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Critique of Self-Care Initiatives in the Helping Professions

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Generally speaking, helping organizations view humans from two polarized lenses.  Some organizations believe that their employees are good people and will always do their best despite any barriers that exist. Other organizations operate as if people are to be significantly controlled. These organizations believe without external control, people will give less than one hundred per cent and will somehow take advantage of benefits or in any way they can.

If you consume literature from publications like Forbes, Macleans (Canada), Time, or even through social media, you undoubtedly have read about efforts of progressive companies to foster production and actually take care of their employees in a holistic manner. We now know about the benefit to production, whatever the product may be, when organizations implement wellness strategies at work and give employees menus of wellness options to choose from which briefly take them away from production to have infusions of wellness.  In fact, this opinion is no longer just an opinion.  The evidence is clear. Organizations and societies who take care of their employees fair better on every indicator of production.

In the helping professions, our organizations are often well intended when they engage us in wellness conversations and efforts, but they often miss the mark. Helping organizations often bring in “experts” to talk to us at staff meetings. This act within itself is view as progressive and helpful. Again, while well intended, helping “experts” and their products miss the mark of what is needed to increase the wellness of helping professionals.  Why is this?

Strategies and self-care models offered to increase our wellness do not fit the nature of our work.  These models are based on static and linear models of work and production. For example, ten minutes of stretching likely benefits a professional helper who works a strict schedule and sees clients in an office for treatment blocks.  One can certainly take ten minute breaks and will reap the stress reducing benefits from those breaks.  Strictly office based helpers can often also find time to exercise at lunch, socialize in the lunch room, and so on, and therefore reap the resiliency benefits of these strategies.

The problem here is that the majority of helping professionals do not work in office based environments and see clients for therapy or for some other time specific service.  The majority of us work in child welfare, children’s or adult mental health, or crisis intervention environments.  Our “schedules” change several times a day as we meet the needs of our clients and respond to our communities’ crises.  A day in the life of a helping professional in these areas of practice looks more like a dog’s breakfast.  We don’t get set break times (they are there but we can’t and don’t take them because we are too busy), we don’t eat at set times and we almost always eat in our cars while travelling from situation to situation.

We forget to pee and poop.  No really we do.  We experience the sensation to pee, but it is often an hour or two or three before we actually remember or have the time to go. To be sure, it is just not possible to interrupt a suicide assessment, crisis phone call, apprehension with the police, or the like, to pee.  Not only do we care so deeply about our clients welfare that we wouldn’t interrupt our process with them to pee, but we also get used to ignoring our bodily indicators and in fact over time we actually divorce ourselves from a great deal of our biology.

This divorce from our biology often happens with ease because we are pumped full of stress hormones which naturally serve to put everything except the crisis at hand on hold.

While I don’t mean to belabour this point, it would be negligent not to note that if you follow the logic about the physiological and biological separations we perform in order to meet the needs of our client populations, you will understand that implementing any menu option from the typical self-care menu is literally impossible.  You can’t meditate on the witness stand, during an apprehension, or a suicide assessment.  You can’t break for a jog when you spend your lunch in your care driving and eating.

Following along with the logic of this work reality means that our self-care has to happen on our own time.  After work whenever that may be.  But if you’ve apprehended on this particular day, you are likely still at the office long after closing time.  You are settling the children at the foster home and then heading back to the office to prepare your court papers.  Your family, if you have one, doesn’t get to see mom or dad tonight because work responsibilities made that impossible.  The family may not get to see you tomorrow either because you may have to leave early for work in order to pick up your court papers and be able to serve them to your client family before court.

There eventually comes a day though when you things “slow down”.   A slowdown of course refers to the day when you get to try and fit in all of thing appointments and other tasks that you have had to put off due to the crises you have been responding to.  On these days you still eat in your care, don’t get breaks, but… you likely pee more regularly.

There seems to be a general understanding amongst us that if you are in this line of work for more than ten years you are a “lifer”.  I mean no disrespect to those that get out after a few years and in fact many of use envy you and are proud of you.  We still consider you one of us if you’ve been on the front line for even a few years before you leave because you “get it” and you are therefore one of us.

