Horizon Star - March 2021

Helpful practices to promote self-compassion

Resilience among health care workers during the COVID-19 Pandemic

Brandi Person, Clinical Psychology Intern

Megan Pollard, Clinical Psychology Intern

for others, prevents against compassion fatigue, promotes resilience, increases happiness, boosts self-esteem, and protects against mental health concerns. The good news is anyone can learn self-compassion and there are many practices that have been developed to help us comfort and care for ourselves in this way!

This past year has been incredibly stressful for many people. Managing the challenges of daily life while navigating a global pandemic is an enormous task and it’s easy to be critical of ourselves for not knowing how to do this. Today, I wanted to share some tips to help cultivate self-compassion. So, what is self compassion? Self-compassion is being open to your own suffering, experiencing feelings of caring and kindness for yourself, taking a non-judgemental attitude toward personal flaws, and recognizing that your experience is part of the common human experience (Neff, 2003). It means viewing your personal struggles in the same way you would a friend or loved one when they are struggling. Self-compassion has 3 key elements: 1. Mindfulness – which helps be present and separate us from our worry/fear; 2. Common humanity – which reminds us that we are not alone in our suffering and protects against the loneliness of social distancing/isolation; and 3. Self-kindness – which regulates fear through connection and warmth with ourselves. Self-compassion has many benefits. Researchers have found it fosters compassion

as humans during a time of social distancing and isolation. Luckily, we can provide this comfort for ourselves! Don’t be afraid to give yourself a hug or place a hand over your heart to feel the warmth when you need it most. • Compassionate Letter: Write a letter to yourself from the perspective of someone who loves you unconditionally. • Focus on a perceived “flaw” or “failure” you have been judging yourself for and ask yourself, “What would my friend say about this?” “How would they convey their compassion for me, especially when I am judging myself so harshly?” • Fill the letter with the sense of kindness and caring you feel from this person. • After writing the letter, leave it for a while then come back and read it later. Allow yourself to believe the words and feel the compassion and other emotions sink in. • Taking Care of the Caregiver: Health care workers need time to recharge and take care of themselves in order to take care of others. This involves giving yourself permission to meet your own needs. • Off the job self-care: Spend time outside of work doing things you enjoy — listen to music, do yoga, spend time with family or those in your bubble, take a bath, play a board game, etc. • On the job self-care: It can be hard to find the time during work to take care of ourselves. When you are stressed or overwhelmed at work try: i. Using self-soothing words (e.g. “I know this is hard and it is OK that you are stressed. Take a minute to breathe.”). ii. Soothing Touch – place one hand on your heart and abdomen, take 2 to3 deep breaths, notice the gentle pressure and warmth of your hands, feel your chest rise and fall naturally. I hope you find these practices helpful and thought-provoking. Remember: self- compassion is a skill and may require time and practice to reap the benefits. Imperfection is part of being human and self-compassion allows us to provide ourselves with the love, connection, and support we need to handle whatever challenges come our way.

As a clinical psychologist in training, I am eager to share howwe can borrow various psychotherapeutic principles to help build resilience inyou—our healthcareworkers (HCWs). The impact of COVID-19 Stress associated withmultiple recommendations from authorities, fear of illness for oneself and loved ones, social discrimination or stigma, financial instability, extended periods of isolation, and ongoing loss and grief is jeopardizing the mental health and resilience in the general population, but HCWs are arguably the most affected group of people in the fight against the virus. Unfortunately, you as HCWs face additional challenges that increase your vulnerability to distress and burnout. You must cope with rapidly changing policies, adapt to work outside your usual scope, manage fear and uncertainty about personal protective equipment (PPE), navigate moral distress and witness trauma. As a result, you are at risk for diminished mental health amidst the pandemic. In a recent study, just over half of HCWs surveyed reported depression symptoms (50.7%), while 44.7% experienced anxiety and 36.1% reported a sleep disorder. Promoting Resilience in Health CareWorkers Resilience can be defined as adapting to changes caused by stressful events in a flexible way and recovering from negative emotional experiences. It’s about our ability to withstand adversity. In health care, resilience encompasses being able to care for patients and oneself while enduring uncertainty and unpredictability. Now, there is the added stress of a global pandemic that has infiltrated our work life (and personal life). COVID-19 is a major threat to our resilience, and research shows we need to protect the mental health of HCWs during the pandemic. After all, maintaining the success of the health care system and provision of health care services depends on the well-being of you, our HCWs. According to the American Psychological Association, it is crucial to promote psychological resilience of during the pandemic so you may continue to work with the intensity and focus your jobs require. Because of your training in understanding wellness, distress, and psychotherapeutic treatment, psychologists are well positioned to respond to this need. Applying Psychotherapeutic Principles to Bolster Resilience Here are a few examples of psychotherapeutic techniques that can offer you the opportunity for reflection and validation, and for learning about the nature of stress, coping, and resilience: • Group Therapy: A group setting offers an opportunity to amplify existing connections

