Self-Care for Mental Health Professionals

In his book, Trauma Informed-Mindfulness With Teens, Sam Himelstein stresses the need for self-care for mental health professionals dealing with traumatised teens.   His final chapter is devoted to self-care and professional practice.  Dr. Cirecie West-Olatunji, counsellor educator,  also stresses the need for self-care for professionals working with people experiencing traumatic stress.  Her video presentation is available as part of the courses provided by the Mental Health Academy.   Both experts in the area of counselling for trauma highlight the impact of vicarious trauma, especially the risk of mental health professionals experiencing compassion fatigue.

Mindfulness for self-care

Sam himself experienced trauma in his early 20s when he lost his sister through suicide. He makes the point that most health professionals will have experienced trauma of some kind and that this experience leaves them open to triggering their own traumatic response through exposure to the trauma stories of other people.  Cirecie highlights the fact that the trauma stimulus can be exacerbated where the professional has previously experienced combined or cumulative trauma. 

Sam emphasises the role of mindfulness in helping the professional to deal with their own re-traumatisation as a result of interaction with others and their emotionally draining stories.  He stresses the role of a personal mindfulness practice in helping him deal with the trauma of his sister’s suicide.

Sam  suggests that a personal approach to mindfulness as a protective mechanism could involve the following:

  • Silent retreat(s): Sam found these exceedingly helpful because they enable you to fully experience your emotions, gain a deep insight into your inner landscape and develop strategies to maintain or regain your equilibrium.
  • Formal practice: this entails inculcating a regular mindfulness practice (either sitting, standing, or walking) where you engage in some form of formal meditation.  This helps to build your concentration to enable deep listening, empathetic response, and the ability to promote wise action.  It also assists you to deal with your own difficult emotions (such as anger, resentment, or frustration), challenge self-defeating narratives and develop resilience in the face of challenging interactions.
  • Beyond meditation: Sam suggests that bringing mindfulness into your everyday life (in daily activities such as walking, washing clothes, eating, shopping), is effectively “mindfulness-in-action”.  It is particularly relevant to your relationships and interactions with others, especially in times of conflict.  One way to develop the necessary calmness and equanimity in the face of emotional challenges is to practice reflection-on-action to eventually cultivate the capacity to reflect-in-action, in the course of something adverse happening to you (whether that adversity is real or imagined).  Sam stresses the importance of daily mindfulness practices in controlling the “ego” which can get out of hand when  it perceives a threat (physical, emotional, or intellectual).

Professional development

Both Sam and Cirecie stress the importance of professional development to build competence and confidence to enable you to operate effectively within your chosen arena of professional practice.  For Sam this is the arena of traumatised youth, especially those who have been incarcerated.  He offers specialised training for health professionals through his Center for Adolescent Studies.  Cirecie’s professional arena includes trauma stress service delivery and training professionals who provide counselling in different countries following disasters such as earthquakes and pandemics.  She conducts research and training through her Xula Center for Traumatic Stress Research.

Cirecie stresses the need to gain control over your workload and, where necessary, seek to negotiate a lighter load (for your psychological welfare and that of your clients).  She maintains that every mental health professional, irrespective of their level of experience and training, has their window of tolerance beyond which they are unable to function effectively.  She gave an example of how a racist client triggered her and how  her experience in working in South Africa with a community where people were consistently dying from AIDS took her outside her window of tolerance and led to a severe illness.  In both cases, she sought professional counselling and recommends this form of professional development for other mental health professionals.

Cirecie highlights the importance of self-knowledge and self-awareness as critical factors in professional counselling, particularly understanding your own negative triggers.  She encourages too the development of your own professional support network that you can draw on for knowledge, experience, resources, and emotional support.  

In Cirecie’s view, personal and professional development extends to conscious awareness of the physical and psychological health risks inherent in the role of a mental health professional.  She urges appropriate preparation for the role through education which will provide motivation for health self-care (e.g., exercise, stretching (to release physical tension), diet, and drinking water).

Reflection

There are many reasons why mental health professionals do not undertake adequate self-care.  When working with clients who have suffered trauma or are currently experiencing trauma, it is critical that the health professional takes time for self-care to enable them to function at their best for the sake of their clients, as well as for their own welfare.  Mindfulness practice is recognised as a key component of this necessary self-care.  As mental health professionals grow in mindfulness, they are better able to identify personal triggers, develop resilience for their challenging work and build the capacity to engage in deep listening.  However, mindfulness practice needs to be supported by an appropriate lifestyle. 

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By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Alzheimer’s Disease – Self-Care for the Carer

If you have a family member or friend suffering from Alzheimer’s disease you may find yourself suddenly thrust into a carer’s role, often with little preparation and understanding of that role.  The tendency is to “soldier on” through all the difficulties and ignore the emotional toll on yourself.  However, there are many resources and people willing to help and mindfulness can play a role in your self-care.

You may be witnessing the cognitive and behavioural decline of someone you love who not so long ago was vital, well-read, highly competent, intelligent, and very aware of current events and global trends.  Now you are having to contend with the emotional, financial, and time-consuming toll of caring for someone who has Alzheimer’s (on top of your daily work and life with their own challenges).

