Breaking the Cycle of Stress: Stress Management Tools for Healthcare Professionals

Introduction

I am Jessi Andricks, and I am a speech-language pathologist. I am also an integrative health and wellness coach with a focus on stress management. Today, we will be talking about breaking the cycle of stress. As helping professionals, we can definitely get caught up in this cycle of stress. With all that is going on globally, we can get stuck in this cycle of stress. We will also discuss stress management tools that we can all use to work through this cycle.

I wanted to tell you more about myself and why I am presenting this topic as a speech-language pathologist. As I mentioned briefly, we are all in the bigger field of being helping professionals. Whether this is social work, speech therapy, occupational therapy, physical therapy, education, healthcare, or whatever it might be. Collectively, we are looking to help others using our expertise, training, education, and background. And in our profession, we give and give, and sometimes we give so much that we do not have a lot left to give. Then, when we run out of time to fill back up, this is when we start to feel really stressed.

As a speech therapist, I definitely started to feel this. I graduated in 2008 from the Medical University of South Carolina. After about three years in the field, my stress started to get to the point that it was not only affecting me at work, but it was also affecting my life outside of work. It became chronic, where I was not able to brush it off and leave it at work. I was starting to feel stressed all the time, and that stress grew each year. It did not matter what setting I was in. I kept thinking that maybe “the next job” or “the next position” would be different. I kept thinking my “dream setting” would finally be perfect and less stressful. I would then be able to be passionate about my profession again. However, stress followed me.

After a few years, I decided that it was not the stress or the wrong setting; I must have chosen the wrong career. When the stress grew to the point that I did not know what else to do, I decided that I needed to make a change.

I decided to follow my passion for wellness, specifically yoga, meditation, mindfulness, and health coaching. I have now been away from the field of speech-language pathology for nearly five years.

I went through a lot of different training in yoga,  mindfulness, and wellness. I learned how to take care of myself and to teach that to others. I found that I was working through managing my stress without realizing that that is what I was doing. I chose this career path because I thought it was what I really loved, and along the way, I realized that it was helping me figure out my stress. And, I swore I would never get back into the field of speech-language pathology because that was the wrong career for me.

However, life happened. The studio where I was working closed as the owner was moving, and I was about to have a baby. I was going to be a new mom, and I did not want to start from scratch. How was I going to go to all of these different gyms and studios while trying to find childcare? I decided I needed stability and went back to speech-language pathology. However, this time, I was going to look at it from a new perspective. I was excited about it for the first time.

I got into the field of teletherapy, which was great in this current climate, with most people working from home. As it was a little bit different from the norm, there was a little bit of stress, but it was still exciting. I needed some new resources and materials to use because I had been out of the field for so long. I discovered when I joined some Facebook groups and other forums seeking these resources that there were many stressed-out speech therapists out there. And, when I started to look even broader into education and other helping professions, there was a lot of stress in these areas. Many felt as I had right before I quit and left the field.

I took all of the training that I had done and started diving even deeper into burnout and stress management and put it together. I wanted to share this information and give tools and resources to speech-language pathologists and other helping professionals. I wanted to help people to learn where the stress was coming from, why it was affecting them, and most importantly, why it was not their fault. I also wanted them to have practical things to use daily to help manage stress no matter what was being thrown at them.

Centering Practice

Let’s do a little practice together. 

Now that we are more centered and how we are feeling, we can show up to learn these stress management tools.

Stressed Out Therapists

• Stressed, overwhelmed, and burnt out
• Feeling inadequate, underappreciated, and overworked.
• Many wanting to quit or wondering if they chose the wrong profession

As a whole, we are stressed out, helping professionals. This stress is leading us to feel overwhelmed and, at times, even burnt out. It brings on this feeling of being inadequate, underappreciated, and overworked with our clients, their families, co-workers, or with the management. We feel that we are not doing enough, we are doing more than enough, or that no one really understands or appreciates what we are doing. This starts to build that stress. This leads to us feeling like we want to quit. And we may wonder if we chose the wrong profession.

• In all ages and experience levels, and types of professions
• Across the board in all settings.
• Many different personality types (example type “a,” type “b,” introverted, extroverted)

Stress is not just happening to new therapists, but it can impact all ages and experience levels, which is happening in all professions. It is not that one profession is harder than the other, but something other than a helping profession might be easier. Or, with more experience, things get easier and less stressful. On the other hand, perhaps with more experience, things become more stressful.

For sure, it is happening across the board in all kinds of settings like medical institutions, private clinics, and schools. We are feeling this stress grow across many different settings.

