Moral Distress Signal

Have you ever found yourself giggling at the most unexpected insult, like "sparrow's fart"? Join us as we kick off this episode of The Spark File with laughter and a light-hearted exchange that sets the stage for a journey through creativity and introspection. We'll explore the wonderful world of "spark files," those magical little tools for capturing inspiration, and emphasize how much more fun the creative process can be with good company. As the conversation unfolds, we'll tackle the anxiety stirred by the relentless election cycle and recent global upheavals. Hear how staying up late with jigsaw puzzles becomes a peculiar form of revenge against bedtime procrastination, as we search for peace amid chaos.

We then transition to managing moral distress, presenting effective strategies to calm the mind with practices like meditation, breathing exercises, and EFT tapping. Reflecting on the timeless wisdom of the Serenity Prayer, we focus on controlling what we can and finding solace in helping others. The discussion emphasizes the transformative power of self-care in building resilience against stress. We cap it off with an invitation for you to share your creative risks and feedback, acknowledging the Lenape and Mohican lands. With a "forever permission slip," we encourage you to chase those sparks of inspiration and turn them into something vibrant. Let’s navigate this creative landscape together with humor, courage, and camaraderie.

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Chapters

• 0:00 The Spark File
• 20:34 Managing Moral Distress
• 32:39 Embracing Creative Sparks Together

Transcript

Susan Blackwell
Welcome to The Spark File where we believe that everyone is creative, but smart, creative people don't go it alone.

Laura Camien
I'm Laura Camien

Susan Blackwell
And I'm Susan Blackwell, and we are creativity coaches who help people clarify and accomplish their creative goals.

Laura Camien
You should know that just by listening to this podcast, you are joining a warm and wonderful clan of creatives.

Susan Blackwell
But hold up, you might be asking yourself what exactly is a spark file?

Laura Camien
A spark file is a place where you consistently collect all of your inspirations and fascinations. Every episode, we're going to reach into our spark files and exchange some sparks, and from time to time, we're going to talk to some folks who spark us too.

Susan Blackwell
And your mission, should you choose to accept it, is to take some of those sparks of inspiration and make something of your own. So, without further ado, let's open up the Spark File. Hi Laura Camien.

Laura Camien
Hi, I was just thinking about how we make the word file like three syllables.

Susan Blackwell
File. Fllllllllll gibberish.

Laura Camien:
Love it, I love it. Yeah, love it, I love it.

Susan Blackwell
Yeah.

Laura Camien
Oh, Suze, I've got a spark for you today that I am ready to share.

Susan Blackwell
I am ready to receive it, and I was just saying to you that, this, I have been running since the crack of dawn and sitting back and getting to drink in the spark you're about to share with me is probably the most delightful and relaxing thing I'll do all day.

Laura Camien
What is that phrase you just made me think of? I laughed so hard. It's in a Kurt Vonnegut play…A Sparrow's Fart? It is Sparrow's Fart. He calls someone, he uses it as an insult. He calls someone a sparrow's fart.

Susan Blackwell
I think we've talked about it on the podcast.

Laura Camien
I laugh so hard, and so you've been up since the sparrow's fart.

Susan Blackwell
Been up since the sparrow's fart.

Laura Camien
That's it right there, which is apparently like when the sun rises, they let out a little poof of gas. But I just thought how imaginative to use it as an insult.

Susan Blackwell
I feel like just knowing that when the sun rises, the sparrows all just toot a little bit…I feel like we've fulfilled the mission of this episode of the Spark File.

Laura Camien
Oh God, I can't even tell you how hard I laughed at that.

Susan Blackwell
You're still laughing.

Laura Camien
It's a gift that keeps on giving All right, all right. So, listen, I like to think of this as a little ditty. This is just a little gem. It was more of a discovery that I made for myself that I thought maybe others might find this useful. We should note this little fact. We are recording this episode just prior to Election Day here in the United States. We have no idea how we're going to be feeling the day after Election Day, which is when this episode is set to air. If 2020 is any indication, we may not even know who the president is when this episode airs the next day. We shall see, but one thing I will note is that this election cycle has been anxiety increasing for myself, for many others, and I think it sort of layers on top of a lot of unprocessed anxiety from the pandemic, anxiety from the last election and the denial of the results, like there's just been so much change and upheaval in so many lives.

Susan Blackwell
Listener. Just I want you to note that, as Laura is saying these things, she's gently massaging her third eye. Just get the full picture.

Laura Camien
What does it mean? What does it mean? I forget who I was talking to. Just the other day, they just kind of declared out of nowhere. “Are we all just going to pretend none of it happened?” Like, are we all just going back to normal and I was like oh, I hear you.

