Tag: self care

We know that self-care is important for everyone. But how do you practice self-compassion and personal wellness when you have been through trauma or are trying to help someone through a traumatic life event? In the first part of a two-part series on trauma-specific self-care, we looked at how your body responds to stress and trauma and what individuals can do to begin healing. Now, in part two, we’ll explore how mental health professionals can take care of themselves while they take care of their clients.

How Does Treating Clients with Traumatic Experiences Affect Me?

The reality is that treating clients who have experienced trauma can have impact. This “inevitable secondary stress,” as Trauma expert and Simmons College Graduate School of Social Work professor Julia Colpitts, MSW, calls it, is natural. We evolved to connect with our pack to survive. When we see or hear other people’s trauma, the areas in our brain that are activated are the same ones that would be activated if it was primary trauma—our own trauma. Mirror neurons are engaged in the trauma’s retelling, and our bodies respond to the story and mimic the survivor’s physiological response. Trauma is, in a sense, contagious. So, what can we do about it?

What Is Secondary Stress?

“Vicarious or secondary stress is empathy in action,” Colpitts states, and it is unavoidable. We are social animals, and we respond naturally to others. The impact ranges from mild to clinically symptomatic, but all responses on the continuum can have a long-term effect. We can get stuck in arousal mode from the continuous retelling of traumatic life events if we don’t actively manage our secondary stress and its impact on us as therapists and mental health providers. It doesn’t have to lead to professional burnout; viewed and managed differently, it can even become an invitation to grow personally and professionally.

Secondary traumatic stress often causes muted arousal responses, either hyper (flood of anxiety, fear, and anger) or hypo (distancing from emotion). Over time, cognitive distortions can develop, altering one’s focus, the content of their thoughts, and even their worldview. Unacknowledged vicarious stress also has a negativity bias, which can obscure our compassion satisfaction and real accomplishments. For therapists who hear traumatic stories that resonate with their own prior life trauma, the arousal response can deepen—and our professional dissociation and burnout, historical and/or cultural trauma, and traumatized organizations can serve to further deepen that response.

Some mental health professionals, like others in the population, cope with secondary stress and trauma by employing short-term relief strategies to manage their state of arousal, such as food and alcohol issues, inactivity or “mindless” (dissociative) activities, and overwork. These primitive defense mechanisms may appear to help for a few hours, but ultimately they all have long-term negative consequences.

Unhealthy coping behaviors such as substance use may have the same effect as ignoring the secondary stress altogether: illness, including serious chronic conditions such as heart disease. Women who are social workers, for instance, are 36% more likely to have heart problems than women in other professions (American Heart Association scientific session, November 2019). And “community and social services” is number one of the top ten professions correlated to cardiac arrest (gender-neutral) (CDC Morbidity and Mortality Weekly Report, 2016). It is therefore crucial that we develop positive coping methods for secondary traumatic stress.

A therapist’s self-care involves acknowledging the continuous stress you are under and allowing yourself a release. We need to proactively prepare for secondhand stress and its impact on us through daily doses of calm interspersed through our days.

Which Tools Should Therapists Use for Secondary Stress?

How do we turn off the arousal response? We activate the care system.

“Self-care is not just what we do after work. Self-care is how we do the work itself.” –Julia Colpitts, MSW

 

First of all, guard against the tendency to overcommit, to overwork in an effort to soothe. Like the proverbial oxygen mask on an airplane, you are ill equipped to help others if you’re not functioning well yourself.

