Give Yourself the Best of Yourself Not What is Left of Yourself
Reflecting on the privilege of having a neurobiology professor become a mentor, one piece of advice they always expressed was to remember that, “In order to give your best to others, you must first give your best to yourself.”
A big aspect of the identities of healthcare workers and caregivers is their love and desire to take care of others—but that love and desire can become all-consuming to the point that personal self-care is put on the back burner. While days are fulfilled with the satisfaction and pride of helping, healing, and taking care of others, it would be remiss to hide from the fact that days are also filled with long hours that are physically, mentally, and emotionally draining.
We had the pleasure of interviewing healthcare professionals, ranging from mental health, surgical, and nursing professionals and gained insight on how they practice self-care. What we learned above anything: that self-care is not only essential but will look different for everyone. It is imperative to find what practices work best for you as it will make you not only a better professional, but person as well.
In talking with mental health professionals, we discovered that bringing work home can be one of the hardest parts of the job. While it cannot be avoided completely, they shared self-care practices that not only helped with this struggle, but in turn helped them become better therapists and counselors. A student well-being advocate shared their self-care regimen that includes regular exercise, occasional meditation, lots of walks and hikes in nature, and time spent with family and pets. Other mental healthcare workers and professionals in the medical field have suggested that committing to a good nutrition, talking to a therapist, keeping a gratitude journal, and using positive-self talk (especially at work) are practices that have greatly improved and maintained their mental health as well as their perspectives on what it means to take care of themselves. It also ultimately led to them rediscovering an excitement and passion for their work in healthcare.
It is also crucial in identifying what is best for your mental health. In talking with a chief medical officer and general surgeon, we learned that it is imperative to identify signs of declining mental health as well as being our own advocates and finding those who will support our mental health decisions. This can look like communicating with bosses, employee advocates, and family members to not only come up with a plan to maintain mental health but to ask for help, as this is a battle not meant to go at alone. Advocating for yourself and asking hospital systems, private practices, and your company what programs they provide to support the mental health of their professionals is not something you have to earn, it is your right.
In talking with surgical professionals, we were moved by their humility and honesty as they described burnout as one of their toughest mental health battles. They worked their whole academic careers and lives to get to this professional point—how could they not be happy? Burnout can manifest in feelings of guilt, uselessness, anhedonia, insomnia, and distraction. While it is important to track these feelings, it is important to take the time to discern why you are feeling this way and what solutions will help. The self-care practices shared above are a beneficial option, but in talking with a NICU nurse turned oncology nurse, self-care practices can also include changing fields, scenery, and colleagues. This nurse expressed that working in the NICU was her dream field since she began nursing school at the University of Virginia. Over a few years in the NICU, this nurse found that she was less present outside of the NICU and less excited to go to work each day. The patients she lost and saw struggling seemed to hide and steer her away from the patients she saved and saw succeeding. She lost her love of being a NICU nurse. “How could I leave and where would I go?” “Will I make an impact somewhere else?” These were some of the questions she asked herself, but little by little she found the strength to identify what she needed—and that was a change in scenery. Now, two years as an oncology nurse, she has more flexible hours, more time to spend with her husband and their two dogs, and feels excited to go to work.
“If you don’t give yourself a break, you will be broken.” Practicing self-care is something healthcare professionals must prioritize so that they continue to find fulfillment, passion, and success in not only their careers, but their personal lives as well. You are worth it. You are deserving of the care you give to everyone else.
Trauma In The Workplace
Workplace Trauma
The increasing emotional strain in the workplace can impact our mental health.Trauma can happen in any employment industry from professionals, healthcare workers, first responders, and caregivers. Stress at work can exacerbate your mental health symptoms as well as lead to anxiety or depression.
For instance, first responders can suffer inadequate or low staffing, working long shifts, and exposure to everyday trauma, making it increasingly more difficult to find a calm head-space while at work and at home. Encountering frequent critical occurrences, exposes first responders to emotional, cognitive, and behavioral struggles that can impair their ability to perform their jobs and function how they desire in their home- life. The signs of anxiety disorders include hypervigilance, anxiety, detachment, intrusive thoughts, poor attention, isolation, and restlessness and may also lead to unhealthy coping mechanisms such as addictive behaviors. Additionally, some first responders struggle with microaggressions, passive-aggressive behavior, or workplace bullying.
Microaggression
Microaggressions are insensitive remarks, inquiries, or assumptions directed at socially and marginalized disadvantaged groups, and can affect anyone from any background and at any professional level.
Communities or identities that can be targeted include, but are not limited to:
- Race
- Gender
- Age
- Sexual orientation
- Disability
Some examples of microaggression:
“Wow, you're a lot different from other Black firefighters.”