It is also occurring in many different personality types. It does not matter if you are a type A or B. For example, Type A people may be very organized and focused and feel like the stress is from planning and prepping a little more. Type B people may feel like they are less focused and organized. There is still stress there as well. Stress can occur whether you are introverted or extroverted. And with everything that is going on in our world right now, we are experiencing this stress even more.

What Stress Feels Like

• Unable to balance work and life
• Not effective or efficient enough
• Exhausted by the amount of growing work
• Not doing the work you were meant to do/Not creating change
• Everything to everyone

Stress is feeling like there is an inability to balance work and life. Work starts to take over. There is no separation anymore. This is whether you are physically or mentally bringing work home. There is not a clear point where life outside of work starts. It all starts to mesh together in a way that becomes stressful. It also feels like we are not effective or efficient enough.

You might be thinking, “If only I could do more,” or, “If only I could be more on top of things and more organized.” “If only I had this extra tool (extra resources), then I wouldn't be so stressed, and I'd be able to get the work done.” We start to think we are not efficient enough. If only you knew a few other ways to do things, you could work faster and not be stressed. There is this constant push to do more and be more that adds to the stress. This leads to feeling exhausted only not by the amount of work that is growing but also by the amount of extra work and effort that you are putting in to get that work done. What ends up happening is you feel like you are not doing the work you were meant to do or not creating the change you set out to do. As a helping professional, you want to create positive change to help people. And when you are feeling inefficient, ineffective, and exhausted, it is hard to feel connected to that work. You then start to question if this is the work that you were meant to do.

At times, you feel like you are everything to everyone, and that can be stressful. There is so much to do, and you are trying to do it all and be there for everyone as much as you can. Then at home, you do not have a moment to let go of the stress. You still are bringing work home with you, but you are also trying to take care of things at home. It becomes incredibly overwhelming and stressful.

Stress and burnout can build. Sometimes we use these interchangeably or think about being so stressed that we are also burnt out. They are definitely related, and you can feel both of these things.

Stress and Burnout

• Stress happens on a daily basis and can become chronic if not managed.
• Burnout stems from chronic stress that is left unmanaged over time. 

Stress is what happens daily. There is always stress. Little things can be stressful and build, and there are big things that are stressful. Stress will always be there, but then new things can come in. Daily stress becomes chronic if it is not managed.

Burnout is a little bit different. Burnout comes from that chronic stress that is left unmanaged over time. You have this daily stress that can build into chronic stress, but then the chronic stress manifests and changes into full-blown burnout. Little things start to build, and then this becomes chronic. When you cannot let go of it, it starts to become burnout.

Burnout

• It is not the same as stress
• Caused by prolonged, chronic stress
• Recognized diagnosis by the World Health Organization
• Characterized as feeling chronically stressed, mentally and physically exhausted, and, when focused on your job, doubts about your capabilities and skill.

Burnout is not the same thing as stress. It is stress at the next level. Burnout has been around for a very long time, and there are many studies on it. However, it was not until last year that it was recognized as a diagnosis by the World Health Organization.

Burnout is a genuine thing and is not a joke. In addition to the chronic stress building, it makes you mentally and physically exhausted. When it is job-related stress and burnout, you doubt your capabilities and skills. That goes back to that feeling ineffective and inefficient.

Stress Vs. Burnout

• Additional effort, pushing through
• Feel more frazzled, scattered, and disorganized in your thoughts
• You have less energy
• Can lead to anxiety
• Physical consequences

With stress, there is almost an excited energy behind it. Usually, when we think of being excited, we think of that as being a good thing. There can be some good behind our stress. We need that little bit of stress at times to motivate us to get going. However, this is the stress that never fades away and becomes constant. Instead of those short times of normal stress, it becomes a problem.

When an excitement never fades, and you feel this hyper energy all the time, this is when you are in stress mode. It takes additional effort to push through and keep doing what needs to be done.

You end up feeling more frazzled, scattered, and disorganized, especially in your thoughts. You are trying to push and push while having this additional excitement. It is like a flame growing brighter and brighter as this energy builds. While you are trying to push through and harness this energy, you do not do as much or focus. Ultimately, you are not as effective as you want to be.

While this energy is building, you really have less energy. I know that does not really seem to make a lot of sense, but this is less effective and efficient. This can lead to more anxiety and nervous feelings. This can lead to physical consequences.

Burnout is the opposite. Burnout can be really sneaky, and outsiders may not realize that you are burnt out. When I felt incredibly burned out, my coworkers thought that I was just very laid back and a “go with the flow” type person who was easy to work with. But in fact, I was feeling burnt out and was giving up. I was putting in what I needed to, but not any more than that. I wanted to leave, and I was spending as much time as I could brainstorming ways to do that. While it can often look like you are just laid back and easy to work with, that might not be what is going on inside.