Then, create a resilience menu. Choose from an array of simple, self-care actions to calm the body and calm the mind—a personal relaxation practice that can radically reframe how you go about your day. As though you are selecting a dish from a restaurant menu, choose the one(s) that sound best to you that day, at that time. And just as we are advised to “eat the rainbow” when it comes to dietary health, your resiliency menu or toolkit works best when you layer soothing actions across the spectrum, and use self-care well not just when there’s a personal crisis, but proactively and intentionally, every day. Some examples of what relaxing options might be on your resiliency menu [link “resiliency menu” to October blog] include:

  • Breathwork, such as box breathing
  • Being kind to yourself—kick out the inner critic
  • Muscle tension release using progressive relaxation techniques
  • Guided meditation, such as those offered by Kristen Neff
  • Sensory stimulation (e.g., aromatherapy, calming visuals, nature sounds, savory tastes, touch, water, sexual activity, massage, Reiki bodywork, and grounding strategies)
  • Acupressure and acupuncture
  • Yoga, tai chi, and other mind-body centering work
  • Conjuring up images of love and connection
  • Self-compassionate meditation and activities, such as bilateral stimulation like the butterfly hug, and affirmations
  • Interacting with animals, including equine-facilitated therapy
  • Mindfulness and related physical practices, such as walking meditation and forest bathing
  • Body scans
  • Expressing gratitude and love

Your resiliency tools not only help to heal the impact of secondary traumatic stress by releasing stored arousal responses and reestablishing a peaceful baseline, they also help strengthen your capacity for joy and presence and prepare you for future sources of stress.

How Can I Support Other Mental Health Professionals’ Well-being?

To journey to wellness together, we need to support positive attachments to ourselves, to others, and to community coregulation. As mental health providers, we can:

  • Talk openly about secondary trauma and its impact.
  • Add moments to meetings that emphasize compassion satisfaction.
  • Practice personal relaxation techniques openly, as appropriate, to model calm.
  • Notice and address when organizations are traumatized.
  • Support setting realistic workloads.

Thank you to Julia Colpitts, MSW, for sharing her keynote presentation and ideas on this subject.

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Mental health can and should be a daily practice, taken into consideration more often than “when something is wrong” or when going through a particularly difficult time. Taking care of your mental health is a preventative form of care and by incorporating daily rituals and practices into your life, you can give your mental health the attention it deserves.

Here are nine things you can do to take care of yourself so you can take care of others:

Take a mental health day. You know yourself best. If you feel that you need a break, take one. If you don’t have vacation or paid time off, consider taking mini breaks throughout the day to renew your energy and spirit. It’s okay to slow down and not feel rushed to cross everything off the to-do list at once.

Switch up your evening routine. Try winding down in a different way than you typically do if you’re feeling particularly stressed or “off.” Think about what relaxes you and adopt that into your routine: reading a book, taking a long bath, chatting with a friend.

Adopt a vacation mentality. Put your phone setting on do not disturb between 9pm-7am. Go swimming instead of sweating at the gym. Walk in the park with a friend during lunch. Ignore emails after you’ve clocked out for the day/week. Whatever you do on vacation that feels relaxing and rejuvenating, try bringing some of that into your daily life.

Meditate for five minutes every day. Perhaps you’ve heard this advice before, but the science doesn’t lie! Meditation eases stress and anxiety, calms your nervous system, helps with memory and so much more. There’s no need to put pressure on yourself to gain some important insight or enlightenment. Sit quietly, focused on your breathing with no judgment of the thoughts in your head. With regular practice, you’ll begin to feel the benefits.

Be mindful of what you eat and drink. It’s a common coping mechanism to comfort our emotions with food, drink or other substances. We all have different nutritional and lifestyle choices, but we suggest being extra mindful when experiencing stress, anxiety or depression as sugar, junk foods and alcohol will make you feel worse (even if you feel better temporarily).

Consider reaching out for professional help. There is no barometer, specific feeling or event that warrants a person to “need” or want professional counseling. We all have varying life circumstances and coping strategies. If you feel like you “shouldn’t be this upset” or that “others have it worse” we suggest allowing yourself permission to seek help. We all deserve it.

Prioritize rest. Our culture values the “hustle” and though hustle has it’s time and place, we also need rest. You know your body and mind best—if you need a morning off work, take it. If you need a long weekend alone, take it. If you need to sleep in just a little bit longer, sleep in! The to-do list is not going anywhere and you’ll need your physical and emotional health in top shape to do your best.