within the health care team. Group learning and discussion of shared experiences can promote collegiality, understanding, connection and belonging. Sharing success stories can help you find joy amidst chaos and can reinforce a sense of purpose. Challenges brought on by the pandemic can be openly discussed and problem-solving can become a team effort that offers valuable support. • Cognitive Behavioural Therapy (CBT) can illustrate the relationship between thoughts, feelings, and behaviors. It emphasizes that even when so much is uncertain and out of our control, we can remain in charge of our own thoughts. Identifying cognitive distortions can be a place to start. An example of such a distortion is “catastrophizing.” HCWs are trained to anticipate worst-case scenarios in the clinical setting, but this pattern of thought can lead to anxiety and fear when applied to other contexts. In terms of behavioural activation strategies, recommendations for behaviours that may have a positive impact on emotion (e.g., exercise, socializing virtually) can provide you with practical guidance. • Mindfulness-Based Stress Reduction can be used to facilitate stress management. Breathing exercises, body scans, and short, guided meditations are grounding. These techniques can be empowering when practiced individually or with patients. This practice may simply entail taking two minutes during each shift to focus on your breathing and give your body a break. An alarm can be set to remind you to take a moment to relax and refocus. • Interpersonal Therapy: Speaking openly

about the process of grief and life transitions can be normalizing and validating as we relate to others, especially when colleagues are grieving (e.g., working with dying patients and their families, losing loved ones to COVID-19, and experiencing the loss of typical social connection). A common role transition that has emerged during the pandemic is from clinician to “hero.” As society applauds the heroes working on the front lines, you may struggle with this new identity and how to navigate it, managing feelings of being an impostor, not doing enough, and not receiving adequate compensation to take on the new title. • Dialectical Behaviour Therapy (DBT) can identify gray areas where opposing ideas co-exist. Sentiments such as, “I am tired and scared and I do not want to go to work” and “This is my calling and I love my job” are common themes. DBT encourages us to hold these thoughts in mind and allow them to both be true, reducing the tension of having to choose. DBT can also focus on the ways you regulate your emotions (e.g. identifying how emotions escalate into distress and how you might de-escalate yourself). • Motivational Interviewing focuses on rolling with resistance and prompting change. It can be helpful in supporting HCWs who are struggling with maladaptive habits and behaviors imposed by the pandemic. To all HCWs: thank you for being resilient during these difficult times! I encourage you to seek support if you are feeling overwhelmed by the impacts of COVID-19.

• Take a Self-Compassion Break: Think of a situation in your life that causes stress and try to feel the emotions associated with it. Say to yourself: a) “This is a moment of suffering.” b) “Suffering is part of life.” (Put your hand over your heart to feel the warmth of touch.) c) “May I be kind to myself.” (Ask yourself what you need to hear in that moment and say it to yourself.) • Soothing Touch: It is more difficult to receive the physical touch/comfort we need



For more self-compassion exercises see: self-compassion.org

Megan Pollard is a Clinical Psychology Intern working with Horizon this year. She currently works at Horizon’s Dr. Everett Chalmers Regional Hospital and Horizon’s Stan Cassidy Centre for Rehabilitation.

Brandi Person, Clinical Psychology Intern

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