Dealing with the symptoms of Alzheimer’s disease

You may have to deal progressively with some or all of the following effects that Alzheimer’s has on your loved one:

  • Disorientation: losing track of where they are; thinking that they are in hospital or just out of hospital when neither is true; thinking they are in a location where they lived many years prior; assuming that their location is somewhere that happened to be mentioned in casual conversation.
  • Rapid memory loss: forgetting what they set out to do and constantly forgetting in the course of some action, e.g., finding their phone, having a shower, locating an object – the result is that everything takes so much longer and tests your patience (despite your good intentions).
  • Loss of practical skills; unable to do normal daily tasks such as cooking, keeping accounts, paying bills, driving the car or operate the TV remote.
  • Mood or personality changes: going from pleasantness to anger and aggression, happy to discontent, calm to agitated, confident to fearful, purposeful to suffering apathy and inertia; or any of the other possible mood/personality swings.
  • Indulging in unusual behaviours: constantly packing up the house expecting to be moved, indulging in unsafe behaviours (e.g., ladder climbing when they are unsteady), tendency to wander and lose their way (even in very familiar territory).
  • Confusion: forgetting who individuals are and their relationships, constantly losing things, thinking that a past event is happening in the present and preparing for it with some anxiety.
  • Difficulty with self-expression: unable to find the words to express what they want to say.

Each of these symptoms is taxing for the carer as well as the person suffering from Alzheimer’s.  As a carer, you may not know what to say, you can become confused about what is true and what is imagined, and you can become uncertain about the best way forward and the decisions that need to be made.

Self-care for the carer

There are many things that a carer for an Alzheimer’s sufferer can do to proactively care for their own welfare and psychological health:

  • Inform yourself about Alzheimer’s disease – understanding the disease helps you to make better decisions, reduce some of the uncertainty you are encountering and provides insights into how best to help the person experiencing Alzheimer’s.  One of the best resources around that is also very readable is Harvard Medical School’s report, Alzheimer’s Disease: A guide to diagnosis, treatment, and caregiving.  This publication details the symptoms of the disease, the impact on the brain and its structure, progression pathways, and, most importantly, incorporates a special section on Caregiving: Day-to-day challenges and beyond.  Understanding the decisions that need to be made, the options available and their impacts, makes it easier to make sound decisions amid the uncertainty and disruption surrounding the role of carer for an Alzheimer’s sufferer.
  • Gaining support from relatives and friends: typically, there is a tendency to “go it alone”, however, the role of carer for an Alzheimer’s sufferer is incredibly personally taxing.  Harvard Health describes caring for someone with Alzheimer’s as “one of the toughest jobs in the world “ and that your own life will be “dramatically altered” in this carer role.  It is vital that you “share the load” with relatives and friends where possible, e.g., with tasks such as visiting the person who is experiencing Alzheimer, talking through decisions, or sharing the financial burden.
  • Drawing on professionals and networks: It is important to draw on the collective knowledge of expert medical professionals such as the family doctor and appropriate specialist services such as a geriatrician or gerontologist. There are also support networks such as Alzheimer’s Association that provides support groups and professional information informed by research.  There are also carer support groups, such as Arafmi, for people caring for those suffering from a mental illness or “psychosocial disability”.
  • Exercise: physical exercise can reduce stress, enhance capacity to deal with stressors and provide the opportunity to “clear the head” and /or think more clearly about decisions to be made and options that can be explored.
  • Take time out: taking time for yourself such as a weekend or week away.  This is more manageable if you have already shared your situation with family and friends and drawn on their support.  It would also enable you to be more mindful about your own life and needs and options going forward. 
  • Developing mindfulness practices: mindfulness has a wide range of benefits that can assist in your role of carer.  For example, mindfulness can help you build resilience; manage uncertainty; develop calmness; deal constructively with difficult emotions such as anger, resentment, and frustration; and improve your psychological health overall.

Reflection

Alzheimer’s is an incredibly draining illness both for the sufferer and the carer. It takes its toll emotionally, physically, cognitively, and financially. It is vitally important for carers to be very conscious about the need for self-care and to be committed to being proactive about mindfulness practice.  As carers grow in mindfulness, they are better able to manage the multiple stressors involved and to achieve a level of equanimity even amid the disruption, uncertainty and turbulence involved in caring for someone with Alzheimer’s.  There are numerous resources available to assist carers and help them to make sound decisions and take wise action. 

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By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Self-Care in Challenging Times

Diana Winston provides a meditation podcast on the need for self-care in these challenging times when every aspect of our external environment is being disrupted – our health, politics, economy, society and climate.  Added to this, is the rising unemployment precipitated by pandemic-induced responses designed to restrict movement and resulting in business upheavals, shutdowns, and permanent closures.  The inner environment for many people is in turmoil – mental health issues are growing exponentially as people experience grief, anxiety, anger, and depression.  Overt racism is on the rise as people project their anger and frustration on those less able to cope.  