“No offense sweetheart, but I would feel safer with a male [police] partner.”
“You’re over 40 year old, are you adequate for this job?”
Microaggressions can have a big impact since they fundamentally represent inequity and show disrespect; they should be treated seriously.
Passive-Aggression
Passive-aggressive behavior is an indirect form of resistance, in which a person appears to comply with the expectations and needs of others but resists them through behaviors like manipulation, inaction, or playing dumb. This behavior is common among employers and coworkers. It is a tacit but powerful method of avoiding the results of an open discussion and direct disclosure of a problem.
Some cases of passive-aggressive behaviors:
Deciding against taking any action that could stop a problem from happening
Befriending you and other co-workers, but spread rumors about them
Being dismissive about suggestions or ideas
Workplace Bullying
The constant torment is a defining feature of workplace bullying. It may affect your life, job, and even physical and mental health. Additionally, because of many power dynamics and hierarchies at work, many victims of bullying endure their suffering in silence.
Another option is more overt bullying, such as belittling, humiliating, and shunning someone in public. Regardless of the methods employed, office bullies are typically adept social manipulators who advance at work by intimidating others.
Some examples of workplace bullying:
Persistent teasing and pranks that clearly go beyond that of affectionately including someone as “just one of the guys”
Holding targeted officers to higher, even impossible, standards of performance than the rest
Ways for overcoming trauma at work:
Give yourself room to finally experience all of your feelings.
Take a break. Giving yourself time to recuperate is the first step in getting over a distressing professional event.
Report to human resources about the possible discrimination or harassment and how it impacts your work and day- day life.
Seek out the assistance of close friends, family, and professionals in your place of employment.
EMDR
Eye- Movement Desensitization and Reprocessing EMDR
What is EMDR?
EMDR or Eye Movement Desensitization and Reprocessing is a form of structured therapy that uses bilateral stimulation (BLS) that allows people to “metabolize” their trauma history but also change limiting belief systems, unhelpful behaviors or unwanted thoughts and emotions. Through EMDR therapy you can also learn to manage triggers and/or symptoms.
BLS can be in the form of eye-movement, alternatingly tapping on your knees or shoulders, alternating sounds etc. which will allow both hemispheres of your brain to communicate effectively and heal. Your therapist will guide you and allow space to process it safely.
EMDR therapy can reduce symptoms of traumatic stress and PTSD and prevent symptoms from worsening.
Stress, PTSD, Trauma and Depression in First Responders
Chronically experiencing traumatic situations and the high levels of stress associated with a profession might eventually harm one's mind and emotions. If the trauma is not addressed, first responders may develop post-traumatic stress disorder (PTSD), which can cause problems with relationships, sleep, and physical health.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA) about 30% of first responders will develop PTSD and will attempt to self-medicate with alcohol.
Due to the perceived stigma associated with mental health, many first responders might not receive the care they require. It's critical to dispel stigma and educate people about trauma as a typical human reaction to a distressing, atypical event in order to combat this. Rates of depression, post-traumatic stress disorder, and substance abuse are exponentially higher amongst first responders when compared to the general public.
EMDR & First Responders
First responders who are coping with trauma may benefit from using EMDR as part of a comprehensive therapy plan.
First responders can specifically benefit from EMDR by learning how to recognize all indications of mental health problems, increase distress tolerance and recover from past events.
The fact that EMDR does not significantly rely on conversation therapy is one of its benefits. There is no need to summarize the trauma, which for some can be triggering or even re- traumatizing.
EMDR can frequently be completed in less sessions than many conventional talk therapy techniques, which is accommodating to first responders’ hectic schedules.
For first responders to rehabilitate, continue to do their jobs successfully and securely, and save other people's lives, EMDR can be a great fit.
Sources:
https://www.apa.org/ptsd-guideline/treatments/eye-movement-reprocessing
https://www.emdria.org/group/emdr-for-first-responders-protective-services-personnel/
https://pubmed.ncbi.nlm.nih.gov/18459532/
Mental Health and Stigma
Mental Health and Stigma
Mental health is just as important as physical health. Our emotional, psychological, and social well-being should be prioritized throughout our lives, from childhood through adulthood. Despite the fact that mental health is just as essential as physical health, there is still a stigma associated with seeking treatment to improve our well-being or heal ourselves. Stigma is defined by some as a sense of shame or judgment from others and affects some populations more than others. .
Mental health influences how we deal with stress, make decisions, and socialize and interact with others. When a traumatic incident or stress occurs in our lives, it can have a significant impact on those aspects.
May is Mental Health Awareness Month, a time to spread awareness about how stress, trauma, and anxiety makes an impact on people’s lives. Mental illness affects one out of every five Americans, making it even more important to not only spread awareness in May but every day.
