Dr Laura Wood, Anya CharnaudWhat is self-care? It is a popular concept we see across social media, the papers, books and wellness gurus, often linked to something a company wants us to buy as the ‘answer’ to our tiredness or sadness. But what does it actually mean and in our everyday lives why should we do it when working in the field of human trafficking or modern slavery?
This piece will take us through one front-line professional’s journey and the consequences of trauma and vicarious trauma (through exposure and connection to the trauma of others) and why self-care is essential to help us function. It is not just about nice baths, cups of tea or yoga. It runs far deeper and has a physiological necessity to it. And in a world that can sometimes make us feel small, self-care can even be a stand of truth and justice that proclaims ‘I matter, that we matter, no matter what comes our way!’
We are governed by our nervous systems, the system in the body that predicts threat and safety and informs us through sensations and often subconscious actions about what to do and when to do it. If we are exposed to trauma (caused by an overwhelming sense of fear and helplessness) vicariously or directly, stress, threats, overwhelm or pressure the nervous system will respond accordingly. It will assess the risk of the situation and send the appropriate messages to the body this is likely to stimulate the survival aspects of the nervous system and trigger the fight (aggression), flight (run away), appease (submit) or freeze (staying still or numbing out) responses.
These are designed to keep you alive but spending long periods of time in them day to day can lead to burnout and exhaustion. To remain secure, and regulated we need to remain in our window of tolerance, the zone of variable but healthy emotions and body responses. Self-care is about strategic actions to help yourself understand and remain in this healthy emotional and bodily zone as much as possible. We don’t want to be agitated, irritable and not sleeping, nor do we want to be numbed out and emotionally cold. Effective self-care has major short and long-term benefits for health, well-being and our challenging work roles.
Here Dr Laura Wood shares her story of trauma and vicarious trauma, the impact it has had on her, and what she needed to do to take care of herself.
“The main thing I wanted to offer in this blog is a personal angle on trauma and self-care as someone who works in this sector and child protection but not in a Lived Experience capacity, or as someone diagnosed with complex trauma, which has additional aspects and nuances I have not experienced. I’m aware that many of us in the sector are going through a really tough time and I know it feels awful but it means you are human and you care.
In my life I have had both personal major stresses and traumas and as a doctor, secondary trauma symptoms. So that has looked like different things at different times including:
- Feeling like my body and brain is constantly buzzing and agitated with poor appetite and weight loss.
- Flat, low mood and a sensation of my body being heavy and sluggish, wanting to curl up in a ball and sleep for hours, wanting to be in the dark and hidden under covers.
- Avoidance, physically feeling I want to run away from particular people, my work and reading or look at anything to do with anything sad or bad in the world, but especially not wanting to go near the work I was meant to do, even though my heart really wanted to do it because I knew it mattered. So that felt even worse because I was very conflicted in my thoughts.
- Smell-memory triggers, a particular medical smell when my dad passed away used to re-trigger my heart pounding and a physical sense of grief and that the world was changing out of my control.
- I’ve had sleepless nights and recurrent bad dreams and creepy dreams, dreams when I’m falling out of control or under a big wave – overwhelm-type storylines.
- And I think probably the most unpleasant was after I had been closely involved with a child who had sadly been sexually abused by a male family member, one of the first when I had ever had to work closely with the details of what happened. I then found myself recoiling a bit from my husband, who is brilliant and I love to bits, and I had a double-vision of him hurting our own girls (a form of ‘de-realisation’ in trauma speak). So what happened, in that case, was like a transparent overlay of horrible things on completely normal daily events of a loving daddy putting his kids to bed.
Many of you might have experienced some similar things or reactions unique to you. It’s all very understandable.
So, what really helped me when I had those experiences, and it’s very likely I’ll have them again at some point, is to know why they are happening and what my brain is up to. Remember, if you have a history of multiple and severe traumas, your response may be more complex than mine with deep and powerful survival mechanisms in place, Your therapist should work with you to help you understand what is most relevant to you as an individual.
I always have in my mind what I call the trauma equation, which is
FEAR + HELPLESSNESS = TRAUMA RISK.
It’s the combo that is the problem. FEAR + HELPLESSNESS. If I’m frightened but can act to sort it out, unlikely trauma. If I’m actually helpless or feel helpless but not scared – likely no problem.
So, on each of these occasions, one or usually more of my senses – sight, sound, smell or physical sensations has gathered information and sent it to my brain to say Laura – there is something dangerous or threatening in the world around you. My body instinctively reacts setting off stress hormones and putting me in survival mode. The same chain reaction happens whether it was a gun or a bear or an overwhelming pile of email demands or a looming immigration bill. And actually, anything that we fear might lead to rejection or people around us not thinking well of us can be really stressful. We are deeply wired to be with other people, as babies we can’t survive without other people, so we have strong survival wiring to not be thought bad of, left out or left behind.
