Self-Care and Self-Compassion: Strategies for Helping Professionals

Jacqueline Ulissey, LMSW

Introduction

According to the World Health Organization, June 24th to July 24th is self-care month. Over the next couple weeks I will share a two part blog series discussing the importance of self-care and self-compassion. Today's focus is on people who work in helping professions. By the end of this article you will have learned the importance of self-care and self-compassion, several strategies for implementation, and why lack of self-care and self-compassion can worsen burnout. Included are several hypothetical scenarios of helping professionals who are burned out and possible strategies they can use to better care for themselves.

The Helper

I want to start this article with a few questions. Something for social workers, therapists, caregivers, teachers, nurses, doctors, police officers, firefighters, and anyone else working in a helping profession to get curious about. What originally drew you to your chosen career? What does it mean to you? Why do you continue showing up to the job? How is it effecting your wellbeing? What are you doing to be kind and care for your needs?

Each of these professions goals are to enhance the welfare of others by protecting, supporting, helping, and serving individuals, families, and communities in the midsts of challenging times. Each of our reasons for choosing our career field is uniquely based on our own life experiences, interests, professional strengths, and future we wish to create. It is likely we genuinely care for our clients/patients/students, the community, and the work we do. At the same time it is important to not neglect our own self-care needs. It is equally important to be compassionate with ourselves. Keep reading for practical tips on how to show yourself some compassion and tend to your needs. Taking time for yourself is beneficial not only to you but to others as well.

Recognizing Overwhelm and Burnout

Any of the careers listed above can be rewarding. It feels good when we can make a positive impact on others' lives. Also, such careers often come with high levels of stress, that accumulate overtime, and have a tendency to sneak up on us. If we do not learn to recognize when we are becoming overwhelmed or heading toward burnout, we hurt our own health as well as our clients. For example, we might lose the ability to empathize with clients, see patients as numbers, have difficulty seeing things from other's perspective, have trouble staying focused and organizing workload, experience insomnia or excessive sleepiness, and more.

Here are examples of why a person could become overwhelmed at work and eventually burnout.

For the past several months a hospital social worker with a large caseload is struggling to find patients affordable resources upon discharge. The ideal solution for a client is far from what is realistically attainable. Communication among hospital staff is lacking. The social worker becomes cynical and makes a distasteful joke with a colleague about a patient. The colleague seems uncomfortable, but does not report the social worker.

A licensed therapist working with adolescents who have experienced trauma comes home crying almost every evening for the past month. The stories her clients share are filled with pain and sorrow. She feels like she isn't helping enough. She is feels guilty and angry at herself. She shouldn't be allowed to feel so distraught since she is not the one with that trauma history. She finds herself unsympathetic of her own kids' concerns and complaints because they pale in comparison to her clients.

A hospice caregiver has had 10 clients die in the past month. He was present with the family during 3 of those deaths. Also, his dad was recently put on hospice at another agency. His grief has become overwhelming. Unfortunately, he has already used up his paid personal leave hours. On the weekends, he numbs himself with alcohol.

One of the fifth grade teachers was moved to teach special education in order to save the school money. She doesn't have the appropriate training, she does not have support from her boss, and she is staying overtime without pay. She is recently divorced with two kids and is struggling to pay rent even with child support and alimony. She was denied a pay raise because the school does not have enough funding. She could potentially apply at a different school, but that would mean a longer commute.

A nurse working a double night shift can't seem to catch a break. He is barely getting 5 hours of sleep at the most, his personal relationships have become strained, he is making careless errors at work. Last week he almost lost his job because he forgot to lock the medicine cabinet.

An ER doctor is incredibly busy seeing patients. He works late, skips lunch, and has no time for anything but work. He recently tended to a patient who is a victim of domestic violence. The hospital team was able to get this patient to safety and the perpetrator is in custody. However, the doctor could not undo some of the damage that was done. He is incredibly angry at himself and the world. All he can focus on is the pain and suffering of the people he is trying to help.