The demand for help is overwhelming on many fronts.   The temptation, according to Diana, is to be so focused on caring for others that we ignore self-care – leading to exhaustion, burnout and personal overwhelm.  Diana’s podcast is designed to help us to find our balance in the face of these overwhelming needs– her guided meditation being one of the many weekly podcasts provided by The Mindfulness Research Centre (MARC) , UCLA.

The need for self-care

Diana makes the point that it is more powerful and helpful to provide help and assistance from a place of equanimity than one of frazzle and burnout – it is more productive to provide from our personal overflow than from our depletion.  Being frenzied and frazzled is not helpful to others nor to our own wellbeing.  The challenge is to find the balance between the many demands of life – our families, relationships, work – and our desire to give support to others in need, whatever form that takes.  Diana stresses the need for self-care to achieve the necessary balance and personal overflow to be able to give from a centre of calmness and gratitude.  She quotes Thomas Merton who maintained that trying to achieve “a multitude of conflicting concerns” can lead to “violence” towards self.

Ways to achieve self-care

There are a many ways to achieve self-care, several of them are already described in this blog.  Diana emphasises the role of meditation in enabling us to provide self-care simultaneously for mind, body, and heart.  Meditation helps us deal with challenging emotions such as feelings of resentment, to handle negative self-evaluation and to find creative ways to give without self-depletion.  It enables us to find equanimity amidst the current turmoil of life.

For some people, movement in the form of exercise, yoga, Tai Chi, walking, or riding is an important component of their self-care.  Personal preferences are important here so that our choices address our personal needs of achieving inner harmony and life balance.  Lulu & Mischka remind us that mantra meditation is another form of self-care – integrating body, mind, and heart, especially if heartfelt and meaningful chanting is combined with movement such as swaying or rhythmic dancing.  Meditation in its many forms enables us to re-generate and to leverage energy in a  unique way.  Some meditation practitioners such as Melli O’Brien of Mindfulness.com offer a free meditation app with several meditations relevant for our times.

Guided meditation on self-care

In her guided meditation on self-care, Diana begins with helping you to become grounded through deep breathing followed by attending silently to the natural rhythm of your own breath.  She encourages you to choose an anchor such as your breath, the sounds surrounding you or bodily sensations (such as the warmth, tingling or a flow sensation in your fingers or feet).   The anchor is designed to bring you back to your focus when distracting thoughts appear.

Diana then encourages you to envisage what it would be like to feel really balanced while at the same time caring for others and yourself and contributing purposefully and meaningfully  to your work or role in life.  Her aim is to encourage you to experience this balance and sense of satisfaction as a motivation to make some small change in your life to achieve a better balance.  She encourages you as a part of the meditation to make a commitment to achieve that one small, re-balancing activity.  For some people, this change may actually involve taking on some form of caring for others if they are not already engaged in helping others.

Reflection

It is easy to lose ourselves in these challenging times when everything is in a state of flux.  Meditation and other forms of self-care can assist us to balance our lives and re-generate and increase our positive energy flow in such a way that we can provide support for others while maintaining our own equilibrium.  As we grow in mindfulness, we enrich our inner landscape, revitalise ourselves and become more open to possibilities both in terms of self-care and caring for others.  We can find our unique way to help and to take wise action to achieve our intentions.

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By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Self-Care and Care for Others in Challenging Times

Resilience is a constant theme of podcasts, online courses, and conferences in these challenging times.  One outstanding example of this is the interview podcast conducted with Michelle Maldonado  by Mindful.org.  Michelle discussed Resilience for Divided Times – the challenge of maintaining equilibrium in times of divisions on the grounds of race, nationality, gender, wealth and health.  The pandemic has unsettled everyone and challenged our way of operating day-to-day and, in the process, heightened anxiety and unearthed deep divisions previously hidden by the routines and busyness of daily life.  IN the interview, Michelle highlights the need for self-care, self-awareness, and pursuit of our own individual contribution to the service of others.

Self-Care for resilience

Without self-care we are unable to care for others and are more likely to contribute to divisions rather than their resolution.  Michelle emphasises the need to get in touch with our challenging emotions and not push them away or ignore them.  She quotes her father who used to say, “No way to it but through it”.  Michelle suggests that with escalating personal challenges, the need for self-care increases and demands that we increase the frequency, duration, and variety of our self-care approaches and mindfulness strategies if we are to build resilience and maintain our balance.   

Many people are finding it difficult to sleep in the current challenging times because of worries about health, finances, employment or restrictions on movement and access.  Michelle shared her own approach to overcoming the inability to go to sleep.  She maintains that often sleep eludes us because our mind is unsettled or constantly ruminating.  Her recommendation is to meditate or write a journal before going to bed to provide a “dump” for the mind and to still the mind’s incessant activity.  This mental activity can be complemented by a “body scan” to identify and release points of tension.  If you wake up prematurely, Michelle encourages you to practise a form of breathing involving exhaling longer than you inhale (e.g. a count of 7 on the exhale and 5 on the inhale) – an approach that activates the parasympathetic nervous system.  An alternative is to get up and write.

Self-awareness to take wise action

Michelle argues that if we lack self-awareness, we can unconsciously inflame divisions by our words and actions.  She maintains that each of us is constantly engaged in perception and prediction – both of which are influenced by our past experiences, including our childhood.  Our perception and prediction can generate a wide array of emotions including anticipation, sense of hopelessness, exhaustion, and excitement. 