• Little effort, giving up
• Feel bored, drained, and mentally exhausted
• You have less motivation and hope
• Can lead to depression
• Emotional consequences

Like the metaphor of a candle flame, stress grows brighter and brighter until the only solution is to burn out. This is what happens when we are in burnout. Instead of pushing and doing more, we now display little effort. We give up on things. "I'll do what I can, but I really do not want to be doing this anymore. I want to help, but I'm just going to do what I need to do to get through the day." Instead of feeling really excited about things, it is more of a feeling of boredom or feeling drained and mentally exhausted. As you are trying to get through this work, you are also trying to think of where else you would rather be or how you could fix the situation. Often, you become detached from your work, leading to feeling less motivated to do more. You may also have less hope around things.

While stress can lead to feelings of anxiety, burnout can lead to depression. Of course, if you are ever feeling this way, go and seek help and do what you need to do to work through this. Burnout leads to emotional consequences, and that is the real difference between the two. Stress management can help you work through burnout. However, it is always important to seek help when you need it.

Another key thing that happens, especially in social work and in other helping professions, is compassion fatigue. This often happens as we work with clients and their families who are dealing with extremely stressful situations.

Compassion Fatigue

• “a feeling of chronic stress, emotional exhaustion and tension often felt by therapists, counselors and anyone in the helping professions...Central to this syndrome is a clinicians’ inability to engage in a productive therapeutic relationship with a patient (van Mol et al., 2015).” from Pro.psychcentral.com
• Can manifest from secondary trauma, overwhelm, depletion

Compassion fatigue can manifest from secondary trauma, being overwhelmed, and when you feel depleted. When you are being compassionate all day and helping clients through all of their problems, it can often lead to you feeling like you do not have a lot left to give. It can become depleting and overwhelming.

By definition, it is a feeling of chronic stress, emotional exhaustion, and tension often felt by therapists, counselors, or anyone in the helping professions.  Central to this syndrome is a clinician's inability to engage in a productive therapeutic relationship with a patient. This is like the analogy of having a cup that you pour from with every person that you work with. If you do not replenish this cup the next day, you will not have anything left to pour. When that cup is empty, it will start to affect your work and how you are showing up in the world.

Pathway of Stress

• Daily
• Chronic
• Burnout

This brings us back to that pathway of stress: daily, chronic, and burnout. Daily stressors are the little things that happen throughout the day. When we are not able to manage our stress, our daily stressors can start to build. It is easy to move on from 1 or 2 stressful situations. You get a new perspective and move on. It can even be something that is a little bit bigger that happens rarely. Again, you can process and move through it. But when these events become bigger and bigger, this stress starts to grow. These daily stressors start to pile up and lead to chronic stress. You are not able to work through them or process them easily.

The other thing that could happen is many small bits of stress that constantly happen throughout your day. Instead of being big things that happen more often, they are small things that are constantly happening, so you never have the moment to step away from them. Or, maybe you are working with someone, and that is stressful. It continues throughout your day where you have all of these stressful moments. When you cannot work through them or process them or move away from the stress, it becomes chronic.

Chronic stress is where you start to feel frazzled and scattered, and you cannot seem to put your thoughts together or work efficiently. When this is left unmanaged, and you cannot find a tool to defuse it, it turns into that full-blown burnout.

How It Shows Up In Daily Life/Work

• Exhaustion both mentally and physically
• Irritability and lack of patience during and/or after work
• Sense of dread around going to work
• Drained and depleted
• Inability to focus on work despite many tasks to do
• Lack of connection and motivation

This might show up in your daily life or your work because you are exhausted mentally and physically. Even if you sit at your computer and do sessions from home or do not get up and move very much, you could still be physically exhausted. Now, of course, not getting up and moving can make you tense and stiff. You feel drained physically and tired in your mind. This can lead to irritability and a lack of patience.

You may start to notice changes with your clients and treatment. You may notice that you do not have as much compassion. Your thoughts may wander, or you just want to get to the end of the day. In contrast, you may notice that you are fine at work, even though you feel this, but you let that irritability and lack of patience show up after work.

As this stress builds, you can have a sense of dread about going to work as you are not sure how you will make it through the next day. This dread can build and start to affect sleep. This can also cause increased anxiety that can also make you feel more drained and depleted.

This can happen a lot in the evenings, especially on Sunday when you are about to go back to work for the next week. You may feel this incredible sense of dread grow during the day. Many people refer to it as the “Sunday blues” or the “Sunday scaries.”

It can also show up as the inability to focus on your work even though you have a lot to do, or you just cannot quite focus and get moving with what you need to do. A lack of connection and motivation can be present. This is really disheartening when we are in a field where we want to connect and be motivated to help others.

The Brain: Why Does Chronic Stress Happen?