Susan Blackwell
We're never going back.

Laura Camien
I feel that I mean, it's yeah. So, everyone's been through a lot, and I feel like I have felt a very particular kind of anxiety, and I kept trying to describe it to Wes, who felt his own version of it as well. And the best that I could do was describe it as like… it's a mix of fear and anger and confusion and righteousness. It turns out, Suze, there is a term in psychology called—

Susan Blackwell
Revenge bedtime procrastination?

Laura Camien
No, no, although, boy, that's a goodie–

Susan Blackwell
But what were you going to say?

Laura Camien
I'm ashamed to tell you. The other night I stayed up until 4am, Suze.

Susan Blackwell
Girl, I got an email from you at like 2 or 3 am.

Laura Camien
That wasn't even the same night. On that night I went to bed at 2am. But this is such a sidebar. Please forgive me, folks. That night I've been doing puzzles to just try to let my brain try to make sense at all.

Susan Blackwell
Jigsaw puzzles?

Laura Camien
Jigsaw puzzles yes, yeah, and I was. It was like 11:30 that night and Wes was like I'm going to hit the sack and I was like, okay, I think I'm going to puzzle a little bit more, like my brain, it's helping my brain. And I think to myself, there's one more episode of this show that I'm watching, so I should probably stop puzzling and switch over to that. If I want to do that tonight, okay, just a minute more of puzzling. I look, I think to myself, after what I think is a few minutes, I'm like, oh man, it's probably like 12:30 now. I should, I should switch over to that episode. Susan, it was 2:00am. It was 2:00, and then I was like, all right, I'm going to just one second more. And and then in, like, 30 seconds later it was 3:15.

Susan Blackwell
You almost stayed up to the sparrows fart.

Laura Camien
I like to see the sparrows fart come in, Susan likes to see it go out. We're on the two sides of that sparrow's fart.

Susan Blackwell
Wow, Laura, that's crazy that you stayed up that late.

Laura Camien
Well, you know there's been a lot going on.

Susan Blackwell
Two nanas, please just retitle this podcast. “Your Two Nanas,” oh, my God.

Laura Camien
So listen, but for realsies, there is a term in psychology that I just discovered, and if everyone else already knew it, forgive me, but that term is called “Moral Distress.” It's a real thing and this phrase is moral distress. It's most often related to nurses and doctors who know the right course of action but they're kept from doing what they need to do because of the rules of the healthcare system or this or that–

Susan Blackwell
Fascinating, Wow.

Laura Camien
Right. So a lot of times it refers to the healthcare system, but in the larger sense, in the broadest definition of moral distress, moral distress occurs when one knows the ethically correct action to take but feels powerless to take that action. And I thought, oh God, I feel like that describes the very particular type of anxiety that I know I've been feeling. And I think a number of people have been feeling it. So let me tell you a little more about it. I read this article in Psychology Today titled That Powerlessness you Feel is Called Moral Distress. Again, this term really helped me put a name to this particular feeling that has risen up in me so many times over the past few years, and let me give you some examples. These are some examples they gave in this article, and then I thought of a few more, but, just stating back, they wrote this during the pandemic, so:

Parents who are caught between homeschooling and sending their children to in-person classes homeschooling and sending their children to in-person classes you know that socializing the child is better for them, and yet you cannot do what's right right now because of the circumstances we're living in, individuals whose values and beliefs are in conflict with, like their state and federal safety guidelines. So, for example, I would like to wear a mask, but I go to the grocery store and no one else is wearing a mask, and I feel this moral distress. Or people in the hospital, unable to be by their side because of health dangers, this feeling of powerlessness. I know what's right in this situation and I cannot do it.

Susan Blackwell
Yeah

Laura Camien
The Supreme Court declaring that a president has immunity.

Susan Blackwell
Uh-huh.

Laura Camien
And all of us are losing our minds. Like, this is so contrary to what we have been taught is right, our foundational beliefs about what is right, and we feel powerless to do anything about it. When leaders intentionally lie to divide the country and we know they're lying and we're like why can't we do anything about this? When law officers hurt a human being and we are our foundational belief system is that law officers are here to help us. They are here to make us feel safe, not to harm us. We are morally distressed by this. When doctors cannot help a mother who is dying while in labor because of rules, regulations, or they have outlawed the medication that this woman needs, we feel moral distress and the dissonance created in our minds when things happen that are contrary to what we believe to be right and we feel powerless to do anything about it. All of this really hit home for me. I just feel like for some time now, it just has felt like there's so many unjust things happening, things that feel morally wrong or unfair, and it is very easy for an overwhelming sense of powerlessness to take root Just the fact that many millions of Americans can't agree on what is right and wrong anymore is morally distressing.

