Preventing Burnout with Micro Self-Care

Rejuvenating Practices for the Burned-Out Therapist

Ashley Davis-Bush

At work, the final straw came one evening when my seventh client of the day---a 34-year-old woman devastated by the unexpected loss of her mother---sat across from me, and I found myself, a grief counselor for more than 20 years, wanting to slap her across the face and say, “Get over it!” That I could even think such a thing was a body blow to my sense of professional ethics and self-respect. What kind of therapist feels like that about a grieving client?

Suddenly, I felt not only overworked and undernourished, but potentially unhelpful, or even damaging, to the people I wanted to help. So I started reading any book I could find on burnout, anything about being personally or professionally fried, toasted, mashed, boiled, and charred.

The dominant advice was simple: do more self-care. Unfortunately, the suggestions, which I’ve since come to call macro self-care, usually seemed to require substantial commitments of time, effort, and often money: take more vacations, meditate 40 minutes daily, or join a health club.

The Breakthrough

Fortunately, a few days later, something happened that started me on a different kind of route to burnout prevention---an approach that even I could follow. It all began when I started to come unglued during an intake interview with a grieving mother, who was telling me in excruciating detail about discovering her 18-year-old son’s dead body in his bedroom after he’d hung himself with a belt.

Although I’d heard numerous graphic and heartbreaking stories throughout my career, this time, I actually started to feel lightheaded. I considered excusing myself to go to the bathroom but was afraid I’d faint if I stood up. I thought about redirecting the conversation, but in that moment, I couldn’t actually speak. I just kept nodding.

And then I remembered an exercise called “strong back, soft front” I’d heard about in a webinar by Buddhist abbot Joan Halifax, author of Being with Dying. She’d devised the practice for people working with the dying and their families to help them strengthen their back for support and soften their front for compassion. So right there in the session, I pulled my belly button toward my spine and straightened my back, imagining a string pulling me up from the top of my head. Then I took a deep belly breath, relaxing my stomach outward and mentally softening toward my client. This process took all of 15 seconds, while my client kept tearfully telling her story, unaware of my experience.

It worked. I felt better. The deep breathing had stimulated my parasympathetic nervous system, making me immediately more relaxed. I regained my dual awareness and recognized that my client’s feelings weren’t my own. I felt more present in the room as my mind cleared.

The Shift

I felt I was onto something, and the germ of an idea---micro self-care---began to grow. Self-care wasn’t just a remote possibility outside the office: it was available inside the office, even during a session. So why not try more quickie, self-replenishing practices throughout the day, every day? While macro self-care was great when I could fit it in, micro self-care was available at all times, on demand. I could assemble an array of brief tools that would be simple, free, and doable.

Micro self-care, I decided, is about the benefits of making small changes with reliable frequency. The emphasis is on repetition. Small and frequent works better to create desirable neural pathways than big and seldom.

The Plan

I knew that for these behavioral changes to have any effect on my life, they needed to become routine---a series of habits as ingrained as brushing my teeth or drinking my afternoon cup of tea.

My initial grounding practice was a one-minute meditation, timed on my phone, inspired by Martin Boroson’s book One-Moment Meditation, which argues that it only takes a minute to reduce your stress and refresh your mind. I focused on one minute of breathing but added a few words. On the in-breath, I thought, I am calm and on the out-breath, I thought, I am grounded. What I noticed is that this short practice allowed me to start my day from a place of peaceful centeredness, rather than from the usual careening rush of a breathless “go, go, go.”

For my postlunch practice, I marched in place, knees high, arms swinging, crossing my right elbow to my left knee and my left elbow to my right knee. I learned this exercise, called the Cross Crawl, from Donna Eden, author of Energy Medicine, as a way to balance and energize the nervous system. I added the words I am awake and ready to the practice. After doing this, I could feel the blood flowing through my body, readying me to face the next appointment with enthusiasm.

My end-of-day practice was an ancient yogic breathing technique I learned from Andrew Weil. You inhale for the count of four, hold your breath for the count of seven, and exhale your breath as if blowing out through a straw to the count of eight. This is repeated three times. Called the 4-7-8 breath or diaphragmatic breathing, this is a standard relaxation resource in the EMDR therapy protocol. For me, it created a state shift in which I could truly leave my work behind and transition more freely to a pleasant evening at home.

So what have I learned? It’s true that self-care is fundamental to my ability to be my best self, personally and professionally. And I haven’t thrown out macro self-care with the bathwater, engaging in those activities as time allows. But it’s the paradigm shift to targeted micro self-care, the cultivation of small replenishing moments throughout the day, that continues to make a crucial difference in my ongoing stress level. I guess my grandmother was right when she told me that “less is more.”

This blog is excerpted from "Little and Often". The full version is available in the May/June 2015 issue. To subscribe, click here. >>

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Topic: Professional Development | Ethics | Mindfulness

Tags: breakthrough | conversation | counselor | deep breathing | emdr | emdr therapy | families | grief | grief counselor | grieving | meditation | psychotherapy | therapist | therapy | networker | Ashley Davis-Bush | micro | self-care

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