As we grow in mindfulness, we can become more aware of our biases, predispositions, and distorted perceptions and create the space to think and act more consciously, skilfully, and compassionately (towards our self and others).  Michelle tells the story of how working closely with Federal Enforcement Officers totally changed her perception of these officers – an erroneous perception built up through newspaper and TV reports.  She saw their humanity, kindness, and concern for others. The danger is that we tend “to lump all people together” – whether they are of a particular location, race, profession, political affiliation, or gender orientation.  We need to challenge our assumptions through curiosity and honest self-inquiry so that we can create the space to understand where others are coming from and be able to take “wise action”, not action fuelled by ignorance, fear, hatred or misunderstanding.  

Contributing to the service of others

When we are confronted with the magnitude of suffering, mental illness, and uncertainty in these pandemic times, we can have a strong desire to help others but can feel overwhelmed by the magnitude of the task.  Michelle assures us that there is a unique way for each of us to make a contribution to the welfare of others.  She suggests that you can sit with the challenge of identifying your role and contribution to the service of others, think about it and attempt to write it down (to provide clarity and order for your thoughts).  With patience and persistence, you can gain the necessary insight to take the first steps and have the courage to “concretize and manifest what is yours to do”.  This may involve overcoming your natural tendency to procrastinate.

Reflection

As we grow in mindfulness through self-care and developing self-awareness, we are better placed to identify any distortions in our perceptions and projections and to manage challenging emotions.  We can build resilience and contribute in a unique way to healing divisions and helping others to achieve the ease of wellness.  

Michelle offers a brief G.R.A.C.E. meditation by way of reflection and integration of her discussion (at the 29-minute mark).  The meditation encompasses gathering attention; recalling intention; attuning to self and others; considering what would serve your self-care needs and the needs of others at this moment; and engaging ethically through deciding one wise action you can take (a first step).

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By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Self-Care for Healthcare Professionals

Dr. Reena Kotecha presented at the 2020 Mindfulness & Compassion Global Summit on the topic of self-care for healthcare professionals.  Reena highlighted the irony of healthcare professionals caring for everyone but themselves and, in the process, suffering pain, disillusionment and burnout.  She shared her own story of depression, mental illness and suicidal thoughts resulting from working as a young doctor in an emergency department in a hospital.  She was drowning in self-doubt, suffering anxiety about the future and trying to cope with her present level of stress symptoms such as palpitations and sleeplessness.  Reena found her way out of the dark hole of depression through meditation.

She highlighted the stresses that healthcare professionals are experiencing in these challenging times of the Coronavirus.  Reena spoke of frontline healthcare workers who had to move out of home to protect their family and/or elderly parents, of the sadness and grief they experienced with the death of patients, of the frustration of having inadequate resources (such as personal protective equipment) and of their fear for their own safety in terms of the impact of their work on their mental and physical health.  Frontline professionals experience the intensity and immediacy of Coronavirus-related stress and emotional inflammation as a result of the risks to the life of their patients and their own life.

Barriers to healthcare professionals seeking help

Reena emphasised that healthcare professionals not only tended to overlook caring for themselves but also failed to seek help for their mental welfare when they really needed it.  She spoke of the barriers that stop healthcare workers from seeking professional support (some of which she experienced herself):

  • Training focus – all the focus of their training is on how to care for others, very little of the training is focused on caring for themselves or how to seek professional help for themselves
  • Priority focus – healthcare professionals are singularly focused on caring for others and they fail to give priority to their own mental and emotional health that would actually enable them to care for others more effectively and in a more sustainable way.  As Reena points out, healthcare professionals are much more comfortable and more proficient in the role of caregiver than that of “care-taker”.
  • Career focus – healthcare professionals become concerned about what others, including management, would think of them if they admitted to not coping and experiencing some form of mental illness (which still carries its own stigma).  They can be concerned about how others will judge them and what impact this would have on their career.
  • Expectations focus – the community has highlighted the heroic efforts of the frontline healthcare workers but this brings with it an unrealistic set of expectations that they are all strong and courageous, free from normal human emotions of fear, anxiety and self-doubts and the resultant experience of depression with its concomitant impacts of inertia, exhaustion, reticence and lack of energy.  In the light of this community expectation set, they are reluctant to admit to “weakness and fragility”.

Young healthcare professionals may begin their career with an unerring focus on their patients, giving priority to their caregiver role and ignoring their own needs.  They may feel really uncomfortable about being seen as “needy” or becoming a “care-taker”.  Professionalism is interpreted by them as being strong and efficient, able to cope with any situation.  Gradually, however, the singular focus on patients begins to take its toll and is compounded by the fact that no matter how hard or fast they work, demand continues to outpace resources and capacity.  They begin to experience stress, fatigue and sleeplessness.  Despite these signs of not coping they push on – driven by their own expectations and the perceived expectations of others, including the “worshipping” community.  Burnout results when the gap between what they are putting in and their intrinsic satisfaction with their work widens to the point where they lose belief in the value of what they are doing – burnout occurs on the physical, emotional and spiritual levels.

