Caring for the Self in 2021
Of any time, 2021 seems worthy of focusing on self-care. In Louisiana we have had 33 named storms this past hurricane season, 5 of which have made landfall in Louisiana. And aside from our weather, 2020 brought the Covid-19 pandemic claiming 234,264 American lives and 5,456[1] in Louisiana, as well as social unrest, racial injustice at the forefront, and an American culture that often feels divided at best.
When it comes to this topic, I can start by admitting that I am not the best at practicing self-care. I work late, overbook for patients in need, and over-volunteer myself for professional activities. I was born with a caregiver personality, and I find joy in caring for my family members before thinking of myself, which is also a default of having 3 young children. Although I am often the last to notice when I need to focus on self-care, I also know that everyone, including me, needs to hold a secure value in caring for one’s self.
However, in the midst of the pandemic, many of us may find this difficult. Activities that may have been our defaults for self-care like yoga classes, social outings, and eating out at our favorite spots may not be open or available. I suspect the holidays will bring additional challenges of balancing safety and self-care as we choose which traditions to honor and which loved ones we are able to see.
Although there may be challenges to finding opportunities for self-care, it remains important—in fact more now than before. Most of us are continuing to practice psychology during the pandemic. A recent article in the American Psychologist[2] brought my attention to how specific challenges of the Covid-19 pandemic can apply to our APA ethics code. Two of the more prominent areas that stood out were 1) providing services in emergencies and 2) the need to monitor our own stress when providing psychological services to others (under personal problems and conflicts). We are all under additional stress during the pandemic, and we are all practicing under extended emergency circumstances. It may feel second nature now after 8 months, but the pandemic compelled almost all of us to change how we practice. We have incorporated telehealth into our care models, and we have found ways to continue our professional practices with very little in-person contact and heavy use of virtual platforms. For those of us like me who identify our ethics as a core element of what forms a psychologist, this makes self-care not just a personal charge but an ethical charge as well. And this is for good reason. Practicing self-care makes us better psychologists for our clients and protects us from burn-out, which is potentially harmful for both ourselves and for those we seek to help. Decades of research on compassion fatigue and vicarious trauma have taught us the importance of monitoring our own well-being and taking real steps toward ensuring we don’t overextend ourselves[3]. We know that other healthcare professions have already started to examine how their fields are impacted by burn-out and stress due to Covid-19[4].
When we are under high stress, it can be tempting to put off self-care. This can be especially true when our pre-covid routines have been so disrupted. But I hope that many of us have self-care activities that we have been able to keep, and perhaps have been able to find new ones. One of my favorites for myself and my clients is mindfulness, which is perhaps best practiced in isolation, and can be practiced almost anywhere and anytime we can find a few moments. Although many people associate mindfulness with meditation only, it is actually the practice of being fully present in a given moment, and focusing your attention on the present rather than the past or future. Practicing being fully present in each given moment of time and in a single activity can be immensely rewarding. And studies on mindfulness reliably show improved mental and physical health outcomes that stretch far beyond the actual time spent in practice[5]. With practice, it can be incorporated into daily life by focusing all of your attention on almost any given task. For me, this might include efforts to be fully present when playing with my kids for a few minutes or narrowing my attention away from to-do lists and stress by being fully present reading them a book chapter before bed. This time is as much for me as it is for them, as I try to put to-do lists or past and future thoughts out of my mind.
Covid has also brought the competency of using video-conferencing to a wider range of people, giving us more ability to virtually connect with our relatives who are physically distant. Earlier this year members of my family from all over the country Zoomed together to celebrate my grandmother’s 92nd birthday in California—I do not think this would have been possible before. And although vacations may be more difficult or feel like they are not worth the risk, I suspect that many of us have learned to take advantage of the outdoors close-by. Over the summer I saw more families and neighbors walking around my neighborhood than ever before, and many have experienced their neighbors become closer and more collaborative, even doing porch concerts while maintaining social distance.
But perhaps one of the most important ways we can practice self-care is to recognize our own limitations and ensure our daily behaviors are aligned with our values (a difficult one for me to remember sometimes). I often say that each of us is only one human, capable of doing one human’s work—and that it’s ok to say no. It’s ok to decline a request, whether personal or professional. And to remember that when there is work to be done, there will always be more to do. Given that I know I struggle with this on my own, I often rely on trusted friends and colleagues to be my guideposts in making healthy choices. It is only by recognizing these limitations and making these choices of omission, that we can make room for positive self-care activities.
In this way, self-care is both an addition of positive activities that we enjoy and recognizing our limitations to not overextend. Self-care activities can change over time and will be different for each of us, as we each have unique interests, and self-care can include any activity that brings joy. Each of us must find our own way to seek and prioritize self-care and balance this with responsibility in our own unique way that feels right in this moment in time. And be open to this changing through the challenges the next year might bring.
(Dr. Erin Reuther is a licensed and board certified clinical psychologist working at Children’s Hospital in New Orleans, LA. She is the current LPA President for 2020-2021)
References:
[1] Numbers from CDC website cdc.gov/nchs/nvss/vsrr/covid19/index.htm as of 11/20/2020.
[2] Chenneville, T. & Schwartz-Mette, R. (2020). Ethical considerations for psychologists in the time of COVID-19. American Psychologist, 75(5), 644-654. http://dx.doi.org/10.1037/amp0000661
[3] Branson, DC. (2019). Vicarious trauma, themes in research, and terminology: a review of the literature. Traumatology, 25(1), 2-10. https://doi.org/10.1037/trm0000161
[4] Ruiz-Fernandez, MD, et al. (2020). Compassion fatigue, burnout, compassion satisfaction and perceived stress in healthcare professionals during the COVID-19 health crisis in Spain. Journal of Clinical Nursing, 29(21-22), 4321-4330. https://doi.org/10.1111/jocn.15469
[5] Grossman, P., et al. (2004). Mindfulness-based stress reduction and health benefits: a meta-analysis. Journal of Psychosomatic Research, 57(1), 35-43. https://doi.org/10.1016/s0022-3999(03)00573-7