(cont.) So, no matter how the election turns out, I think many of us have had this lingering moral distress from the past five to eight to 10 years, like it's been a journey. So, according to this article in Psychology Today, when we are morally distressed, we often feel muzzled, restricted, devalued, unheard or dismissed. We easily become fueled by anger, disgust, fear and frustration, and over time, these emotions can fill us with anxiety, depletion or depression. A sense of being fragmented can set in, leaving us to question who we or others are at their core and what the world is generally. Research shows that moral distress has long-term consequences, such as burnout, exhaustion, numbness, disconnection and diminished moral sensitivity, also called “compassion fatigue.” And the whole root of moral distress is this sense of powerlessness.

(cont.) I can't even tell you how many times, like I have felt or heard someone else express, like, I don't understand how this person, who is so smart, is planning to vote in this way, knowing everything that they know. It rocks us. We can't make sense of it. It's like we have talked before about narcissism or dating an alcoholic. You cannot apply logic. You can't apply logic. It's not going to get you there, but it's very upsetting. So the way that moral distress lives in us. Like many other things, it sets off our stress response system, because we're hardwired to detect and respond to threats not only physical threats, but psychological and existential threats, like those to our integrity or our foundational beliefs. Moral distress activates our nervous system and we know what happens. Then we get flooded with a deluge of chemicals that leads to physical, emotional and cognitive changes.

(cont.) As we would say in the Spark File changes in our hearts, minds, bodies or behaviors. That's very real, friends. It means our heart rate and blood pressure go up, our muscles tighten, all non-essential functions become dormant or get less support or blood supply. For a period of time, articulating or expressing ourselves appropriately can become difficult or simply too tiring. Over time, after many threats, we become biased and quickly defensive of perceived potential threats, our capacity for empathy lessons. It affects our relationship to others and on and on it triggers our fight, flight or freeze responses. But over and over and over again, and according to this Psychology Today article, this ongoing dysregulation caused by repeated experiences of unprocessed moral distress can build up at an embodied level. What does that mean? It means it can literally build up in our body, in our tissues.

(cont.) They say it leaves moral residue or ethical plaque. I am not making these terms up and I am amazed by it. Moral residue or ethical plaque that lodges itself in our very being even after any one crisis is over, like an occluded artery. “This moral occlusion can threaten our very existence,” that is a quote. Again, I am not making it up, wow, I'm not making it up. And I'm just so happy to know that this whole thing has a name. That whole process I just described is called the “Crescendo Effect.” There's a model that illustrates how moral distress and moral residue are linked and how the lingering feelings and discord from moral distress can cause significant damage over time, especially when someone is repeatedly exposed to morally distressing events.

Susan Blackwell
Wow.

Laura Camien
Now, a lot of things were written about this because of the nurses and doctors during COVID and how incredibly distressing that was for them. But I also, when I read this, I thought, crap, we are all in mortal danger here, because I think we're all feeling, and have been feeling, moral distress for quite some time.

Susan Blackwell
Yeah, as you're talking, I, you know, we’ll like to go—one of our fun favorite things to do is just to go for a drive. Just go out for a drive. And when I see Trump flags in people's yards, and some of them are people we know…and I start on this crazy tilt-a-whirl ride of like, how can they? They may be having the same experience, the flip of the coin, the other side of the aisle. They're doing the same thing, but I, I get into what feels like a spin or a spiral and I've, I have tried sometimes successfully, sometimes unsuccessfully to not even start, to not even start. But I want to be an informed person, so that means taking in news, etc., and I feel like we're soaking in it, like I don't know how we–

Laura Camien
It’s everywhere. And I think you're right, Susan, because I think that people who disagree with us politically also feel it, which leads me always to the conclusion of like right, because they're getting a different reality than we are from the news and therefore that–how is that right, how can that be? And then I start, and then it'll take me down the road of moral distress because how are we, how have we not fixed our news system and fact checking, and, you know? And then suddenly we're spiraling. I think, like, having a name to it gave me a little bit of relief, because so many times like this–anywhere from rage to frustration to anxiety, like—it can leave you feeling like, am I crazy? What, like, what is happening? So, like you mentioned, best if we can not go there in the first place, I'd like to talk a little bit about how we handle it when we feel it coming on.

Susan Blackwell
Bring it on–

Laura Camien
Are you ready?

Susan Blackwell
Bring it on, yes.