Mindfulness as self-care for healthcare professionals

Self-care for healthcare professionals is a lifetime passion for Reena, partly generated by her own early professional experience but also reinforced by the healthcare workers who seek her help and support during these highly stressful times.  She is the founder of Mindful Medics – an 8 week course for healthcare professionals incorporating mindfulness, emotional intelligence, neuroscience and positive psychology. Participants in the course have experienced significant benefits for their mental and physical health as well as in their overall personal and professional lives.

Reena is also a highly recognised public speaker on the topic of her lived experience.  For example she presented at the Happiness and Its Causes Conference in 2018 on the topic, Personal Story: Healthcare Starts with Self-Care.   In her Summit presentation, Reena provided a gratitude meditation designed to focus on appreciation for what we have in the present to displace a focus on a disturbing past or anticipatory anxiety about the future.  There is so much that we can be grateful for and savour in our life – nature and our environment, the development of our children, our achievements and rewards and the space of being alone

Reena in an article, titled I am grateful…, recommends strongly that we develop a constant practice of expressing gratitude for the simple things that we have in our lives and highlights the neuroscience research that supports the benefits of gratitude for mental health and wellbeing.

Reflection

It is important to express compassion for others, especially healthcare professionals and those directly impacted by the Coronavirus.  However, we have to recognise the enormous stress healthcare workers are experiencing in these challenging times and be more aware of not adding to that burden by perpetuating the expectation that they, individually and collectively, can cope with any challenge at no cost to themselves.  We can also offer our support for people like Reena who are helping healthcare professionals to develop mindfulness as a means of self-care.  The Mindful Healthcare Speaker Series is one ongoing event that we can support.

As we grow in mindfulness by focusing on self-care through mindfulness practices and gratitude meditation, we can become more conscious of what we are thinking and feeling and be better able to appreciate the present moment and all it has to offer in terms of overall wellness and happiness.  Mindfulness enables us to identify our barriers and expectations, acknowledge when we need help, develop strategies to cope more effectively and progressively build our resilience.

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Image by Petya Georgieva from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Overcome Your Habituated Way of Reacting and Restore Your Energy and Power

In her podcast interview with Tami Simon, Dr. Lise Van Susteren identified four patterns of reaction to life challenges that she describes as “survival strategies”.  If we can understand these patterns of behaviour, we can regulate our normal way of responding to stimuli we encounter in life and develop more tolerance towards others.  In her book on Emotional Inflammation, co-authored with Stacey Colino, Lise offers a process to discover our triggers and recapture our balance, energy and power.  The book spells out the 7-step process, called RESTORE, and looks at ways we can personalise this process in line with our preferred survival strategy.

Four survival strategies that become habitual behaviour patterns

Lise maintains that the four survival strategies she has identified are based on solid empirical evidence and her own life experience.  She suggests that your preferred survival strategy is shaped not only by your personality and temperament but also by your life experiences and the people who influenced you throughout your life.  The four survival strategies are:

  • Nervous – fearful and anxious because they are able to clearly see dangers, both present and pending, and are capable of providing a warning and catalyst for action through their vigilance and thorough research (they “run the numbers”).
  • Molten – angry and outraged response to situations that are perceived as immoral, unjust or irresponsible and that constitute grounds for justifiable anger.
  • Revved – frantic response to the needs of others leading to ignoring own needs and resultant personal exhaustion.
  • Retreating:  a reflective and considered response that exhibits humility and compassion for others while exercising patience in the pursuit of resolution of issues and challenges.

Lise identified herself as a person who adopts the “revved” survival strategy.  She cannot say “no” to requests and finds herself in a whirlwind of activity giving talks and presentations and writing articles and other publications.  She identified Greta Thunberg’s “How Dare You” speech to world leaders, participating in the 2019 UN Climate Action Summit, as an example of a “molten” survival strategy – her words and actions precipitating a global, youth climate change movement.  In reflecting on my own response to the Coronavirus and its resultant impacts, I can identify my survival strategy as “retreating” – which is clearly shaped by my life experiences and the people who were most influential in impacting my thoughts and actions in response to anxious and challenging times. 

Lise suggests that if you can understand your habituated survival strategy, you will not only be more tolerant of others but also be better able to respond differently and more effectively when the occasion demands it – because you will have been able to reduce your “emotional inflammation”. She proposes the RESTORE process as a way to achieve these ends.

