A Therapist Practices Necessary Self Care
It began as it always does, with a tickling cough, a raspy form of asthmatic breathing that would do Darth Vader proud, which is enhanced by a crackling sound that resembles rustling tissue paper. It is like a motley crew of musicians are performing a bizarre symphony that could have been whipped up by composer John Carpenter. Add to that the feeling that several wayward dwarfs: Sneezy, Achey, Drippy, Cranky, Whiny, and Pukey have been hi-ho-ing their way through my system and I am ensconced in jammies on a beautiful Spring day when I would much rather be cavorting outside enjoying the welcome thaw after a frigid and snowy winter.
Reluctantly, I canceled a teaching job and a day full of clients this week. I knew I wouldn’t be at my best with them and felt like Typhoid Mary with the cough progressing to alarmingly deep and bronchial. Rest assured that I generously spray Lysol in my office to prevent spread of nasty germs. Since I work with children as well as adults, the risk of infection is even greater.
I am not a novice in the field, having offered some form of counseling since 1979 and know all too well, the implications of burnout. It has a cumulative effect and in my case, it mirrors the definition (commonly held as well as alternative offered by a former client who was dealing with heroin addiction) of insanity.
- Doing the same thing over and over and expecting a different result.
- Knowing exactly what is going to happen and doing it any way.
In my case, it involved 10 or so hour work days during which I would see 6-8 clients five days a week, as well as writing and editing assignments and teaching occasionally in the morning and evening. Sneaking in 3-4 necessary gym workouts and I was once again setting myself up for taking a tumble. I justified my schedule by telling myself that at least it wasn’t as rigorous as it had been pre-heart attack in 2014. I also caught myself in being hypocritical since I am an unflinching advocate of scrupulous self- care with my clients. Healer, heal thyself, indeed.
Since Friday morning, I have slept more hours than usual, napping and then waking, tending to medication regimen, showering, changing pj’s and sheets, guzzling peppermint tea and seltzer, eating not a whole lot. One clear sign that I really do feel ill, is that, as it is both Passover and Easter weekend, I have not felt even the slightest urge to indulge of my drug of choice: chocolate.
As a Social Worker, I am compelled to follow the NASW Code of Ethics. These principles guide my steps as I engage in work with clients and their families, as well as co-workers and supervisors. Although it doesn’t specifically indicate that best practices call for R & R, hot tea and a day off under the covers, it is implied to prevent impairment on the job. Since my intention is always to be present for those I serve, it is essential that I follow the guidelines I set for myself and them. As I run down the checklist, it is gratifying to know that I:
- Take time for fitness
- Immerse in nature
- Enjoy the company of family and friends
- Refrain from substances (alcohol is something I consciously choose not to imbibe)
- Practice yoga
- Set boundaries, which is essential for this recovering Co-dependent.
- Sleep 7-8 hours a night
- Eat healthfully
- Avoid taking on the issues and emotions of clients
Ashley Davis Bush, author of Simple Self-Care for Therapists: Restorative Practices to Weave Through Your Workday shares that we, “need to keep our instrument, our presence, well cared for.” As therapists, we are called on to be in tune with our clients. I question how I can do that as well if I am tone deaf to my own basic needs. Although I could anticipate the outcome that I am facing now, I didn’t take action until I was in the throes of respiratory distress. My well-meaning friends and family have noticed for years my tendency to burn the candle at both ends until there was no more wax left.
From a body-mind integrative perspective, there are those, including the late Louise Hay who would describe respiratory issues as having a connection to ‘unresolved fear, depression and grief’. Her pioneering book You Can Heal Your Life was released more than three decades ago.
She added that feelings of unworthiness to receive are part and parcel of pulmonary conditions and recommendation this affirmation as ameliorating: “I have the capacity to take in the fullness of life. I lovingly live life to the fullest.”
By way of full disclosure and in the spirit of a body-mind-spirit wake up call, the first portion of this article was written more than 72 hours ago with a weekend interlude spent initially in the ER and then in required horizontal mode on a med-surg unit of a hospital where once upon a time I had been employed as a social worker and on numerous occasions, had received stellar treatment.
My nurse friend, Ondreah Johnson had stopped by earlier on the day, her smile covered by a mask since her cancer treatment compromised immune system was at risk. Bearing flowers, tea, soup, vegan cornbread and crackers, she wagged her finger at me as she often does, for putting my own health in jeopardy and in very short order was urging me to go the ER for a nebulizer treatment, since the meds my PCP had prescribed weren’t cutting it. I reluctantly agreed, knowing that had she not been there, I would have waited until after midnight and driven myself as I had on the day of the heart attack in June of 2014. She bundled me into the car and within minutes had dropped me off as she went to park. Naturally, I thought I could walk from the lot, so she all but kicked me out at the entrance.
In less than 15 minutes, I was escorted to a room, given a designer hospital gown in which to ensconce myself and sprawled out the gurney. A few blood draws, a pee test and chest x ray later, the ER doc who recognized me from my Fall visit for kidney stones, pronounced that I had pneumonia and he wanted to admit me for observation and treatment for a day or so. My mind reeled into “how can I afford to miss work?” mode. My friend reminded me that I am no good to anyone if I sound like I am hacking up a lung, in addition to depleting my reserves. While Ondreah left to drive the hour back to her home, I hunkered down and watched A Dog’s Purpose that had me laughing and crying and pondering the meaning of my own life. An interesting irony took place yesterday when a young therapy dog named Bailey came to visit. She and the primary canine character in the film shared the name.
Over the course of the following few days, I came smack up against my own limiting beliefs that went beyond terror of losing income. I had my worthiness and purpose all tied into performance. I questioned who I am if not a healer. Would people want me in their lives if I didn’t meet their needs? I looked at my earlier perceptions of asthma and how I came to believe that pushing myself to succeed without ‘babying’ myself, since my parents didn’t do so over this health issue, was what was required, to be a fully functional human being. Of course, they took care of my medical needs with regular visits to the family doctor’s office for allergy shots and check-ups but didn’t want the diagnosis to hold me back. I bought into the ingrained belief that I should do it all, regardless of consequence. I carried it off well into my 50’s and in the past few years, since my parents’ deaths, taking on the mantle of family matriarch, doubling down on my fiercely independent mindset and behaviors, I was on a direct path to the current crash and burn.
As I was leaving the hospital with several new meds to add to the pharmacopeia, I was receiving well meaning guidance (which my defensive activity addict brain translated to ‘lecture’) from another friend Lisa who came to fetch me and ferry me home. We talked about recognizing my barometer signals that tell me I am about to become toast, since I, like many workaholics, don’t always know. Fatigue is one clear indicator, as is forgetfulness, working and playing more hours than are physically plausible. I realized that I don’t need to prove anything to anyone. As if to rub it in my face a wee bit more, my roommate for yesterday, reminded me so much of my mother, in appearance and somewhat in demeanor. We had lengthy conversations about how we came by our desire to be all things to all people, genetically and culturally. As a bonus, it turns out that her daughter who stopped by to visit, and I had already crossed paths and shared some of the same circles.
This therapist is taking the same good advice I dish out; self-care is crucial.