors expend great energy caring for others, they sometimes neglect caring for themselves. In the Counseling profession, we call cura personalis Self-Care, and it is a value that is encouraged within our profession--for students, practitioners, and counselor educators alike.
One way of caring for the Self is to become more reflective, introspective, and attentive to one's own experience. Howard Gray, S.J. (2008) states that this kind of disposition "suggests three activities: be attentive to the reality about you, reverence what you encounter, and appreciate how this kind of presence leads to revelation" (p. 200). Ignatian spirituality calls one to learn the art of stopping, reflecting, and appreciating, or in other words, "becoming more humanely alert and responsive to the world around you" (p.200). Ignatian spirituality, although a Western tradition, shares many characteristics with an Eastern tradition: Buddhism, and more specifically, Mindfulness.
In its simplest form, Mindfulness is present-focused, non-judgmental, compassionate attention. Mindfulness-based approaches for treating psychological disorders and physical ailments are snowballing in popularity. From the treatment of depression and anxiety to helping people cope with chronic pain and stress, Mindfulness-based approaches (such as Mindfulness-Based Stress Reduction, Dialectical Behavior Therapy, Mindfulness-Based Cognitive Therapy, and Acceptance and Commitment Therapy) have a common component, which is Mindfulness. Although Mindfulness comes to us from the Buddhist faith tradition, the core concepts and practices have become integrated into many Western approaches to treating mental disorders and promoting overall health and wellness.
Given the popularity and usefulness of Mindfulness, I chose to integrate the approach into the COUN 764, Counseling and Psychotherapy, to give students experience exploring the skills before they begin teaching the skills to clients. As a clinical mental health counselor who has personally benefited from daily Mindfulness practice, I also recognized the value of students learning these skills for their own health and well-being--an application beyond the clinical. Knowing how some graduate students can struggle with anxiety related to their own competencies, stress related to multi-tasking and role juggling, and perfectionism and difficulty with self-compassion, I saw many possible benefits to training counseling graduate students in Mindfulness. Because our goal is to train thoughtful, reflective practitioners who know themselves and care to know others, it seemed obvious to me to include Mindfulness in the Counseling curriculum.
During mid-semester, students were required to experience three weeks of daily Mindfulness practice. During previous weeks, students learned about the history of Mindfulness, health benefits of Mindfulness practice, and applications within the clinical setting. Specifically, students learned about Mindfulness-Based Stress Reduction (MBSR) and its applications for anxiety disorders, chronic pain, and depression. Students practiced various forms of Mindfulness, including
- Sitting meditation
- Body scans
- Walking meditation
- Mindful eating
While engaging in these practices, students experimented with different focuses of awareness. They focused on the breath, a part of their body, the body as a whole, an object, sound, thoughts as thoughts, and they spent time in choice-less awareness. As students engaged in these practices, they worked to maintain self-compassion and a position of non-judgment. The overarching goal of these practices was to teach students how to anchor themselves to the present moment, rather than ruminating on the past or thinking about the future.
In addition to practicing present-focused awareness, students learned deep, diaphragmatic breathing. They practiced this type of breathing in class and helped coach others who were having difficulty learning this cleansing breath pattern. They also learned how to position the body to encourage comfort while sitting in meditation.
After engaging in each Mindfulness practice, students discussed their experiences in small and large groups. Students shared the challenges they faced when attempting the various skills, focusing primarily on the cognitive difficulties inherent in attempting to remain present-focused. Students shared frustrations about their wandering minds and how they tended to think and feel negatively towards themselves as a result of the inability to remain focused. They also found self-compassion to be a challenge during this process. Because many students will eventually teach clients Mindfulness-based therapeutic interventions, I felt it was critical for students to process these reactions in order to increase their understanding of possible client reactions to the same skills. After students learned and practiced various Mindfulness skills, they proceeded to the next phase of their Mindfulness training--individual practice. I should note that the timing of this exercise was deliberate: Students were required to complete this assignment during the busiest weeks of the semester--midterms.
After practicing Mindfulness in the classroom, students engaged in daily practice for three weeks and kept a log of their experience. They could choose from the skills practiced in the classroom, or from any normal daily activities--such as showering, driving, hiking, gardening, playing with their children, playing the guitar--anything. The goal of each daily practice was to do the activity fully, completely, with present-moment awareness, without judgment, and with self-compassion. Students were to record the date of the practice, the activity completed mindfully, any noteworthy cognitive, emotional, or physical responses, and the duration of the activity.
Many students began their three-week practice by integrating the activities we practiced in class. Many students attempted sitting meditation and body scanning into their daily routines while some experimented with mindful eating. By the second to third week, students seemed more open to incorporating a mindful approach to basic activities such as driving, walking to class, and playing with their children. Some used sitting meditation and diaphragmatic breathing before taking midterm examinations in other classes. Others signed up to take yoga for the first time. It was evident by week three that students were beginning to appreciate the time they were giving to themselves, and they were noticing the health benefits of the practice.
Upon completion of the three weeks of Mindfulness practice, students wrote short reflection papers describing their experiences. After reading their reflections, I found several themes in the majority of papers, including: frustration about the timing of the assignment, initial ignorance about Mindfulness and its benefits, initial concerns about reconciling Mindfulness with Christian faith, a positive experience with Mindfulness, and an interest in continuing daily Mindfulness practice. Most students began their papers honestly, sharing how frustrated they were to receive this assignment during midterms and believing that these practices would take away from their productivity. They also shared stereotypes about meditation and the people who do it. They discussed fears about reconciling Mindfulness practice with their Christian belief systems, wondering how they could synthesize this.
After sharing their initial thoughts, perceptions, and biases, students reflected on their "turning point" experience, when it struck them that Mindfulness practice was actually adding to their productivity, improving their focus, aiding their relaxation, and contributing to their overall well-being. This experience of Mindfulness reinforced Gray's (2008) assertion that "whether the professional work is coaching, research, or academic planning, what the Ignatian tradition offers is not a time-consuming addition to an already heavy workload" (p. 200). Gray also suggests that it is through the practice of Ignatian spirituality that a person becomes a soul. I would suggest that Mindfulness practice encourages graduate counseling students to live and practice more soulfully.
Students who initially shared trepidation about Mindfulness due to religious beliefs came to the realization that they could apply the skills to their current religious practice and spiritual exercises, and get more from these experiences in the process. Two students shared that Mindfulness deepened their spirituality and helped them feel closer to Christ. Overall, students expressed a desire to continue exploring Mindfulness practice. They recognized the challenges inherent in staying present-focused but also the benefits of working hard to do so. They realized that self-compassion and non-judgment are more difficult than they seem, and the experience with Mindfulness piqued their interest to continue their journeys toward greater self-knowledge, compassion for self and others, and a deeper understanding of cura personalis.
Gray, H. S.J. (2008). Soul education: An Ignatian priority. In G. Traub (Ed.), A Jesuit Education Reader (p. 200). Chicago: Loyola Press.