The RESTORE process

Lise maintains that the RESTORE process is a pathway to overcoming habituated responses to the things that trigger us while providing us with a means to regain our equilibrium and power to contribute to a better world.  Each of the seven steps of the process draws its name from one of the letters of the word, “restore”:

  • Recognise your feelings – identify and name your feelings, not denying or avoiding them.  The more you deny your feelings, the stronger they become and the greater is their influence over your words and behaviour leading to an increasing number of negative, unintended consequences.  This also involves getting in touch with your body and what it is telling you about your level of stress and agitation and the difficult emotions you are experiencing, particularly in situations where you perceive you have no control over what is happening.
  • Examine your triggers – gain an understanding of your triggers and their impact on your words and actions.  This involves a willingness to reflect on situations that led to a high level of reactivity on your part.  It also entails identifying the people and experiences that have shaped your habituated, unhelpful responses.  The process previously described for dealing with resentment is an example of this self-exploration.   Both this step and the former require self-observation and self-intimacy that can be developed through meditation, mindfulness practices and reflection. 
  • Steady the natural rhythm of your bodybreathing with the earth, somatic meditation and mindfulness practices help to restore your equilibrium that arises when you are attuned to the natural rhythm of your body. 
  • Think yourself into a safe space – often we are overcome by negative self-talk which makes us inflexible and destroys our equilibrium.  Working with your mind is necessary to achieve emotional agility and the capacity to adapt to ever-increasing stress situations. Jon Kabat-Zinn provides a cautionary reminder that “you are not your thoughts” – they are like passing clouds, while you are the peaceful and resilient reality behind those clouds. 
  • Obey your body – this entails self-care including physical exercise, practices like Tai Chi and yoga, avoiding foods that your body experiences as harmful, reducing stress by achieving a better work-life balance and using self-care services especially if you are a carer.
  • Reconnect with nature – Lise suggests thatyou can “reclaim the gifts of nature” by accessing its healing benefits and its capacity to stimulate appreciation and gratitude and inspire awe.  Mark Coleman offers online courses on nature meditation to assist you to reconnect with nature.
  • Exercise your power – Lise argues that to consolidate your newfound equilibrium and power, you can become an “upstander” instead of a “bystander” – taking effective action in the world (e.g. on climate change) out of a sense of thoughtfulness, compassion, self-belief and hope.  This is the pathway to joy – pursuing a purpose beyond yourself that reduces self-absorption.

Reflection

As we grow in mindfulness through nature meditation, mindfulness practices and reflection, we can deepen our self-awareness and tolerance, build our understanding of what triggers our unhelpful responses, develop equilibrium and reconnect with our personal energy and power to create positive change in the world. 

Throughout our restorative approaches we need to practise self-compassion, not beating up on ourselves for any shortcomings or shortfalls.  Louise Hay recommends that we practise the affirmation, you’re always doing the best you can with the understanding and awareness and knowledge you have.

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Image by NickyPe from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Carers Need Self-Care

Much of the focus in the resources on mindfulness is on ways to help people who are suffering from conditions that are debilitating such as mental illness or chronic pain.  Very little of the resources focus on ways to help carers in their role – ways to manage the physical and psychological toll of caring for someone else on a constant and extended basis.  Carers are the overlooked group – forgotten by others and themselves.

Carers: people who care and support others

Carers come in all shapes and sizes  – adults looking after ageing parents who may be suffering from Alzheimer’s disease; siblings caring for a family member who has a mental health condition such as schizophrenia, anxiety or depression; or anyone caring for someone suffering from a physical condition such as paraplegia, chronic pain or cancer.  According to Carers Australia, carers are people who provide unpaid care and support to family members and friends who have a disability, mental illness, chronic condition, terminal illness, an alcohol or other drug issue or who are frail aged.

The toll of caring

The “burden of care” can be felt both physically and psychologically.  The physical toll for carers can be excessive – they can become exhausted and/or accident-prone, suffer from sleep disorders or experience bodily symptoms of stress such as irritable bowel syndrome, chronic fatigue or related conditions like fibromyalgia. The physical toll of caring can be experienced as cumulative stress and lead to chronic conditions that adversely affect the carer’s long-term health.

The psychological toll of caring can also be cumulative in nature and extremely variable in its impact.  Carers can experience negative emotions such as resentment or anger, despite their compassion towards the person who is being cared for.  They can become extremely frustrated over the paucity of time available for themselves, the opportunity cost in terms of inability to travel or to be away for any length of time, the lack of freedom (feeling tied down), the lack of improvement in the condition of the person being cared for or the financial impost of caring (preventing desired savings/purchases or home improvements). 

Carers do not have inexhaustible personal resources – physical, psychological and financial.  They can suffer from compassion fatigue which can be hastened by emotional contagion resulting from close observation of, and identification with, the pain of a loved one.  Hence, carers can experience depression, anxiety or grief – reflecting the emotional state of their loved ones who are suffering.

The toll on carers has been the subject of extensive research.  For example, Emma Stein studied the psychological impact on older female carers engaged in informal aged care.  Sally Savage and Susan Bailey reviewed the literature on the mental health impact on the carer of their caregiving role and found that the impact was highly variable and moderated by factors such as the relationship between caregiver and receiver and the level of social support for the carer.

Being mindful of your needs as a carer

The fundamental problem is that carers become so other-focused that they overlook their own needs – their need for rest, time away, relaxation and enjoyment.  Normal needs can become intensified by the burden of care and the associated physical and psychological stressors.  Carers tend to neglect their own needs in the service of others.  However, in the process, they endanger their own mental and physical health and, potentially, inhibit their capacity to sustain quality care.

Carers can inform themselves of the inherent physical and psychological consequences of being a caregiver, particularly if this involves intensive, long-term caring of a close loved one (where feelings are heightened, and the personal costs intensified).  Mental Health Carers Australia highlights the fact that people who care for someone with a mental health illness are increasingly at risk of “developing a mental illness themselves”.