• Brain’s reaction to a perceived threat.
  • Brain wired to find threats
  • Stress is perceived as a threat.
  • Stimulates “fight or flight” in the amygdala
  • The brain stays in the cycle of stress, looking for threats

Why does this even happen? We know that there is that chronic stress, but why are these things so incredibly stressful? Why is it that some people do not seem to be as affected by it while others are? What is it that is going on?

First, chronic stress is not your fault. It is not even really the fault of those stressors that are out there. Stress is your brain’s reaction to a threat or to what it perceives as a threat. Our brains are wired to process all of the information out there that we are in touch with throughout the day. Our brains are also wired to protect us specifically from threatening, negative, or stressful things. Stress is perceived as being negative and as threatening because it is negative. This is the way our brains have evolved. A “survival mode” has evolved to help us to survive.

As humans developed, we did not have a lot of modern or small day-to-day stresses. We had big things going on like “eat or be eaten.” We needed to know what to do at that moment. In fact, in the past, our brain was always looking for threats. When it saw something threatening, the response would be fight, flight or freeze, or even hide.

Now, this is what our brain does whenever we are feeling stressed or see a stressful situation. This evolutionary response was something that was meant to protect us, and that worked really well. It protected us and was wonderful to have. And then, over time, this constant vigilance was not needed, and you were able to come down from that stress. You were able to process what happened and move on. And as our brains evolved, we were able to work through those problems even more.

As our brains evolved, our world evolved as well. Now, there are many things, big or small, that can be stressful throughout our day. As protection, our brain is working hard to identify these threats. Every time it does this, it starts to stimulate that stress response, fight, flight, and freeze.

This response is being stimulated more and more. We do not want to be stressed, and then this becomes stressful, and our brain sees that as a threat. It sees it as more stress. It is a continual cycle. We get stuck in this cycle of stress. Our brain, when trying to protect us, creates more stress.

Parts of the Brain Involved

• Thalamus
  • Acts as a filter
• Hippocampus
  • Working memory and learning
• Amygdala
  • “Fear” and protection center
  • Fight, Flight, Freeze
• Prefrontal Cortex
  • Reasoning
  • Problem Solving
  • Executive Functions

A few parts of our brain work when we are not stuck in the chronic stress mode that can help us. The thalamus acts as a filter. When we get information, it processes it and lets us know where we need to send it. If it gets sent to the amygdala, this sets off a stress response. If it is sent to the prefrontal cortex, this is where it can be problem-solved. The response will involve reason. The thalamus is a filter that takes the information and decides where it needs to be at that moment.

The hippocampus works with working memory and with learning. This is the part of the brain that recalls information. For example, if you were in the middle of a debate, you could recall the information you need. It also helps with some of the learning centers of our brain. When this part of the brain is feeling stressed, it gets smaller and shrinks. Then, we are not able to recall information or learn as much. We are also not processing new information that is coming in. If you have ever been in an argument or an incredibly stressful debate, you might not have been able to think of a good response at the moment. And then later, you think of it easily. When the stress is gone, you are then able to clearly come up with this perfect response.

In this situation, the thalamus, or filter, is no longer able to filter things out due to stress.

The prefrontal cortex is the newest part of our brain. This is the part of the brain that really makes us who we are. It is the most highly evolved part that allows us to reason, and problem solve. Our executive functions are here. We can really think about things and work through our problems using this part of the brain. The tools you have in this area that work so well are turned down when you feel stressed. When you are in the fight, flight, or freeze mode, this area is turned down, and the more primitive areas of the brain take over.

Amygdala Hijacking

• Amygdala
  • Takes over
• Thalamus
  • Bypassed
• Hippocampus
  • Shrinks in size
  • Reduced learning and memory
• Prefrontal Cortex
  • Overridden

In times of stress, the amygdala takes over. The amygdala is the ancient fear or ancient protection center of our brain. It is where the fight, flight, and freeze response comes in. The amygdala is involved in stress because it is where the stress response kicks off. It turns down the other parts of the brain that usually help us work through challenges and come up with solutions. It also sends signals out into our body with the release of hormones. This is called amygdala hijacking. The amygdala takes over, and the thalamus gets bypassed. We are no longer filtering things out. The hippocampus, as we said before, shrinks in size, causing reduced learning and memory. Lastly, the prefrontal cortex is overwritten. The amygdala hijacks all these other wonderful parts, and this response builds while these other responses slowly get smaller. This is why it is so hard to get out of this cycle of stress.

Cycle of Stress

• The brain perceives stress as a threat or “negative.”
• Continues to look for more threats and “negatives.”
• Stress grows and becomes more stressful.
• The brain perceives it as a threat or “negative,” and the cycle continues

The cycle of stress is when the amygdala hijacks everything, and our brain perceives stress as a threat. With the cycle of stress, our brain continues to look for more threats and negatives because that response is so strong. We get stuck in that fight, flight, or freeze response. And as the stress grows, it becomes more stressful.

