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2.0 The Importance of Self-Care
2.1 Why Is Self-Care So Important?
2.2 Self-Care Activities
2.3 Further Reading in Self-Care
2.4 The Basics…
Working with Victims of Crime: A Manual Applying Research to Clinical Practice
2.0 The Importance of Self-Care 
2.1 Why Is Self-Care So Important?
A farmer was using a well-used, dull, rusted axe to cut a huge oak tree on his property. His neighbour was
passing by and saw that the farmer was making no progress at all. "At this rate," the neighbour thought to himself,
"it will take him years to chop that gigantic tree down."So he said to his friend, "Why don't you sharpen your axe?"
The farmer replied, breathless: "I can't (chop)…take the time (chop)…Must cut down (chop)…this tree (chop)…by
tomorrow."
Based on a Sufi Teaching Tale
Like the farmer chopping down the tree, we, as victim service workers, can get caught up in trying to reach our
goals. We do not think about how we are doing our work or how we can do it better because we are so busy. As
workers we want to help. This is the reason we do this work. However, we can lose sight of our own needs
because of all the work we see around us. We say, "What are my problems/ stress/ exhaustion in comparison to
what this person is dealing with!?!" This single-minded focus is also quite seductive because others working
with victims will support these "selfless" and "self-sacrificing" acts as dedication and empathy. The author
disagrees with this view. As we stop taking care of ourselves, we wear down the major tool of our work. Like
the farmer chopping the oak with a dull axe --- there is activity but how useful is it? We also need to have
empathy for ourselves, as the tool with which we work. The bottom-line is that if we are trying to help clients
build skills then we need to take care of ourselves. We need to act as models of self-care. For this reason,
the manual begins with a discussion on the importance of workers looking after themselves.
Although it goes without saying that working with victims can be stressful, some researchers have looked at
this issue. Brown and O'Brien (1998) found that 65% of workers in battered women's shelters are moderately to
highly stressed due to anger and frustration related to both victim behaviour and perpetrators. Added challenges
of the job include stress related to time pressures, red tape, physical demands and lack of achievement (Brown
& O'Brien, 1998). Thus, these researchers found that job stress is not only related to the clients, but also to
dealing with the system. This is likely not very surprising to workers. However, this point is important to
emphasize to administrators and supervisors who should monitor themselves and their staff for signs of burnout
and job stress.
In a study looking at different types of clinicians, Holmqvist and Andersen (2003) interviewed experienced
therapists who worked on a special project with war-related trauma victims. They compared this group with
therapists from general therapy settings and group homes. They found that therapists who worked with trauma
victims reported being less objective, less "motherly", and feeling less enthusiastic than those working in
general therapy. In comparison to those working in group homes, trauma-therapists reported being more anxious
and embarrassed. Further, as these therapists worked with trauma victims they became more detached, more bored
and reported less anxiety and reservation (Holmqvist & Andersen, 2003). Perhaps as the therapists become more
detached they were better able to deal with the anxiety related to their work. Holmqvist and Andersen (2003)
emphasized the importance of therapist self-care and noted the danger that distancing could interfere with good
clinical work.
Self-care is important; our self-care activities, however, can have positive or negative effects depending on
what self-care activities we use. Passive methods such as avoidance, ignoring the stress source or using alcohol
or drugs are not the best way of dealing with the stress because they do nothing to address the underlying
problem (Pines & Aronson, 1988). Left unchecked, stressed-out workers can end up quitting, becoming ill or
basically just becoming less and less effective in their daily work. Thus, it makes more sense to move towards
more active ways of coping such as talking about our sources of stress, getting involved with other activities or
changing the source of our stress (Pines & Aronson, 1988). These researchers also found that workers who have
a positive attitude also show less career burnout.
Another important issue in self-care is balancing home and work life. A later section will discuss building a
balanced life. However, workers should also keep in mind that we do not exist only at work. We can have stress
in our home life. Money worries, relationship problems, medical stresses do not disappear just because we walk
through our office door. Remember---stress at home can affect work just as easily as stress from work can affect
home. The activities and skills described below can help us deal with stress in all parts of our lives, not just
the challenges of work.
2.2 Self-Care Activities
Each worker is different. We each need to identify what healthy self-care behaviours will help us reduce
stress and fatigue. This will help us both in our work with victims and in our ability to build a balanced life.
The following areas are possible ways that workers can seek balance. This may also help ensure that we increase
our success with clients and still meet our personal needs in the rest of our lives.