Laura Camien
All right. This particular article is interesting because I found a lot about moral distress, not as much on what to do about it. This article puts an emphasis on resilience training, like becoming morally resilient. We've talked about that. I totally get it. That's wonderful. Over time, we want to become more resilient Great. But what I was looking for is like in the immediate sense, right now, when I feel moral distress taking hold. What can I do? And the biggest thing I think we can do is to learn to self-regulate. Like learning to self-regulate meaning by regulating our nervous system. It has a million benefits. Self-regulation is like the answer to a thousand different quote-unquote problems. A million benefits to learning to regulate, but helping to deactivate moral distress is one of them. So what can help us self-regulate? Meditation, which Susan has talked about.

Susan Blackwell
Check.

Laura Camien:
Breathing exercises.

Susan Blackwell
Check.

Laura Camien
EFT tapping, which I'm big on.

Susan Blackwell
Check, check, check

Laura Camien
All of them help our nervous systems. All of them are go-to tools that can help us all manage this. I also sometimes, when I just need a quick instant calming down, I also use a simple mantra. I think you might use a similar one, but I'll just close my eyes. If I can, I'll, and sometimes I might not. If I'm in public, I might not do the part of like.... I cross my arms and put one hand on each shoulder and simply say to myself, “I am safe, I am loved. I am safe, I am loved.” And I will just breathe deeply and repeat that a few times until I feel my body calming down. Simple, but it works in the moment if you're in a pinch and I just need to calm down. It can bring your mind back from the macro view of the world, the wars, the threats, the fears and back into the micro: Do I have food, water and shelter? Do I have loved ones? Yes, I am safe. I am loved. That is of immediate help.

Susan Blackwell
Nice.

Laura Camien
Then I will ask myself what is within my control right now? What is within my control? So many of us have heard the serenity prayer: “God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.” So, fun fact, many people attribute this prayer to Alcoholics Anonymous and they think that's where it began, but it actually dates back about 10 years before AA started, to a Protestant theologian named Reinhold Niebuhr in the early 1930s. No matter where it came from, it has been a very useful invocation for people who are struggling with things that feel overwhelming. My mom had this phrase embroidered and framed. I think she embroidered it and then framed it. She had a version of this prayer hanging in our house growing up and it was right next to the embroidered sign that I told you about, Suze, that has hung in our house forever. That said “Dull people have immaculate homes.” Laughter. We weren't big on having a perfectly you know, yeah, you get it, you get the point. But so, mom, those felt like to me growing up. These two mantras were like front and center. You know, as a kid, you're just a sponge, you're like. I guess these two things are really important.

Susan Blackwell
Yeah!

Laura Camien
So they stayed with me. But keeping our minds on what exactly is in our control can help to fight feelings of anxiety or powerlessness. So, setting aside the election all of the very big topics and very real concerns we may be having that we do not have immediate control over I thought we could take a look real quick at the things that are within our control. First, I want to acknowledge our privilege here. Not everyone is able to answer the question that I ask myself and say that they have food and water and shelter, and I do not take that for granted.

Susan Blackwell
Yeah, Yeah.

Laura Camien
Not for one second. For that reason, I'm going to start our list of things that are within our control with number one. We can control how and how often we help others, whether this is donating to causes, volunteering at the community center, helping your neighbor get to their doctor's appointment. You do not need to be in a position of power to make a difference, and the good news is, helping others helps you too. There's a ton of research about how volunteering improves our health. They don't even understand all the linkages yet, but they have proven time and time again that people who volunteer, people who help others, improve their own physical and mental health. The American Heart Association says, compared to non-volunteers, volunteers have less depression, less anxiety, higher self-esteem, higher life satisfaction, greater happiness and a greater sense of meaning in life. I mean damn. That's a list of benefits.

(cont.) I know that I personally always feel better when I take the focus off of myself and put it onto someone else, who needs help, and just focus on them and ask you know, how can I help, what can I do? And that could be offering your partner or your parents help in the kitchen, could be organizing a fundraising effort or a protest. It's one thing that we can control how often and how we help others. Number two, we can control how we treat ourselves. Mindset, taking care of ourselves, how kind you are. When I think about moral residue and the physical ramifications of the stress we've all gone through for the past nearly a decade, I think how we treat ourselves is even more essential. This includes the food we put into our bodies, how often we move our bodies, the amount of rest we allow ourselves, boy that hits home after our little conversation there.

Susan Blackwell
Come on, come on.

Laura Camien
And the way we speak about ourselves and to ourselves, these things matter. Each and every one of us is in control in large part of these aspects. So choosing to treat ourselves with kindness, offering ourselves grace, nourishing ourselves, all these things will help us to self-regulate and to counter the effects of stress and powerlessness.

