3 Self-care

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Contents

• Objectives
• Self-care
• Setting boundaries
• Self-compassion
• Case study

Objectives

When you have completed this chapter you should be able to:

1. Define self-care, self-compassion and mindfulness.
2. Explain why self-care and self-compassion are important.
3. Describe how we should take care of our physical and emotional needs.
4. Define personal, work and confidentiality boundaries.
5. Understand how to practice mindfulness.

Self-care

3-1 What is self-care?

Self-care means:

• Giving ourselves the same kindness and care we would give anyone else
• Recognising that our health and wellbeing are important
• Making sure we have what we need to stay physically and mentally healthy and well.

Taking care of ourselves is called self-care, and being kind to ourselves is called self-compassion. Both self-care and self-compassion are very important parts of making sure we are strong enough to be kind and take care of others.

Self-care is making sure we are physically and emotionally strong.

3-2 Why are self-care and self-compassion important?

Care work can be very stressful because we hear about other people’s problems all day long. This can make us think that other people have more or bigger problems than we do. We then judge ourselves harshly when we struggle, even though care workers may need more support than other people. It can be easy to forget to look after ourselves when we are focused on helping others.

When we spend our time helping others, we forget that we experience the same stress and worries as other people in the com­munity. We may think we have to be strong for other people and should not waste time looking after ourselves. This is not true, because in order to help others, we have to make sure we take extra care of ourselves.

We need to take care of ourselves so that we are able to take care of others.

3-3 Is it selfish to take care of ourselves?

No. It’s not selfish at all. It’s the best thing we can do to help others. When we feel physically and mentally strong, we think clearly and have more energy. This allows us to do more at work and also to have better relationships with our friends and family. It is not possible to help lift others up when we are down on the ground.

3-4 How do we take care of our physical needs?

When we give care to others, we need to make sure we are strong and healthy. We do this by taking care of our own physical needs. When we take care of our body we make sure we:

• Spend some time outside each day.
• Exercise and move in ways which help us relax and feel happy.
• Make sure we get enough rest and sleep.
• Eat regular, healthy meals.
• Keep well hydrated.

We need enough relaxation, exercise, healthy meals and sleep to remain physically strong.

3-5 Why do we need to be mentally well when we care for others?

Mental health conditions affect our mood, thinking and behaviour. When we are mentally healthy, we can be patient, calm, kind and empathic to those who need our kindness and care. This can be difficult if we are feeling tired, depressed, sad, anxious or are struggling to think clearly. Poor mental health makes it difficult to connect with other people. Care workers are at risk of mental health problems.

3-6 How do we take care of our mental health needs?

Care workers are no different from the people we help. Everyone needs to feel safe, seen and connected, and to know their basic needs will be met. Some of the ways we can take care of our mental health is to recognise that we are at risk of developing mental health problems and make sure we give ourselves the care and kindness we need to be able to help others. We also need to have clear boundaries and a good support system.

Self-care and self-compassion are essential to remain emotionally strong.

Setting boundaries

3-7 What does it mean to have boundaries?

Boundaries are like fences. A boundary is a set of rules or guidelines which lets people know what sort of behaviour is acceptable. Boundaries are important because they allow us to feel safe. There are many different types of boundaries. In care work, we need to have clear personal boundaries and work boundaries. We also need to respect other people’s personal boundaries.

3-8 What are personal boundaries?

Personal boundaries are the rules or values we have about what is allowed and what is not. For example, most people have boundaries around touch. Other people can’t touch us without permission, and we can’t touch other people where and how we like. Can you think about personal boundaries you may have?

3-9 What are work boundaries?

Work boundaries are clear guidelines about the work we can do (scope of practice) and when we need to refer to other people. We also have boundaries about work hours. Clear boundaries help us to feel safe at work. Everyone feels safer when boundaries are clear and when we work towards keeping these boundaries. Boundaries let us know what to expect. When we are clear about our boundaries, it is an act of self-care.

Personal and work boundaries are needed to feel safe.

3-10 What other boundaries are important at work?

There are many work boundaries. Two main boundaries are about maintaining confidentiality and not accepting gifts and favours. When we work in positions of power, like giving care to those who feel weak and vulnerable, it is especially important that people can trust us to not share their secrets and not use their vulnerability against them.

