Helping Professions and Emotional Balance

Helping professions must practice to achieve emotional balance.  Working conditions for the helping professions have become more and more difficult over time, especially with the advent of so called “helpful technologies” and ever-increasing governmental/funding requirements for documentation.  When I started in the (behavioral health) field of clinical psychology and addictions in 1985, the entire medical record was a total of 6 pages.  The assessment report, treatment plan, progress notes, releases, communications, and termination report were added as expected.  The for-profit attack on health care has only made matters worse.  And even large non-profits with $1,000,000 plus CEOs and CFOs, again, cut into salary and benefits for staff as well as placed additional pressure to produce, produce, produce and produce. The very organizations dedicated to helping people with serious medical and psychological needs have, themselves, become little more than stress-mills – burning out otherwise dedicated and professional personnel. Staff dissatisfaction and rampant staff turnover have added yet more stress to the “helping environments.”  The preponderance of novice inexperienced counselors fresh out of graduate school adds more stress. For an eye-opener, examine closely how some emergency rooms and in-patient psychiatric facilities deal with seriously mentally ill consumers.  Restraints, restraints, restraints appears to be the treatment of choice, or perhaps the treatment that can be delivered by tired, frustrated, perhaps burned out staff.  It appears in the age of technological advances and concerns about money in health care (even

Medicaid will shift to values-based reimbursement), have resulted in a work environment NOT AT ALL conducive to good mental health.  Personally, I am in favor of outcomes-based reimbursement so long as the designated outcomes are set by informed, experienced clinicians and NOT some government bureaucrat who may never have had professional experience sitting with a client or patient. In such a hostile environment, even clinical supervision (if existing) has become a review of utilization and case audit discrepancies rather than helpful clinical  inputs and emotional maintenance activities.  So, what is the helper who remains in such an environment to do?  The American Psychological Association has presented some sound advice on this matter.  Under the heading of “Research-based strategies for better balance” here is what the association recommends for helper self-care.

1. Practice Mindfulness on a Regular Basis – Even the most critical meta-analyses have documented beneficial effects of mindfulness, meditation, and yoga on stress, anxiety, depression, physical pain, and emotion regulation (i.e., addictions). Some support exists for improved sleep quality and even greater happiness. Check in with yourself during the day and take a  brief mindfulness break with or without your client/patient. Practice regularly on your own for the best results. Some studies have documented that regular mindfulness practices improved executive brain functioning, reduce limbic power, and buffers stress reactivity.
2. Reframe, reframe, reframe – What are the pay-offs from your work?  Pay more attention to positive in the workplace than to negatives. Even neutral (or even better, positive) reappraisal may be helpful. It is a good idea to take a brief mental break to note what good things have happened at work. What is your emotional status at the time of the check-in?
3. Seek support from positive psychology – Strive to be in charge of you emotions. Positive emotional experiences support resilience, self-esteem, satisfaction and even gratitude. Practice simple gratitude (another mindfulness tool) about what you do have rather than what you want.
4. Use social and emotional support – Connect emotionally with your colleagues, and use the time for mutual support rather than moaning and groaning about “how bad” things are at work. Remember in eye-to-eye/face-to-face communications your mirror neurons are always “on;” so be aware of the impact your facial, behavioral and verbal emotions have on co-workers.  Keep it positive and supportive!
5. Use supervision well – If you have acceptable supervisions at work, be aware that the pressure on supervisory staff is even more serious. An effective supervisor should know more than you know, and a good supervisors should be able to support you keeping things in balance. If you do not have adequate supervision at work, consider purchasing better supervision on your own – even if it is once a month it can be helpful.
6. Move your body and get outside if possible – Mindful movement is an under-utilized mindfulness ractice in health care settings. Yoga stretches, exercise, qi gong, and tai chi movements can be very helpful in transforming your negative energy into positive energy. If possible enjoy nature as much as possible WHERE you work. Get some fresh air and sunlight into your body.
7. Use more self-compassion – Self-compassion is another under-utilized mindfulness practice in health care systems. Life is made up of suffering, joy/happiness, and neutrality/boredom. When you suffer, practice self-compassion; when you are happy, practice gratitude; and, when you are bored, wait for impermanence to change everything. Then start allover again.  Self-compassion will assist you in showing compassion for the suffering people you are helping, rather than viewing them as part of your work problem. This is simply projection at it’s worst.
8. Practice spirituality or religion – If you are involved deeply here, these practices may be highly effective in helping you cope better with work and other demands, and be more fulfilled in life.
9. Lastly, reflect on personal meaning – Reflect on your personal meaning in life and how work makes up part of that aspect of yourself. The rewards you obtain from helping others may be greater than you think, so long as you are not totally stressed out doing it. Take time to be with your personal meaningfulness.

Refer to Weir, K. (July/August, 2016). Monitor on Psychology.Washington, DC: The American Psychological Association, 42-46.  Go to this blog (Mindfulhappiness.org) to review other posts on self-care, self-compassion, etc. Note: Some items noted here come from my blog not the APA article.

By Anthony R. Quintiliani, PhD., LADC

From the Eleanor R. Liebman Center for Secular Meditation in Monkton, Vermont

Author of Mindful Happiness  

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