Susan Blackwell
Hmmm.

Laura Camien
Number three, next thing we can control to a large degree who we surround ourselves with or invest ourselves in and how we treat them. When the world at large feels out of control, we can look to the day-to-day world we have created for ourselves, and one of the things I feel so grateful for this has not always been true in my life is that I have built a world—largely due to choosing Wes as my partner, and you as my friend and business partner—I have built a world where I am surrounded, I mean truly surrounded by the most positive, encouraging, empathetic, inspiring, courageous, creative human beings, and I mean a 360 degree view. I look around and I have no unnecessary drama. Of course, there can be healthy conflict or disagreement, but it is a day-to-day existence that is based on love and respect and silliness and laughter and creativity, and I want to say to everyone it is possible to surround yourself with people who share your values and make the world a better place. It starts with who we choose to invest our time and energy into and, once we make that investment, treating each other with kindness and respect.

(cont.) And finally, number four who and what we give our attention to Closely related to the previous one, but who and what we give our attention to is within our control. If we give our attention to drama, we're likely to get more drama. If we give our attention to things that make us feel bad, or even things that make us feel “meh,” we get more “meh,” like social media—giving away our time and energy to something that doesn't feed us energetically, emotionally or spiritually can contribute to that moral distress and to the feelings of powerlessness. But we can choose where to put our attention. Where we put our attention can be the biggest gift we give ourselves and those around us. There's so many things that are within our control, but those are my top four. I don't know about you, Suze, but I found it soothing to know there was a name for the very particular mix of feelings that come up when things don't feel right in the world. But I don't have any power to do anything about it. Let's name it to tame it: It's “Moral Distress.”

Susan Blackwell
Laura. I love this.

Laura Camien
You love it?

Susan Blackwell
Right on time.

Laura Camien
All right, well, listen, we've got a lot of ethical plaque buildup and we need to get moving.

Susan Blackwell
I agree. I need to go have my ethical plaque levels checked.

Laura Camien
I know it's like if only we had a little like a cholesterol pill for it. We need to get a move on, like let's learn how to handle this. I'm so aware that the words I'm saying right now will be heard the morning after the election and it's hard to predict how we'll be feeling if we have any answers. But I think it's clear whatever the results of the election, unfortunately, we are likely to have continued disputes and disagreements. I don't think our moral distress is going to dissipate immediately, even if we're thrilled with the election outcome, I think our country has a lot of healing to do. I am personally praying the results of the election usher in a new era, one where our foundational principles are restored, people come together and remember our common humanity and we can all begin to regulate our collective nervous system. But in the meantime, we can bring our focus inward and start with our own.

Susan Blackwell
Amen, Amen. Thank you, Laura Camien.

Laura Camien
You bet. For the morally distressed.

Susan Blackwell
You got your finger on my pulse over here.

Laura Camien
Oh, do I?

Susan Blackwell
Yes!

Laura Camien
I was so happy to have a name for it.

Susan Blackwell
I can't wait to tell Nathan that feeling, that spiral when we get whipped up. That's what it is. That's what it is.

Laura Camien
That's what it is. We know what is right and we feel powerless to do anything about it. And it is crazy, yeah.

Susan Blackwell
Thank you, Laura.

Laura Camien
You're welcome.

Susan Blackwell
I'm going to go tell Nathan, but first we're going to, we're going to wrap this up.

Laura Camien
We're going to wrap it.

Susan Blackwell
Friends. That's it. This episode of the spark file was made on the lands of the Lenape and the Mohican people and, as always, we hope this puts another bunch of sparks in your file. Listen to me: if there's a spark you'd like us to explore or if you'd like to learn more about how to coach with us to accomplish your creative goals, you can email getcreative@thesparkfile.com or you can reach us through our website, thesparkfile.com.

Laura Camien
We'll even happily take your feedback, but you know the price of admission. First you've got to share a creative risk that you've taken recently.

Susan Blackwell
You can follow us on social, @thesparkfile, and be sure to subscribe, rate and five-star review this podcast. It really helps other listeners to find us. Also, If you liked this podcast, we hope that you'll share it with people that you love. Maybe it will be of use to them. And if you didn't like it: I am safe and I am loved, and so are you.

Laura Camien
Nice. If something lights you up and gets your creative sparks flying, we're writing you a forever permission slip to make that thing that's been knocking at your door. It's your turn to take that spark and fan it into a flame.

Susan Blackwell
You know you gotta take it…

Both:
And make it!

Exit Music