1. Psychological self care

2. 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

3. 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

4. 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)

5. 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

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

7. 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)

8. 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.

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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