The life cycle of a lifer is as varied as is a day in our line of work.  Sadly though, many of us lifers don’t fare so well in our own personal lives.  There are many reasons for this but for me based on my dedication to understanding the harmful effects of trauma, it boils down to the cosmic roll of the dice of our stress hormones, traumatic exposure both direct and indirect, and to the overall impact of our divorce from our biology and often our bodies.  Many helping professionals  get sick from our work.  We all know colleagues who have chronic illnesses that really boil down to the harmful effects of stress.  The academic literature is now abundant in this area so you don’t need me to tell you about it.

The cost of our caring is too often too great.  I know we wouldn’t have it any other way but it is also not fair and just.  Given the strength of the literature in the area of trauma, burnout and compassion fatigue in the helping professions and the clear health consequences of chronic stress, I believe we can do much better in helping ourselves lead lives full of more wellness.  This requires a change in the structures of our work, it requires a change in organizational culture, and it requires a commitment of each one of us to be brave enough to talk about the cost of caring.

Next, we need to change organizations that view employees as ultimately malignant.  People don’t choose to be sick and they don’t want to be sick.   To be clear, psychological and emotional illness is a real risk in our work.  And, psychological and emotional illness can lead to a myriad of legitimate physical ailments ranging from the common cold due to compromised immune systems to auto immune illnesses like irritable bowel syndrome.

Organizations who view employees with suspicion are using faulty logic.  Not too long ago in my province we had a Premier who successfully waged a ware on welfare recipients by convincing the population that people on welfare are cheaters and have lazy characters. This of course is not true. People don’t choose to or want to be on Welfare.  Similarly, it is not flaws in our characters that make us ill.  We are not weak, and we do not need discipline to help us be more productive during times of illness.

What we need is wellness initiatives that fit with the nature of our work. These initiatives need to be dynamic and individualized.  I believe that we need individual wellness plans which are akin to Individualized Education Plans for children in our school systems with learning needs. We need modifications at times and accommodations that reflect the true nature of the stress in our jobs.

We cannot be expected to own our wellness when by its very nature our work often leaves us exhausted and without adequate time to rejuvenate. The ownership needs to be jointly held by us and our organizations, communities, and professional organizations.  We need nap pods, we need exercise equipment on site, and we need kindness which includes life affirming strategies aimed at reducing the host of risk factors are work puts us at risk of.

We also need parity with other helping professions and service providers such as first responders – Police, Fire, and Ambulance. I’m not sure how this has happened but we have lost a lot of ground in this regard.  In many provinces and jurisdictions, Police officers now make six figures and have the benefit of early retirement at full pension.  Most urban Police stations and fire halls have onsite gyms.  I do not begrudge this, in fact I applaud it.  But, we are also first responders and we are by and large not a healthy population by any indication.

Most importantly, we have to be clear about these truths. It is surely hard to admit that our work makes many of us ill in one way or another and by the very nature of our illnesses we want to avoid talking about them and truly addressing them.  We need to adopt real risk reducing strategies such as those employed by our Police partners. Can you imagine a Police officer attending a client home alone?  Working in partners is one of the most basic risk reducers available to us but we don’t have that option much of the time.

The evidence is not just anecdotal and therefore should not be dismissed. What needs to happen now is for us to bravely open up global conversations and create global movements to address our wellness.

Perhaps ironically, we are in fact a vulnerable population who are charged with serving, protecting and healing other vulnerable populations created by our society.  Society and systems create vulnerable populations, individuals do not create vulnerability in themselves.

Leaders who are responsible for the wealth of research pertaining to the cost of caring in our areas of work need to collect and collate information regarding the positive effects of workplace culture in addition to wellness options where organizations own the efforts and reap the benefits of those efforts. And, we need to strongly advocate for the end of career benefits that our Police, Fire, and Ambulance colleagues experience.

I believe we need an organization for social workers and helping professionals, a think tank of sorts,  whose purpose is to improve our lives at work and at home.  I’m sorry to have to say this but our professional organizations have missed the mark here.  More often than not, they exist to monitor and discipline us while protecting their interests. Who will protect and nurture our interests?

Written by Clint Robson

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Clint has recently joined Social Work Helper as Digital Marketing Coordinator and Writer. He is a Canadian Social Worker who earned an Honors Bachelor of Social Work (BSW) from Laurentian University and a Masters of Social Work (MSW) from McGill University. Clint is in his 20th year of Social Work practice with interest and expertise in macro and systems level analysis and intervention, domestic family violence, trauma, stress, and post traumatic stress, child maltreatment, and solutions to reduce the impact of trauma in the helping professions.

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