Are You Sitting on the Chair, or Is the Chair Sitting on You?

On dozens of airplane trips, I have half-heard the flight attendant giving the safety demonstration say, “Put your oxygen mask on yourself first before putting it on your child.” On my last flight, I actually pondered these words and how they relate to the helping professions. Those of us who are therapists or otherwise in a service role must of course literally make sure we are “breathing” or we will be of no help to the people in our care.

Helping professionals tend to focus their energies and attention toward the service and care of others, often to the detriment of our own well-being. We may be so committed to service and healing, we forget that when we are “burned out,” the people to whom we are providing treatment won’t be getting the level of professional care we are capable of offering.

Attitudes That May Affect Self-Care Practices

Caregivers feel the effects of many pressures, and there may be times when we feel as if the chair is sitting on us, rather than us sitting on the chair. Meditation masters know this well. When the chair is sitting on us, so to speak, our self-care routines may be negatively impacted.

This self-reflection activity can be a helpful tool to explore your relationship with self-care.

Turn your awareness inside and notice your experience when you imagine hearing the words: “It’s okay to take care of yourself.”

How do you stop yourself from getting adequate self-care? Are any of the following feelings or beliefs familiar to you?

• “I don’t have time to exercise (or __________).”
• “My clients need me.”
• “I need to work more to make it financially.”
• “My sessions always run over because I want clients to get as much as possible, so I don’t get the 10-minute break I need.”
• “My service work comes first. Play is self-indulgence or laziness.”
• “There are too many demands on me—work, relationship, children, financial needs—I come last, it seems.”
• “Time is just not on my side.”
• “I get more and more stressed and accommodate by getting less and less sleep, until I collapse.”
• “The only way I get to stop is when I get sick.”
• “If I take some time off, there’s so much to catch up on when I get back that it’s not worth it.”
• “I feel ashamed when I feel needy. It’s just not okay.”
• “I feel the pain of those I am treating so deeply that I sometimes get overwhelmed and take on their hopelessness.”
• “My needs are so small compared to those of others in my care.”
• “I have a great practice. I don’t feel a need for supervision or peer support.”
• “I have a strong ethic of service.”
• “When I’ve gotten myself to the point of being exhausted, I make it worse by feeling ashamed that I haven’t taken care of myself, and then I try to cover it up even more … it becomes a vicious cycle.”

Effects of Inadequate Self-Care

Self-care is a significant ethical issue because a lack of self-care can contribute to stress, burnout, and dulled awareness. These conditions are likely to interfere with the normal abilities of helping professionals to feel resourced and to handle difficult situations. “Resourced” means being connected to and supported by personal resources, such as centeredness, confidence, compassion, education and training, supervision, empowerment, and a social network. Being un-resourced can increase our vulnerability to misusing power.

Self-care is a significant ethical issue because a lack of self-care can contribute to stress, burn-out, and dulled awareness.Recent brain and energy research offers specific data about the impact of stress on the brain. When stressed, blood flows away from the brain and into the extremities in preparation for “fight or flight.” This reaction can leave us less able to be connected and creatively respond to challenging situations.

Take a minute to recall—we have all had these moments—a time when someone arrived for a session and you were physically tired, emotionally exhausted, burned out, or stressed. What was that experience like?

Diminished or insufficient self-care can lead to:

• Lack of alertness or inattention, which may contribute to murkier boundaries, a decreased sensitivity to transference, under-involvement, a lack of compassion, or otherwise impaired judgment.
• Reduced warmth and generosity. Annoyance, anger, or frustration may be experienced more easily. Defensiveness may increase, and resentment for those in treatment may develop and build.
• Inadequate recordkeeping
• Other effects may include overconfidence, over-involvement, or illness and burnout.

Misusing Power Against the Self

The right use of power describes power that is used to prevent, reduce, and repair harm, both for people in treatment and for the Self. This use of power encompasses ethical behavior and ethical attitudes to prevent harm to ourselves as well as those we treat.

We can misuse our power with ourselves in a number of ways:

1. By failing to prevent or reduce harm to ourselves. We may get so overwhelmed or overworked that we develop debilitating symptoms of caregiver burnout.
2. Failing to repair harm to ourselves. We may become overly self-critical, develop unreasonable expectations, lack self-compassion, and/or feel ashamed and not attend to healing these concerns.
3. Failing to promote our own well-being. This may take the form of undervaluing our work and effectiveness, not drawing nourishment from our work, and/or not confidently owning our role power.

Through the right use of power, we can promote sustainable well-being for those in treatment and the Self. Though self-less service is often thought of as the ideal, what is more truly needed is self-full service, or service from a full use of self. In self-full service, we are the ones in the chair, and we have our oxygen masks on.

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