Write down as many inspiring messages as you can. They can be lyrics, affirmations, reminders to move your body, drink water, have gratitude—any message that uplifts you. Keep them close by, such as in a desk drawer, a large jar or your phone’s notebook app. If you need a pick-me-up, reach for one. Alternatively, download an app that sends positive affirmations to your phone daily. It’s proven that we bring to life the thoughts that we tell ourselves (even unconsciously), so let yourself think positive thoughts!

When we feel that we are in control of our thoughts, feelings and emotions we’re bound to continue the work that allows us to feel that way. However, if you think you may need professional help, reach out. Everyone needs help at some point in life. It takes courage and strength to recognize when help is needed and seek it out.

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As mental health professionals, you may suggest the importance of self-care to your clients, but do you have a difficult time implementing a practice in your own life? During the last year specifically there’s been an increase in demand for mental health services as individuals are navigating the effects of the pandemic. It’s essential as a counselor, therapist or clinician that you recognize any signs of stress or fatigue and implement self-care into your daily routine.

This may differ from person to person, but look for the following:

  • Losing your sense of humor
  • Problems developing at home
  • Having low or no energy
  • Becoming irritated with clients
  • Other physical and mental signs of stress include change of appetite, trouble
    sleeping, feelings of overwhelm or that things can never seem to go right

Consistently as a mental health professional, you give so much of yourself to your clients. This has every potential to leave you feeling emotionally depleted if there is an absence of other forms of support or self-fulfilling activities. Further, the cumulative stressor of an ongoing pandemic has been a shared trauma experienced by both client and clinician concurrently. This has presented us with an environmental parallel process while engaging with our clients. As such, it becomes increasingly more vital for us, as helpers, to ensure that we find ways in which to enrich our lives outside of session as a way of practicing self-care.

Outside of your career, you’ll want to be sure that your relationships are not “one-way streets.” It may be second nature for you to always listen and always give, but your personal relationships need full participation and commitment from all parties.

Why is practicing self-care important for mental health professionals?
When mental health professionals do not consider their emotional, physical and spiritual wellbeing as a priority, their outlook on their careers or the profession itself can change which may lead to severe stress or burnout.

Here are ways to implement talking the talk and walking the walk:

  • Join a peer group
  • Consider attending counseling
  • Create boundaries with clients
  • Set office hours (and stick to them!)
  • Take vacations/holidays

How can mental health professionals incorporate self-care into their daily practice?
Nurturing your wellbeing looks different for everyone and also may differ in the various stages of your life. Look for moments within your day-to-day to reflect and care for yourself. Make it a part of your routine and non-negotiable on your calendar.

Small acts of daily self-care include:

  • Go for a walk
  • Meditate, pray or practice mindfulness
  • Journal or write down thoughts and feelings as they arise
  • Nourish yourself with water, movement/exercise and nutritious foods
  • Set priorities on your to-do list ensuring there’s time for yourself

It may feel difficult or selfish at first to make yourself a priority. However, when you take proper care of your wellbeing, you’ll be able to increase the quality of care, impact more lives, and serve your clients better. That starts with taking care of yourself on a consistent, guilt-free daily basis.

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Are you feeling busy, distracted and exhausted? Even after the emotionally overwhelming year we’ve all just experienced, we haven’t slowed down and taken time for ourselves. Further, our society doesn’t value the practice of introspection, the observation of one’s own mental and emotional processes. Introspection, or self-reflection, is the willingness to recognize and determine your “old programming” that no longer serves you so that you can build new “programming.” How this can be done? With a calm mind to start.

How do I calm my mind?
Having a calm mind will allow you to concentrate and feel more relaxed. This practice will vary person to person, but here are some suggestions:

  • Take a few deep breaths; practice breath work
  • Stretch your body
  • Go for a walk; move your body
  • Journal, meditate, pray

How do I practice self-reflection?
When your mind is calm, allow yourself to draw inward and think deeply on the issue, emotion or memory at hand. To help, ask yourself:

  • What does this make me think?
  • How does it make me feel?
  • How does it hold me back?