How It Shows Up In Daily Life

• Fight: Argumentative, cynical
• Flight: Need to find a new job or setting, get out as soon as you can each day
• Freeze: Feeling like it will never get any better

Fight Mode. In our modern world, it might show up as feeling more argumentative. If you get an email from someone and think, "Why do they think I need to do that? This is not what my job is about.” Or, "Don't they know I have so many other things to do?" You can become cynical, "Why are we even doing this? It's not going to work anyway.” “No one understands." We get caught in that fight mode.

Flight Mode. When you are in flight mode, you might also try to flee the situation, the job, or your career. You may try to get out of your work as soon as you can each day. Or, if you are working from home, you may try to log out of that last session as soon as you can.

Freeze Mode. If you are in a “freeze” mode, this is not that you are frozen and hiding from work, but you might feel like you are frozen or stuck. It is never going to get any better. You are not sure what else to do. This is not a fun way to be. It is not a way that we want to be showing up in our daily lives.

Common Causes

• Paperwork
• Caseload/Patient Load
• Scheduling
• Setting and Delivery model
• Accessibility for patients and clients
• (Productivity)

One common cause of this is paperwork. It is constantly changing, and there is so much of it. Paperwork can become incredibly overwhelming and can feel like it is taking away from the work that you want to be doing with your patients.

There is also your caseload. It can be way too big or even too small. This is not something that you necessarily get to choose.

There is also scheduling, especially trying to figure out how to see people during this pandemic. How can you see them at home? Can you still do groups? If you can see people individually, how will you fit everyone in? If you are working with students, how can you work with them through the school day?

The setting and delivery model can be problematic. Perhaps you are working from home where normally you would be face-to-face in person. It can be tough to figure out accessibility for your patients to help them get their services.

The other thing stressor is productivity. This depends on the setting that you are in and how you are seeing your clients. You might be told that you need to see a certain number of clients and bill for certain things, but you will not get paid for it. This can also get really tricky, and it is also constantly changing.

There are so many things that can stress us out throughout the day. It will be different for each of us. These are some of the big things that are always going to be there. Even when they change and get better, they will still be there. We have to figure out how to work through that stress.

• Uncertainty
• Out of therapists’ control
• Constant changes

Other common causes are uncertainty, things beyond the therapist's control, and constant changes.  

How Do We Reduce Stress?

• To decrease stress, rewire the reaction to it.
• It’s not always about changing the stressors but about turning off the cycle of stress.

How do we reduce this stress? We know it is there, and we know our brain is going to be looking for it. How do we break out of that cycle and reduce that stress response? To decrease and reduce stress, we have to rewire our reaction to it. It is not about changing the stressors because even if you change those, new ones will take their place. It is about rewiring the way your brain sees and reacts to stress. It is all about turning off or turning down that cycle of stress.

Create a Positive Shift to Break the Cycle of Stress

• What does to body and mind: Increases overall wellness and well-being
• What it does for Therapist’s work: Improves focus, productivity, efficiency
• How it Works: Let go of stress easier – not stuck in a cycle

The way that we do this is to create a positive shift. When we create a positive shift, it breaks the cycle of stress. This helps increase your overall wellness and well-being because you do not feel that stress or burnout anymore. You are also not feeling mentally and physically depleted and exhausted. It improves your focus, productivity, and efficiency as you are not feeling as frazzled, scattered, or disconnected from your work. You can focus and do the work that you want to do. It helps you to let go of the stress. You will feel stress, but you will be able to manage it. Or,  if you do find that you are stuck in that cycle, you know how to break it and get back out of it.

What is Stress Management?

• Definition: “set of techniques and programs intended to help people deal more effectively with stress in their lives by analyzing the specific stressors and taking positive actions to minimize their effects.”
• Explanation: a wide spectrum of techniques and psychotherapies aimed at controlling a person’s stress level, especially chronic stress, usually to improve everyday functioning.
• Examples: meditation, exercise, stepping away from the situation (walk in nature), healthy eating, mindfulness activities

Stress management is a set of techniques and programs intended to help people deal more effectively with stress in their lives by analyzing the specific stressors and taking positive actions to minimize their effects. A wide spectrum of techniques and psychotherapies aim to control a person's level of stress, especially chronic stress, usually to improve everyday functioning. It is using positive actions to minimize specific stressors.

It is breaking that cycle of stress with a positive shift. Some examples are things like meditation, exercise, and stepping away from the situation like going for a nature walk, healthy eating, so you feel nourished, and mindfulness activities. These are just a few examples.