3-11 What is the confidentiality boundary in care work?

Confidentiality tells people it is safe to talk to us because we will not tell others what they have told us. This is a very important part of making others feel safe. When we hear people talking about others and sharing stories that don’t belong to them, we stop trusting them, as it shows us that they don’t have clear boundaries. In the same way, we need to be able to share things which are troubling us, while also trusting that those we talk to will not gossip about what they hear.

People will only trust us if they know we keep confidentiality boundaries.

3-12 Why should we not accept gifts and favours?

Children, adolescents and the people we take care of need to know they can get help even when they have nothing to give in return. It is important that we give care and kindness to everyone, not only to those we like or those who give us things. There is no need for people to buy our help. We must never accept gifts for giving care. When we take gifts or favours from people, it is similar to taking a bribe. This makes it more difficult to refuse to give them what they want. Even thank you gifts can be confused as a way of ensuring that we will provide care when it is needed again.

Accepting gifts or favours is similar to accepting a bribe.

Self-compassion

3-13 What is self-compassion?

Scientists have found there are three very important parts to self-compassion. The first part is feeling connected to others and realising we are not alone in our struggles. Secondly, we need to learn to give ourselves the same kindness we would give to a close friend. Lastly, we need to become more mindful about what we are experiencing.

3-14 Why is feeling connected important for care providers?

Humans need each other to survive. When we work in stressful areas, it is especially important to feel that we belong and can connect safely with other people. Peer support groups are an important way in which we support each other. When we share stories with peers who experience the same struggles as we do, we are better able to see we are not alone. We can see everyone has their areas of strength and we all struggle with different problems. This is a very important part of self-compassion.

3-15 What is self-kindness?

Self-kindness means giving ourselves the same understanding and kindness we would give a close friend. If we spoke to our friends the way we sometimes speak to ourselves, we would have no friends left. We are as worthy of our own kindness as anyone else in the world. When we know how to be kind to ourselves, then we begin to understand how to be kind to others. Being mindful and self-aware is an important part of self-compassion.

Part of self-compassion is applying kindness and accepting yourself.

3-16 What is mindfulness?

Mindfulness is the same as self-awareness. Mindfulness means we become fully aware of what is happening in our body in the present moment. Most of the time, we don’t really notice our body until something goes wrong. We may not notice our hands until we hurt a finger and then we notice just how much that finger does. When we train in mindfulness, we try to notice the feelings in our body. This is an important part of feeling empathy.

Mindfulness is being fully aware of what we are experience at that moment.

3-17 Why are humans not more mindful and self-aware?

Humans get into the bad habit of thinking too much, and this distracts us from what is happening in our body. Modern technology like cellphones and computers distracts us even more. It is good to be able to think, but this can be very tiring if we always think about things which have already happened, or worry about things which may never happen in the future.

3-18 How can we become more mindful?

It can take years of practice before we are able to be mindful all the time. We start by practising for a few minutes a day and slowly make the practice time longer. Mindfulness is a habit we need to build. There are many ways of practising mindfulness and we do not need any equipment to start. We just need to focus on our breath and try to notice when we get distracted, so we can bring our focus back. Mindfulness is about noticing when we get distracted and being able to bring our attention back. Slowly we will be able to become more and more aware of what is happening in our body. This will help us to be empathic and compassionate.

Start by practising mindfulness for a few minutes each day and slowly make the practice time longer to build a habit of mindfulness.

3-19 What can we focus our attention on to learn mindfulness?

There are many, many ways to practise mindfulness. We can try to focus on our breath, or any sensations and movement of our body, or we can focus on a sound such as the ticking of a clock. Mindfulness is noticing when we become distracted and then bringing our attention back with kindness.

3-20 How can one focus on the breath?

To do this practice, sit on a chair and make yourself comfortable. Keep your back straight and feet flat on the floor. Breathe out slowly and completely through your nose. Hold it for as long as is comfortable. Breathe in slowly and fully through your nose. Hold it. Keep going for a few more breaths. See if you can notice what parts of your chest move when you breathe. Does your tummy move? Can you feel the air moving in and out of your nostrils? If you get distracted, bring your attention back to your breath, with kindness.

Focusing on the breath is a good way to start learning to be mindful.

3-21 How can one focus on body sensations and movement?

