Psychological self care

Learning objectives To recognise and clarify the demanding nature of mental health work To identify the advantages of psychological self care To reflect on individual coping strategies To map personal and professional resources To draw up a personal action plan to maximise resources for good psychological self care

Normal reactions to stress HOW MANY DO YOU RECOGNISE? Causes of stress can be: Internal – arising from within the individual External – arising from the external events and demands The effects of stress can be: Physical Psychological Behavioural Cognitive

Physical signs of stress Including: Feeling tired most of the time Sleeping difficulties (too little, too much, poor quality) Constipation and diarrhoea Headaches and other aches and pains Nausea High blood pressure Skin disorders Heart racing Night time sweating Poor appearance (hygiene, clothing, grooming)

Behavioural signs Inability to sit still Frequent crying Including: Inability to sit still Frequent crying Doing more work – there is never enough time Being constantly “on the go” Avoidance of work or being later for work Spending longer working but getting less done Putting things off/indecisiveness Increased alcohol consumption Having minor accidents Altered eating patterns (too much, too little, poor nutrition) Biting finger nails Under performing Being argumentative/irritable Demonstrating poor judgment Losing interest in relationships/work/sexuality

Emotional signs Including: Frustration Anxiety Restlessness Despair Irritability Dread of the future Feeling angry, hurt, worried

Cognitive signs Difficulty in making decisions Difficulty in concentrating Negative thoughts such as “I can’t win”, “I can’t cope” Forgetting things Reduction in problem solving Ruminating (repetitive thoughts)

Burnout: Warning signs Common early warning signs which may indicate that staff are not receiving sufficient levels of support and maybe becoming overwhelmed include: occasional episodes of “not coping” increasing cynicism towards the work in which they are engaged increased sickness rates If these warning signs are not recognized and the necessary supportive actions taken, staff will become increasingly less effective and eventually be unable to work.

Symptoms of burn out loss of a sense of humour persistent sense of failure anger/resentment progressively more cynical, afraid and lonely sensitive to criticism cannot be bothered depressed feelings of panic

Behavioural signs of burnout resistance to patient contact and going to work working harder to achieve less increasing social isolation avoidance of contact with colleagues clumsiness aggressive driving inability to sit still or settle eating too much or too little nervous laughter

Cognitive signs of burnout negative thinking: thoughts about leaving the job loss of creative problem solving inability to concentrate or listen dehumanising patients suspicion and mistrust of others inability to make decisions forgetful inability to make plans thinking about the past

Advantages of psychological self care A different relationship with yourself – one that is understanding and accepting of your strengths and vulnerabilities. The ability to recognise and reflect on your own reactions and feelings. The ability to listen to your own intuitions. The capacity to listen accurately and actively to another person. The ability to look after yourself psychologically when you need to. An acceptance of individual uniqueness, differences and similarities. A clearer sense of order in terms of what matters most. More effective and thoughtful decisions regarding actions to be taken. A healthier balance between attachment and detachment. A reduction of the fears associated with one’s own distressing feelings and reactions and those of others

Psychological self care Principles Balance your work and leisure time Prioritise the way in which you spend your time – do not allow others to waste it Control interruptions Allow time for thinking and the unexpected Delegate work whenever it is appropriate Be assertive – learn to say “no” both to unnecessary work and to taking on other people’s tasks Put past mistakes behind you – do not dwell on them Review significant problems and learn to manage them better – make realistic action plans

A personal action plan People are unique individuals. Everyone reacts differently to some degree to stressful and demanding situations Knowing yourself will provide your greatest source of strength and inner resilience in difficult and challenging circumstances

A personal action plan Psychological “housekeeping” - time alone for internal reflection. No matter how busy, no matter how many demands, make a date with yourself on a regular basis to review what you need Use any type of personal writing to aid this process – a diary, review of the previous week, anticipating/thinking in advance about situations which may be more demanding Identify whether sources of stress are internal (how you are thinking) or external (the events themselves) Talk to yourself in a friendly, helpful way, as if you were supporting a good friend. Identify what you can change – within yourself, with your colleagues, within your organisation – to maintain optimum psychological care. Find someone to talk to when needed. Do not wait until you are reaching breaking point