12 Self-Care Strategies: A Précis
Although research on psychologist self-care has not progressed to the point where randomized controlled trials (RCTs) have been conducted, there is a robust and growing body of empirical research. The research results, generated by diverse methodologies and numerous investigators, converge on 12 effective self-care strategies for psychologists (Norcross & Guy, 2007). And these same strategies probably prove effective for ordinary people as well; contrary to rumor, psychologists are people too. Below we outline these 12 strategies (see Norcross & Guy, 2007, for amplification and self-care checklists for each).
12 Self-Care Strategies
1. Valuing the Person of the Psychotherapist. Self-care begins with self-awareness and personal commitment. Assess your self-care as you would a patient’s. Identify your vulnerabilities and sabotages. Writing, journaling, logging, or self-monitoring can track your progress. Secure honest feedback from loved ones and coworkers. Build on your successful self-care as opposed to simply adding new items onto the list. Make self-care a priority, not an indulgence.
2. Refocusing on the Rewards. Re-experience the privileges of the profession. Notice the life rewards associated with clinical work. Feel the career satisfaction. Practice the mental set of gratitude. Recall Emerson’s words: “It is one of the most beautiful compensations of life that no man can sincerely try to help another without helping himself.”
3. Recognizing the Hazards. Begin by saying it out loud: Clinical work is a demanding and often grueling enterprise. Affirm the universality of occupational hazards by sharing with colleagues. Beware the classic stressors of the “impossible profession”: emotional isolation, distressing patient behaviors, inhumane working conditions, physical exhaustion. Practice acceptance of the inevitable stressors. Cultivate self-empathy. Adopt a team approach.
4. Minding the Body. Don’t overlook the bio-behavioral basics. Protect your sleep. Insist on bodily rest. Secure adequate nutrition and hydration during the day. Engage in regular physical exercise. Arrange for contact comfort and physical gratification. In your quest for sophisticated self-care, return again and again to the physical fundamentals.
5. Nurturing Relationships. Cultivate a support network at the office: Clinical colleagues, supervision groups, clinical teams, office staff, community professionals, and mentors. Equally important, secure nurturance away from the office: spouse/partner, family members (including pets), friends, spiritual advisors, and Colleague Assistance Programs. Ask yourself repeatedly, “Who has my back?” Expectedly, psychotherapists find help relationships both deeply satisfying and highly effective for self-care.
6. Setting Boundaries. Maintain boundaries (a) between self and others as well as (b) between professional life and personal life. During the day, schedule breaks, restrict caseload, refuse certain clients, insist on a livable income. Consider the 90% rule: only schedule up to 90% of desired hours to allow time for emergencies, family demands, and self-care. Balance client desires and self-preservation by saying “no” to patients, such as no shows, late cancellations, unpaid bills, and non-emergency intrusions in your life. Demarcate a boundary between work and private life with a transition ritual.
7. Restructuring Cognitions. Monitor internal dialogue by your preferred method. Identify corrosive expectations about your performance as a clinician; for example, “I must be successful with my patients practically all of the time,” “I should not have problems; after all, I am a psychologist!” Manage problematic counter-transference reactions by self-insight, self-integration, empathy, anxiety management, and conceptualizing ability. Be gentle with yourself; shed the heavy burden of perfectionism that psychologists carry.
8. Sustaining Healthy Escapes. Beware the prevalent unhealthy escapes of substance abuse, isolation, and sexual acting out. Practice absorbing errands and healthy diversions away from the office, e.g., travel, hobbies, humor, relaxation, exercise. How do you play? Restore yourself with vital breaks, days off, personal retreats, vacations, and mini-sabbaticals.
9. Creating a Flourishing Environment. Harness the power of your work environment, thereby avoiding the fundamental attribution error (FAE) that your distress is solely your fault. Take an environmental audit of practice setting/office. Evaluate your work environment in terms of 6 key dimensions: work load, control, reward, sense of community, respect, and similar values. What is unsatisfactory and what can be done? High work demands plus high constraints is a toxic combination. Enhance the comfort of your work safety, privacy, lighting, ventilation, furniture, and aesthetics.
10. Undergoing Personal Therapy. Practice what you preach by seeking personal psychotherapy. Confront your resistances not to pursue personal treatment. Return to personal psychotherapy periodically throughout the lifespan without shame. Supplement psychotherapy with self-analysis. As an alternative, obtain an annual satisfaction checkup. Integrate with other forms of self-development, such as creative arts, meditation training, yoga.
11. Cultivating Spirituality and Mission. Reclaim your “mission” in life and in entering the profession. Cultivate wonder at the human spirit; it will enable you to pull hope from hell. Connect to the spiritual sources of your hope and optimism regarding behavior change. Confront squarely your own yearnings for a sense of transcendence and meaning. Become a citizen-therapist by merging your vocation with social activism. Let your life speak – manifest your core values in and outside the office.
12. Fostering Creativity and Growth. Strive for adaptiveness and openness to challenges – the defining characteristics of passionately committed psychologists. Involvement in diverse professional activities (e.g., psychotherapy, assessment, teaching, research, supervision) balances your workload and expresses the full array of skills. Attend clinical conferences, read literature, and form study groups to access the life springs of continued education. Expect a lifetime of struggle for awareness and growth; self-renewal is an ongoing process, not a CE workshop. Source
How to do the writing ritual:
1. Write honestly and openly about your deepest feelings and thoughts about the situation you are in or went through. Make sure you keep these writings private or you may find yourself unconsciously censoring what you write and diluting the effects of the writing. Consider destroying what you wrote after it is complete, again for the same reason. Perhaps making a ritual of the burning or destroying of the writing. (See the next section of this chapter for some hints about doing that kind of ritual.)
2. Write for a relatively short time, say 15 minutes. This writing is often draining or emotionally difficult. Limiting the time makes it both a bit more tolerable and more likely that you will do it.
3. Write for only four or five days. This time limit seemed to work very well in the experiments that were done. They are not carved in granite, however, and if you find you need more time, you can take it. One of the points of this limit of a few days is again to contain the experience so it doesn,t take over your life.
4. Try to find both a private and unique place to write, somewhere you can both be uninterrupted and someplace that won,t be associated with other things or that have the usual smells, sights and sounds of places you already know well.
5. Don,t worry about grammar or spelling or getting it right. Just write.
6. During the writing days, try to use the same time each day or evening to write. It,s not crucial, but it can sometime give your unconscious mind some structure and preparation time if it knows exactly when the writing will take place. This can also help contain the emotions and intrusive thinking that may occur and interfere with your day or evening
7. Writing seems to be the most powerful, but if for some reason, that won,t work for you, you could try "writing by speaking into a tape recorder or a video camera.
8. Ignore these guidelines if you discover something else works better for you. Everyone is unique.
Sources: Opening Up: The Healing Power of Expressing Emotions, James Pennebaker, NY: Guilford, 1990.
The Writing Cure: How Expressive Writing Promotes Health and Emotional Well-Being, eds. Stephen J. Lepore and Joshua M. Smyth, APA: Washington, DC, 2002."
Bill O'Hanlon, M.S., Possibilities
551 Cordova Rd., #715 Santa Fe, NM 87505
800.381.2374, Fax# 505.983.2761
PossiBill@aol.com, www.brieftherapy.com
MINDFULNESS