It’s important not to judge yourself. Be honest with yourself so that you’re not tempted to imagine how you should feel. Don’t be afraid to dig deeper! You’re trying to access the root of the issue and you will most likely come across resistance. This is your ego/mind trying to protect you from uncomfortable and harmful emotions.

Additionally, you can ask yourself questions in order to get to know yourself better whether or not you’re currently working through an issue. Start with these:

  • What am I really scared of?
  • Am I holding on to something that I can let go of?
  • When did I last push passed my comfort zone?
  • What do I want most in life?
  • When was the last time I made someone smile?

Why should I practice self-reflection?
With self-reflection comes self-awareness. You’ll begin to see your thoughts, behaviors, emotions and reactions in real time as you experience them. You can determine which ones bother you, don’t serve you or harm you and learn to let them go. By slowing down, calming your mind, and asking yourself substantial questions to draw on old issues, you can then learn to shift your behaviors, thoughts and reactions to ones that better represent you, your values and beliefs.

The more you reflect, the easier you’ll be able to hold yourself accountable. This not only benefits you directly, but it also benefits those you surround yourself with. You may even inspire them to be more introspective!

What are benefits to introspection?
A self-aware person can expect myriad of benefits, but here are some that may be true for you:

  • Clarity
  • Self-control
  • Less stress and anxiety
  • Higher self-esteem and pride
  • Increased emotional intelligence
  • Easier time coping with challenges
  • Appropriate reactions to situations
  • Realize their potential and become more aligned

Remember, slowing down, calming your mind and regular self-reflection may come with resistance­­­­ from your mind, your family, even your job. Stay strong­­–this time is essential for your mental health. It’s okay to start small and always be gracious and patient with yourself. You’re in the process of changing how you think, feel, and behave. You’re changing your life!

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This article originally appeared in Macaroni Kid on March 26th, 2020 by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine

This is indeed a really strange time—not going to work, having the kids and even (for some) a spouse at home. How unexpected. This is not something any of us had planned on. For some, this is a great adventure in family time. For others, it may feel like a really overwhelmingly big challenge. The threat of illness and possible financial problems can keep us stressed. You are not alone in that.

In whatever frame of mind you are experiencing this time of being sheltered, remember that you are not alone. Parents all over the country and the world are adapting to this temporary hiccup in our lives. It is a little like the ice storm years ago that cut power for weeks. We were all experiencing the same thing and life was disrupted.

We will get through this with our own stories to tell and one day this will be a memory. In the meantime, one of the best ways we can cope is by practicing self-care. 

What is self-care? Basically, it means taking time to care for our own needs. The result of doing this is that we will have more energy for the tough jobs, like parenting. It is taking care of ourselves that gives us energy. Think of what happens when your vehicle runs out of gas. It stops; nothing works. When we humans run out of energy, we stop too. It causes us to feel moody, sad, anger easily; we may fill with anxiety. Sometimes when we do not take care of ourselves, something else stops us, like an illness, depression, and other things that sap our strength. Caring for ourselves, especially during stressful and uncertain times like this is not just a good thing, it is essential!

Here are some ideas for quality self-care. This is not just the “get a cup of tea” variety (which can be very nice), but things which may give you lasting fuel for your tank.

Remind yourself that what you are doing is important. Families isolating to protect themselves and the greater community is really important. We are in this together. Everyone is doing a little extra to keep everyone safe.  

Find people with whom you stay in contact. Share ideas for kids’ play or meal planning with a friend who is also home with kids. Check on neighbors, parents, and singles you may know. Think of it this way: reach out to one that feeds you, one that needs you, and one that makes you laugh. These brief contacts can restore your energy and spirit.

Put those kids on a schedule. Organize their day for them (this is really for you). Divide their time so they are not just on electronics (too much is not good for kids) or not driving you crazy with wrestling, fighting or bickering. Help each of your children to identify what they would like to do in each area. 