A police officer has responded to several break ins near her neighborhood. She is hyper- vigilant at home, jumps at the slightest sound, and is having nightmares that her house will be broken into next. These symptoms have been going on for longer than six months which indicates possible PTSD.

A firefighter's coworker and friend recently passed away due to a building collapsing on him during a fire. The firefighter has survivors guilt. He wonders if there is anything he could have done to prevent his friend's death. He is experiencing panic attacks at work.

Importance of Self Care and Self Compassion

As you read in the examples above, work-related stress within helping professions can prevent people from caring for their basic needs of food and rest, cause anxiety, anger, grief, and negativity, put strain on relationships, and lead professionals to utilize unhealthy coping mechanisms. It is important we check in daily with ourselves and seek support when needed. Adulting is not for the faint of heart. Professional and personal responsibilities can seem insurmountable. Maybe we received messages that if we cared enough about our work we would tough it out. Self care is selfish. You can sleep when you're dead. No pain no gain. Sound familiar? Sometimes we must temporarily push down our feelings so we can get the job done. However, that is not a long-term strategy. If we are not getting good quality sleep, nutrition, and exercise how can we expect to be present at work. If our mental health is suffering how can we provide best care for clients? How can we have a peaceful home life when we are angry and stressed from a long day at work?

If we ignore our needs because we are so focused on serving others, then we will eventually burn out. As the saying goes, you cannot pour from an empty cup. It is important we understand this and advocate for ourselves. We can allow ourselves to be patient, to have self-compassion, to set boundaries, and to ask for help. If you were told as a child that your needs do not matter and that you have no inherent value, then you were lied to. Now you might struggle to stand up for yourself and feel good enough. If you took on more responsibilities than a child should have due to emotionally immature, neglectful, or abusive parents, then it might be hard for you to take a break and let someone else take over. You may have anxiety and are focused on everything that could go wrong. If your family emphasized the importance of achievements, you might feel like you are not doing enough with life.

Also, if we harshly judge and berate ourselves, focus solely on our shortcomings and mistakes, and spiral into shame, we become stressed, hopeless, and unmotivated. Practicing self-compassion is an antidote to shame,, which Dr. Kristin Neff, a leading expert in the concept, describes as having three elements: self-kindness vs self-judgement; common humanity vs isolation; and mindfulness vs over identification. To summarize, a person who is compassionate with themself recognizes the unfairness of the world and is kind to themself through suffering and failure. They acknowledge they are not alone in their suffering and emotions. It is part of the human experience. In knowing this they are less likely to see bad things in life as happening only to them. They allow themselves to feel their feelings without judging themself and without getting caught in a negativity loop. They find balance in how they express their emotions neither suppressing or exaggerating them.

Implementing Self-Care and Self-Compassion Strategies

Before implementing self-care strategies it is necessary to become mindfully aware of what we need in the present moment. We shall turn off autopilot and ask ourselves if in this moment at this time we are hungry, thirsty, need to stretch our legs or get some fresh air. Self-care extends past the basic needs for survival. Other self-care domains include mental health, emotional well being, social life, spiritual, workplace, and financial. Personal interests, time, and money will influence what a person chooses as their self-care practices. Examples include spending time in nature, participating in an activity, reading a book, watching a favorite show, taking a long weekend vacation, journaling a gratitude list, having a spa day, spending time with friends, etc. Going back to the examples earlier in this article, here are ways to practice self-care and self-compassion. Scroll up to refresh your memory on the scenarios that might lead to burnout.

In the first example of the hospital social worker there are three issues at play that led to the social worker's reaction. Overwhelm due to quantity of clients needing to be discharged, clients who have inadequate financial resources, and poor communication and triage among hospital staff. First the social worker apologizes to her colleague for the remark she made about her client. Next she seeks counsel from other hospital social workers asking what their caseload is like. Everyone's caseload averages about the same. So, she now knows not to take it personally. She and the other social workers discuss how large caseloads are effecting their ability to successfully help clients when leaving the hospital. A more experienced social worker offers insight on how to cope when there is no simple solution for a client. This helps the social worker not be so hard on herself. Together they advocate for clearer communication and propose possible solutions to have more manageable caseloads.

