Dear MHPs, Please Take of Yourself!

The second wave of the COVID-19 pandemic has been difficult for most people. People have lost their family members, lost jobs, ran out of their savings, experienced financial crunch, and what not!

They started experiencing mental health-related issues such as anxiety, symptoms of depression, high levels of stress, breakdowns, panic attacks, and grief.?

There was a surge in the number of people looking for mental health services. Therapists saw a sudden increase in the number of clients. A lot of my colleagues were working overtime to accommodate clients.?

We (MHPs) as a community experienced burnout. MHPs were dealing with the increased workload, work stress, emotional exhaustion, compassion fatigue, and vicarious traumatization (Vicarious trauma is the emotional residue of exposure that counselors have from working with people as they are hearing their trauma stories and become witnesses to the pain, fear, and terror that trauma survivors have endured).

I saw a sudden increase in the number of clients. On average, I used to see 3 clients a day, but it increased to 6-7 clients a day. And I was not prepared for this sudden increase in workload. Eventually, I started experiencing fatigue and was falling sick almost every week.?

The second wave of the pandemic and its consequent impact on health care professionals, especially mental health professionals have led to conversations around the importance of self-care for mental health professionals.??

This topic has been ignored for a very long time. Honestly, I have personally avoided self-care. And it’s not just me! Many mental health professionals preach self-care to clients but do not practice it for their well-being. For a lot of MHPs, it’s a challenge to put the concept into practice in their own lives.?

Let’s address the elephant in the room!

Why self-care is important for mental health professionals?

I read an interesting blog a few days back. It said, “If you are gasping for air, you can’t help other people.” This made me think of another instance, where flight attendants ask you to wear your oxygen mask before helping others in case of emergency!

Mental health professionals who do not indulge in mental, physical, and emotional self-care often run out of “oxygen” and cannot effectively help their clients because all of their energy is going out to the clients, and nothing is coming back to replenish the MHPs energy.

Burnout and emotional exhaustion often impact an MHPs ability to empathize with the client. MHPs experiencing compassion fatigue may deny clients' traumatic experiences, over-diagnose and pathologize clients, and become increasingly less attuned and empathetic.

There have been multiple pieces of research that focus on this question. Freud (1937) discussed?the stressfulness of a therapist?which impacts therapeutic success. Bettney, (2017) also identified the work-related issues of large caseloads and negative team environments as being additional stressors for mental health practitioners?

MHPs also experience stress when their clients do not show improvement, there is a symptom relapse, or suicidal ideation/attempts, aggressive or violent behaviors. This is emotionally draining for most professionals.?

Let’s talk about burnout!

Burnout is often described in terms of emotional exhaustion, reduced productivity, low self-efficacy, and decreased personal achievement. Burnout is prevalent amongst mental health professionals. In research, it was shown that over 13% of MHPs were at risk of burnout.?

If not dealt with, burnout can result in poor quality of life, practitioners experiencing mental health as well as physical health issues. It also reduces overall therapeutic effectiveness, indirectly harming the client’s progress and growth.?The cumulative effects of emotional, mental, and physical burnout thus can lead to professional impairment in the provision of services.?

To summarise, when mental health professionals are not taking care of themselves, they are not only putting their well-being at risk but also harming their clients.

Think about it! Will you be able to drive a car on an empty tank??

?What do we do about it??

What do you tell your clients about self-care? Do you tell them to engage in a self-care activity every day? Do you ask them to put self-care in their routine? Why aren’t you doing it for yourself!?

The first step in moving towards self-care is identifying the barriers! What is stopping me from engaging in self-care? Am I working too much? Am I procrastinating? Why am I not able to take care? This introspection will give you a lot of answers!

Now that you have got your answer, contract for a change! Formulate a self-contract. Think about whether you agree with a particular activity. Identify whether you have the skills to engage in that activity. Identify when, where how will you accomplish this activity!?

Say, for example, I self-contracted for exercising. I figured out what kind of exercise is congruent with my body’s strength and flexibility. I identified the exercises that I enjoyed doing. Then I finalized the schedule, that is, the number of days, time, and where I would do it.?

Another thing that is important for an MHP is to get supervision. A supervisor is usually a senior, experienced MHP. The supervisor and supervisee can meet once or twice a month, depending on the convenience and requirement. A supervisee can discuss how client’s situations impact them. Supervisor also provides guidance when you are stuck, don’t know how to proceed with a client or when there is a difficult client. Supervisors can also help you understand whether the client is the best fit!

I remember at the beginning of my career I had a difficult client. I used to experience anxiety before her sessions. I took this up with my supervisor and she guided me on how to go about it. Eventually, I was more confident about taking those sessions. The stress was still there, but it had reduced significantly.?

Ever been in the client’s chair. IMHO, EVERY MHP SHOULD TAKE THERAPY! We are humans; we also have our baggage! We get triggered too by some client’s stories! How do we deal with this? Sign up for therapy!

I have taken therapy to deal with my issues. It helped me understand my boundaries as a human and as an MHP. It also helped me learn skills; how to conduct interviews, how to calm the client down, how to initiate a session, and how to close it. I picked up certain behaviors from my therapist and I still use them.?

It is difficult but got to do it! SET BOUNDARIES with your clients and COMMUNICATE IT to them! Having open, honest communication with clients about work hours, emergencies, logistics, etc. is extremely important. It not only helps you but is also helpful for the client.?

I have struggled with this at the beginning of my career. I remember my client’s texting me at 11.50 PM to book a slot. And I was in a dilemma whether to respond or avoid. Setting clear boundaries and communicating this with the client has proven to be helpful!?

You need fuel too! Self-care is the fuel that drives your car! See self-care as food for the soul!