While mental health stigma impacts everyone, it affects first responders, healers, and caretakers in particular.
First Responders
85 % of first responders have had symptoms associated with mental illness. Many first responders, however, will refuse to seek help or treatment. The cause for this is stigma's toxicity.
Discrimination, shame, and even loss of status were all common categories of stigma for first responders. Unfortunately first responders suffer in silence. Because their jobs are considered as heroic in the public eye, requesting help or treatment can be seen as a sign of 'weakness.' Fear of negative consequences or being demoted or fired if diagnosed with a mental health illness/disorder are other reasons why first responders may not seek help.
Caregivers
Caregivers are no strangers to stress, and mental health symptoms. Whether a caregiver is caring for a sick parent, spouse or child, stress, trauma, anxiety, and depression have a significant impact on their mental health. Most people do not seek help during the difficult and long periods of caregiving. Stigma is at the forefront, just as it is for first responders.
Some caregivers experience self-stigma, which is defined as unfavorable attitudes and sentiments about one's own mental illness, including internalized shame. Caregivers may feel cut off or alienated from others around them. As a result of perceived stigma, caregivers of people with mental illnesses experience shame, low self-worth, and social isolation.
Some caregivers may not seek help because they are stigmatized by the belief that mental illness is genetic or hereditary. Also, some believe that by seeking treatment to ask for help, their sense of obligation to the person they are caring for is reduced. They feel 100% responsible for caregiving while balancing work, social life, and family difficulties, which can lead to caregiver burnout, a state of physical, emotional, and mental tiredness, and struggles of co- dependency.
To remove the stigma of mental health, the perception has to change regarding what mental health really is and how mental health services are beneficial for everyone.
What is trauma?
What is trauma?
Trauma is the emotional, physical or cognitive reaction as a result of a distressing or disturbing situation that you may have experienced. Although, learning about an horrific event or witnessing it can be enough to feel overwhelming. When people think about trauma and its definition, the initial thought is believed that trauma only occurs as a result of abuse or a natural disaster. At Invisible Wounds Therapy and Wellness, we define trauma as "anything that has had a negative impact on you," acknowledging that no experience is too big or too small to deserve healing.
Understanding trauma, its triggers, and how to recover and manage it is critical. Trauma can transform the way a person views themselves, others, and the environment around them. Everyone's emotional, physical or cognitive response is different and the factors that influence it are distinct. Trauma can occur in adults as well as in children. Traumatic incidents can occur at any age and can have long-term consequences. While we can often “bounce- back” from experiences that have left a negative impact on us, without support, or left untreated, it can turn into Post-Traumatic Stress Disorder (PTSD) or other “clinical” concerns such as depression or anxiety.
There are three categories of trauma: acute, chronic, and complex. Acute trauma is often caused by a single “recent” occurrence (often within the last 3 months). If the trouble you are experiencing as a result of it is left unsupported and untreated, it can lead to chronic trauma (reactions or symptoms lasting 3 months or more). Complex trauma is often the result of multiple exposures of “negatively impacting events,” within a short time- frame or life- time. For instance, childhood abuse or neglect.
First responders, for example, can suffer from chronic trauma and may be subject to complex trauma as a result of their life-experiences as well as demanding and dangerous work environments. According to National Alliance on Mental Illness, “it’s estimated that 18-24% of dispatchers and 35% of police officers suffer from post-traumatic stress disorder”. Being the first to arrive on the scene, putting their life at risk and assisting people in challenging situations over long periods of time, including possible lack of sleep and self- care, can be very taxing.
The same is true for caregivers who may experience caregiver burnout or compassion fatigue, resulting in physical, emotional, and mental exhaustion. Caregivers may witness traumatic incidents such as a loved one's medical emergency, repeated hospital emergency room and ICU visits, acute confusion, or devastating falls and injuries. These events can also be classified as a form of trauma. Caregiver burnout occurs when stressed caregivers do not receive the help they require, or when they attempt to do more than they are capable of, resulting in a shift in feelings from caring to compassion fatigue, a type of stress caused by caring for others. Unlike burnout, compassion fatigue strikes immediately leading to emotional and physical exhaustion and grows over time.
While all of the stress and traumatic events are occurring, it is best to seek help and healing.
Being honest with yourself, seeking support from family and friends and ultimately a professional can begin the step to healing. If you find yourself reacting more quickly than is helpful, experience difficulty sleeping, over or under- eating, nightmares, find yourself sad, isolating or very irritable, and often “triggered,” we encourage you to seek help. In therapy, the goal isn’t to judge or to discriminate, but to offer a safe space for you, a platform to process your history and a way to learn how to manage and experience well-being.