Being a therapist can be such an incredibly important, invigorating, fulfilling career, yet the complexity of the work and the immersion in painful stories can often create difficult demands on our mental health. At the end of a long day of clients, I can sometimes find myself tired, overwhelmed, or dysregulated. In order to be able to downshift to home life and to be able do it all again tomorrow, I aim to regularly incorporate Therapist SOS (Strategies of Self-Care) exercises.
There are distinct occupational hazards that accompany clinical work, especially in our current pandemic world, and we owe it to ourselves and our clients to attend to them regularly. Putting off, ignoring, or resisting self-care can result in blind spots, distraction, mistakes, compassion fatigue, and even burnout. Because we all want to avoid a crisis situation where we’re raising a white flag of emergency SOS (which is believed to have originally come from sailors signaling for help from a vessel in distress to mean “Save Our Ship”), we can instead more regularly apply a therapeutic type of SOS for resetting and recharging. Evidence-based research into the science of self-care supports a multitude of benefits of self-care: sustaining stamina, increasing flexibility, improving creativity, maintaining optimism, and enriching therapy. And experience-based evidence suggests it is crucial.
Knowing the why of self-care is vital, but the when is another question that clinicians may not ask directly but becomes interwoven into our habits. Clinician self-care requires tuning in intellectually, psychologically, and somatically. Knowing when external and internal events are disrupting our sense of well-being is the first step in being able to make changes, but such shifts aren’t possible if we aren’t paying attention. And because therapists are, by nature, caretakers, we tend to often put our own care last on the list.
While most clinicians know that self-care is a responsibility benefiting ourselves and our clients, application and systematic execution is often inconsistent. We all want to prevent burnout but don’t always fully accept and commit to this goal. Given that our profession is unique in that one of the most essential “instruments” of our work is ourselves, staying fine-tuned through ongoing self-awareness and regular bouts of mindful personal-battery recharging across our personal and professional lifespans is imperative.
The COVID Impact
Most therapists who’ve been practicing over the past several years have stories about the rising intensity and overload they’ve been seeing and feeling since early 2020. There was an increased need for mental health care, and we wanted to properly respond. There was also a sudden need for sessions to be held virtually, and for us to adjust to all of the complexities related to this new method of being with our clients. For most of us, the technological learning curves and computer-screen fatigue were a new, unexpected aspect of our work. The way in which we therapists were simultaneously experiencing the same crisis as our clients also had a significant impact, from continuously talking about the fears, the what-ifs, and the news headlines hour after hour to the growing number of emails about COVID-19-related problems. We plunged into unknowns along with our clients, attempting to properly assimilate in effective ways and to find hopefulness amidst the many negatives.
Despite the grief, loss, and change, the pandemic did bring out many creative, thoughtful, heartwarming, funny, and beautiful things that humans did. The notion of creating new routines, going outside, taking breaks, and laughing was psychological first aid that now needed to be practiced regularly. Therapists also saw some of the silver linings of the COVID crisis, such as appreciating the shorter commute, more comfortable work outfits, and quick hellos to family members in the midst of the work day. While no one will likely mind the return to more normalcy over the coming years, we all have likely appreciated some of the positive changes that have been revealed by the tragedy.
A Daily Head-to-Toe Practice
In order to engage effectively in our clinical practices, we, too, must practice. There are long-term SOS skills we need to nurture continuously, such as getting enough sleep, eating nutritious food, exercising, socializing and taking vacation. However, it’s in-the-moment SOS skills that need to be called upon more regularly at the end of each workday. Prior to the pandemic, when transitioning from work to home always involved a car ride, I was able to be more intentional about singing loudly to a song on the car radio or rolling down the windows to feel the breeze through my hair. But the pandemic forcing more at-home sessions meant there was not the built-in commute time to settle and transition. Instead, I shifted to a simpler head-to-toe self-care reset routine.
Starting at my head, I use my eyes to observe and describe something pleasant or positive in my environment. I might notice a color I like or something outside the window, and I soak that in for a few moments. I intentionally turn to look at a new angle of the room or switch places to view the space from a different perspective, as there’s often a visual fatigue that comes from being in the same position for much of the day.
Moving to my mouth, I aim to find some kind of compassionate self-talk. I might name-to-tame, such as "I had a lot of challenging clients today" or "My last session of the day brought up lots of imposter syndrome feelings." Or I might aim for more general self-statement, like "I have really showed up for a lot of people today" or "I really appreciated that compliment from this morning."
The chest area reminds me about breathing. As much as I try to regulate my breath throughout the day, some cleansing breaths to signify more of a focused intention can be helpful at the end of the day. I vary the type of breathing exercise I might do, whether it’s 7-11, square, hot chocolate or something else. A hand on my chest also can signify giving love and reassurance back to myself, something therapists do in a virtual way for their clients all day long.
Checking in with my gut or stomach area helps me to know if anything is needing more focused work. Is there something that feels uncomfortable and unresolved that needs awareness? Do I need to make a note about something to investigate further with a particular client at some future time? Do I need to nurture some feeling or sensation that’s been built up during the day before I can transition to home life?
Finally, moving to my feet reminds me to ground myself back into my life. After a day of brief visitations into others’ lives and issues, I need to come back into my own life. This might involve standing up in a mountain, tree, or power pose. Or I might simply feel my feet on the ground from my chair, slowly pressing one toe at a time onto the carpet as a means of paying attention to all the parts.
I am spending more days at the office again, and so my commuting time allows me to return to that transition time once again as a reminder to reset. However, I’ve found that spending a few moments to engage in an intentional head-to-toe approach at the end of the day is actually a bit more effective. Not only is this a good idea, it’s actually an ethical imperative. Using brief self-care strategies at the end of each day helps me to be more self-aware, regulated, and emotionally resilient. And with this, I am striving to bring my best self home and then back to work again.
Photo © iStock/Ponomariova Maria