Self-care for the carer

One of the more effective ways that carers can look after themselves is to draw on support networks – whether they involve family, colleagues or friends; broad social networks; or specific networks designed for carers.  Arafmi, for example, provides carer support for caregivers of people with a mental illness and their services include a 24-hour carer helpline, carers forum, blog, educational resources, workshops and carer support groups. Carers Queensland provides broader-based carer resources and support groups.

Carers tend to go it alone, not wanting to burden others with “their” problem(s).  They are inclined to refuse help from others when it is offered because of embarrassment, fear of dependency, concern for the other person offering help, inability to “let go” or any other inhibiting emotion or thought pattern – in the process, they may stop themselves from sharing the load.

Carers could seek professional help from qualified professionals such as medical doctors or psychologists if they notice that they are experiencing physical or psychological symptoms resulting from carer stress.

Mindfulness for carers

Carers can use mindfulness practices, reflection and meditation to help them cope with the physical and emotional stresses of caregiving.  Specific meditations can address negative feelings, especially those of resentment and the associated guilt.  Mindfulness practices can introduce processes that enable the carer to wind down and relax – such as mindful breathing, mindful walking, mindful eating or using awareness as the default when caught up with “waiting” (a constant companion of the carer role).

Carers can employ techniques such as body scan to relax their bodies and release physical tension.  Deep, conscious breathing can also help in times of intense stress such as when experiencing panic. For people who are religious, prayer can help to provide calm and hope.

Dr. Chris Walsh (mindfulness.org.au), offers a simple mindfulness exercise for self-care by carers in his website article, Caring for CarersThe exercise involves focusing, re-centering, imagining and noticing (thoughts, feelings and bodily sensations).

As carers grow in mindfulness, they can become more aware of the stress they are under and the physical and psychological toll involved. This growing awareness can lead to effective self-care through social and professional support and meditation and/or mindfulness practices. Mindfulness can help carers develop resilience and calmness in the face of their stressful caregiver role.

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Image by Sabine van Erp from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

How Can We Manage When Our Daughter or Son is in Pain?


Susan Piver
, Creator of the Open Heart Project, addresses this question in response to an inquiry from one of her many followers. The danger when someone very close to us is suffering, is that we are tempted to take on their pain, to be so empathetic that we treat their suffering as if it is our own.

This identification with the sufferer was the very problem raised by Susan’s follower in relation to her daughter’s pain:

How do we prevent ourselves from hurting on behalf of the other person?…. Her pain feels like my pain, and makes me so upset and sad. 

Susan’s response is given by way of a brief input and a guided meditation. She asserts that you cannot prevent yourself from feeling the pain of someone close to you – to do so would stop you from feeling anything. You would effectively turn off your feelings to protect yourself but in the process destroy what makes us essentially human – the capacity to feel and be compassionate.

The damaging effects of closing your heart to pain

Susan uses the analogy of a gate which has two positions – open and closed. So our heart, or our feeling with and for another, tends to be in one or other of these positions – either open hearted or closed. Susan deliberately called her life’s work the Open Heart Project because it is essentially designed to help people to open up to the full range of their experience – beauty and darkness, happiness and pain, freedom and restraint.

Susan paints a graphic picture of the difference between an open heart and one that is closed by describing the difference as that “between awake and asleep, alive and numb, present and deluded”. She suggests, however, that you cannot just be totally identified with the other person’s pain – you have to be able to achieve a separation from the other’s suffering – not own the suffering of another. Richard Davidson describes this capacity as “social cognition” which his research into the science of compassion demonstrates is essential for the “balance and welfare” of the person observing the suffering.

Susan cautions that we need to be conscious of the “toll” that feeling for another’s suffering has on ourselves. In her view, shutting off our own pain to protect our self is really self-damaging because it numbs us. The way forward is to feel the pain but actively engage in genuine self-care, whatever form that can take for you personally (this could involve exercise, yoga, Tai Chi, meditation, prayer, time with family and/or friends, accessing social/professional support or a combination of these).

Managing through compassion meditation

One of the benefits of being able to manage the pain you experience when your daughter or son is suffering is that it lays the foundation, or “pathway” as Susan describes it, to genuine compassion for others. This capacity for genuine compassion can be further developed through different forms of compassion meditation. Daniel Goleman and his neuroscience colleagues have demonstrated through research that compassion meditation develops in people an “altered trait” that is evidenced through increased kindness and generosity.

Compassion meditation, often described as loving kindness meditation, frequently begins with extending kind thoughts to someone close to you, progressing to an acquaintance, to someone you have heard about or a group of people experiencing some form of suffering and finally taking in someone you find difficult. This expanding expression of compassion can be underpinned by self-compassion meditation.

As we grow in mindfulness, we can become increasingly aware of, and sensitive to, the pain and suffering of those close to us. If we shut off these empathetic feelings, we can numb ourselves to the full range of human experience and prevent ourselves from expressing our feelings. Active self-care is essential to manage the personal toll of being empathetic and maintaining an open heart. Compassion meditation can build our capacity to sustain compassionate action not only for those closest to us but to everyone, whether we like them or not.