When my stress and survival response kicks off
My heart pumps fast and my breathing goes up to suck in oxygen for my muscles so I can run or aggressively fight.
My gut starts churning and I’m on and off the loo as the body clears me out so I can make a faster get away. This brain – gut link via the vagus nerve is huge – some therapists call the connection the soul nerve, its where we get the term ‘gut instinct’ from and why shame and horrible feelings we often feel in our gut or like our heart has dropped down heavy.
My legs are tense, even muscular pain or like jelly getting me ready to fight or run or collapse and hide from danger.
I hardly sleep at night because that’s a dangerous thing to do if I’m in a threatening environment and a deep sleep stops me from protecting myself.
I can’t think very clearly because there is no point in overanalysing danger, my body wants me outta there. Things that used to be lovely or neutral now feel like threat.
My dreams and double vision are ways my brain is telling me – something bad, dangerous, and threatening happened near you or to you and you have to protect yourself from it.
If the stress or trauma response gets stuck on high, that’s when I start getting physical health problems, usually linked to some kind of inflammation in my body.
So instead of hating these body feelings and brain thoughts or being scared of them I make myself comfy in a safe place or with a cosy blanket and a cup of tea, this calms the body fizz down a bit and helps me turn by thinking brain back on and I am curious and I literally talk to myself
“Laura, what are you actually afraid of here and what can we practically do to make you be and feel safer?” (we being me and my brain and body sorry I know it’s weird! I’m just going to own it!)
“Laura, what do you actually feel helpless or out of control about here, and how can we get some perspective and truth and strategy about that going on?”
A lot of the time I will write down a few points that my brain is churning over so it doesn’t feel like it has to keep reminding me, and then I literally say to my brain (because research says we believe what we say to ourselves) ‘thank you brain and body for trying to protect me, I appreciate you but you can step down now. I’m safe and OK’. Remember that we spend more time with ourselves than anyone else on the planet, its vital that we are on the same team as our own body and brain. For those of us who are going through therapeutic work, I believe this is a big part of what therapists help us to do.
And then I repeat those steps when necessary, so that bit of psychoeducation really helps me. My symptoms have lasted days, weeks and sometimes months depending on the underlying cause or if there was grief to work though slowly too. Remember in my case this is not developmental or complex trauma I have had to work through.
Most of the time I’ve also found that my strongest stress or trauma symptoms co-inside with me having a physical health blip such as having low iron or for me I have a wonky thyroid so especially if anything is not settling, and particularly if its linked to heavy tiredness or flatter mood I have quite frequently found I need a blood test and some physical health medication too. And that makes sense because we are whole people. I have also taken time out of work, for example stopping my research during the pandemic when we had multiple deaths in the family and I had intense caring responsibilities. 360 C trauma is incredibly hard for anyone, so when I that happens, I put down whatever I can.
There is one other bit of personal work that has really helped me, and it is an issue I see time and time again when I have supported other doctors pastorally, particularly women. And that is to take a bit of time to be curious about what people and life experiences have told me about what it looks like to be a good person, and particularly as a female, a ‘good girl, we don’t complain, we sacrifice our own needs for others, we’re meant to do it all and be it all with a smile on our face. And I think where that goes unchecked and we work in caring or support sectors particularly we can get ourselves in a twist, thinking things like well this client or colleague has been through far worse than I have, how dare I be finding this hard when all I have done is listen or read about it. We can start thinking that we are selfish or weak or not cut out for our jobs or and we can end up trying to keep going with a big sense of shame and personal failure weighing us down which makes us want to isolate ourselves and makes it hard to be fully present.
If we think ‘well, I’m a strong person so that will never happen to me, and other people who are struggling must have some kind of weakness or just need to sort their lives out a bit’, then we start shaming, blaming or being irritated with people around us. Both those ends of the spectrum can cause us some trouble.
So it’s been really helpful for me personally to do some curious digging when thoughts and body feelings come up connected to my work in this and child protection sectors and just see what the return address is for some of these things. And I’ve realised that there are many things in the culture I grew up in I actually just don’t agree with and don’t want to pander to. It’s helped me realise that being ‘nice’ in that bland kind of sense often just leaves injustice and fake peace behind and saying a firm no and looking after myself and knowing I matter too helps me support and love others far better both now and in the long run. So, in effect, truth-checking in my own life has been really helpful.
Finally, I want to leave you with a challenging quote from Professor Audre Lorde, a Black civil rights activist last century who said this about self-care, in a setting of horrific generation discrimination and pain in herself and her community
‘Caring for myself is not self-indulgence, it is self-preservation and that is an act of political warfare‘. “
PART 2 coming soon.