Decide to be more mindful during something like hand washing or hand sanitising. Then every time we wash our hands, we try to remember to practise mindfulness. If we forget, we are kind to ourselves and try to remember the next time. When we remember, we focus all our attention on our hands. What do our hands look like? What do we feel when we wet them and rub them on the soap? Do water and soap feel different? Can we smell the soap? Do both hands feel the same? Are there any rough areas? Are the fingers stiff? Does washing make our hands feel different to how they felt before washing? We focus our mind on our hands and the sensations in our hands. If we notice we are distracted and have forgotten about our hands, we bring our attention back with kindness.

3-22 Are there any problems with becoming more mindful?

Sometimes, when we are mindful we start to notice things we don’t like about ourselves. If we are not able to show self-compassion, we may start to feel more stressed. It is very important that we learn to be kind and not judge ourselves when we are distracted or do things wrong. No one is perfect. We should be kind to ourselves, and try to do better next time.

3-23 How do we take care of our emotional needs?

The best way to take care of our emotional needs is to be kind to ourselves. As we become more mindful, we start to notice how we judge and criticise ourselves all the time. Kindness doesn’t mean we indulge and pamper ourselves. Kindness means we accept that, like everyone else in the world, we are not perfect. Everyone struggles at times. We are no different from other people. Like anyone else, all we can do is try our best.

3-24 Will self-compassion make us lazy?

No. It is not correct to think that judging, blaming and punishing ourselves makes us work harder, or that being kind will make us lazy. Questioning ourselves all the time makes us anxious, depressed and less able to work properly. Many studies show that when people are kind to themselves, they are more willing to try new things, have better mental health and can be more empathic.

Self-compassion makes us more empathic and effective in our work.

3-25 Is self-compassion the same as self-pity?

No. Self-compassion is not about feeling sorry for yourself. Self-compassion is understanding that we are trying our best in difficult circumstances. We need to be kind to ourselves and stop criticising and judging ourselves. It is self-judgement that makes people feel like victims and sorry for themselves. If we are kind to ourselves, we are more able to take control of our lives, and face and accept the challenges we experience.

3-26 Does being kind to ourselves make us weak?

No. Self-compassion is not weakness. It is the most powerful way of coping and developing resilience. When we think we must be strong all the time, we get stuck and struggle a lot. No one is strong all the time. Everyone feels frightened, hopeless, inadequate and out of their depth at times. When we can accept that and be kind to ourselves, we very quickly feel powerful again.

3-27 Will self-compassion make us less successful?

We live in a very competitive world. Many people think they must be better than others to be successful and important. We may think we must keep pushing ourselves to achieve. None of this is true. Everyone has value and no one is perfect. It’s almost impossible to be above average all the time. Sometimes we do shine, but mostly we are just ordinary. That is good enough, as long as we do our best.

3-28 When should we practise self-care and self-compassion?

All the time. We must make it a priority and get into the habit of taking care of ourselves. We need to look after our physical needs and attend to our emotional needs, especially when we feel stressed.

We need to practise self-care and self-compassion all the time.

3-29 How can peer support groups help?

Peer support groups are not places where we moan and complain, but rather places where we can give support to each other. To be useful, peer groups need to have clear boundaries so that people feel safe to share and access support.

Case study

Mavis is a 39-year-old community health worker. Mavis is a kind and eager care provider who works hard. She often takes on extra work and seems to have the perfect life with two children and a kind husband. Recently, Mavis has been struggling to sleep properly at night, she feels tired all the time and has been shouting at her children. Her husband has lost his job. Mavis is always very hard on herself and doesn’t think she works hard enough. She is frightened that others will think she is lazy if she doesn’t take on more work. The more exhausted she feels, the more she judges herself.

1. What is happening with Mavis?

No one is perfect. What we think about ourselves is often very different from how other people see us. Many people who care for others struggle with doubt and uncertainty at times. This is normal. Mavis is very judgemental of herself. Her husband’s job loss is an added stress which can make her life even more difficult.

2. What can Mavis do?

Mavis can recognise that she is suffering. She can try to show herself the same kindness that she would give to a close friend. Suffering is a part of life, and we are not alone in suffering. When Mavis can give herself the kindness she needs, she will be able to relax, get some sleep and be more able to think about ways to change her situation.