Getting to 'ok'
Using active stress-management skills to keep you going through busy times
“Are you doing ok?”
A colleague asked me this the other day after I’d finished morning signout and was lingering to chat before heading home.
I knew why they were asking: I was in the middle of a very busy stretch of work, and the previous week had included one of the most emotionally difficult situations of my career so far.
I reflected for a moment, trying to get at the real answer behind the “fine” that wanted to sneak out.
“Actually, yes,” I answered. “I’m tired. But, I’m ok. Not great. But surprisingly ok.”
At a different point in my career, this may not have been true. I’d have been powering through without taking time to reflect or recover.
While true recovery is not possible during the busy stretch I was in (~100 hours of work in 11.5 days), I’ve learned that it’s possible to make things better for myself if I utilize a specific process that I’ve come to call Active Stress Management (more on that below).
In their book, ‘Burnout,’ Emily and Amelia Nagoski define wellness in one of the best ways that I’ve heard:
“Wellness is not a state of being. It is a state of action.”
This is in line with the Global Wellness Institute’s definition of wellness:
“Wellness is the active pursuit of activities, choices and lifestyles that lead to a state of holistic health.”
In other words, wellness is not a place we reach. It’s a set of actions that we take in order to allow ourselves to get through difficulties.
In order to be well, we have to be active participants in our lives, including during the busy times. This can be especially challenging for busy healthcare workers who also experience sleep-deprivation, moral injury, and secondary trauma as part of their jobs.
To help myself, I started utilizing techniques from the Components for Enhancing Clinician Engagement and Reducing Trauma (CE-CERT) model and incorporating them into my day, including while I’m at work.
The CE-CERT model, developed by Dr. Brian Miller PhD, is comprised of five elements that require conscious oversight:
Experiential engagement
Parasympathetic recovery
Reducing emotional labor
Conscious Narrative
Decreasing Rumination
While originally designed for trauma counselors, the CE-CERT principles are applicable to anyone in a helping profession, including healthcare workers.
It is built on evidence-based actions and skills that allow helping professionals to fully engage in their work and consciously address painful feelings that naturally arise when working with patients.
Unfortunately, many of us still get stuck in the cycle of stress when we are busy.
However, by actively addressing our stress (whether activated by secondary trauma or not), we can get out of the stress cycle and get closer to wellness. Being intentional about this has allowed me to be more well (or “ok”) during hard stretches of work than I would have been in the past.
I have found that experiential engagement (aka: ‘feeling your feelings) and parasympathetic recovery (aka: ‘activating the recovery response’) are the easiest for me to incorporate into my workday.
Here’s an intro to how I do it:
Experiential Engagement: Aka ‘Feeling your feelings’
It comes as no surprise to those who know me that I don’t love to feel my feelings. I especially hate talking about them. But, the data show that it’s especially important not to try to suppress your negative emotions. Those who do experience higher rates of mental illness than those who don’t.
In order to get better at this, I’ve incorporated a practice of utilizing my ‘Songs to cry to” playlist and, whenever possible, a quick trip to reflect by the lake near my house. I take a few moments to breathe (parasympathetic recovery, more below) and experience whatever feelings I’m bringing with me as a result of my job.
Often, as it was recently, it’s grief. It helps to acknowledge them, and it lets me return home (or head to work) lighter than I was before.
Parasympathetic recovery: aka activating the recovery response
Stress is caused by the sympathetic nervous system. It’s the chemical reaction that’s activated to produce fight, flight, or freeze.
This can be helpful. But, as healthcare workers, it’s not helpful to get stuck in the cycle of stress that I referenced above.
Instead, we have to signal to our bodies that we are ‘safe’ to allow the cycle to break.
That’s where the parasympathetic nervous system comes in.
It allows you to get out of the cycle and on your way with your day. And you can do it at work.
These practices are all evidence-based, and they can help you in as little as 60 seconds:
Here’s what microbreaks for recovery look like for me while I’m at work:
taking 5 minutes to walk the stairs with a great playlist
getting outside for 15 minutes to hydrate, eat, and read something non-work related
I understand that our days are extremely busy. But, because of the stress cycle, we often think that we can’t take a break or that we don’t have time for one.
But this is exactly why we need to take one.
We need breaks in order to be more well.
If you don’t think you have time, consider how you might build these practices into your day (your commute, walking somewhere, etc.). Give yourself 1-3 minutes as a place to start, and build up from there.
If you want to learn more about how to build these skills for you and your colleagues, get in touch. I teach often about this topic.
At the time this post comes out, I’ll be on well-deserved real break where I have blocked my calendar in order to recover properly.
Microbreaks and wellness practices incorporated into our day are not enough, but they can help us.
My challenge to you is to try it for yourself.
If you’ve tried these practices or others, it’s still possible that you’ll need professional help from a therapist, physician, or medication (or all three). I encourage you to get help.
It’s possible to be strong and also be struggling. If you or someone you know is struggling, the National Suicide and Crisis Lifeline is always available by calling 988 or via their website.