Stephen’s story – the self-medication cycle
I’ve been quite lucky that over the years I have done many things by chance rather than design that have contributed to being in general good health and well-being. As you’ll find out later in the book, I wasn’t a fan of exercise at school, but as a young adult I found a great passion for running, weight training and squash, all of which helped mitigate my other passion, food. I do like to eat. Although again, by chance, I do enjoy for the most part quite healthy food. I just enjoy a lot of it!
I was brought up going to church so was conscious of the benefits of quiet contemplation and as a child and teenager, in a pre-computer game era, hanging out with friends was largely an outdoor pursuit. I carried this love of the outdoors with me throughout my adult life and, as we know, being outside is good for you. I have translated my faith as a younger person into adult enquiry about mindfulness and meditation as there are many parallels between those pursuits and the prayer that people of faith engage in.
I hadn’t really had much cause to consider self-care as I was engaging in self-care activities without really realising I was. But then as a social worker things took a bit of a turn. I found myself struggling with difficult cases and found it difficult to keep myself organised. I got into the habit of leaving things until the last minute. I hit that dangerous place most of us get to where we think we know what we’re doing. In reality, especially in a profession like social work, you never completely know what you are doing and always need to be learning and developing. I lost focus and felt as though I was always trying to keep up. I did keep up, nothing went wrong, everything got done, but it was all done in quite a chaotic way. This was exacerbated when I became a manager. There’s an assumption that because you are good at one thing, you will be good at another, and while I think I did a fine job as a manager, it came at a cost. I relate to what Lisa was saying above when she talked about thinking about work all the time.
My solution was to drink wine. Every night. This was the only way I could get to sleep. This inevitably led to a hangover the next day, which meant that I drank copious amounts of coffee. I was an expert in the caffeine crash. Drinking so much wine and coffee made me feel dreadful, but all was well as I found a solution. Over-the-counter medication in the form of codeine took away the dreadful stomach pains and headaches I was feeling in the early afternoon and gave me a relaxed feeling. Codeine is an opiate so is very addictive. It also makes you constipated, and coffee, as you may know, agitates the bowel and can help you go to the toilet. Can you imagine! Internal uproar, which led to feeling even more lousy, which meant the cycle of alcohol, caffeine and codeine to try and feel better started again. A conversation with a friend who is a doctor alerted me to the harm codeine was doing to me when taken regularly and I stopped immediately.
I look back on that period of time now, probably a period of around six months, and reflect on how dreadful I felt day in, day out. That cycle was driven by stress and by not knowing how to manage the stress I was feeling in a positive way. I chose a negative route. Ultimately, choosing a negative route makes you feel worse in the long run. The difficulty is that negative routes are often easier. It takes commitment to look after yourself properly and do the right thing for your body and mind. It’s all about developing healthy habits.
Thriving in professional practice
Enough about us. Let’s get started. We have found out so much on our various journeys that we want to share with you. Small steps really do make a big difference. I’d suggest you grab yourself a pen and a notebook because I think you’ll find it really useful to make notes as you go and jot down your responses to some of the questions we will pose for you. Writing things down helps to consolidate ideas and makes action more likely. Books are tools so I give you permission to write in the margins and underline things and put big asterisks against the bits you want to find again. And if you want to break the spine of the book so you can lay it flat, go on, do it.
Let’s go.
Reference
Eiseley, Loren (1979) The Star Thrower. New York: Harvest.
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Self-care: the fundamental principles
Stephen
The context
The modern world is a stressful place. Our physical and mental attributes that evolved many centuries ago were designed to deal with a very different world to the one we find ourselves in today. The Industrial Revolution saw the creation of cities and factories and a working day that never needed to stop. Electricity meant the lights were always on and if the lights were always on then the people could always be working and the owners of the ‘means of production’, the bourgeoisie, as Marx named them, could always be earning more money. No longer were we subject to the coming and going of day and night and the turning of the seasons, but rather we were chained to the wheel of capitalism. Then capitalism sold us the dream. The architects of advertising, the manufacturers of consumerism, told us that if we were working hard we could afford to buy all manner of things and in buying all manner of things we could be transformed into the best version of ourselves by surrounding ourselves with stuff that shows how successful we are. I’d argue that we are currently seeing a backlash against this with many people turning inward to find fulfilment internally through nutrition, meditation and minimalist lifestyles. Yet we still live, work and play in the world as it is.
The problem is that once you are on the treadmill it is hard to get off. The bills need to be paid; the mortgage needs to be covered. The repayments for the car need to be found so that you can get to the job that helps you pay for it. In all of that, somewhere, despite the efforts of 1960s counterculture, we lost ourselves. Our identity has become bound up in the things we have rather than the people we are. What we are has become more important than who we are. The first question we always ask at a party is ‘What do you do?’ Invariably we respond by telling the person what we do for a paid job. You probably say, ‘I’m a social worker’. Or maybe you don’t! We could respond differently, ‘I’m an adventurer at the boundaries of the capacity of my mind and body.’ But we don’t. And there it is, we are defined, with all of the baggage that goes with the label and nothing about who we are, of which ‘social worker’ is merely one part.
James et al (2019) say ‘social worker’ is very much who you are and not what you are, alluding to the pervasive, life-absorbing nature of the role. We bring ourselves and everything we are to the job. That means being professional, empathetic, sympathetic, driven, always there for people, sacrificing, giving, going the extra mile and taking one for the team. The problem is that underneath all of that giving of self we run the risk of slowly disappearing. When this happens, we slowly detach ourselves from the very people we came into the job to support. The literature on this subject has defined this as ‘compassion fatigue’. The problems and distress that you hear about and uncover become just part of the job and the risk is that you simply start to process people. The stories feel familiar, so everyone gets the same response. Such an approach, though, is not satisfying and merely compounds the problem, and compassion fatigue leads to burnout which leads to presenteeism. You are at work, but you are not really at work. You are there physically going through the motions but mentally you are detached, distant. If this continues you will burn out. Peterson (2018, p 60) makes the sobering point that not only can a lack of self-care have implications for you, but also ‘mistreatment of yourself can have catastrophic effects on others’. Failure to take steps to care for yourself and be able to adequately discharge your professional responsibilities could have an impact on you, the people who are ‘in your care’ and your family, as a direct consequence of your poor physical and mental health.
Who are social workers and where is social work happening?
Social