In the second scenario it is clear the therapist is dealing with compassion fatigue that is effecting her mental well being and relationship with her children. She assesses her work schedule and financial obligations. Fortunately she is able to take a week off work and upon returning rearrange things in a way that allows her more time to decompress between clients. She also remembers a time earlier that year when one of her friends who works in the mental health field expressed similar concerns and emotional distress. She didn't get angry at her friend. Instead she was patient and allowed her friend to vent. She acknowledged the heavy toll of carrying other humans' suffering. As she remembered this moment she realized she is her own worst enemy and perhaps she could try responding to her own situation like she did to her friend. She finds a therapist who helps her process some of the upsetting client experiences. She also works with the therapist on how to be compassionate with her kids instead of comparing their struggles to the struggles of her clients.

In the third example, it is actually a fellow hospice staff who confronts the caregiver after an in service meeting. Things have taken a turn for the worse and the caregiver has shown up to the meeting reeking of alcohol. The caregiver knows he needs help with his addiction and needs support to deal with his grief. Luckily his boss is willing to work with him. The boss is able to offer 5 days off at 50% paid leave while the caregiver finds a support group for grief and alcoholism. He works with the caregivers schedule. The boss is also open to allowing the caregiver to work in a different department temporarily as long as his skillset matches.

The fifth grade teacher from scenario number four is dealing with stress both at work and at home. She is experiencing financial stress, feelings of inadequacy due to not being trained to work with special needs students, and is working for a school that does not have the best interest of their teachers and students in mind. Since she has already tried to get support from the school to no avail, she reaches out to her ex husband. She doesn't feel comfortable asking for more money, but does request that he take the kids for a couple weeks so she has time to find rental assistance and figure out a long-term strategy. She also applies for another teaching position. She is hired a month later. She negotiates for a higher salary to help compensate for the longer commute. The hiring manager happens to be on the board of education. When she learns about what the other school is doing, she brings it to the board's attention.

The nurse in example five takes some time to think about what he needs to feel more energized and more focused at work. It is obvious he needs more sleep. Unfortunately, he is not allowed to change his work schedule at this time. That means he will need to catch up on rest during his days off. He informs his roommates of this and sets appropriate boundaries. They are understanding and able to accommodate.

The ER doctor in example six gets honest with himself and his family about how his work is effecting him. He still wants to be a doctor but feels burnt out from working in the ER. Based on his credentials, experience, and financial situation he is able to cut his hours while he works on switching to another specialty. During his interview process he asks what measures are in place to prevent and address physician burnout.

The police officer in the seventh example opens up to her sergeant and is moved out of patrol into another department while she gets assessed for PTSD and treated for the trauma. Another officer is stationed outside her home to offer protection should the need arise.

In the last example, a firefighter is dealing with survivors guilt and panic attacks after the death of another firefighter. He finds comfort with the other firefighters who were there that day. There is a strong sense of brotherhood among them. He allows himself to feel is feelings and not mistake it for weakness. He recognizes that maybe it is easier for him to turn his anger inward at himself and overestimate how much control he should have had in the situation than feeling the pain of having lost his friend. He is gentle with himself as he goes through the grieving process. He finds ways to keep his friend's memory alive.

Some common themes in the examples above include seeking support both at work and at home, setting boundaries, finding others with shared experiences, being a friend to oneself instead of the harshest critic, and advocating for self. In some examples the person's employer was willing to work with them. As you read in other situations, the person's best action was to leave their current job and go somewhere else that appreciated them. Dealing with workplace burnout, compassion fatigue, and stressful work events is not always simple. But if we can be honest with ourselves about our needs, allow ourselves to feel without judgment, and be okay seeking support that is a good place to start.

With much compassion,

Jacqueline Ulissey, LMSW