Here are some possible divisions of time:

  • Help with making and cleaning up meals and doing chores
  • School studies time or completing worksheets
  • Outside time (daily!) for the kids to burn off energy
  • Dancing or high energy playtime
  • Quiet time (puzzles, reading, napping)
  • TV/game/video time

Set boundaries on these activities and take charge.

Limit news consumption. Too much reading, watching and listening to the news can contribute to anxiety. The news cycle repeats throughout the day, so you will always get the latest when you tune in. Always remember to get your news from reliable media sources, and when possible from different viewpoints.

Practice gratitude. At the end or the beginning of each day, take stock on those things for which you are grateful. Think about each child, each supportive person in your life, and moments big and small that made life better. Look for and acknowledge those places in your life where you are truly rich. 

Lastly, remember you are not alone. We will all get through this challenge “at a distance” but together. Spring always comes, let’s be grateful for that.

 

Luanne Starr Rhoades, LCPC, LADC, CCS is a professional counselor and the Outpatient Therapy Director at Health Affiliates Maine, a mental health and substance abuse treatment agency serving adults, adolescents, children and families. For more information or if you or someone you know needs help, call us at 877-888-4304 or visit our website www.healthaffiliatesmaine.com and click on “Referrals.”

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Cold Dark Season Has Reader Depressed

Winter is here and it is a difficult time for me. Between the cold, the dark, and the lack of outdoor time, I get really depressed. I know about SAD and have tried light therapy. I think it helps some but not enough. What other things can I try?

This article originally appeared in Macaroni Kid on February 13, 2019 by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine

Question: 

Winter is here and it is a difficult time for me. Between the cold, the dark, and the lack of outdoor time, I get really depressed. I know about SAD and have tried light therapy. I think it helps some but not enough. What other things can I try?

Answer: 

Winter is a difficult time for many.  Some people enjoy winter because they have sports like skiing or snowmobiling, which causes them to look forward to it.  For many of us, winter is to be tolerated.  Some, like you, have the added difficulty where seasonal circumstances, like the lack of light, which affects your mood and leads to depression.  For some, the difficult months come on in February and March due to an accumulated effect of reduced daylight.  You mentioned SAD, which stands for Seasonal Affective Disorder.  SAD can cause depressed mood, social withdrawal, and mental health problems like increased anxiety, eating disorders, substance abuse, and suicidal thoughts.  

Here are some interventions that can help:

Preplan winter.  As the winter season approaches each year, fill your calendar with activities both social and physical.  Schedule lunch with friends, movie nights, family game and puzzle challenges.  Have a lot of interactions with people you care about.  Social supports and things to look forward to can make the winter seem to go faster.

Bundle up and get out!   Plan to be outside in the morning or the middle of the day whether it is cloudy or sunny.  Daylight helps; try to get out whenever you can.  Some sufferers like to wear yellow lenses which reduce blue light and make everything brighter.

Buddy up with another that may also be troubled by the difficult winter.  You can help motivate each other with physical activity and healthy eating.

Boost up the self-care.  This is the time to focus on your own needs.  Do an inventory of the physical, social, emotional, and spiritual areas of your life.  Are there any needing attention or outlet?  What can you add to bring life into balance? Counselors can help with this.

Use your light therapy every day. Think of it as a daily medication. Start in the fall as the daylight first starts to shorten. Place the light in front of you every morning for a half hour.  Eat breakfast by it or read.  Do it every day.

Plan a winter getaway.  If you have the means, taking a vacation to a sunny climate during winter months can be a real lift.

Check with your doctor.  This problem is likely to come back every year, as long as you live where the days are shorter in the winter.  If you haven’t already, see your doctor for medication, It is best to do this in the early fall so the medication will be at therapeutic levels come the dark months. This will help with the hormone imbalance caused by the lack of light.

Consider vitamin D.  Ask your doctor about this.  People who live in wintery climates often have low levels of vitamin D.  This is the vitamin that is produced in our bodies by sunlight interacting with our skin and has many healthful purposes, including treating and preventing depression.