Self-assessment
As a beginning of understanding our stress levels, we should continually assess and examine our feelings,
thoughts and behaviour (Grosch & Olsen, 1994). We need to understand the difference between normal fatigue and
the exhaustion that is related to burnout. This is different for each person. Often burnout fatigue may appear
as not feeling rested after sleep, losing energy quickly, feeling frustrated, feeling empty and "wrung-out"
(Grosch & Olsen, 1994; Pines & Aronson, 1988). Needless to say, these can also result from physical illness so
consulting a doctor is important if one suspects a medical problem. However, consulting with peers and
supervisors can also help us to understand where we are and how we can better cope. As workers we need to listen
closely to our bodies, feelings and thoughts, but also listen closely to feedback from others. Listening to
co-workers, friends and family can be a good way to keep track of our stress levels. Thus, advice and insight
from any source needs to be examined to decide what works for each of us. Interested workers are referred to
Richardson (2001) who included a self-awareness exercise in the appendix of her publication on vicarious trauma.
Use of effective supervision/ peer support
As mentioned in the Self-Assessment section, workers must rely on others to give them feedback on their stress
level (Gorman, 2001; Grosch & Olsen, 1994; Kottler, 1999). Researchers have found that workers who feel supported
by their supervisors, friends and family showed less emotional exhaustion and felt more connected to other people
and their own feelings (Brown & O'Brien, 1998). As workers, we need to build a support network that helps
support us and from whom we can receive clear, direct feedback. Building a network of support that tiptoes
around us, or treats us like a delicate glass figurine, will not help if we need clear feedback. Remember --- this
may include feedback from friends and family, because they may be in the best position to notice small changes
that could grow into big problems. They also can help support us in making sure that we do not focus only on
our work (Kottler, 1999). In building this system, we could include "burnout checks", checking on stress and
exhaustion levels, as part of normal supervision or team discussions.
Setting boundaries
Workers need to learn to set clear boundaries (Grosch & Olsen, 1994; Kottler, 1999). Anyone working in the
helping profession knows this pearl of wisdom, but many ignore these boundaries when overworked or stressed.
Boundaries are basically the limits that we set on ourselves to ensure quality care. Remember --- setting strong
boundaries does not mean that we cannot be adaptable. As workers, we simply need to be aware of our boundaries
and how to apply them in a way that benefits both ourselves and our clients. One worker might decide that she
never works past 6 pm, another doesn't give out his home number, a third will not talk to her clients about her
personal life. Team discussions and supervision meetings are excellent times to explore boundaries. Different
people and different professions draw boundary lines differently --- the key question is: "Do my boundaries
help me build and keep resources to the benefit of myself and my clients?" By always putting our needs last, we
risk becoming less effective as a worker and person.
Building a balanced life
This element is closely related to setting boundaries (Grosch & Olsen, 1994). The reason people discuss a
balanced life and setting limits so much is that boundaries are often one of the first things we give up as we
start to ignore our needs. Thus, working over a couple of lunches is "no big deal", because that's when the
client can meet. Certain offices and supervisors may even see this as "dedication". However, this behaviour is
the first step to ignoring our own needs and, potentially, to burnout. There is a fine line between being the
"hero" of the clinic and needing to go on stress leave!
Workers who become overly focused on work run the risk of meeting our personal needs through providing help to
clients (Kottler, 1999). These personal needs may be to feel useful, have social contact, be valued, or address
unresolved childhood or relationship issues. Remember--- meeting our needs in our job does not necessarily mean
we are meeting our client's needs. If, on the other hand, we are meeting our needs in other areas (e.g., through
home life, friendships, spirituality, etc.) then we may be less likely to try to get this at work.
What does a balanced life look like?
We each find balance in different ways. Basically, we need to look at the different roles we play in life:
spouse, worker, friend, parent, child, and so on. Which are the most important? Each worker should arrange her
roles in order of importance and set aside time for those things she feels are the most important. Where do we
recharge our batteries? For example, if self-care is important, we will set aside time in our week for activities
that we view as soothing. These might include meeting friends for coffee, reading a "fun" book (not a
work-related manual like this!), playing baseball, meditating, golfing, painting or whatever we like to do to
recharge. It can be useful to write out a "Recharge List" of things that help us unwind and keep it handy so that
when we feel tense or overwhelmed, we can quickly look at the list and do something on it that will help us take
a breather.
The key to understanding a balanced life is to realize that we each have limited resources; we cannot do it all.
Stress in any part of our life will affect our resources in other areas. Stress at work affects our home life.
Financial stress affects our work and relationships. This is normal. Balancing our life is basically a process
of deciding how many resources we have and then using those resources in areas that are important to us.