Mindfulness, Positivity, Self-Care

Some important tools are mindfulness, positivity, and self-care.

Mindfulness

• Mindfulness is the act of bringing your awareness to yourself and the present moment. It is the act of going inward to check in with your feelings and thoughts and notice what is going on around you.
• Definition: the quality or state of being conscious or aware of something.
• Being aware of your thoughts, feelings, and physical sensations
• Taking a “pause” before, during, or after moments of stress to see patterns that show up

Mindfulness itself is the act of bringing your awareness to yourself and the present moment. The act of going inward to check in with your feelings and thoughts and notice what is going on around you. By definition, mindfulness is the quality or state of being conscious or aware of something. Mindfulness is being aware of your thoughts, feelings, and physical sensations. It is being aware of what is going on within you and what is going on around you. It is that full picture and being fully aware, just like we did at the very beginning in that practice where we checked in. It is taking a pause before, during, or after moments of stress to see patterns that show up. You can also use mindfulness to pause before a stressful, while something is stressful, or check in after to see how you are doing after that stressful event has occurred.

Positivity

• Positivity is more than just “being Happy.” It is being aware and mindful of the positive aspects and moments of your daily life to help cultivate more optimism, kindness, and a positive outlook, while in turn, decreasing the feelings of negativity, anxiety, and chronic stress.
• Definition: the practice of being or tendency to be positive or optimistic in attitude
• More focus on what is working
• Less focus on what is not working

Positivity is one of the tools of mindfulness, and it is more than just being happy. Being happy is not what positivity is about. It is being aware and mindful of positive aspects and moments of your daily life. These are the little things in your day that are positive and going well. This is then used to help cultivate more optimism, kindness, and a positive outlook while decreasing feelings of negativity, anxiety, and chronic stress. This foundation of positivity helps to decrease the feeling of negativity and chronic stress.

The definition is the practice of being or tendency to be positive or optimistic in attitude. Basically, positivity is more focused on what is working and less focused on what is not working. It is not that you are ignoring the negative things or the things that are not working. Since your brain is already looking for the threat, you are helping your brain to shift to notice the working things.

Self-Care

• A type of mindfulness and positivity practice that allows you to take care of yourself, so you are better able to show up in the world to be of service to others and yourself fully.
• Any activity that helps you to check in or tune in to how you feel and what you need
• NOT things that help you to check-out of tune-out

Self-care is a type of mindfulness and positivity practice that allows you to take care of yourself so that you can show up in the world to be of service to others and yourself fully. This is what being a helping profession is all about.  

Self-care is super trendy. It is something that you might be seeing everywhere, but it is not selfish. It is also not something you do to ignore the stress that is going on. Self-care is any activity that helps you to check in to see how you feel and what you need. It is taking a moment to take care of yourself.

It is not saying go home after work and binge on tv shows for the entire evening. In contrast, there are days when we absolutely need that. Once in a while, you might be so drained and exhausted that you cannot process anything. However, this is not helping you work through and manage that stress when this becomes your regular go-to. It is just ignoring the stress. If you ignore it too much, it can start to build behind you.

Self-care is the time to check in and tune in even when you find it uncomfortable and not always perfect and wonderful. It is working through these stressful moments.

How They Work

• Rewire the brain to notice more of the positive and less of the stress.
• Build resilience so day to day stressful events and triggers are perceived as less threatening.
• Become less reactive to stress and are better able to manage it, leading to burnout and exhaustion.

Stress management techniques rewire the brain to notice more of the positive and less of the stress. They help you build resiliency so that day-to-day stressful events and triggers are perceived as less threatening. Again, it is not that they are gone or that you are changing them, but they are not sticking to you as much. You can say, "This is stressful, and I'm feeling the stress right now." Then, you work through it and move on to something else. You become less reactive to stress which leads to less burnout and exhaustion.

3 Main Types of Mindfulness

• Meditation
• Movement
• Journaling

There are three main mindfulness practices. Now, as I said before, in those examples, there are a lot of mindfulness and stress management practices out there. You can do anything mindfully if you are using awareness and checking in while you are doing it. There are a lot of things that can be positive and forms of self-care. Three main tools really work and that have been shown to help. They are meditation, movement, specifically mindful movement, and journaling.

Meditation

• Draw your focus inward to lessen the stress
• Studies show it can help rewire the brain to handle and manage stress better.
  • Increases the gray matter thickness of your brain
  • Reduces activity in the amygdala
  • Reduces cortisol levels (the stress hormone)
  • Increase your focus and effectiveness, and decrease mental fatigue

Meditation is becoming more mainstream. Meditation has been around for thousands of years, and it has become more mainstream now because it has been shown to affect your brain in a good way. It helps your brain to handle the daily stress that you are feeling. This draws your focus inward to help lessen the stress. It helps you to check in and see how you are doing. Studies also show that it helps rewire the brain to handle and manage stress better, which we are looking for.