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Image by Gerd Altmann from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Can You Experience Compassion Fatigue?

Kelly McGonigal in her presentation for the Mindful Healthcare Summit challenged the widely held belief that you cannot experience compassion fatigue. Many people contend that compassion fatigue does not occur because the heart is capable of endless kindness and love for others. Kelly maintains that motivation and goodness of heart are not sufficient to prevent the depression and burnout that can result from compassion fatigue. She asserts that compassion has to be supported by adequate self-care if it is to be sustained.

Compassion and the stress response

Kelly argues that compassion is like the stress response when viewed physiologically. Compassion floods the body with hormones such as dopamine and marshals the body’s energy to relieve the suffering of others. However, while this can be very energising and exciting in the short term, compassion takes its toll in the longer term both bodily and mentally, as we do not have endless physical and mental reserves.

The possibility of compassion fatigue can be increased where a helping professional or carer experiences vicarious trauma or moral distress – the latter being defined as being required to do things that clash with a person’s values or moral perspective, a frequently occurring ethical dilemma within the medical profession.

Compassion fatigue

Kelly suggests that compassion fatigue occurs when a person lacks the energy and resources to pursue their motivation to care in such way that it achieves personal satisfaction (activates the reward system). Outcomes achieved fall short of personal expectations and/or the expectations of others, despite the strength of the caring intention. The compassionate person feels exhausted and feels that the more they give the less they experience satisfaction – the gap between input of energy/time and the expected satisfaction increases, leading to burnout. The depletion of energy and satisfaction could be the result of factors outside the helper’s/carer’s control – such as structural blockages, breakdown in information exchange, overwork or under-resourcing.

Compassion needs nourishment

One of the issues that exacerbates the problem of compassion fatigue is the belief in the endless capacity of an individual to be compassionate through the goodness of their heart or the purity of their intentions. As a result of this false belief, helpers/carers fail to take the necessary actions to nourish themselves (and their compassionate action) and/or are reluctant to accept compassion extended to them by others.

Personal nourishment can take many forms – getting adequate sleep, meditation (especially self-compassion meditation), listening to relaxing/inspiring music, prayer (whatever form it takes) or drawing strength and healing from nature. It also requires an openness to receiving compassion from others – challenging false beliefs such as “no one else can do this”, “I will be seen to be weak if I accept help from others”, “I really shouldn’t pander to my own needs by having that short break or having a reasonable period for lunch”, “I can’t afford to become dependent on others for assistance”. Additionally, positive social connection– to offset the tendency to withdraw under extreme stress– is a critical source of self-nourishment.

As we grow in mindfulness through meditation our awareness of others’ suffering and our motivation to help are heightened. The capacity for compassionate action is not limitless and needs nourishment. Central to this nourishment is self-compassion.

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By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

What Is Your Unique Purpose in Life?

In the previous post on Finding Your True Purpose, I drew on the interview podcast by Stephen Cope.  In that post, I explored what Stephen refers to as the “four-stage path of action”.  The first stage, however, discerning your true purpose, is where people often become stuck and unable to move forward, for multiple reasons (including doubts).

Stephen suggests several ways to help you progress in deciding what is your unique purpose in life – what best utilises your knowledge, skills and personality for the greater good.  This can be a challenging task and may take some time to discern – it could involve immersing yourself in an area of interest to establish the needs that are present in that arena.  Research may precede action.

What is your unique purpose in life?

Some of Stephen’s suggestions may help with gaining clarity about your unique purpose.   He suggests that you can focus on three areas to gain further insight into any “unconscious obstacles”.

  1. What lights you up? – what in your life generates positive energy, captures your commitment or engages you over lengthy periods?  The way to access this is to write a list of things that light you up, without censoring the list.  Look for themes or connections amongst items on your list, and you may find a pointer to your unique purpose.
  2. What is your deepest duty right now? – you will have duties as an employee, friend, colleague, parent, citizen, partner.  What duty flowing from any of these roles is felt so deeply that if you do not fulfil it, “you will feel a profound sense of self-betrayal”?
  3. What personal challenges do you face? – do you have a health issue, relationship challenge, a problem involving your child or children or a workplace issue?  What do these challenges inspire you to do? It may mean helping others to show self-care or establishing a support group for parents who have lost a child or for people experiencing work stress.  Some people have established a foundation or committee to enable them to engage others in supporting them in their endeavours to do something for the common good.

Famous people such as Gandhi and Robert Frost found their unique purpose and proceeded  to develop what Stephen calls “unified action” – where you increase your focus on the area of interest and peel away anything that is not contributing to your unique  purpose.     Extraordinary people have achieved extraordinary outcomes but there are many more “ordinary people” who have excelled at what they do because they have realised a singular focus and a commitment to act in accord with that focus.

As we grow in mindfulness through meditation and reflection (particularly on our interests, our duties and our challenges), we can gain clarity about our unique purpose, find creative ways to fine tune our actions and increase the integration of that purpose into our daily lives.

 

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Image source: courtesy of cocoparisienne on Pixabay

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.