Luanne Starr Rhoades, LCPC, LADC, CCS is a professional counselor and the Outpatient Therapy Director at Health Affiliates Maine, a mental health and substance abuse treatment agency serving adults, adolescents, children and families. For more information or if you or someone you know needs help, call us at 877-888-4304 or visit our website www.healthaffiliatesmaine.com and click on “Referrals.”

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Health Scare Calls for Self Care

I recently had a health scare. While I am okay, my doctor has urged me to take better care of myself, in particular, carving out time for reducing stress...

This article originally appeared in Macaroni Kid on January 16, 2019 by Luanne Starr Rhoades, LCPC, LADC, CCS; Health Affiliates Maine

Question: I recently had a health scare. While I am okay, my doctor has urged me to take better care of myself, in particular, carving out time for reducing stress. I have been successful in making some changes to diet and increasing my exercise but I really struggle with finding ways to relax and unwind. I’m not the bubble bath taking or knitting type. I think a lot of people struggle with this so I hope my question is helpful to others as well: What activities can help me reduce stress?

Answer: 

I am glad you are okay.  Stress is a killer, and we all need to realize the immediate and lifelong need to take better care of ourselves.  You are already making positive changes and I hope that you keep moving forward with making diet and exercise changes. Small changes can lead to big improvement if you resolve to make it important.

Stress can be self-induced or can have external causes.  Self-induced stress can come from negative self-talk and unrealistic expectations. To illustrate this, think of a picture you may have in your head about how your day/life should be going.  When our reality doesn’t match that picture, we have stress.  External stress can be caused by others, events or circumstances for which we have little or no control.  During external stress, self-care is very important. Take some time to understand where your stress originates.  Understanding this can lead you to ways to manage it.  Here are some ways to reduce or manage stress for both mind and body: 

Vigorous vs calming activities:  Instead of bubble baths and knitting, how about tennis, biking or boxing (weather permitting, of course)?

Take mini breath breaks—Do this while sitting at a stop light, while waiting for the microwave to finish, or while having a quiet moment.  Relax your shoulders, and take in your breath deep into your diaphragm, three times or more.  Be careful that you are breathing deeply and slowly (causing your belly to move in and out); not at the top of your lungs.  These two ways of breathing stimulate the nervous system in different ways, and breathing low in your diaphragm triggers a relaxation response. Explore meditation skills to reduce stress. There are several helpful online resources.

Narrow your focus– If stressful events/tasks have you feeling anxious or worried, switch your focus to the here and now.  Here is an exercise to help illustrate this:  If you are drinking a coffee or tea, stop for a moment and feel the warmth of the mug in your hand.  Stop and recognize the aroma and  the taste on your tongue.  Breathe in deeply and take a moment of gratitude for the pleasure it brings.  Spending time being mindful of your coffee is so much better than suddenly finding it gone.

Get grounded—Grounding techniques can be helpful when things feel particularly out of control.  Stop and notice parts of your body that touch the chair, the floor.  Listen to the world around you and think about what you notice.  This is called “grounding” and can be incredibly calming.

Manage expectations and perfectionism—Work on accepting that you will never be perfect, or do things perfectly or have a perfect family; these expectations of yourself and others are not worth the risk of adding lethal stress to your life.  A good book is When Perfect Isn’t Good Enough by Martin M. Antony, PhD and Richard P. Swanson, MD.  Talking with a counselor can also help you with this.  

Schedule self-care – Your doctor asked you to “carve out time” to reduce stress.  You may have to schedule it.  I have co-workers who use their 10-minute breaks to walk the parking lot for exercise and a social connection.  We reduce stress by briefly escaping or by talking about it with someone who can help us process it. Lastly, many of us wear many hats and are really good at taking care of others.  This “health scare” is a signal it is time to care for YOU. 

Luanne Starr Rhoades, LCPC, LADC, CCS is a professional counselor and the Outpatient Therapy Director at Health Affiliates Maine, a mental health and substance abuse treatment agency serving adults, adolescents, children and families. For more information or if you or someone you know needs help, call us at 877-888-4304 or visit our website www.healthaffiliatesmaine.com and click on “Referrals.”

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