Who Says Self-Care Has to Be Monumental?

Simple Yet Effective Practices You Can Use on the Go

Ashley Davis Bush

It was a series of upending life events over a period of years—some bad, some good, all unexpected and disorienting—that gradually propelled me into a state of mind-numbing, body-exhausting burnout. First, there was my husband’s cancer, his surgery, and the seven months spent watching him suffer through the spirit-breaking ordeal of chemotherapy. During those months, I’d prayed and cried and white-knuckled my way through an endless, dark valley of alternating fear, anguish, and desperate hope.

But then it was over. My husband got better. The casseroles stopped appearing on our doorsteps, and the encouraging cards and calls stopped coming. We both plunged heart and soul back into our lives. Daniel, as if to make up for the time he’d lost, started full-time graduate school in mental health counseling. I began expanding my practice to cover the costs of his schooling and the pile of medical bills we’d accumulated. I also signed a contract on a book deal, with a deadline looming. Meanwhile, we had five children of our blended family still at home, four of whom were teenagers. Life felt something like walking uphill, against the wind, in a blizzard.

The Breakdown

And I got tired—tired all the time, and irritable much of the time with Daniel and the kids. Worse, I began feeling apathetic at work, even as my clients’ painful stories began following me home, haunting my dreams at night. Then my back blew out, as if telling me I couldn’t bear the weight of my life. As I recalled the story of a burnt-out colleague who’d quit the field altogether to open a Greek restaurant, I began to wonder if this was my fate.

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, join a health club or at least do yoga and get aerobic exercise four or five times a week, begin painting or cooking or gardening, go to a spa, spend time in nature, make lists every day of what you’re grateful for, get more sleep, and so on. It wasn’t that there was anything necessarily wrong with these suggestions, but always implicit was the idea that self-care needed to be a big, life-changing project, and that unless you approached it with that kind of investment, you were wasting your time.

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.

After my client left, I asked myself, What just happened? I’d had a freakout followed by a turnaround. I’d engaged in a spontaneous, brief practice that had helped me feel calmer right in the midst of a disturbing experience. I’d interrupted a stress response without interrupting the session—and it hadn’t cost any money or taken much time. In essence, I’d protected and replenished myself through the use of a directed and intentional practice of micro self-care.

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. This mirrors what we’re learning from the newest developments in self-directed neuroplasticity—that the brain’s ability to reorganize itself with new neural networks happens with the targeted use of brief, repetitive experiences. 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. And I knew that habits are best formed when they include a trigger, or prompt. So I strategically incorporated a grounding tool at the beginning of my workday to start the day feeling anchored and steady, an energizing tool right after lunch to counteract the afternoon energy slump, and a relaxing tool at the end of my workday to help me leave work at the office before transitioning to home.

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. Occasionally, I added a background sound of ocean waves from a free app of nature sounds. 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, rather than the sluggishness that often comes with the postlunch blues.

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.

For a week, I diligently worked with these three practices. As I used them, I told myself, I’m doing this to take care of myself today. I’m doing this because I need restoration and I deserve self-care. In fact, highlighting the compassionate nature of these activities increased my felt sense of being renewed and fortified my intention to continue.

Today, years later, I’m more on equanimity cruise control than in crisis mode. That said, life is still life. Last year, I grieved the loss of my beloved 15-year-old golden retriever. This year, I launch another child to college, which includes a mixture of pride and joy, as well as emotional and financial strain. And clients continue to come with heartbreaking stories.

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.”


Ashley Davis Bush has been practicing in the field for more than 20 years. She has a private practice and is a Huffington Post contributor and the author of six self-help books, including Simple Self-Care for Therapists.

This blog is excerpted from "Little and Often" by Ashley Davis Bush. The full version is available in the May/June 2015 issue, Burnout: New Approaches to Rekindling the Flame.

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Photo © Getty Images/Jose A. Bernat Bacete

Topic: Mindfulness | Professional Development

Tags: Ashley Davis-Bush | breathing exercises | burnout | deep breathing | Depression & Grief | grief and loss | meditating | meditation | micro | Mindfulness | self-care | self-compassion | therapeutic breathing

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Monday, January 4, 2021 10:45:37 AM | posted by Susan Moitozo
Thank you for a great set of practical tools and strategies that are manageable

Tuesday, September 4, 2018 1:58:08 PM | posted by
Great article! I, too, have experienced a panic attack in the midst of a client session. Not often, but concerning enough. I think your reliance on mindfulness practices, subtly exercised as your client talks, are sage. Thank you for sharing this article, which I have saved.

Sunday, November 13, 2016 4:46:15 PM | posted by Catherine
Thank you for this post. I am panicked, in a crisis, not unlike the one you describe in the beginning of the article. While reading the article, I was reminded that I am not alone, that other people endure horrendous situations while holding the lives of their families together, and I was able to use all of the calming techniques you suggest, giving immediate relief. Thank you.

Monday, September 26, 2016 2:56:31 AM | posted by Richard Piscopo
Thanks for sharing. I have had similar experiences and find that now I can ground myself more easily. I have included another exercise form cigong where I tap all over my body starting from head down to my feet. I find that this brings the blood closer to my upper skin and feel relaxed. I agree; frequent repetition until it becomes a habit.

Sunday, August 21, 2016 7:01:05 AM | posted by Elizabeth Cush
Ashley- I love the the idea of micro self-care! There are days when I've seen a lot of clients that I need a way to reground and refocus. I plan to write a blog on self-care and why it's so hard to do and I would love to have you comment on the benefits of micro habits. Elizabeth Cush, MA, LGPC