In the areas that process stress, it helps to increase the gray matter thickness. In the areas where we want to be functioning more, it helps to bolster those areas of our brain. While it is doing this, it reduces the activity in the amygdala and dampens that stress response so it can no longer hijack the body and the brain. It also then no longer sends out signals to your body to release your stress hormones, such as cortisol, from the adrenal glands. Then, within the brain itself, the thalamus, the hippocampus, and the prefrontal cortex all get turned back on to allow for good decision-making.

Meditation is usually focusing on one thing, like your breathing and letting all other thoughts drift through. By doing this, you are increasing your focus, effectiveness, and decreasing the mental fatigue that comes with trying to do too many different things simultaneously. While meditation can really help you in all of these ways, it can also be tricky to figure out and intimidating. Many people think that you need to clear your mind completely and that there are no thoughts allowed. Or, they think that you have to be in some sort of a big meditation sanctuary or completely overhaul your lifestyle. This is not the case. You can start meditating for only one to five minutes. It does not have to be hours of your day or even 20 minutes at a time.

• How to start:
  • 1-5 minutes at first, build to 5+ minutes
  • Most days of the week
  • Use for focus and letting go of thoughts
  • You do not have to “clear your mind” of all thoughts
  • Try guided meditation, audio or classes, visualizations, or mantras.

Start with one to five minutes and build up to five minutes or more. Start small to fit it into your day, and then add more as you can until you get to the point where you can sustain this practice. Do it for most days of the week. It does not have to be perfect or every single day. You do not want it to become stressful if you do miss a day. Go for most days of the week and use it for focus and letting go of thoughts rather than having to clear your mind completely. It is more about not being attached to a specific thought and letting your thoughts drift. And when you notice that you have jumped on a thought train, and you have started spiraling along, come back to your original focus and breath. It can be really tricky to get started on your own, but you can absolutely do it.

You can also try some guided meditation audios or classes. There are lots of great apps out there like Calm, Headspace, and Ten Percent Happier. I also have some at jessiandricks.com. You can even just go on YouTube and find some. There are also visualizations that you can use or mantras when you are trying to work towards maybe a specific like a loving and kindness meditation when trying to build that compassion back.

There are many different ways that you can get started with the goal of overall stress reduction.

Movement

• Step away from anxious and stressful thoughts.
• Having a mindful movement practice can help you to move out of an anxious or stressful moment.
  • Increases blood flow and deepens your breath
  • It pulls you out of the anxious thought spiral
  • Allows thoughts to flow more freely
  • Creates a shift to positive thinking

Movement, specifically mindful movement, is a way to help you step away from those anxious and stressful thoughts. Having this practice can help you move out of that moment and find more space in your body and brain to start processing things again.

Moving helps increase blood flow and deepen your breath. And when we have that deeper and steadier breath, we begin to feel an overall sense of calm. It also pulls you out of that anxious-thoughts spiral. When stress is happening, or you are sitting and trying to get work done, there is lots of space for you to be in your head and not in your body. And when we are only in our head, it can make those thoughts continue to spiral and ruminate. Movement helps you to get back into your body to feel more grounded and to feel your body. We are feeling what is going on in our bodies, and we are using that to allow ourselves to get out of that stressful moment. And then, when we are out of it, it allows our thoughts to start to flow freely. We are pulling out of that cycle of stress to bring those other parts of our brain back online. We can have some other thoughts flow in, which helps us create that positive thinking. Have you ever noticed that when you go on a walk somewhere or do something that involves using your body, you start to suddenly have all of these ideas or ways to solve all these problems? New thoughts start flowing in.

• “Mindful Movement”
• *Not exercise for punishment or exhaustion/depletion
  • Examples:
  • Yoga or Pilates/Barre
  • Walk or Run outdoors
  • Hiking or Climbing
  • HIIT or Cardio
  • Weight Lifting/Training

Mindful movement means that you are using your exercises or workout, not as a punishment or a way to be exhausted but to feel more grounded and energized. It is whatever you need to do to feel better and to feel less stressed.

Some examples of this are yoga, Pilates, or barre class. This is where you are focusing on being mindful of how you are moving your body. Or, you connect with nature and go outside for a run, walk, hike, or climb. You could go to fitness classes and do high-intensity or cardio workouts. Or, you do some lifting or training. Again, this is because it is enjoyable, and it feels good and not because you are punishing yourself. Anything could be mindful movement.