Through planning ahead, we are more likely to feel in control and less likely to feel that stress runs our life.
Remember --- these activities will likely improve our overall quality of life, not just our work.
Education and professional development
Workers can always benefit from professional development and training. These activities not only teach new
skills, but also give time for us to reflect on our performance. In other words, these activities sharpen our
skills (axe) by taking time to reflect (noticing the dullness) and add or improve skills (sharpening). Although
developing skills around self-care and setting boundaries is important, the benefits associated with learning any
new skill or looking at an issue with a new vantage point can help recharge the worker in providing services. In
a sense, setting aside time to read this manual is self-care.
Services for workers
Workers also need to learn when to seek out help. Possible treatment options include self-help (e.g., reading
self-care books), support groups, psychotherapy, and outpatient or inpatient treatment (Grosch & Olsen, 1994;
Kottler, 1999). Basically, these direct methods of dealing with stress help us take care of our needs. This is
the farmer taking the time to sharpen his axe. The choices we make depend on our goals. For example, it may be
important to deal with past issues at a deep level, so therapy may be the best approach. However, we may just
need a place to "unload" our stress, thus a self-help group may be in order. Self-help resources are a great way
to identify new ways to deal with stress around work and home. It all depends on our stressors and goals. We may
also find that we use a mix of methods, using different things at different times. We are the best judge of what
works for us, but we can all benefit from getting help and feedback from others.
Conclusion
It may seem odd to begin a manual on the psychological effects of crime victimization with a discussion on
workers. This approach is used for one key reason: working with people in distress is a highly stressful and
highly rewarding activity (Grosch & Olsen, 1994; Pines & Aronson, 1988). Workers should not ignore the rewards
of this work, but these benefits can only be felt if we feel healthy (Kottler, 1999). Workers best serve
themselves and their clients by watching their stress and actively pursuing activities that build personal
resources. There can sometimes be an expectation that we can handle everything. This may be an expectation
we have of ourselves, or it may become part of the culture in the helping agency. Such views are tempting
because the work is very important.
Some view working with victims as a "calling" wherein we silently shoulder the stress. This view misses the
point. Working with crime victims is difficult. It is normal that we will sometimes feel drained. Working with
victims is rewarding. It is normal that we will feel moved and inspired. As workers we must remember that we
need to take care of ourselves first, before we can take care of others. If we ignore our own care we are like
the farmer chopping the tree with a dull axe--- we're busy but we're not getting anywhere.
2.3 Further Reading in Self-Care
Self-care activities are important. This is a manual on crime victims, not workers, and so self-care activities
are only briefly introduced in the above section. Interested readers are directed to the following resources and
websites to increase their knowledge in working with victims and self-care. Good self-care should help us to
improve our job satisfaction and effectiveness in our work and daily life. Of particular note is the
publication:
Richardson, J. I. (2001). Guidebook on vicarious trauma: Recommended solutions for anti-violence workers.
Ottawa, ON: Health Canada.
Web link:www.phac-aspc.gc.ca/ncfv-cnivf/familyviolence/pdfs/trauma_e.pdf.
The following resources can be found on the Internet:
The International Society for Traumatic Stress Studies: Good links and resources:
www.istss.org
Hope Morrow's Trauma Central: Several articles on vicarious traumatization and
burnout: http://home.earthlink.net/~hopefull/
Dr. Laurie Anne Perlman has a selected bibliography on the web at:
www.isu.edu/~bhstamm/ts/vt.htm
National Center for Post-Traumatic Stress Disorder:
www.ncptsd.org
National Family Violence Clearinghouse, Health Canada:
www.hc-sc.gc.ca/hppb/familyviolence
2.4 The Basics…
- Self-care is key to better service delivery.
- Workers need to take care of themselves first, if they are to effectively help their clients.
- Workers can be models of good self-care.
- Workers can choose to apply effective coping strategies (dealing directly with the problem) rather
than poor coping strategies (avoidance, ignoring, "working through the stress").
- Self-care behaviours can include:
- Self-Assessment - watch for signs of stress and strength (Grosch & Olsen, 1994; Kottler, 1999).
- Use of effective supervision from superiors and peer support from co-workers (Grosch & Olsen,
1994; Kottler, 1999).
- Setting boundaries, both in your work and home life (Grosch & Olsen, 1994).
- Building a balanced life (Grosch & Olsen, 1994).
- Using support groups, therapy, outpatient treatment, etc. (Grosch & Olsen, 1994).
- Education and professional development.
- Spend time reading on self-care and try some of the activities suggested.
… Sharpen your axe
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