• Let go of negativity and create more positivity.
• Shift from a place of stress to a place of positivity.
  • Allows you to release the stressful moment
  • Draws awareness to thought patterns
  • Rewires your brain to shift out of “flight or fight” mode
  • Shift attention from “threats” to positive moments

This is used to let go of negativity, create more positivity, and shift from that place of stress to a place of positivity.

Journaling

• Brain Dump
  • Write down anything for 5 minutes to help clear your head
  • Great when ruminating on thoughts - gives them a place to go
  • Useful when you can't sleep
• Positivity/Gratitude Journal
  • Write down 3 positive moments from your day
  • It helps shift the brain to notice what is working
  • Over time gives you positive moments to look back on

The other thing that can help with stress is journaling. This really helps us move out of that moment that we are stuck in and create that positive shift. Journaling is not just keeping a daily diary of things where you are writing down everything that happened that day and cataloging it, but you are specifically using this journal to work through stress.

There are a lot of styles of journaling. A brain dump and a positivity/gratitude journal are examples. The brain dump helps you to get out of that moment, and the other draws you back to a place of positivity and builds up that positive foundation.

Brain Dump. This is where you write for at least five minutes, and you write down anything that is going on in your thoughts at that moment. It does not have to be something that happened that day. It is whatever is stuck in your head that you cannot seem to stop thinking about, and you are not sure how to work through it. It helps you to clear your head and take these thoughts and give them somewhere else to live. This strategy is perfect when you are ruminating. Maybe, over time, you can find a pattern and figure out a strategy to work through that pattern.

This is also good if you are having trouble sleeping because of these pervasive thoughts. We need sleep to recharge and to feel good. It is the ultimate self-care. When you cannot sleep and are stuck with these thoughts, this can help you work through them.

Positivity/Gratitude Journal. Another great thing is a positivity or gratitude journal. This helps you build up a positive foundation in your day. It is simply writing down two to three moments from your day that are positive. They could be small or big. You can also do this as bullet points or write down a paragraph about each one. This is whatever works to help you to reflect. Again, these could be big life-shifting things, or they can be something tiny like a smile from someone or your technology worked that day. Perhaps, you had five minutes of free time. It helps your brain to notice that positive things are going on. This is shifting to what is going well and how can we do more?

Over time, you then have a journal of positive moments to remember and reflect on.

Put It Together

• Time to try
  • Meditate
  • Move
  • Journal

When we put these together, we can meditate, move, and journal. We can use these to help us manage and work through that stress. It is time for you to give these a try. Time for you to work through and figure out what style of meditation you want to do. Do you want to do a guided meditation or repeat a mantra? Do you want to sing or visualize something? What type of movement might work best for you in your day? And where can you fit that in? Figure out if you are stuck on thoughts, then journal about that. Or, are you wanting to build up more gratitude, more positivity in your day?

Start small. Pick one and try it for a week or pick a few times during your day that might work best. Look at what you can easily do. What are you already doing that you can build upon? How can you get these going within your life? Here are some key strategies you can use:

• Set a time each day to practice one or all of these
• Notice which practice resonates with you the most
• Pay attention to your thoughts during the day
• Use techniques regularly (when stressed and when not)

Set a time each day to practice one or all of these. It depends on how much time you have and what is realistic for you. You do not want to decide that you will do all of them for two hours every day when you do not have that time already built in.

As you figure this out and start to use them, notice which one resonates with you the most. Which one is really helping you or that feels easiest to implement? Start from there and add that in.

Then, start to pay attention to your thoughts during the day. Where are you on autopilot? Where are you not even realizing that the stress is starting to build and be triggered? Starting to notice your thoughts can be helpful to use during your workday. Start to notice the shifts that these strategies create once you start using them. And then, use these regularly. Again, it does not have to be every day but go for most days of the week. Getting into some sort of routine if you can and using these techniques when you feel incredible moments of stress and when you are not. They can build a foundation that keeps stress from affecting you as deeply.

Positive Shift

• Remember that things will not always be perfect and stress-free, but you have these tools to use.
• These tools will help to create a more positive shift in your way of thinking and reacting, even when there are stressful situations at hand.

This is our positive shift. Remember, things will not always be perfect and stress-free. Now, you have tools to use when you are in those moments of stress. These tools will help to create a more positive shift in your way of thinking and reacting even when there are stressful situations at hand.

Summary

Thank you so much for joining me today. If you have any questions, you can always find more information at jessiandricks.com or email me, jessi@jessiandricks.com.

References

References are available in the handout.

Cultural Competence Resources

For additional information regarding standards and indicators for cultural competence, please review the NASW resource: Standards and Indicators for Cultural Competence in Social Work Practice https://www.socialworkers.org/LinkClick.aspx?fileticket=7dVckZAYUmk=&portalid=0